Psychosocial and organizational determinants of safe food handling at retail and food service establishments: a systematic review and meta-analysis.

Various psychosocial and organizational factors have been investigated as determinants of food handlers' food safety behaviours. A systematic review and meta-analysis of studies in this area was conducted to identify and synthesize the key behavioural determinants. Standard systematic review steps were followed: comprehensive search strategy; relevance screening; article characterization; risk of bias assessment; data extraction; and random-effects meta-analysis. Sixty-two relevant studies were identified, and knowledge was the most commonly investigated behavioural determinant (n = 51). Increased knowledge was consistently associated with safe food handing behaviours across both correlation (r = 0.30; 95% confidence interval [CI]: 0.12, 0.46; n = 24 studies; I2 = 98%) and odds ratio (OR) measures (adjusted OR = 1.85; 95% CI: 1.27, 2.70; n = 3; I2 = 0%). Seven other behavioural determinant categories were also consistently associated with various food safety behaviour outcomes. In contrast, no association was found between food handler experience and behaviour. The findings can inform the development of targeted training initiatives for food handlers.

Explaining the food safety behaviours of food handlers using theories of behaviour change: a systematic review.

Theories of behaviour change can explain the factors affecting food handlers' use of food safety practices. A systematic review was conducted on this topic to identify which theories have been applied in this area and to determine which theories are the most consistent predictors of food handlers' behaviours. Standard systematic review procedures were followed: comprehensive search strategy; relevance screening of abstracts; article characterization; data extraction; risk-of-bias assessment; and descriptive analysis. Among 19 relevant studies, the most commonly investigated theories were the Theory of Planned Behaviour (n = 9 studies) and Health Belief Model (n = 5). All investigated theories were useful to explain food handlers' behavioural intentions and behaviours related to food safety across different settings, and could serve as useful frameworks for future research and practice. However, there was wide variability in the predictive ability of the theories and their specific constructs, indicating theories should be adapted to the local context of application.

Explaining Consumer Safe Food Handling Through Behavior-Change Theories: A Systematic Review.

Consumers often engage in unsafe food handling behaviors at home. Previous studies have investigated the ability of behavior-change theories to explain and predict these behaviors. The purpose of this review was to determine which theories are most consistently associated with consumers' safe food handling behaviors across the published literature. A standardized systematic review methodology was used, consisting of the following steps: comprehensive search strategy; relevance screening of identified references; confirmation of relevance and characterization of relevant articles; risk-of-bias assessment; data extraction; and descriptive analysis of study results. A total of 20 relevant studies were identified; they were mostly conducted in Australia (40%) and the United States (35%) and used a cross-sectional design (65%). Most studies targeted young adults (65%), and none focused on high-risk consumer groups. The outcomes of 70% of studies received high overall risk-of-bias ratings, largely due to a lack of control for confounding variables. The most commonly applied theory was the Theory of Planned Behavior (45% of studies), which, along with other investigated theories of behavior change, was frequently associated with consumer safe food handling behavioral intentions and behaviors. However, overall, there was wide variation in the specific constructs found to be significantly associated and in the percentage of variance explained in each outcome across studies. The results suggest that multiple theories of behavior change can help to explain consumer safe food handling behaviors and could be adopted to guide the development of future behavior-change interventions. In these contexts, theories should be appropriately selected and adapted to meet the needs of the specific target population and context of interest.

Avian influenza prevalence among hunter-harvested birds in a remote Canadian First Nation community.

