https://doi.org/10.33698/NRF0224-Sonam Yangchen Bhutia ,Sushma Kumara Saini,Manmeet Kaur,Sandhya Ghai
Abstract : Introduction : Food hygiene is the most important measures to ensure the safety of food from production to consumption. Food borne diseases are problem for every country in the world but they can be prevented. Keeping in mind regarding the prevalence of food borne diseases a study was undertaken. Objective : To assess the knowledge and practices on food hygiene among the adults residing in Dhanas and Daddu Majra Colony, UT, Chandigarh. Methodology : A survey method was adopted through home visits by using convenient sampling technique 201 adults were enrolled for the present study. Interview schedule for knowledge assessment and observation checklist were used for assessing the knowledge and their practices to obtain the data. Knowledge and practices on food hygiene among the adults were assessed by interviewing and observation in their own homes. Results : The present study revealed that there were good practices regarding purchasing i.e. checking expiry date, food and water storage practices like the storing food grains in a container with a tight lid ,storing the drinking water in a closed container, home hygiene practices i.e. having animal shed away from the house, waste disposal practices like emptying the dustbin daily in a community bin/ collecting it by a garbage collector, hand washing practices like wetting hands and applying soap and rubbing for 20-30 secs, rubbing palm to palm, food preparation like tying hair when cooking, cutting vegetables just before start of cooking. However some of the incorrect practices are not checking anything when purchasing food items, keeping the cooked food in a hot pot as such/ utensils uncovered for more than 2 hrs, storing the raw vegetable along with the eatable items and storing the raw meat/ poultry along with other food items/ above the cooked food/ freezer, not tying and covering hair and sores in hands during cooking and not taking precautions when cooking, keeping the pet in the kitchen/near the bedroom/inside the room and not keeping dustbin. Hence, all the food hygiene practices were not good. Therefore, it is very important to educate the community and bring an awareness on food hygiene.
Keywords
Food hygiene, adult
Correspondence at
Dr. Sushma K. Saini
Lecturer
National Institute of Nursing Education PGIMER, Chandigarh
Introduction
Food hygiene is an essential part in every individual life. Good food is a basic need of human body. It is the basic material which the body need for its survival and well being. Good food is indispensable for health at all stages of life and for satisfactory growth during infancy, childhood, adolescence and adulthood. The food we consume in our everyday life can become unsafe and contaminated if not handled carefully. Food can become contaminated at any point during slaughtering or harvesting, processing, storage, distribution, transportation and preparation resulting in diseases constitute nearly half of all reported outbreaks under IDSP for the period 2011-164. As home is the place greatest proportion of food are consumed and thereby the chances of errors in food borne illness.1
As the risk of food handling the food is usually increased. contamination is on higher side, the people at the greatest risk are the elderly, infants, pregnant mother and those with immune disorders etc. Food-borne diseases referred to illnesses acquired through consumption of contaminated food which is a major public health problem worldwide. It has estimated that 1 in 10 people fall ill every year as a result of eating contaminated food. African Home-cooked poultry is believed to be the most common transmission route of the bacteria Campylobacter to humans.5 It is where people are unaware regarding the risk of contamination and doesn’t take adequate precaution when handling it. Studies have also revealed about the outbreak of food borne illness due to contaminated water and foods and by means of zoonotic food borne transmission as a result of consuming and South East Region have the highest contaminated meat.6-9
There was also an burden of food borne diseases contributing to one third of the global deaths due to epidemiological association between gastro intestinal illness and the consumption of diarrhoea in children under five years of age.contaminated food.8 Though, food borne Diarrhoeal diseases are responsible for more than half of the global burden of foodborne diseases, causing 550 million people to fall ill and 230 000 deaths every year.2 This is as a result of eating raw or undercooked meat, eggs, fresh produce and dairy products contaminated by norovirus, Campylobacter, non-typhoidal Salmonella and pathogenic E. coli. There are also other major contributors of foodborne diseases i.e. typhoid fever, hepatitis A, Taenia solium (a tapeworm), and aflatoxin.3 In India, burden of food borne diseases is not known as they go unreported. As per the IDSP data from 2011 – 15 shows food-borne outbreaks together with acute diarrhoeal diseases are the most common, costly yet preventable public health problem if adequate food hygiene is practised.
It is also very important to ensure that the food is safe at the time of purchase itself. A study was conducted where 3.5% never checked for expiry date and 52.4% never checked the brand and 40.5 never checked the labels when purchasing food.10 Thus, consumers should be vigilant when purchasing the food products to avoid unnecessary food borne hazards.
