ASSESSMENT OF FOOD SAFETY KNOWLEDGE AND PRACTICES AMONG FOOD HANDLERS IN RESTAURANTS

ABSTRACT
Food borne disease remains a major public Health problem across the globe. The high incidence of food borne illness has led to an increase in global concern about food safety. The purpose of this was to assess food safety, knowledge and practices among food handlers in restaurants in Nnewi Urban. The researcher utilized a cross sectional descriptive survey design and a convenient sampling method was used to reach one hundred and eighty (180) food handlers from two randomly selected towns in Nnewi Urban. A validated questionnaire and checklist constructed by the researcher were used to collect data. Information obtained from the questionnaire and checklists were subjected to descriptive statistics and chi-square test of association at 0.05 level of significance. Analysis of data was done with the SPSS version 20.0. Findings revealed that majority (77.9%) of respondents had good knowledge of food safety. Above average (58.6%) were observed to have good food safety practices. There was no relationship between age of respondents and knowledge of food safety (p = .693). There was no relationship between educational level and food safety practices (p = .404).Length of service of respondents was significantly related to their practice of food safety (p = .015).Based on these findings, it was recommended that Health and Environmental Authorities should improve on the implementation of existing food hygiene laws. Nurses, Public health officers and Health educators; should intensify efforts to correct poor food safety practices. The government and related health agencies should provide the necessary logistics to ensure that all restaurants / food handlers are registered especially in rural areas.
 
 
 
CHAPTER ONE
INTRODUCTION
Background to the Study
Food is an important basic necessity, its procurement, preparation and consumption are vital for the sustenance of life. Food is any substance that can be taken through ingestion to supply nutrient and energy for growth and development. Food has direct influence on health and it is therefore pertinent to keep food free from contamination, (Daniyan & Nwokwu, 2011). Food handlers play important role in ensuring food production and storage, (Abdalla & Suliman, 2009).
Food safety is an area of public health action to protect consumer from the risks of food poisoning and food borne diseases, acute or chronic. Unsafe food can lead to a range of health problems: diarrhoeal disease, viral disease (the first Ebola cases were linked to contaminated bush meat); reproductive and developmental problems, cancers. Food safety is thus a prerequisite for food security (WHO, 2015). Unsafe food can contain harmful bacteria, viruses, parasites or chemical substances, and cause more than 200 diseases ranging from diarrhea to cancers (WHO 2015).
New threats to food safety are constantly emerging, changes in food production, distribution and consumption (globalization of food trade, mass catering and street food); changes in the environment; new and emerging bacteria and toxins; antimicrobial resistance – all increase the risk that food becomes contaminated (WHO, 2015). Increase in travel and trade enhance the likelihood that contamination can spread. The World Health Organization helps and encourages countries to prevent, detect and respond to food borne disease outbreaks- in line with the codex alimentarius, a collection of international food standards, guidelines and codes of practice covering all the main foods (WHO, 2015). Access to sufficient amounts of safe and nutritious food is the key to sustaining life and promoting good health. Food borne and water borne diarrhoeal diseases kill an estimated 2 million people annually, including many children (WHO, 2015). Food safety, nutrition and food security are inextricably linked. Unsafe food creates a vicious cycle of disease and malnutrition, particularly affecting infants, young children, the elderly and the sick (WHO, 2015).
Food safety requires much more than a clean premises (Adewunmi, Ajayi, & Omotoso, 2014). The knowledge of food handlers’ practices is the key to addressing the trend of increasing food-borne diseases (Adweunmi et al, 2014). Food poisoning and other food borne diseases could occur in restaurants located in places such as schools, hostel, hospitals and market places where food and drinks are served or sold to groups by food handlers (Adweunmi et al, 2014). The high incidence of food borne illness has led to an increase in global concern about food safety (Van Tonder, 2007). In the UK alone it is estimated that there are a million cases of food borne disease each year, resulting in 200,000 hospital admissions and 500 deaths (Food Standards Agency, 2011). Similarly, in the US, one in six of the population is thought to suffer from food borne disease annually with 3000 deaths attributed to this cause (Painter, Hockstra & Tauxe, 2013). While there are no known estimates of the global economic burden from food borne disease, in the UK it is reported to be I.8 billion pounds per annum (Food Standards Agency, 2013).  Individuals aged over 60 years, pregnant women, children under five years and others with a compromised immune system are thought to be particularly vulnerable to the effects of food borne disease.  Several food-borne disease outbreaks have been reported to be associated with poor personal hygiene of people handling food stuffs (ACMSC, 2009).
Food borne diseases are increasing in both developed and developing countries. Diarrhoea diseases, mostly caused by food borne microbial pathogens, are leading causes of illness and death in developing countries, killing an estimated 1.9 million people annually at the global level (Adewunmmi et al, 2014). Food contamination may occur at any point during its journey production, processing, distributing, and preparation (Green 2006). Infection can also be acquired through contaminated unwashed fingers, insects, circulation of bank notes and wind during dry weathers (Isara, 2009). Street food have been designated important sources of affordable food, but often do not meet proper hygiene standards, in large part because of weak regulatory systems, lack of good financial resources to invest in safer equipment, and lack of education for food handlers. The food may satisfy immediate needs, but pays little attention to food safety (Santosh, Nogueira, & Patara, 2008).
However, in developing countries, biological contaminants largely bacteria and other parasites constitute the major causes of food-borne diseases often transmitted through food, water, nails and fingers contaminated with faeces. Accordingly, food handlers with poor personal hygiene could be potential sources of infections by these micro-organism (Ifeadike, Ironkwe, Adogu, Nnebue, Emelumadu, Nwabueze & Ubajaka, 2014).
In recent years, changing lifestyle, breakdown of joint family system and increase in number of working women has led to consumption of ready-to-eat foods from restaurants (Santosh et al, 2008). These have resulted in more school children, university students, and workers depending on restaurants for breakfast and midday food, thus the whole community is involved. The implication is that people in the community are exposed to hazards of purchasing food from restaurants that may harbour dangerous pathogens or have the potentials of spreading infection to a large number of populations. Food handlers in restaurants are required to follow health standards of handling food and keeping their cooking areas clean and bacteria free. An adequate supply of safe, wholesome and healthy food is essential to the health and well being of humans (e-How, 2011).
Statement of Problem
All over the world, people are seriously affected everyday by diseases that are caused by consuming unsafe food. Good food safety practices to prevent and control food borne diseases should therefore be emphasized. The food we eat should be free from contaminants such as microorganisms and chemicals (United Nations Food and Agriculture Organization, 2010). Food borne illness is a preventable and under reported public health problem. It presents a major challenge to both general and at risk populations. Each year, millions of illness in the United States can be attributed to contaminated foods.
Food borne disease remains the major public health problem across the globe. The high incidence of food borne illness had led to an increase in global concern about food safety (Van Tonder, 2007). Food borne diseases are increasing in both developed and developing countries (Adweunmi et al, 2014). A recent article reviewing the burden of food borne illness in the U.S highlighted the frequency with which Americans consume foods prepared outside the home as one of the five primary factors contributing to the occurrence of food borne illness (Jones & Angulo, 2006 in Nyachuba, 2010). Several food-borne disease outbreaks have been reported to be associated with poor personal hygiene of people handling food stuffs (Adweunmi et al, 2014). Diarrhoea diseases, mostly caused by food borne microbial pathogens, are leading causes of illness and death in developing countries, killing an estimated 1.9million people annually at the global level (Adweuni et al, 2014). Significant to this fact is that in November 2015 a total of 43 adult female cases and 3 paediatric cases reported at the general out-patient and children emergency respectively of Nnamdi Azikiwe University Teaching Hospital (NAUTH). Medical records NAUTH. In Nigeria, there are a large number of local eateries and restaurants. Increased rural to urban migration, increase in the number of working women, changing lifestyles, and breakdown of joint family system have led to consumption of ready-to-eat foods from restaurants. Nnewi community is the location of the popular Nkwo market which is the largest motor spare parts market in West Africa. Hence a lot of people flock into Nnewi urban for business. These individuals also depend on restaurants and food vendors for food.
Purpose of the Study
The purpose of this study was to assess food safety knowledge and practices among food handlers in restaurants in Nnewi urban.
Specific Objectives
The objectives of this study were to:

