What Surveys Say about Food Handling in the Home and at Retail

Presented bySheryl Cates

RTI International

Presented atThe 94th Annual International Association for Food Protection Meeting

Lake Buena Vista, FL• July 8–11, 2007

RTI International is a trade name of Research Triangle Institute

3040 Cornwallis Road ■ P.O. Box 12194 ■ Research Triangle Park, NC 27709Phone 919-541-6810 e-mail scc@rti.orgFax 919-541-6683

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Overview

ConsumersAwareness and behavioral complianceGap between knowledge and practiceCharacteristics of consumers with risky practices

Food service workersSelf-reported preparation practicesFactors impacting safe food handlingFoodborne illness risk factors

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Recent Research on U.S. Consumer Food Safety Practices

Safe Food Handling: American Attitudes and Behavior Survey (Partnership for Food Safety Education, 2004)

RTI/TSU/KSU Survey of Consumer Storage Practices for RTE Foods (Cates et al., FPT, 2007; Kosa et al. JFP, 2007; Kosa et al. JFP, 2007)

Survey on Produce Safety (Li-Cohen and Bruhn, JFP, 2002)

Meta-analysis on food safety knowledge and practices (Patil, Cates, Morales, JFP, 2005)

Review of food safety studies (Redmond and Griffith, JFP, 2003)

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Clean

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Awareness and Behavioral Compliance for “Clean” Messages (I)

Source: Partnership for Food Safety Education, 2004.

MessageSeen/Heard

Always Do

Usually Do Gap

Thoroughly wash & sanitize surfaces used for raw meat, poultry, or seafood before using for fresh fruits & vegetables

94% 76% 14% –18

Wash hands with warm water & soap for at least 20 seconds after handling raw meat, poultry, seafood, or eggs

85% 65% 19% –20

Wash fresh fruits & vegetables under cool running tap water

80% 61% 24% –19

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Awareness and Behavioral Compliance for “Clean” Messages (II)

MessageSeen/Heard

Always Do

Usually Do Gap

Wash hands with warm water & soap for at least 20 seconds before handling raw meat, poultry, seafood, or eggs

74% 53% 21% –21

Wash fruits & vegetables just before preparing or eating

71% 49% 26% –22

Scrub firm produce, such as melons & cucumbers with clean produce brush

49% 26% 17% –23

Source: Partnership for Food Safety Education, 2004.

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Preparation of Fresh Fruits and Vegetables

% of Consumers*

Fruit or VegetableDo Not Wash

Rub with Hands

Scrub with Brush

Wash under Running

WaterApple 4 22 6 86Whole carrot 2 8 17 74Whole broccoli 2 5 1 79Head or leaf lettuce 4 6 <1 88Whole melon 36 5 4 35Strawberries 2 6 1 88*Respondents could select multiple responsesSource: Li-Cohen and Bruhn, JFP, 2002.

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Separate

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Awareness and Behavioral Compliance for “Separate” Messages (I)

MessageSeen/Heard

Always Do

Usually Do Gap

When at home, store fresh fruits & vegetables separate from raw meat, poultry, & seafood

92% 77% 16% –15

Never place cooked food on plate that has previously held raw meat, poultry, or seafood

91% 73% 9% –18

Wash cutting boards, utensils, & countertops with warm water & soap after preparing each food

94% 67% 19% –27

Source: Partnership for Food Safety Education, 2004.

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Awareness and Behavioral Compliance for “Separate” Messages (II)

MessageSeen/Heard

Always Do

Usually Do Gap

When shopping, keep fresh fruits & vegetables separate from raw meat, poultry, & seafood

78% 53% 23% –25

Use one cutting board for fresh fruits & vegetables and separate one for raw meat, poultry, & seafood

71% 47% 15% –24

Store raw meat, poultry, or seafood on bottom shelf of refrigerator

46% 33% 18% –13

Source: Partnership for Food Safety Education, 2004.

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Cook

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Awareness and Behavioral Compliance for “Cook” Messages (I)

MessageSeen/Heard

Always Do

Usually Do Gap

When cooking in microwave, make sure foods are heated thoroughly

87% 65% 24% –22

Cook eggs until yolk and whites are not runny

70% 51% 16% –19

Bring sauces, soups, & gravy to rolling boil when heating

65% 48% 26% –17

Source: Partnership for Food Safety Education, 2004.

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Awareness and Behavioral Compliance for “Cook” Messages (II)

MessageSeen/Heard

Always Do

Usually Do Gap

Use food thermometer for checking internal temperature of meat & poultry when cooking

78% 31% 18% –47

To prevent listeriosis in at-risk populations, thoroughly heat all ready-to-serve meats such as lunch meats & hot dogs

35% 29% 17% –6

Source: Partnership for Food Safety Education, 2004.