It was reported that in Vietnam and South East Asia widespread consumption of raw/undercooked meat, fish and raw vegetables. The use of untreated waste water and sewage for agriculture also led to the risk of food borne diseases.11 Therefore it is important to ensure that there is a safe including: food related diseases, causes of food poisoning and preventive measures for food poisoning such as hand washing, washing vegetables and cooking supply of food otherwise it can be a source appropriately.16 There is a need of food of infection. Food can also be contaminated during both food preparation and storage.9
The most common problems associated with the contamination of food are improper storage of cooked food, unclean hands, inadequate reheating, cross contamination from raw to cooked food, contaminated water, not maintaining the correct temperature for cooking poultry and contamination of food with livestock faces.13,14 WHO has given a five keys to safer food are keep (i) clean i.e. hand washing before preparing food, after going toilet cleaning utensil and kitchen area (ii) separating raw and cooked food (iii) cooking thoroughly (iv)keeping food at safe temperature (v) using safe water and raw material.12 There was a higher risk for food safety errors in families with children, older persons and pregnant women.
In a study it was stated that majority of the individual involved in cooking are female who had a better hygiene practices than man. Approximately 44% of respondents did not acknowledge that food service workers with cuts on their fingers or hands should avoid handling cooked or unwrapped foods.15 Another study indicated that in terms of preventive measures of food poisoning, mothers’ knowledge was not satisfactory concerning most items safety programs to address the full range of factors that impact food preparation behaviours. Hence, it is very important to know about the knowledge and practices related to food hygiene among the people so that preventive actions can be taken to correct the errors.
It is evident from the above mentioned studies regarding the prevalence of food borne diseases and its serious consequences on the health. As food borne diseases sometimes goes un reported due to lesser knowledge among the public in India. Therefore, there is a need to find out its prevalence and take the necessary preventive action in the future. Hence, the need was felt to assess the knowledge and practices on food hygiene among the adults residing in Dhanas and Daddu Majra Colony, Chandigarh.
Material and Methods:
A quantitative research approach was carried out in which a exploratory descriptive design was used to assess the knowledge and practices of adults on food hygiene in Dhanas and Daddu Majra Colony, UT, Chandigarh. The study was conducted among the adults residing in Dhanas and Daddu Majra Colony from July – September 2016. Using convenient sampling technique total 201 adults residing in Dhanas and Daddu Majra Colony, UT, Chandigarh were selected for the study. Ethical clearance was taken from the Institutional Ethics Committee, PGI, Chandigarh.
Tool for collecting data was interview schedule and observation checklist. Interview schedule consist of two parts i.e. socio demographic profile and knowledge assessment questionnaire on food hygiene. Observational checklist to assess the practices and hygiene consist of four parts i.e. hand washing assessment checklist, food preparation assessment checklist, kitchen hygiene practice checklist and personal hygiene checklist.
Content validity of tool was done by the experts in the field of Nursing, Community Medicine, Psychology and Sociology. Reliability of the interview schedule (Cohen Kappa was 0.98 ) and observation checklist (Cohen kappa was 0.77) was assessed using Cohen Kappa method. The consent form and the tool were translated from English to Hindi and Hindi to English by the researcher to check the translation validity. The investigator assessed their knowledge and practices on food hygiene through home visits. The interview schedule was conducted in their respective homes. Initially the consent was taken from the adults/ person involved in cooking at home and thereafter a total of 201 adults/ person involved in cooking were interviewed as per the interview schedule. The practices of food hygiene was observed by using checklist. As it was difficult to assess all the aspects of food hygiene at one visit, multiple visits were made till all the information in the checklist were obtained. The time taken for collecting the data was 40-60 min approximately. The timings for observing the food hygiene practices were done during breakfast preparation(7am-9:30am), lunch preparation(11:30am-2:30pm),dinner preparation(6pm:7:30pm). Analysis and interpretation of data was done using descriptive statistics: percentage, mean, standard deviation were used to analyze the data.
Results:
Socio demographic profile of adults involved in cooking
As per the socio demographic profile, it was observed that more than 60% of the subjects were migratory population and are migrated from the state of Uttrakhand, Himachal Pradesh and Uttar Pradesh. Per capita of income of the between Rs.166.66- 12000/- As per type of the family, 84% were from nuclear and remaining 16% were from joint family. Most (81.5%) of the subjects were Hindu and 18.5% subjects were Sikh, Muslim and Christian. Majority of the cooking (98.5%) was done by the females and were housewives (74%). The mean age of adults involved in cooking was 32.25 ±5.94. Educational status of majority of the females (67.1%) was illiterate. As per the dietary pattern of adults residing in Dhanas and Daddu Majra Colony more than 60% of the families were non vegetarian.
