“A STUDY TO ASSESS THE KNOWLEDGE AND PRACTICE
ON
FOOD
HYGIENE
AMONG
SELECTED CANTEENs
FOOD
HANDLERS
OF
AT BIJAPUR WITH VIEW TO
PREPARE AN INFORMATIONAL BOOKLET”.
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
BANGALORE
PROFORMA FOR REGISTRATION OF SUBJECT FOR
DISSERTATION
MR. KISHOR. BAJANTRI
COMMUNITY HEALTH NURSING
FIRST YEAR M. Sc NURSING
YEAR 2011 -2013
BLDEA’S SHRI B M PATIL
INSTITUTE OF NURSING SCIENCES
SOLAPUR ROAD, BIJAPUR - 586103
0
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
KARNATAKA, BANGALORE
ANNEXURE II
PROFORMA FOR REGISTRATION OF SUBJECTS FOR
DISSERTATION
1
NAME OF THE CANDIDATE MR. KISHOR BAJANTRI.
I YEAR M. SC. NURSING
AND ADDRESS
SHRI B.M.PATIL INSTITUTE OF
NURSING SCIENCES, BIJAPUR-586103
2
3
4
NAME OF THE
SHRI B.M.PATIL INSTITUTE OF
INSTITUTION
NURSING SCIENCES, BIJAPUR -586103
COURSE OF THE STUDY
I YEAR M. Sc. NURSING
AND SUBJECT
COMMUNITY HEALTH NURSING
DATE OF ADMISSION TO
04.07.2011
THE COURSE
5
TITLE OF THE STUDY
“A STUDY TO ASSESS THE KNOWLEDGE AND PRACTICE ON
FOOD HYGIENE AMONG FOOD HANDLERS OF SELECTED CANTEENs AT
BIJAPUR WITH VIEW TO PREPARE AN INFORMATIONAL BOOKLET”.
1
6.
BRIEF RESUME OF THE INTENTED WORK
INTRODUCTION
Food is the prime necessity of life, were food businesses have become
widespread in recent times, in response to the changing life style and food
consumption of people. They offer convenience and ease of access to food to
busy individuals, who are unable to prepare their own meals regularly at home
food comes in to contact with human hands during harvesting, storage,
preparation and service.1
In large scale cooking, food passes through many hands, there by
increasing the chances of food contamination due to improper handling.
Deliberate or accidental contamination of food during large scale production
might endanger to the health of the consumers, and have very expensive
repercussion on a country.1
The number of factors which contribute to food contamination are
storage room, equipment, utensils, knives, wooden boards, the tables and other
surfaces which come in contact with food, the food ingredients water, air and
the cutlery and serving dishes used in food preparation and service.2
More than 250 different food borne diseases have been described, they
are classified as: bacterial, viral, parasites, chemical poisoning, food toxins. The
common infectious diseases transmitted by food handlers are diarrhoea,
dysenteries, typhoid and paratyphoid fever etc.3
An estimated 76 million cases of food borne diseases occur each year in
the United states. The great majority of these cases are mild and cause
symptoms for only a day or two. Some cases are more serious, and CDC
estimates that there are 3,25,000 hospitalizations and 5,000 deaths related to
food borne diseases each year.4
Food hygiene is a measure taken to ensure soft, wholesomeness and
soundness of food at all stages from its growth, production, manufacture and
2
final consumption. It is important that food handlers be free from any
communicable diseases-colds, any other respiratory ailments, cuts or boils as
they may be responsible for transferring these to the food, their by spreading
the infection to persons consuming the food.3
Therefore it is essential is to have complete medical examination for food
handlers at the time of employment. Any person with history of typhoid fever,
diphtheria, chronic dysentery, tuberculosis or any other communicable disease
should not be employed. Persons with wounds, otitis media or skin infections
should not be permitted to handle food or utensils. The day to day appraisal of
the food handlers is also equally important. Those who are ill should excluded
from food handling. It is also important that any illness which occurs in a food
handlers family should at once be notified.2
6.1 NEED FOR THE STUDY
Food is a product that is rich in nutrients required by microorganisms
and may be exposed to contamination with the major sources from water, air,
dust, equipments, sewage, insects, rodents and employees. Due to the changes
in food production, handling and preparation techniques as well as eating
habits, the fact remains that food is the source for microorganisms that can
cause illness.5
US centers for disease control and prevention (USDHHS-DC1996)
revealed that the outbreaks of food borne diseases. Which resulted from foods
of animal origin had caused approximately 76 million illness, 325,000
hospitalizations and 5000 deaths each year. Data obtained from USA, suggest
that 20 to 40% of such illness is associated with the consumption of
contaminated food where catering establishment are the most frequently cited
sources of sporadic and outbreak food borne infection.5
When food handlers did not practice good personal hygiene or proper
handling they can be the vector for growth of microorganism through hands,
cuts, mouth, skin and dry hairs etc.5
3
A meta analysis study was conducted to assess knowledge, attitude, and
practice among food handlers at residencies of collages and canteen regarding
food safety. Total 65 food handlers where interviewed through questionnaires,
the result reveals that 93.9% respondent had good knowledge on personal
hygiene. As per observation study explains that food handlers had good
knowledge but poor in practice. As per report of Manning and Snider 81% of
respondent are aware of importance of hand washing but only 2% observed
washing their hand thoroughly. According Anon (2003) most cases of food
borne diseases are due to improper handling of food, inappropriate use of
temperature, cross contamination, poor personal hygiene and inadequate
utensils. An aspect of attitude 76.9% stated that safe food handling is important
part of their job responsibility; regarding practice only 60% had washed their
hands thoroughly with soap and water before handling the food. Hence training,
motivating and initiation should be provided to encourage food handlers by
practicing appropriate attitude and procedure on working in food area (Nurul
Huda 2008). 5
Food hygiene is defined as all conditions and measures that are
necessary during the production, processing, storage, distribution and
preparation of food, to ensure that it is safe, sound, wholesome and fit for
human consumption.6
A research study was conducted to evaluate food hygiene knowledge,
attitude and practice of food handlers and food business in Accra. It involves
field survey and lab analysis of microbiological study of food sample collected
from hotels. The semi structured interview questionnaire used for the
