Western Australian public’s perceptions of food poisoning and food handling practices

Christina M Pollard, Xingqiong Meng,

Sophe Williamson, Jim Dodds & Colin W Binns

Environmental Health Association State Conference, 26 August 2014

Associate investigators:

• Prof Rob Donovan

• Prof Peter Howard

• Mr Jim Dodds

• Ms Susan Leivers

• Ms Pernilla Ellies

Statistician:

• Dr Rosie Meng

Chief investigators:

• Dr Christina Pollard

• Prof Colin Binns

• A/Prof Deborah Kerr

• Dr Tarun Weeramanthri

• Ms Alison Daly

• A/Prof Mark Law

Advisory Group:

• Trevor Shilton

• Denise Sullivan

• Dr Sarah Joyce

• A/Prof Anne Taylor

• Bruce Maycock

• Dr Jo Clarkson

• Mr Michael Moore

• Mr Steve Pratt

Guideline 5

Care for your food; prepare and store it safely.

Food-borne illness is a common, costly and preventable public health issue:

Australia in 2010 : Estimated 5.4 million cases a year, costing $1.2 billion annually*

*OzFoodNet Working Group (2010)

Dietary guidelines recommend that we eat more fresh foods

Australian dietary advice

EAT MORE

Fruit, vegetables, diary foods (milk, yoghurt, cheese), lean meats, fish, eggs

EAT FRESH

VARIETY

http://www.eatforhealth.gov.au/guidelines/australian-guide-healthy-eating

PERCEPTION OF RISK

Dietary guidelines recommend that we eat more fresh foods

Concern food-borne illness growing, particularly for vulnerable groups such as elderly people and younger adults,

(poor food handling practices)

PERCEPTION OF RISK

Monitoring and surveillance helps us put things into perspective

Food safety is a culturally specific issue

Dietary guidelines

INDONESIAN• Consume food which is

prepared hygienically

• -23% washed hands before cooking in 2007

the focus in Indonesia should still include the importance of hand washing and hygienic food preparation, as also the focus of other Asian countries

• Prepare food hygienically and wash hands before food preparation, before eating/ feeding child and after defecation

VIETNAMESE 2011 (4/10)• Eat various foods and regularly

change dishes. • Choose and consume clean

and safe foods and drinks • Drink enough boiled water

daily, limit consumption of beer, alcohol and sweetened foods.

CHINA• Choose fresh and sanitary

foods

Usfar, A Fahmida U 2011 APJCN 2011;20(3):484-94. Ge, K 2011 APJCN 20 (3):439-446.

WHY DO THE RESEARCH

Contamination can occur during food preparation or storage and the risk is reduced with correct food safety handling practices.

Foods that support the growth of food-borne bacteria should be stored at or <5C, or at or >60C

WHAT IS KNOWN –CONSUMERS:

• Store food >5C

• Don’t wash hands during food preparation

• Poor food safety knowledge

WHAT IS NOT KNOWN –CONSUMERS:

There is limited information available on the Western Australian population’s knowledge regarding food safety.

http://www.foodstandards.gov.au/consumer/information/pages/howtoreadfoodlabels/usebyandbestbeforedatesaus/Default.aspx

‘More people are eating out…?’

To explore factors associated with self-reported food poisoning among WA adults between 1998 and 2012.

Survey design

Department of Health’s Nutrition Monitoring Survey Series

• 6042 Western Australian adults 18-64 years

• Telephone survey –randomly selected

• Representative sample

• 1998, 2001, 2004, 2009, 2012

Limitations

• Self-report

What we asked

Food Poisoning

• ‘In the last 6 months have you experienced vomiting and/or diarrhoea, which you suspect may have been food poisoning? ’

• ‘Was the food poisoning positively identified by a doctor or nurse?’

Knowledge

• ‘How often do you put your cold or frozen food in an ‘‘Esky’’ to transport it from the shops to home?’

• ‘What do you think is the maximum temperature a fridge should operate at?’

Possible associations

Behaviours

• ‘Do you have any responsibility for doing the food shopping (choosing and preparing meals) in your household?’

• ‘Which meal did you buy from a restaurant, takeaway, lunch bar, canteen, or other prepared food outlet yesterday?’

Socio-demographics

• age,

• gender,

• income,

• education level,

• paid employment, and

• country of birth.

17% had suspected food poisoning in the 6 months and only 13% of these reported it to a doctor or nurse.

Ranging from the highest 20.3% in 2001 to the lowest 11.6% in 2012 BUT not a significant change

2.4%overall

• 82-88% some responsibility for food shopping

• 90 %, some responsibility for meal preparation

• 28% bought takeaway meals on the day prior to the survey –no change over time….

What were the odds

Food poisoning• No difference in prevalence of

food poisoning from 1998-2012 (19% in 1998 to 11% in 2012)

• 18-24yrs and 25-34yrs twice as likely than those 55-64 to suffer food poisoning

• If ate out once twice in the day prior 2.4 times more likely, one 1.2 times as likely

• Rural 30% less likely than metro remote 6% more likely

Reports to Doctor or Nurse

• 18-24 yr olds 4 times more likely than had food poisoning confirmed in 2009 but disappeared now

Esky use has increased since 1998, 16% always use an Esky/cooler bag since 2009 (4% always in ‘98)

Fridge thermometers have increased since 1998, 37% had fridge thermometer in 2012 (11% in ‘98)

Correct domestic fridge temperature?

Most bacterial growth can occur between 5-60oC; so, foods that support the growth of food-borne bacteria should be stored at or below 5oC, or at or above 60oC

Max

4oC60% said they knew the maximum temperature that a refrigerator shouldoperate at, 1/3rd who said they knew gave the correct temperature

0.2

25.5

34.2

21.8

4.1

1.9

12.2

010

20

30

40

%

-6/-1 0/3.9 4 5 6 7 >=8Maxmum temperature a fridge should operate at (in Celsius)

Figure 1 Maximum temperature a fridge should operate at reported by Western Australian adults 18-64 years (n=2239) who said they knew the temperature; Nutrition Monitoring Surveys Series, 1998, 2001, 2009 and 2012

Odds of what consumers know

What they think they know

• Men 2.5 times more likely than women to say they knew the maximum temperature

What they know

• In 2012 people were more likely to give the correct temperature

SO WHAT

1/5th of adults report food poisoning in last 6 months –likely to be more as may not capture vulnerable groups

Very few confirm food poisoning

More people answer refrigeration question correctly in 2012, have thermometers in their fridge and use Esky’s or bags

BUT

Still low knowledge and practice

• ONLY 1/3 correct temperature

• ONLY 1/3rds use Esky

Eating out – need to continue food handling practices for businesses

WHERE DO PEOPLE GET THEIR INFORMATION

Only 1/3rd of people use the Internet to source nutrition or dietary information

?increasing

More likely to be women

Reducing the risk