Food purchasing practices shows that majority of the adults were buying fresh fruits/ vegetables and checking expiry date when purchasing food items. The practices that are to be corrected are checking nothing when purchasing, and buying detergents and food items together in one bag. (Table 1)
Table 1: Food purchasing practices of adults
N=201
| Variables | N(%) |
| Items checked before buying | |
| Ø Check ISI mark/ AG mark and expiry date | 3(1.5) |
| Ø Check only expiry date | 188(93.5) |
| Ø Check nothing | 10(5) |
| Kind of fruits and vegetables purchased from the market. | |
| Ø Fresh | 196(97.5) |
| Ø Fresh and bruised | 5(2.5) |
| Practices of carrying the detergents and food items. | |
| Ø Detergents and eatables in different bags/ never buy together. | 59(29.4) |
| Ø Detergents and food items together in one bag | 142(70.6) |
In terms of food storage practices of adults, good storing practices were observed on storing the food grains in a container with a tight lid, storing the left over food in refrigerator for 1- 2 day, consuming the meat on the very same day/ covering it in a container and storing it in a refrigerator, covering the left over food and keeping it in refrigerator/in a utensil with water, washes and stores fruits and vegetables in a vegetable bucket of refrigerator, storing the cooked food for more than 2 hrs by covering and keeping it in a refrigerator/ in a utensil with water, reheats the left over food once before eating and stores raw meat below cooked/ready to eat food. Majority of them were following good practices, but there was also poor practices like keeping the cooked food in a hot pot as such/ utensils uncovered for more than 2 hrs, eating the left over food directly, storing the vegetable along with the eatable items/ where ever there is a space in the refrigerator and storing the raw meat/ poultry along with other food items/ above the cooked food/ freezer.(Table 2)
Table 2 : Food storing practices of adults
N=201
| Variables | N(%) |
| Method of storing the food grains. | |
| Ø Store it in a container with lid closed, covered in a polythene, sack bag. | 185(92.1) |
| Ø Store it in a container uncovered | 1(0.5) |
| Ø Consume it on the same day | 15(7.4) |
| Method of storing the cooked food for more than 2 hrs | |
| Ø Cover and keep it in a refrigerator/ keeps in a utensil with water | 109(54.2) |
| Ø Keep it in a hot pot as such/ utensil covered | 89(44.3) |
| Ø Consume it immediately after cooking | 3(1.5) |
| Left over food | |
| Ø Cover and keep it in refrigerator/ keeps it in a utensil with water | 127(63.1) |
| Ø Discard it/ feeds the animals/ cover and keep it as such in a pot, utensil | 72(35.9) |
| Ø Cooks in required amount | 2(1.0) |
| Duration of storing the left over food in refrigerator* | |
| Ø 1 day- 2 day | 136(67.7) |
| Ø More than 3 days | 3(1.5) |
| Measures taken to eat left over food before eating | |
| Ø Reheat once and eat it | 112(55.8) |
| Ø Eat it directly | 83(41.2) |
| Ø No left over food left for eating | 6(3.0) |
| Method of storing fruits and vegetables in the kitchen | |
| Ø Keeps in a refrigerator | 131(65.2) |
| Ø Keeps it in a vegetable rack, table, plastic basket/ keeps on the floor with | 59(29.3) |
| newspaper spread on it | |
| Ø Consumes on the same day | 11(5.5) |
| Practices of storing the fruits/vegetables in the refrigerator | |
| Ø Wash and cover it with a bag/ wash and place it directly | 72(35.8) |
| Ø Only cover it with a bag/ place it directly | 61(30.3) |
| Area for storing the vegetables in a refrigerator | |
| Ø Store it in a vegetable bucket of refrigerator | 109(54.2) |
| Ø Store it along with the eatable items/ wherever there is a space in the refrigerator | 24(11.9) |
| Non vegetarian food preparation in the kitchen# | 137(68.1) |
| Method of storing the raw meat
Ø Consume it on the same day/ cover it in a container and stores in refrigerator |
137(68.1) |
| Area for storing raw meat/ poultry in the refrigerator | |
| Ø Below cooked or ready to eat food | 6(3.0) |
| Ø Keep it along with other food items/ above the cooked food/ freezer | 3(1.5) |
*No refrigerator/doesn’t store: 62(30.8) #Vegetarian: 64(31.9)