INTRODUCTION: Avian influenza virus (AIV) prevalence has been associated with wild game and other bird species. The contamination of these birds may pose a greater risk to those who regularly hunt and consumed infected species. Due to resident concerns communicated by local Band Council, hunter-harvested birds from a remote First Nation community in subArctic Ontario, Canada were assessed for AIV. Hunters, and especially those who live a subsistence lifestyle, are at higher risk of AIV exposure due to their increased contact with wild birds, which represent an important part of their diet. METHODS: Cloacal swabs from 304 harvested game birds representing several species of wild birds commonly hunted and consumed in this First Nation community were analyzed for AIV using real-time reverse transcription polymerase chain reaction. Subtyping was performed using reverse transcription polymerase chain reaction. Sequences were assembled using Lasergene, and the sequences were compared to Genbank. RESULTS: In total, 16 of the 304 cloacal swab samples were positive for AIV. Of the 16 positive samples, 12 were found in mallard ducks, 3 were found in snow geese (wavies), and 1 positive sample was found in partridge. The AIV samples were subtyped, when possible, and found to be positive for the low pathogenic avian influenza virus subtypes H3 and H4. No samples were positive for subtypes of human concern, namely H5 and H7. CONCLUSIONS: This work represents the first AIV monitoring program results of hunter-harvested birds in a remote subsistence First Nation community. Community-level surveillance of AIV in remote subsistence hunting communities may help to identify future risks, while educating those who may have the highest exposure about proper handling of hunted birds. Ultimately, only low pathogenic strains of AIV were found, but monitoring should be continued and expanded to safeguard those with the highest exposure risk to AIV.

Achieving Control of Occupational Exposures to Engineered Nanomaterials.

Occupational exposures resulting from Engineered Nanomaterials (ENMs) can pose a challenge for applying traditional risk assessment, control, or evaluation standards. This article discusses the limitations in traditional risk management approaches when it comes to ENM exposures, reviews current monitoring options, and suggests an interim management framework until research can meet the standard of evidence required by legislators. The proposed Nanomaterial Occupational Exposure Management Model (NOEM) offers a pragmatic approach that integrates resources from current academic research to provide a framework that can be applied by both industry and regulators. The NOEM Model focuses on addressing three concerns to exposure management: Risk Assessment, Exposure Control, and Exposure Monitoring. The resources supported for meeting these three components involve the integration of the Control Banding Nanotool and Nano Reference Values, both of which have been piloted and accepted through peer-reviewed processes and industry consultation.

Bird harvesting practices and knowledge, risk perceptions, and attitudes regarding avian influenza among Canadian First Nations subsistence hunters: implications for influenza pandemic plans.

BACKGROUND: There is concern of avian influenza virus (AIV) infections in humans. Subsistence hunters may be a potential risk group for AIV infections as they frequently come into close contact with wild birds and the aquatic habitats of birds while harvesting. This study aimed to examine if knowledge and risk perception of avian influenza influenced the use of protective measures and attitudes about hunting influenza-infected birds among subsistence hunters. METHODS: Using a community-based participatory research approach, a cross-sectional survey was conducted with current subsistence hunters (n = 106) residing in a remote and isolated First Nations community in northern Ontario, Canada from November 10-25, 2013. Simple descriptive statistics, cross-tabulations, and analysis of variance (ANOVA) were used to examine the distributions and relationships between variables. Written responses were deductively analyzed. RESULTS: ANOVA showed that males hunted significantly more birds per year than did females (F1,96 = 12.1; p = 0.001) and that those who hunted significantly more days per year did not perceive a risk of AIV infection (F1,94 = 4.4; p = 0.040). Hunters engaged in bird harvesting practices that could expose them to AIVs, namely by cleaning, plucking, and gutting birds and having direct contact with water. It was reported that 18 (17.0%) hunters wore gloves and 2 (1.9%) hunters wore goggles while processing birds. The majority of hunters washed their hands (n = 105; 99.1%) and sanitized their equipment (n = 69; 65.1%) after processing birds. More than half of the participants reported being aware of avian influenza, while almost one third perceived a risk of AIV infection while harvesting birds. Participants aware of avian influenza were more likely to perceive a risk of AIV infection while harvesting birds. Our results suggest that knowledge positively influenced the use of a recommended protective measure. Regarding attitudes, the frequency of participants who would cease harvesting birds was highest if avian influenza was detected in regional birds (n = 55; 51.9%). CONCLUSIONS: Our study indicated a need for more education about avian influenza and precautionary behaviours that are culturally-appropriate. First Nations subsistence hunters should be considered an avian influenza risk group and have associated special considerations included in future influenza pandemic plans.

Variation in the microbiological quality of commercially produced vacuum-packed cooked sliced meat between production and the end of shelf-life.

