Food Handling in the Home What are Consumers Really Doing and How Effective are the Risk Communication Messages They are Receiving? Lydia C. Medeiros,

Food Handling in the Home Food Handling in the Home What are Consumers Really Doing and What are Consumers Really Doing and

How Effective are the Risk Communication How Effective are the Risk Communication Messages They are Receiving?Messages They are Receiving?

Lydia C. Medeiros, Ph.D., R.D.Professor, Human Nutrition and Food Safety

Department of Human NutritionThe Ohio State University

Objectives for Today’s TalkObjectives for Today’s Talk

• What are the important consumer food handling behaviors and do they practice this behavior in the home?

• Where do consumers get their food safety information and do they use it effectively?

. . .is most effective when targeted toward changing those behaviors

that are most likely to result in foodborne illness.

Food Safety Education . . .Food Safety Education . . .

Food Handling Behaviors to Food Handling Behaviors to Control Foodborne IllnessesControl Foodborne Illnesses

Methods

• Expert Panel• Web-based Delphi study• Review, Revision, Reflection• Application

Medeiros et al. JADA 2001;101:1326-1339.Kendall et al., JADA 2003; 103:1646-1649.Hillers et al., J Food Protec. 2003;66:1893-1899.

Human Fecal PathogensNorovirus

Shigella spp.Hepatitis A

All cause illness with small number of cells

Practice Personal HygienePractice Personal Hygiene

Hillers et al., J Food Protec. 2003;66:1893-1899.

Wash hands with warm soapy water before handling food

If you are ill with diarrhea, only prepare food for

yourself but not others

Properly bandage and glove cuts and burns on hands before handling food

Practice Personal HygienePractice Personal Hygiene

Medeiros et al. JADA 2001;101:1326-1339.

Washed hands with warm soapy Washed hands with warm soapy water before handling foodwater before handling food

Low-Income Women, Simulated Food Prep Study (n=70)Low-Income Women, Simulated Food Prep Study (n=70)

Kendall t al., J Food Protec. 2004;67:2578-2586.

Behavior Observation (n, %)

Yes, washed before . . . 64 (91.4)

Yes, but incorrectly washed . . . 4 (5.7) *

No, did not wash . . . 2 (2.8)

* 3 rinsed only, 1 cleaned while washing dishes

How often do you typically wash How often do you typically wash your hands in a day?your hands in a day?

Rural Farm and Non-Farm Homeowners (n=52)Rural Farm and Non-Farm Homeowners (n=52)

Frequency Number (%)

Less than 5 X / day 3 (5.7)

5-10 X / day 24 (45.3)

> 10 X / day 25 (47.2)

No difference farm/ non-farm (P<.05)

Doorn et al. 2008, Manuscript in preparation.

Do you wash your hands with Do you wash your hands with soap and water prior to eating?soap and water prior to eating?

Rural Farm and Non-Farm Homeowners (n=52)Rural Farm and Non-Farm Homeowners (n=52)

Frequency Number (%)

Never 1 (1.9)

Sometimes 7 (13.2)

Usually 15 (28.3)

Always 29 (54.7)

No difference farm/ non-farm (P<.05)

Doorn et al. 2008, Manuscript in preparation.

Zoonotic PathogensCampylobacter jejuni

Salmonella spp.Vibrio spp.

Toxoplasma gondiiYersinia enterocolitica

E. coli O157:H7Same pathogens are associated with

both control factors

Cook Food Adequately andCook Food Adequately andAvoid Cross-ContaminationAvoid Cross-Contamination

Hillers et al., J Food Protec. 2003;66:1893-1899.

Use a thermometer to make sure that meat and poultry are cooked to safe temperatures

Cook shellfish until the shell opens and flesh is fully cooked; cook fish until flesh is opaque and flakes easily with a fork

If pregnant, immunocompromised, or elderly, heat hot dogs and lunch meats to steaming hot or 165o

Cook Foods Adequately Cook Foods Adequately

Medeiros et al. JADA 2001;101:1326-1339.

How would you judge if the following How would you judge if the following meats are adequately cooked prior to meats are adequately cooked prior to

consumption? consumption? Rural Farm and Non-Farm Homeowners (n=52) Rural Farm and Non-Farm Homeowners (n=52)

Food Thermometer Time Visual

Whole chicken (roasted) 26 (49.1) 31 (58.5) 29 (54.7)

Ground beef (grilled) 6 (11.3%) 26 (49.1) 37 (69.8)

Beef steak (grilled) 7 (13.2) 25 (47.2) 39 (73.6)

Pork roast (roasted) 25 (47.2) 25 (47.2) 20 (37.7)

Doorn et al. 2008, Manuscript in preparation.