As per food preparation practices, good practices observed were : using towel/clean cloth for wiping hands in the kitchen, washing dirty utensils immediately after cooking, washing the plate/ utensil with soap and water used for keeping raw meat, avoid cooking when sick. Incorrect practices are wearing ornaments as such when cooking, not tying and covering hair when cooking, not covering the sores in hands during cooking and not taking precautions like covering the nose and mouth when sneezing and coughing/ washing hands. Incorrect personal hygiene practices are not removing ornaments before cooking, not tying and covering the hair, sores in hands when cooking (Table 3)
Table 3: Food preparation and personal hygiene practices of adults
| Variables | N(%) |
| Material used for wiping hands in the kitchen | |
| Ø Towel or clean cloth | 139(69.1) |
| Ø Dupatta/ None | 62(30.9) |
| Practices of washing the vegetables for cooking | |
| Ø Before cutting | 60(29.9) |
| Ø After cutting/ before and after | 141(70.1) |
| Period of washing the dirty utensils in the kitchen | |
| Ø Immediately after cooking | 107(53.2) |
| Ø While cooking/ washes after an hour after cooking/ washes after 2hrs and above | 94(46.8) |
| Ways of handling the plate/ utensil after using it for keeping raw meat/ poultry#
Ø Wash it with soap and water |
137(68.1) |
| Ornament putting practices while cooking | |
| Ø Remove it before cooking | 16(8.0) |
| Ø Put it as such when cooking/ Sometimes put and sometimes removes it | 185(92.0) |
| Hairstyle while cooking | |
| Ø Tie and cover it with a cloth | 79(39.3) |
| Ø Open it as it is/ occasionally ties and open them/ tie them up | 122(60.7) |
| Ways of handling the sores in hand when cooking | |
| Ø Cover it with a bandage/ cloth | 84(41.8) |
| Ø Do not do anything/ Apply medicine and keep it as is/washes with soap and water, | 105(52.2) |
| apply oil, wear gloves | |
| Ø Doesn’t cook with sore hand | 12(6.0) |
| Ø Cooking done when sick | 102(50.8) |
| Ø Avoid cooking when sick | 99(49.2) |
| Kind of precaution taken while cooking | |
| Ø Covers the nose and mouth when coughing and sneezing/ washes hands | 22(10.9) |
| Ø No precaution taken | 80(39.9) |
| Ø Doesn’t cook when sick | 99(49.2) |
#Vegetarian: 64(31.9)
In terms of water storing practices, tap water was the main source of water supply for adults residing in Dhanas and Daddu Majra Colony, Chandigarh. Majority of the adults were using bucket and bottle for storing the water. Good practices like storing the drinking water with a lid closed, washing water storage container everyday, using clean articles for transferring the water out of water storage container, storing the drinking water for less than 10- 12 hours and washing the water storage container everyday was observed. Incorrect practices are storing the ice cubes for more than 12-24 hrs in a refrigerator. (Table 4)
Table 4: Water storage practices of adults
N=201
| Variables | N(%) |
| Source of water supply in house
Ø Tap Ø Pump |
178(88.6) 23(11.4) |
| Measures taken for purifying water at home
Ø Boiling, filters Ø Do not take any measure |
14(7.0) 187(93.0) |
| Store drinking water | 100(100) |
| Container used for water storage
Ø Plastic bottle, camphor, can, steel vessel, jar, bucket ,tub, water cooler, earthen pot Ø Bucket and bottle Ø Camphor, bucket and bottle |
34(17.0) 125(62.1) 42(20.9) |
| Ways of storing drinking water
Ø Store it in a covered container/ plastic bottle with lid |
100(100) |
| Articles used for taking out water from water storage container
Ø Cup/jug/mug/ /long handled vessel// katori/glass/ lotta/ any available container Ø Tilt the water storage container |
110(54.8) 91(45.2) |
| Duration of storing drinking water
Ø Less than 10-12 hrs Ø 12-24 hrs |
118(58.8) 83(41.2) |
| Duration of storing ice cubes in refrigerator*
Ø Less than 10-12 hrs Ø 12-24 hrs/ More than 24 hrs |
15(7.5) 51(25.3) |
| Frequency of washing water storage container
Ø Everyday Ø Alternative day/ once in a week/ after 3 days and above |
129(64.1) 72(35.8) |
*No refrigerator/ doesn’t store ice cubes: 135(67.1)