A study of the microbiological quality of cooked, sliced vacuum-packed meat was undertaken. Three hundred and eighty-one samples were taken (127 sets of three samples) from 55 commercial premises that produced packets of sliced, cooked, vacuum-packed meat for retail sale. The set of three samples consisted of one from the unsliced, cooked meat, one from the sliced product immediately after slicing, and one sliced packet for end of shelf-life testing. Samples were examined for aerobic colony count (ACC), Enterobacteriaceae, Escherichia coli, Listeria, and Salmonella. When compared to current UK guidelines for the quality of ready to eat food, samples were found to be unsatisfactory for ACC, Enterobacteriaceae, and E. coli. Unsatisfactory rates increased at the end of shelf-life compared to the unsliced meat sample results. No samples were positive for Listeria monocytogenes or Salmonella. This data is important for producers setting the shelf-life of their products.

The cooling profile of hot-cooked mussels stored in domestic insulated coolers amongst food vendors in Prince Edward Island, Canada.

It is common during outdoor events on Prince Edward Island, Canada for vendors to store hot-cooked mussels in domestic coolers. Provincial legislation states that hot product should be maintained at a minimum of 60 °C. A study was conducted to ascertain how long mussels could be stored before the temperature decreased to less than 60 °C. Hot, cooked mussels were placed into coolers and the temperature measured every 10 min for 4 h. It was found that when the cooler was unopened, the mean temperature dropped to less than 60 °C in 56 min. For coolers opened every 10 min, the mean temperature decreased to less than 60 °C in 38 min. For coolers opened every 10 min with mussels removed, the mean temperature decreased to less than 60 °C in 52 min. It was concluded that mussels should not be stored for more than 30 min and temperature should be regularly monitored.

Widespread acquisition of antimicrobial resistance among Campylobacter isolates from UK retail poultry and evidence for clonal expansion of resistant lineages.

BACKGROUND: Antimicrobial resistance is increasing among clinical Campylobacter cases and is common among isolates from other sources, specifically retail poultry - a major source of human infection. In this study the antimicrobial susceptibility of isolates from a UK-wide survey of Campylobacter in retail poultry in 2001 and 2004-5 was investigated. The occurrence of phenotypes resistant to tetracycline, quinolones (ciprofloxacin and naladixic acid), erythromycin, chloramphenicol and aminoglycosides was quantified. This was compared with a phylogeny for these isolates based upon Multi Locus Sequence Typing (MLST) to investigate the pattern of antimicrobial resistance acquisition. RESULTS: Antimicrobial resistance was present in all lineage clusters, but statistical testing showed a non-random distribution. Erythromycin resistance was associated with Campylobacter coli. For all antimicrobials tested, resistant isolates were distributed among relatively distant lineages indicative of widespread acquisition. There was also evidence of clustering of resistance phenotypes within lineages; indicative of local expansion of resistant strains. CONCLUSIONS: These results are consistent with the widespread acquisition of antimicrobial resistance among chicken associated Campylobacter isolates, either through mutation or horizontal gene transfer, and the expansion of these lineages as a proportion of the population. As Campylobacter are not known to multiply outside of the host and long-term carriage in humans is extremely infrequent in industrialized countries, the most likely location for the proliferation of resistant lineages is in farmed chickens.

Home Away from Home: How Undergraduate and Graduate Students Experience Space and Place in a new Health Sciences Building.

Buildings contribute in crucial ways to how students experience learning spaces. Four schools within a faculty (nursing, nutrition, occupational and public health, and midwifery) moved into a new Health Sciences building Fall of 2019. This new building created a unique opportunity to explore the intersection between higher education and learning space design, informed by concepts of space and place, and students' profession specific and interprofessional learning experiences in a new Health Sciences building. A qualitative descriptive design was used. All undergraduate and graduate students within the four schools were invited to participate. Focus groups were undertaken to gain a rich understanding of students' experiences and views of their space and place of learning. Data collection involved focus group data from profession specific participant users and interprofessional participant users. Inductive thematic analysis of focus group transcripts generated an initial coding scheme, key themes, and data patterns. Codes were sorted into categories and then organized into meaningful clusters. A building planning development project document relating to the vision, intentions, design, and planning for the new building provided content from which to view the study findings. The study data contributed to the conversation about space and place and its influence on higher learning within specific intraprofessional and interprofessional student groups and provided insight into the process of actualizing a vision for a new learning space and the resultant experiences and perceptions of students within that space/place.