1. assess food safety knowledge by food handlers in restaurants in Nnewi urban
2. assess food safety practices in preservation of food in restaurants in Nnewi urban.
3. identify food safety practices in preparation of food by food handlers in Nnewi urban.
4. ascertain food safety practices in serving of food by food handlers in Nnewi urban.

Research Questions

1. What knowledge do food handlers working in restaurants have about food safety in Nnewi urban?
2. What are food safety practices of food handlers in preservation of food in Nnewi urban?
3. What are food safety practices of food handlers in preparation of food in Nnewi urban?
4. What are food safety practices of food handlers in serving of food in Nnewi urban?

 
Research Hypotheses

1. There is no relationship between age of the respondents and knowledge of food safety in Nnewi Urban.
2. There is no relationship between educational level of the respondents and food safety practices.
3. There is no relationship between length of service of respondents and food safety practices.

Significance of the Study
Findings from this study will provide useful information for policy formulation and strategic information with respect to food safety knowledge and practices in Nnewi urban and Nigeria at large. The study will also generate information that can aid health and environment authorities to improve on the implementation of existing food safety laws, leading to a more effective regulation of restaurants. It will add to the already existing body of scientific knowledge with respect to food safety knowledge and practices. Findings from this study will also reveal areas of deficiencies by food handlers in these restaurants. This will enable nurses, public health officers and health educators to intensify efforts to correct the identified anomalies, thus reducing the risk of food borne diseases.
Scope of the Study
This study was confined to food handlers in restaurants in Nnewi urban and their food safety knowledge and practices in the areas of preservation, preparation and serving of food.
Operational Definition of Terms
Food Safety refers to the way food handlers preserve, prepare and serve food in restaurants.
Food safety knowledge refers to the information the food handlers have about preservation, preparation and serving of food in ways that prevent food borne illnesses.
Food handler is a person involved in preparing, serving or even packaging of food to people in Nnewi urban.
Restaurants are establishments that prepare and serve food, drinks to customers. Meals are generally served and eaten in the premises but may also offer take-out and food delivery services.
Food safety practices in preservation of food refers to a set of practices performed by food handlers in preservation of cooked food and perishable food such as meat and poultry. It includes refrigeration and freezing.
Food safety practices in preparation of food refers to those activities performed by food handlers in preparation of food which includes hand washing, proper washing of cutting boards, cooking utensils. It also includes stopping the spread of bacteria through cross contamination.
Food safety practices in serving of food refers to the activities performed by food handlers in serving of food for example, storage of food before serving, covering of hair, wearing of aprons