Pet animals like dog/ cat/ mouse/foul/ parrot/love birds was kept at homes. As per home hygiene related to pets/domestic animals/rodents, good practice like making a separate place for pet to live, keeping the pet away from the kitchen/ balcony/ outside the house when cooking, discarding the pet faeces by throwing it directly into the dustbin, keeping the animal shed away from the house, using the animal excreta for preparing cowdung and manures, absence of holes/burrows on the floors and walls of the house, taking measures to control the rodents. Though majority of them followed good practices, there are also some poor practices like keeping the pet in the kitchen/near the bedroom/inside the room when cooking, discarding the pet faeces directly into the street/outside the road, keeping the location of animal shed near the kitchen, dumping the animal excreta directly into an open land, presence of holes/ burrows on the floors and walls of the house, not taking measures to cover the holes/burrows on the floor and walls of the house permanently. (Table 5)
Table 5: Home hygiene practices related to pets, domestic animals and rodents by adults
N=201
| Variables | N(%) |
| Presence of pet animal | 21(100) |
| Types of pet at home
Ø Dog/ cat/ mouse Ø Foul/ parrot/ love birds |
10(47.6) 10(47.6) |
| Separate place for pet to live in house | 13(61.9) |
| Location of the pet when cooking
Ø In the kitchen/ near the bed room, inside the room Ø Away from the kitchen, balcony/ outside the house |
8(38.1) 12(57.1) |
| Ways of discarding pet faeces
Ø By throwing it directly into the dustbin Ø By throwing it directly into the street/outside on the road |
11(52.3) 8(38.1) |
| Presence of domestic animal | 16(100) |
| Location of animal shed
Ø Away from the house Ø Near the kitchen |
13(81.2) 3(18.8) |
| Disposal of animal excreta
Ø Preparing cow dung cakes/ manures Ø Dump it directly into an open land near the house/ away from house |
11(68.8) 5(31.2) |
| Ø Absence of holes/ burrows on the floors and walls of the house*
Ø Presence of holes/ burrows on the floors and walls of the house |
177(88.1)
24(11.9) |
| Measures taken for the holes/ burrows on the floors and walls of the house
Ø Cover it permanently Ø Do not do anything/ cover it temporary/ partially |
1(0.5) 23(11.4) |
| Measures to control rodents#
Ø Measures taken Ø Do not take any measures |
163(81.1) 4(2.0) |
*No burrows/ holes: 177(88.1) #No rodents: 34(16.9)
As per the waste disposal practices of adults, good practice like emptying the dustbin by garbage collector/ disposing it into a community bin everyday was observed among the adults. Incorrect practices are not keeping dustbin for discarding waste, using a temporarpolythene/sack bag/ bamboo cane/ plastic bucket, not keeping separate bins for kitchen and household garbage, absence of lid in dustbin, not disposing the biodegradable and non biodegradable waste.(Table 6)
Table 6: Disposal of waste practices by adults
N=201
| Variables | N(%) |
| Type of dustbin used in house | |
| Ø Foot operating pedal dustbin | 20(10.0) |
| Ø Polythene/ sack bag/bamboo cane/ tin/ plastic bucket | 176(87.6) |
| Presence of separate bins for kitchen and household garbage | 29(14.4) |
| Presence of lid/ cover in dustbin* | 81(40.2) |
| Practice of disposing biodegradable and non biodegradable waste | 27(13.4) |
| Duration of emptying dustbin | |
| Ø Everyday | 141(70.1) |
| Ø Alternative day/ once in a week | 55(27.3) |
| Place/ area for emptying dustbin | |
| Ø Taken by garbage collector/ dispose it in a community bin | 186(92.5) |
| Ø Dispose in the river side/ forest/ near the open space outside the house/ road | 15(7.5) |
*No dustbin: 5(2.4)
As per the hand hygiene practices, good practice of wetting their hands and washing it under tap water, rubbing palm to palm, rinsing hands thoroughly under water, applying soap and rubbing the hand for 20- 30 sec, rubbing backside of both the hands was observed among the adults. Poor practices like rotational rubbing, backward and forwards with clapsed fingers of right hand in left palm and viceversa, thumb encircling, cleaning the nails, interlacing in between the fingers, removing jewellery, watches, ring are to be corrected. Regarding food preparation practices, good practices was observed like washing their hands thoroughly with soap and water, tying their hair when cooking, cutting the vegetables/ fruits just before the start of cooking, cutting and throwing away the bruised areas on vegetables. Incorrect practices are not covering hair with cloth when cooking, not washing knives with soap and water before and after use, not boiling soup/ stews/ gravy when cooking. (Table 7)