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Chill

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Awareness and Behavioral Compliance for “Chill” Messages

MessageSeen/Heard

Always Do

Usually Do Gap

Maintain refrigerator at 33–40˚F 64% 56% 23% –8Defrost frozen foods in refrigerator, cold water, or microwave

89% 53% 28% –36

Use refrigerated leftovers within 3–4 days 78% 43% 30% –35

Discard perishable foods left at room temperature for more than 2 hours

71% 38% 25% –33

Use refrigerator thermometer 57% 35% 12% –22

Source: Partnership for Food Safety Education, 2004.

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Ownership and Use of Refrigerator Thermometers

Unsafetemperature

Safe temperature

(≤40˚F)

Refrigerator temperature (using study-provided

thermometer)Have refrigerator

thermometer

Source: Kosa et al., JFP, 2007.

Yes

No

72%89%

11%28%

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Compliance with Recommended Storage Time Guidelines for RTE Foods (I)

Product

Storage Timefor Open Package

(≤ x days)

Stored for Recommended Time

or Less

Precut fresh fruit 5 91%

Bagged salads 5 87%

Frankfurters 7 87%

Precut fresh vegetables 5 70%

Vacuum-packed luncheon meats 5 57%

Source: Cates et al., FPT, 2007.

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Compliance with Recommended Storage Time Guidelines for RTE Foods (II)

Product

Storage Time(Combined

Unopened & Opened)(≤ x days)

Stored for Recommended Time

or Less

Smoked seafood 14 92%

Cooked crustaceans 4 72%

Deli salads 5 64%

Freshly sliced deli meats 5 50%

Soft cheeses 7 40%

Source: Cates et al., FPT, 2007.

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Characteristics of Consumers Who Are More Likely to Consume “Risky” Foods: Meta Analysis Findings

Raw or Undercooked Food Demographic Category Ground Beef Eggs Shellfish MilkGender Male NE

WhiteHispanicAsianBlack

18–2930–5455+

<= HS> HS

MetroNonmetro

Metro Status

Education

Age

Race/ethnicity

NE=Not evaluated.Source: Patil, Cates, Morales, JFP, 2005.

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Characteristics of Consumers Who Are More Likely to Engage in Risky Food Handling Practices

Young adults (ages 18–29)

Males

Individuals with more than a high school education

Individuals with relatively higher incomes

For seniors, individuals who live alone/are not married

Some regional differences

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Key Findings

Studies are based on surveys of reported practices, which often overstate actual behavior

There is a gap between what consumers know and what they do when cooking at home

Consumers lack consistency in following recommended practices

Consumers have improved their safe handling practices, especially for clean and separate, but the job is not done yet!

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Areas for Improvement

Handling of fresh produce

Using a food thermometer, especially for small cuts of meat and poultry

Messages related to chilling foods—refrigerator thermometer use, proper defrosting, safe storage of foods

Prevention practices for listeriosis among at-risk populations

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Recent Research on U.S. Food Service Food Safety Practices

Research conducted by CDC’s Environmental Health Specialists Network (EHS-Net)

FoodNet Population Survey (Green et al., IJHEH, 2005)Focus groups with food workers and managers (Green and Selman, FPT, 2005)Observation study on food hand washing practices (Green et al., JFP, 2007)

FDA Report on the Occurrence of Foodborne Illness Risk Factors (FDA, 2004)

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Self-Reported Food Preparation Practices

60% did not always wear gloves when touching RTE food

23% did not always wash their hands between handling raw meat and RTE food

53% did not use a thermometer to check for doneness of meat and poultry

5% worked while sick with vomiting or diarrhea

Source: FoodNet Population Survey, Green et al., IJHEH, 2005.

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Factors Associated with Safer Food Handling

Workers who cooked reported changing their gloves more often than workers who did not cook

Older workers and managers reported washing their hands more often than younger workers and non-managers

Workers in chain restaurants more frequently reported using thermometers than workers in independently-owned restaurants

Source: FoodNet Population Survey, Green et al., IJHEH, 2005.

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FDA Report on Occurrence of FoodborneIllness Risk Factors: Areas to Improve

Date marking of open containers of commercially-processed RTE, potentially hazardous foods

Holding potentially hazardous foods at 41°F or below

Proper, adequate handwashing

Prevention of hand contamination

Surfaces and utensils cleaned/sanitized

Source: FDA, 2004.

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Factors Impacting Safe Food Preparation Practices: Focus Group Findings

Time pressure/high volume of businessStructural environment, equipment, resourcesManagement/coworker emphasisWorker characteristicsNegative consequencesEducation and trainingRestaurant proceduresGlove and sanitizer use

Source: Green et al., FPT, 2005.

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Factors Related to Appropriate Handwashing: Findings from an Observation Study

Handwashing More Likely to OccurWith food preparation activities compared to other activities (e.g., handling dirty equipment) except putting on glovesWorkers provided with food safety trainingMultiple hand sinksHand sink in workers’ sight

Handwashing Less Likely to OccurWorkers were busyGloves worn at point at which handwashing should occur

Source: Green et al., JFP, 2007.

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Key Findings

Barriers exist to following recommended food handling practices

Improvements needed Proper holding/time and temperature controlHandwashing

Employee training should use a risk-based approach

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Questions?

Sheryl C. Cates, RTI Internationalscc@rti.org