respondents, the results reveals that knowledge and practice of food hygiene of
the respondents are found statistically independent, 85.7% respondents were
chosen defrosting meat in refrigerator. Regarding food storage majority of
respondent (66.7 to 80%) were new the correct temperature for food storage.
Around 11.1% and 40% of respondents of different hotels expressed that they
have handled food even when they are having diarrhoea and almost all workers
reported that they were working when they are sick with vomiting and
4
diarrhoea, Majority of the respondents were not used head gears and gloves
while handling food. This observation suggest that there should be strict food
hygiene checkups should be followed.1
By considering the above statistical facts it is clearly observable that
there is a strong need for providing the knowledge regarding food hygiene for
the food handlers. Because food handlers seems to be playing significant role in
preventing the various health hazards that occurs due to food contamination.
6.2 REVIEW OF LITERATURE
A research study was conducted to evaluate the knowledge, attitude and
practice of food handlers in food businesses in Turkey. Total 764 food handlers
were interviewed concerning to food safety issues among food handlers. The
result reveals that only 9.6% where using protective glouse during their
working activities, around 47.8% participant had not undergone an basic food
safety training, The mean food safety knowledge score was found 43.4+ or –
16.3. Overall the study also reveals that food handlers had lack of knowledge
regarding the basic food hygiene. The paper highlights that their should be
immediate need for education and awareness regarding safe food handling
practices among food handlers.7
A study was done on evaluation of a health education intervention on
knowledge and attitude of food handlers working in a medical college in Delhi
India. Among 136 samples the health education was given them by interaction
sessions using a flip chart and posters. After3 months post test was conducted.
The result showed that there was a significant increase in knowledge about
hand hygiene measures, namely washing hands before handling food 23.5% to
65.4% and keeping nails cut and clean (8.1% to 57.4%) was observed baseline
self reported hand washing practice reveals low figures for washing hands after
micturation (82.4%), smoking (52.8%) and consistent use of soap at the
workplace (24.3%), and after micturation (14. %)which improved after health
education but not to the desired extent finding highlight the importance of
providing health education in food and personal hygiene to food handlers and
5
incorporation the same in existing guidelines for good establishments laid down
by civic agencies in Delhi and elsewhere.8
A survey study was conducted on food hygiene knowledge and attitude
among Chinese food handlers in Fong song tong district. Total 580 Chinese
food handlers were interviewed face to face with self designed questionnaire.
Only 1.4% respondents achieved full scores of knowledge. The correct
response of personal hygiene knowledge was statistical and significantly higher
than food handling knowledge (p< 0.05)About 79% respondent showed
expressed there is need of food hygiene education, The study is explain of that
compare with secondary education at least, the secondary educated and above
had better knowledge on food hygiene. It expressed that there is need for
motivation on traditional training model, community based education etc.9
A study was conducted in food safety knowledge and behaviour of
women infant and children (WIC). prodgamme participant in the United state in
conjunction with industry efforts to reduce food borne pathogens. Consumers
play an important role in decreasing food borne. Total 1598 clients were
surveyed. The result reveals that the majority of the respondents revived food
safety information through WIC (70.7%), family(63.1) and television (60.7%).
94.3% respondent recognized necessity for washing and sanitizing cutting
boards and utensils. But only 66.1% knew the correct ways to sanitize. About
58.4% of respondent acceptable thawing method for meat but 21% were used
keeping meat on the counter or in a sink filled with water (20.6%). The study
also reveals that there is significant difference in knowledge behaviour, thawing
methods among deferent racial and ethnic group, were white respondents had
higher knowledge than the black. The results of the study suggests that there is
need for food safety education for own income consumers.10
A study was conducted at Amritsar city on the personal hygiene among
food handlers. The result reveals that the majority of the food handlers had lack
of personal hygiene, like poorly kept nails, irregular bath, dirty working cloth,
lack of foot wear, Among food handlers 12.9% were suffering from intestinal
parasitic infestation out of which 42.8% were contributed by entamoeba
6
histolytica. Incidence of carrier state of salmonella among food handlers was
found to be 0.47%. It reveals that habits on personal hygiene among food
handlers were not satisfactory.11
A community based cross-sectional study was conducted on health
status and personal hygiene among food handlers working at food
establishment around a rural teaching hospital in Wardha District of
Maharashtra, India. Total 160 food handlers of both sex were selected
randomly. Stool examination and nail culture was also done. Point prevalence
of morbidity was 54(33.75%) and period prevalence 26.25%. 21.87% were
anemic microbial positively rate for their stools and nail culture was 97%. The
study explains that pre placement and periodical medical checkup is the key to
improve health status of food handlers for better food safety.12
A study was conducted on food hygiene behaviour among hospital food
handlers.161 food handlers of two different hospital settings were evaluated
they also screened for nasal carriage of staphylococcus aurous as well as for
enteric pathogens and parasites only 28.8% were observed to have actually
washed their hands especially between handling cooked and uncooked foods.
The nasal carriage of staphylococcus aurous was 24%. Also a periodic inservice programme of health education on food safety and hygiene should be
introduced to alert them of their responsibilities.13
7
6.3 PROBLEM STATEMENT
“A Study to Assess the Knowledge and Practice of Food Hygiene
Among Food Handlers of Selected Canteens at Bijapur With a View to Develop
an Information Booklet”.
6.4 OBJECTIVES