Table 7: Hand washing and food preparing practices of adults
N=201
| Variables | N(%) |
| Handwashing | |
| Remove jewellery, watches, ring etc | 11(5.4) |
| Wet the hands and wash it under tap water | 199(99.0) |
| Apply the soap and rub the hands for 20 -30 sec | 176(87.6) |
| Rubs palm to palm | 191(95.0) |
| Rubs backside of hand both sides | 118(58.7) |
| Interlacing/ in between the fingers | 13(6.4) |
| Cleaning the nails | 15(7.5) |
| Thumb encircling both sides | 6(3.0) |
| Rotational rubbing, backwards and forwards with clapsed fingers of right hand in | 3(1.5) |
| left palm and vice versa | |
| Rinse it thoroughly under water | 197(98.0) |
| Drying it with a towel/ cloth piece | 55(27.3) |
| Food preparation | |
| Washes the hands thoroughly with soap and water | 194(96.5) |
| Ties the hair properly | 187(93.0) |
| Covers the hair with a cloth | 57(28.3) |
| Washes vegetables/ fruits under tap water just before eating, peeling, cutting | 109(54.2) |
| Cuts and throw away the bruised areas on vegetables | 147(73.1) |
| Cuts the vegetables just before the start of cooking | 181(90.0) |
| Washes knives with soap and water before and after use | 52(25.9) |
| Discards the rotten fruits/ vegetables | 82(40.8) |
| Boils the soup, gravy and stews | 61(30.3) |
As per the infrastructure of the kitchen is concerned only 13% of the families was having a clean kitchen ventilator/ exhaust fan whereas 26% families were not having ventilator/ exhaust fan. In terms of kitchen hygiene, good practices like not keeping the cooked food at room temperature for more than 2 hrs, no packed food items with expiry date, covered water storage container, covered food grains with a tight lid, keeping the water storage place without algae/ mould/ dirt, keeping the food covered, not keeping the left over food in refrigerator for more than 3 days, using clean separate jug/mug for taking water from water storage container, gas stove without spills, washed utensils without dust/ oily layer surface, storing fruits/vegetables in the vegetable bucket of refrigerator, no rotten fruits/ vegetables inside refrigerator, refrigerator clean and without spills and kitchen counters without dust or crumbs of food. Though majority of them has followed good practices, there are some incorrect practices like not keeping the kitchen ventilator/exhaust fan clean, not keeping the food items with covered lid in the refrigerator, not keeping a clean separate kitchen towel, washing area with algaes/ moulds, cupboards with dust, not using clean separate cloth for cleaning kitchen counters, water bottle inside refrigerator with dirt, moulds/ algaes in washing area, dirt/ cow web/ greasy area in the kitchen wall. (Table 8)
Table 8: Hygiene practices in the kitchen of adults
N=201
| Variables | N(%) |
| Clean kitchen ventilator/ exhaust fan## | 26(13.0) |
| Absence of dirt/ cow webs/ greasy area in the kitchen wall | 78(39.0) |
| Kitchen counters without dust or crumbs of food | 107(53.2) |
| Gas/ stove without spills | 125(62.1) |
| Washed knife | 84(41.8) |
| Cupboards without dust at the corners** | 55(27.3) |
| No dirty utensils left in the sink | 99(49.2) |
| Washed utensils without dust/ oily layer surface | 114(56.7) |
| Floor without spills, no spots on the floor | 82(40.8) |
| Absence of blocked sink and drain in the washing area/ by the waste food | 161(80.1) |
| Absence of moulds and algae in the washing area/ sink | 62(30.8) |
| Clean separate kitchen towel | 40(19.9) |
| Clean separate cloth for cleaning kitchen counters | 45(22.3) |
| Water bottle in the refrigerator without dirt | 60(29.8) |
| Covered the cooked food | 137(68.1) |
| No cooked food kept at room temperature for more than 2 hrs | 181(90.0) |
| Covered food grains with a tight lid# | 149(74.1) |
| No packed food items with expiry date | 199(99.0) |
| Covered food items in the refrigerator | 35(17.4) |
| No left over food in the refrigerator for more than 3 days | 125(62.1) |