No difference farm/ non-farm (P<.05)

Wash knives, cutting boards and food preparation surfaces with hot water and soap after contact with

raw poultry, meat and seafood

Clean food preparation surfaces with paper towels or clean cloths and hot soapy water

before and after food preparation.

Avoid Cross-ContaminationAvoid Cross-Contamination

Medeiros et al. JADA 2001;101:1326-1339.

Risk Factors for ContaminationRisk Factors for ContaminationHousehold Household Listeria monocytogenesListeria monocytogenes

Rural Farm and Non-Farm Homeowners (n=52)Rural Farm and Non-Farm Homeowners (n=52)

Type of contamination Risk Factors

Environmental contamination

(LM positive on sink, counter, or refrigerator)

Model:R2 = 0.179, P<0.001

Animal factor score

Behaviors associated with factor score

• Contact with a pet cat• House cat goes outside• Location of where cat fed – household

living quarters, such as kitchen• Location of cat litter box – household living

quarters, such as kitchen

Doorn et al. 2008, Manuscript in preparation.

Pathogens associated with temperature abuseC. perfringensStaph aureus

Bacillus cereus

Cause relatively mild illnesses

Keep Foods at Safe Keep Foods at Safe TemperaturesTemperatures

Hillers et al., J Food Protec. 2003;66:1893-1899.

Store all perishable foods at or below 40⁰F (4.4⁰C)

Do not prepare food more than 2 hours before serving without plans for proper cooling and reheating

Keep hot food at or above 140⁰F (60⁰C)

Keep Foods at Safe Keep Foods at Safe TemperaturesTemperatures

Medeiros et al. JADA 2001;101:1326-1339.

Refrigerator TemperatureRefrigerator Temperature Rural Farm and Non-Farm Homeowners (n=52)Rural Farm and Non-Farm Homeowners (n=52)

Statistic Temperature ( F)̊ Temperature ( C)̊

Mean (Standard error mean) 39.7 (0.60) 4.3 (0.33)

Minimum recorded temperature 30 -1.1

Maximum recorded temperature * 50 10

Doorn et al. 2008, Manuscript in preparation.

* Number of households above 40 F (4.4̊ C) = 19 (37%)̊

• Defined as refrigerated, ready-to-eat foods produced or processed in some way that doesn’t

kill pathogens• Some foods are higher risk than others

• Level of risk dependent on life-stage and immune status

pregnancy, childhood, elderly, immune-compromised

Avoid Foods fromAvoid Foods from Unsafe Sources Unsafe Sources

Kendall et al., JADA 2003; 103:1646-1649.

Drink only pasteurized milk and fruit juicesAvoid eating raw sprouts

If pregnant, immunocompromised, or elderly:avoid soft cheeses, cold smoked fish, cold deli saladsavoid hot dogs and lunch meats that have not been

reheated to steaming hot or 165º F

Avoid Foods fromAvoid Foods from Unsafe Sources Unsafe Sources

Kendall et al., JADA 2003; 103:1646-1649.

Food PreferencesFood PreferencesPregnant WomenPregnant Women

At-Risk Food Frequency

Cold deli or lunch meats, served without reheating 65%

Alfalfa or other raw sprouts 56%

Soft cheeses 42%

Homemade cookie dough that contains raw eggs 40%

Eggs with runny yolks 36%

Smoked fish served cold without reheating 26%

Raw fish or foods containing raw fish 15%

Rare or medium-rare hamburger 12%

Raw (unpasteurized) milk 9%

Athearn et al. Maternal Child Health J 2004; 8:149-162

Factors influencing cancer patients’ willingness Factors influencing cancer patients’ willingness to follow food safety recommendations.to follow food safety recommendations.

Medeiros et al., 2008, J Food Protec. In press

AcknowledgementsAcknowledgements

Funded by• USDA, National Research Initiative• USDA, National Integrative Food Safety Initiative

Research Team• Ohio State University

– Jeffery LeJeune– Gang Chen– Janet Buffer

• Colorado State University– John Sofos– Patricia Kendall– Mary Schroeder

• Washington State University– Virginia “Val” Hillers– Verna Bergman

Questions?Questions?

Rooster Research, 2008Rooster Research, 2008