To assess the knowledge regarding food hygiene among food handlers as
measured by structured knowledge questionnaire.

To assess the practice regarding food hygiene among food handlers as
measured by structured practice checklist.

To find out the association between the knowledge and practice of food
hygiene among food handlers.

To find out relationship between knowledge and practice of food hygiene
among food handlers with selected demographic variables.

To provide informational booklet regarding food hygiene.
6.5 OPERATIONAL DEFINITION

Assess: In this study it refers to systematic way of collecting
information by food handlers regarding food hygiene.

Knowledge: In this study it refers to correct response given by food
handlers regarding food hygiene.

Practice: In this study it refers to the activity performed by food
handlers regarding food hygiene.

Food hygiene: In this study it refers to all conditions and measures that
are necessary during the preparation, processing, storage and
distribution of food, to ensure that it is safe, sound, wholesome and fit
for human consumption.

Food handlers: In this study it refers to the individuals who are coming
in contact with food. Throughout the chain of preparation, processing,
storage, and serving of food working in selected canteen.

Canteens: In this study it refers to a place where meals are prepared and
8
served to the people.

Informational booklet: In this study it refers to systematically organized
instructions of knowledge and practice on food hygiene.
6.6 ASSUMPTIONS

The food handlers may have inadequate knowledge and practice on food
hygiene.

Informational booklet may improve knowledge and practice of food
hygiene among food handlers.
6.7 HYPOTHESIS:
Following hypothesis will be tested at 0.05 level of significance
H1: There is a significant difference between knowledge regarding food
hygiene among food handlers.
H2: There is a significant difference between practices regarding food
hygiene among food handlers.
H3: There is a significant relationship between the knowledge and practice
regarding food hygiene among food handlers.
H4: There is significant association between the knowledge and practice
regarding food hygiene among food handlers with selected
demographic variable.
6.8 DELIMITATION
Study is delimited for:

The study is limited to 100 samples by using convenient
sampling technique.

Study period is limited to 4-6week.

Study area is limited to selected canteens at bijapur.
9
7.
METHODOLOGY
Methodology of research indicates the general pattern of organizing the
procedure for gathering valid and reliable data for problems under
investigation.
7.1 Sources of data collection
Food handlers of selected canteens at Bijapur
7.1.1Research design
Descriptive research design
Research approach
Descriptive exploratory research approach will be used for this study
7.1.2Setting
The study will be conducted in selected canteens at Bijapur.
7.1.3Population
Population for the study comprises of food handlers at selected
canteens of Bijapur.
Research Variables

Food hygiene.

Knowledge and practice.

Demographic variables.
7.2 Method of data collection
7.2.1 Sampling procedure
Food handlers will be selected using convenient sampling technique
7.2.2 Sample size
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7.2.3 Inclusion criteria

Food handlers who are willing to participate.