| Vegetable/ fruits stored in a vegetable bucket inside the refrigerator | 101(50.2) |
| No rotten fruits/ vegetables inside the refrigerator | 102(50.7) |
| Refrigerator clean and without spills | 120(59.7) |
| Covered water storage container (for drinking and cooking) | 167(83.0) |
| Water storage place without algae/ mould/ dirt at the floor | 146(72.6) |
| Water storage container without dirt | 85(42.2) |
| Uses clean separate jug/ mug for taking water from the storage container | 125(62.1) |
*No refrigerator: 67(33.3) #Do not store food grains: 15(7.4)
**No cupboards: 2(1.0) ##No ventilator/ exhaust fan: 52(26.0)
As per waste disposal practices adults followed a good practice of keeping the garbage bin away from the food preparation area. Poor practices like not keeping a separate garbage bin for kitchen waste, not covering the garbage bin with lid, garbage bin with littering and overflowing of waste was observed. Regarding hygiene practices related to domestic animals/pets/ rodents/insect, good practice like absence of holes/ burrows in the kitchen and absence of rodents was observed. Incorrect practices are not keeping the pet away from the food preparation area, keeping a separate shed for domestic animals and pets. (Table 9)
Table 9: Waste disposal and hygiene related to domestic animals, pets, rodents and insects practices of adults N=201
| Variables | N(%) |
| Waste disposal | |
| Separate garbage bin for kitchen waste* | 29(14.4) |
| Garbage bin kept away from the food preparation area | 171(85.0) |
| Garbage bin covered with lid | 29(14.4) |
| Area around the garbage bin with no littering and overflowing of waste | 61(30.3) |
| Domestic animals, pets, rodents and insects** | |
| Pets kept away from food preparation area | 11(5.5) |
| Separate shed for domestic animals and pets | 17(8.4) |
| Absence of holes/ burrows in the kitchen | 181(90.0) |
| Absence of rodents/ mice in the kitchen | 175(87.0) |
| Absence of flies, cockroaches in the kitchen | 77(38.3) |
*No dustbin: 5(2.5)
**No pets: 180(89.6)
All adults were practicing personal hygiene like absence of swelling and ulceration in gums, no open wounds/sores on hands, absence of eye discharge, absence of pediculosis. Other good practices like keeping clean mouth with no foul smell, absence of dandruff, combingand tying the hair neatly, no body odours, taking bath regularly. Though majority of them was following good practices, there are some incorrect practices like not trimming nails of fingers and toes and not wearing clean clothes. (Table 10)
Table 10: Personal hygiene practices of adults
N=201
| Variables | N(%) |
| Personal Hygiene | |
| Taken bath | 138(68.7) |
| Cut/ trimmed nails in fingers and toes | 86(42.8) |
| Worn clean clothes | 114(56.7) |
| No body odours | 140(69.7) |
| Clean teeth, no foul smell from mouth | 190(94.5) |
| No swelling and ulceration in gums | 201(100) |
| Hair combed and tight neatly | 162(80.6) |
| No open wounds/ sores on hands. If yes, then covered with bandage/ cloth piece | 201(100) |
| No eye discharge | 201(100) |
| Absence of pediculosis | 201(100) |
| Absence of dandruff | 187(93.0) |
Discussion
Food borne and water borne diseases are common problem in the world. These problems can be preventable but due to the lack of adequate knowledge it has been causing a serious risk to an individual health. There are number of disease caused by the unhygienic foods namely; s a l m o n e l l o s i s , l i s t e r i o s i s , campylobacteriosis, botulism, cholera, E. Coli infection, norovirus infection, shigellosis and hepatitis. These problems are very much common in a developing country like India due to poor hygiene practices. Keeping in mind regarding the prevalence of foodborne diseases, a study was conducted to assess the knowledge and practices on food hygiene among the adults residing in Dhanas and Daddu Majra Colony where 201 samples were selected using convenient sampling technique.
Food borne disease can occur when adequate measures are not taken at any of the stages. A study was conducted to assess the food purchasing practices where majority of the adults were checked for occurs commonly during bathing, drinking, preparing the food or consuming the food which is prepared by using the contaminated water.