Host association of Campylobacter genotypes transcends geographic variation.

Genetic attribution of bacterial genotypes has become a major tool in the investigation of the epidemiology of campylobacteriosis and has implicated retail chicken meat as the major source of human infection in several countries. To investigate the robustness of this approach to the provenance of the reference data sets used, a collection of 742 Campylobacter jejuni and 261 Campylobacter coli isolates obtained from United Kingdom-sourced chicken meat was established and typed by multilocus sequence typing. Comparative analyses of the data with those from other isolates sourced from a variety of host animals and countries were undertaken by genetic attribution, genealogical, and population genetic approaches. The genotypes from the United Kingdom data set were highly diverse, yet structured into sequence types, clonal complexes, and genealogical groups very similar to those seen in chicken isolates from the Netherlands, the United States, and Senegal, but more distinct from isolates obtained from ruminant, swine, and wild bird sources. Assignment analyses consistently grouped isolates from different host animal sources regardless of geographical source; these associations were more robust than geographic associations across isolates from three continents. We conclude that, notwithstanding the high diversity of these pathogens, there is a strong signal of association of multilocus genotypes with particular hosts, which is greater than the geographic signal. These findings are consistent with local and international transmission of host-associated lineages among food animal species and provide a foundation for further improvements in genetic attribution.

Institutional Engagement Practices as Barriers to Public Health Capacity in Climate Change Policy Discourse: Lessons from the Canadian Province of Ontario.

Public health engagement in the communication, discussion, and development of climate change policies is essential for climate change policy decisions and discourse. This study examines how the existing governance approaches impact, enable, or constrain the inclusion, participation, and deliberation of public health stakeholders in the climate change policy discourse. Using the case study of the Canadian Province of Ontario, we conducted semi-structured, key informant interviews of public health (11) and non-public health (13) participants engaged in climate change policies in the province. The study results reveal that engagement and partnerships on climate change policies occurred within and across public health and non-public health organizations in Ontario. These engagements impacted public health's roles, decisions, mandate, and capacities beyond the climate change discourse; enabled access to funds, expertise, and new stakeholders; built relationships for future engagements; supported knowledge sharing, generation, and creation; and advanced public health interests in political platforms and decision making. However, public health's participation and deliberation were constrained by a fragmented sectoral approach, a lack of holistic inter-organizational structures and process, political and bureaucratic influences, irregular and unestablished communication channels for public health integration, and identities and culture focused on functions, mandates, biased ideologies, and a lack of clear commitment to engage public health. We conclude by providing practical approaches for integrating public health into climate change discourse and policymaking processes and advancing public health partnerships and collaborative opportunities.

Determinants of Food Thermometer Use and Poultry Washing among Canadian Consumers.

ABSTRACT: Previous surveys have found that few Canadians report using a food thermometer to check cooking doneness, and many report rinsing or washing poultry prior to cooking. A cross-sectional survey study was conducted to investigate the sociodemographic and psychosocial determinants of the reported use of these behaviors among Canadians. A questionnaire was developed, guided by the Theoretical Domains Framework, and pretested through 10 cognitive interviews. The questionnaire was administered in English and French on 18 November 2019, to an online panel of 524 Canadian consumers. Logistic and ordinal regression models were constructed to evaluate determinants of consumers' reported thermometer ownership (yes or no) and thermometer use and poultry washing frequencies (each measured on a 5-point Likert scale). Nearly two-thirds of respondents (64%; n = 333) reported owning a food thermometer. Thermometer ownership was more common among males (odds ratio [OR] = 1.48, 95% confidence interval [CI] = 1.02, 2.15) and those with higher income categories. Nearly 45% of these respondents (n = 147) reported often or always using their thermometer to check cooking doneness. The frequency of engaging in this behavior was best determined by four psychosocial constructs: behavioral intentions, beliefs about consequences, self-efficacy, and habits. Nearly two-thirds of respondents (64%; n = 333) reported often or always washing their poultry before cooking it. This behavior was more frequently reported by males (OR = 1.51, 95% CI = 1.002, 2.28). It was also predicted by six psychosocial constructs: behavioral intentions, beliefs about consequences, self-efficacy, social influences, social responsibility, and habits. Habits had the largest influence on both behaviors. The study results can inform the development of more targeted food safety education and outreach initiatives to improve these behaviors among Canadians.