Food handlers who can understand either Kannada or English.

Food handlers who are present during the time of study.

Food handlers with age of more than 15 years.
7.2.4 Exclusion criteria

The food handlers who are not present during the time of
study.

Food handlers who are not willing to participate.

Food handlers who are below the age of 15 years.

Food handlers who had training on food hygiene.
7.2.5 Instruments intended to be used

Socio demographic proforma.

Structure interview schedule.

Structure practice checklist.
7.2.6 Data collection method

Permission will be obtained from concerned authorities.

Purpose of the study will be explained to the subjects.

Informed consent will be obtained from subjects.

Data will be collected by structured knowledge questionnaire and
structure practice check list through interview method.
7.2.7 Data analysis plan
Data will be analysis according to the objectives and hypothesis of the
study using descriptive statistics like mean, median, frequency, and percentage.
Inferential statistics like chi squre-test, Karl Pearson correlation test and data
will be presented in the form of tables, graphs and diagrams.
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7.2.8 HAS ETHICAL CLEARANCE OBTAINED?
Yes
1.
Confidentiality and anonymity of the subject will be obtained
2.
Informed consent will be obtained from the subject
3.
Written permission will be obtained prior to study.
7.3 DURATION OF THE STUDY:
4- 6 weeks.
7.4 DOES THE STUDY REQUIRE ANY INTERVENTION OR
INVESTIGATION TO BE CONDUCTED ON PATIENTS OTHER
HUMANS OR ANIMALS?
No.
Sample for the study would consist of 100 food handlers.
12
8.
LIST OF REFERENCES
1. George Amponsah Annor, Ekua AnamoabaBaiden. Evaluation of Food
Hygiene Knowledge Attitude and Practice of Food Hygiene in Food
Businesses in Accra, Ghana. Food and Nutrition Sciences, 2011; 2:8306.
2. Park. K Preventive And Social Medicine; 19th edition, Jabalpur,
Banarasidas Bhanot; feb 2007.
3. Onila Salins. Essence of nutrition Jaypee brothers Medical publishers
(p) ltd New Delhi.
4. Department of Health and Human Services centre for diseases control
and prevention, food borne illness. 2007 mar available from
http://www.cdc.gov/ncidod/dbmd/diseaseinfo/foodborneinfection.
5. Siow Oi Nee and Norrakiah Abdullah Sani. Assessment of Knowledge,
Attitude and Practice (KAP) Among Food Handlers at Collages and
Canteen Regarding Food Safety. Sains Malaysiana 2011; 40(4): 403-10.
6. S Kamalam essentials in Community Health Nursing Practice. Jaypee
Brothers, medical publishers (p) ltd, New Delhi.
7. Murat B, Azmi SE, Gokhan K. The evaluation of food hygiene
knowledge, attitude, and practiceof food handlers’ in food businesses in
Turkey. Science Direct [Online] 2005 jan 1 [Cited 2008 Sep 21];
8. Rahul Malhotra, PannaLal, Krishna S, Prakash, DagaM K, Jugal
Kishore. Evaluation of a Health education Intervention on Knowledge
and Attitude of Food Handlers Working in a Medical Collage in Delhi,
India. Asia-Pacific. Journal of Public Health October 2008 ;.20 (4): 2776. Available from URL: http://www.sciencedirect.com/science.
13
9. C H Tang1 and U W Fong2. A Survey of Food Hygiene Knowledge and
Attitude among Chinese Food Handlers in Fong Song Tong District,
available from [email protected]. 2004; 16(2):120-4.
10. Kwon J, Wilson AN, Bednar C, Kennon L. Food safety knowledge and
behaviors of women, infant, and children (WIC) program participants in
the United States.J Food Prot available.
11. Mohan U, Mohan V Raj. A study of carrier state of typhi, intestinal
parasites and personal hygiene amongst food handlers in amritsar city.
Ind J Comm Med [Serial online] 2006 [Cited 2008 Sep 21]; 31(2):
2004-06. Available from URL:http://www.ncib.nlm.nih.gov/pubmed.
12. Abhay Bhausaheb Mudey, Naveeta Kesharwani, GargiAbhayMudey,
Ramchandra C Goyal, Ajay K DawaleVasant et.al. Health Status and
Personal Hygiene Among Food Handlers Working at Food
Establishment Around a Rural Teaching Hospital in Wardha District of
Maharashtra, India.
13. Oteri T, Ekanem EE. Food hygiene behavior among hospital food
handlers.Public health may1989; 103(3):153-9.
14. Sumati R, Mudambi,Shalini M. rao. Food sciences; new age
international (p) Ltd publishers New Delhi.
15. Dr M Swaminathan Advanced text book of food and nutrition.
Bangalore; 2.
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