Salmonella and Campylobacter in United Kingdom retail raw chicken in 2005.

The United Kingdom Food Standards Agency commissioned a survey of Salmonella and Campylobacter in raw, whole chickens at retail in Wales and Northern Ireland between March and December 2005 to measure the baseline prevalence rates of these two significant pathogens. In total, 877 retail samples were examined for Campylobacter and Salmonella by enrichment methods. Overall contamination rates of 70.2% for Campylobacter and 4.0% for Salmonella were found. There was a statistically significant difference in Campylobacter rates between fresh and frozen samples, with fresh samples having a higher rate. There was no statistically significant difference between samples taken from retailers and butchers. Campylobacter was significantly more common in Northern Ireland than in Wales. Salmonella was significantly more common in Wales. The findings indicate the need for further investigation to explore why measures that have been successful in reducing Salmonella in the United Kingdom in recent years have failed to contribute to the control of Campylobacter. Identifying the factors responsible could lead to the introduction of more effective controls throughout the industry.

The Welsh Food Microbiological Forum and the All-Wales Shopping Basket Sampling Program: a model for the surveillance of microbiological quality in ready-to-eat foods.

In the United Kingdom, the monitoring of microbiological food quality and the prevention of foodborne disease are the responsibility of a number of different organizations. In 1993, to develop and extend ongoing local collaborations within selected local food groups in Wales (comprising local authorities and the Public Health Laboratory Service), the Welsh Office invited all local food groups in Wales to create a forum to coordinate the sampling and examination of ready-to-eat foods and the centralized collection of results for the whole of Wales. This paper describes the development, structure, and aims of the forum. It also discusses the outcomes of the first nine years of activities, describes the randomized sampling program for ready-to-eat foods that has been developed; and assesses the benefits that have resulted.

Are Campylobacter cases low risk for public health follow-up?

OBJECTIVES: Most Campylobacter cases are treated as low risk enterics (LRE) and receive a mailed letter from Toronto Public Health (TPH) with a questionnaire to gather basic risk information. This study sought to identify reasons why Campylobacter cases who were sent this questionnaire did not respond to the letter and to determine whether any of these cases were working in a high-risk occupation. METHODS: Cases reported to TPH between June 11, 2012 and December 6, 2012 who had not returned the questionnaire within 30 days were telephoned. Participants were asked about awareness of the original letter, reasons for not responding, and whether they worked in a high-risk occupation. RESULTS: Of the 226 cases identified as not responding to the letter, 172 (76.1%) were reached, and 162 (71.7%) answered the survey questions. The most frequent reason chosen for not responding to the original letter was "forgot" (54.4%). The most common suggestion chosen for ways to encourage response to the original letter was "more information on importance of returning questionnaire" (19.1%). Of the 119 cases with a known occupation, 3 (2.4%) were employed in a sensitive occupation - these include a family physician, a food server, and a line cook. None worked while ill. When prompted with a list of reasons for not returning the questionnaire, the majority of respondents indicated that they "forgot" (54.4%); the next most frequent response was "recovered by illness no longer considered it relevant" (21.5%). CONCLUSION: To increase response rates in the future, a cover letter should more clearly explain why the response is being solicited by Public Health, even after recovery from the illness, and the form should be simplified for mail return. A very small number of clients originally not reached through the course of the routine LRE program were working in sensitive occupations. Since none reported working while ill, the likelihood of direct or indirect transmission of Campylobacter from these three individuals was low. Using a LRE system to monitor a widespread mostly low-morbidity gastroenteric illness can be an effective public health strategy.