In Bulgaria, 91.1% agreed that personal hygiene can prevent food contamination , 90% of them stated that uncovered abrasion or cuts on fingers and hands can cause cross contamination of food and 92.2% took precautions when coughing and sneezing, 47.8% never wore accessories when cooking food.29 Similarly in the present study, majority of the subjects took precaution when cooking, and also bathed daily. Whereas on other side, their ornament removing practices when cooking was poor, and more than 50% did not cover the sores in hands before cooking. WHO has given a five keys to safer food are keep (i) clean i.e. hand washing before preparing food, after going to toilet cleaning utensil and kitchen area (ii) separating raw and cooked food (iii) cooking thoroughly (iv)keeping food at safe temperature (v) using safe water and raw material.12 Hand washing is one of the most effective way of expiry date and the brand.10
In the present preventing the spread of food borne study, majority of adults were checking the expiry date followed by brand mark. The need of awareness is very important among the adults when purchasing food to ensure the consumption of safe food. One must be cautious when purchasing the food to avoid unnecessary food borne hazards.
The most common problem causing food borne illness in developing countries is through faeco-oral contamination. Poor sanitation, unsafe water, poor hygiene hand washing is one of the common barrier of these problems. Water contamination infection. In the present study, almost all adults were following a good practice of wetting their hands and most of them were washing it under tap water, rubbing palm to palm, rinsing hands thoroughly under water, applying soap and rubbing the hand for 20- 30 sec. The other steps like rotational rubbing, backward and forwards with clapsed fingers of right hand in left palm and viceversa, thumb encircling, cleaning the nails, interlacing in between the fingers, removing jewellery, watches, ring are needed to be emphasized.
Studies has shown that highest consumption of food takes place at home where home cooked poultry was one of the most common cause of the Campylobacter infection among the humans.5 It occurs when one is unaware and do not follow the food hygiene precautions when handling raw poultry. Studies have also revealed about the outbreak of food borne illness due to contaminated water and foods and by means of zoonotic food borne transmission as a result of consuming contaminated meat.6-9 In our present study 1.5% of the non vegetarian adults were storing the food items along with the poultry/ above the cooked food/ freezer. It is where the chances of cross contamination can increase resulting in food borne diseases.
In Vietnam and South East Asia consumption of raw/undercooked meat, raw vegetables, living in close proximity of the human with animals animal and use of untreated waste water led to the risk of food borne diseases.11 Evidence also suggested that livestock play a significant role in food contamination.14 In our study, majority of adults had kept a separate place for pets to live, and kept the pets away from kitchen when cooking, discarded the pet faeces into the dustbin, kept the animal shed away from the house, used the animal excreta for preparing cowdung and manures. Studies have stated that majority of the individual involved in cooking were female and possessed secondary educational level where approximately 44% did not acknowledge cuts/ sores to be avoided when cooking.15 In the present study, majority of females were involved in cooking and were housewives and mostly illiterate. It was found that 52.2% do not do any thing with the cut/ sores in hands when cooking.
Food borne diseases has become a major public health concern and consumption of contaminated food has resulted into morbidity and mortality worldwide. Food can become contaminated during slaughtering/ har vesting, processing, storage, distribution, transportation and preparation. This problem is very much common in homes when one is unaware of it. Therefore, it is very important to ensure that the food that we consume is safe to eat. The reason for conducting the study is to assess the knowledge and practices on food hygiene. Thereby, necessary steps can be taken in future by the health care providers working in community in educating and making the public aware of the food safety and food hygiene in preventing foodborne diseases.
On the basis of the study it was recommended that the community health nurses and other health professionals working in a community can assess the knowledge of food hygiene and can provide health education by creating health awareness on different health issues.
References
- Foodborne diseases. [online] [cited 2017 J u n e 1 0 ] : A v a i l a b l e f r o m : U R L : http://www.who.int/topics/foodborne_diseases/ en/
- World Health Media centre. [online] [cited 2017 June 8]: Available from: URL: http://www.who.int/mediacentre/news/releases/20 15/foodborne-disease-estimates/en/
- WHO Estimates of the Global Burden of Food borne Food borne Disease Burden Epidemiology Reference Group 2001- 2015. . [online] [cited 2015 November 8]: Available from: URL: http://apps.who.int/iris/bitstream/ 10665/199350/1/9789241565165_eng.pdf
- Alert CD. Food borne diseases and food safety in India . [online] [cited 2017 June 8]: Available from: URL: http://www.ncdc.gov.in/writereaddata/ linkimages/cdalert03175347761127.pdf
- Angela B, Eve CM, Michael S. Uninvited Guests at the Table – A Consumer Intervention for Safe Poultry JFS [abstract online] 2013 Aug [cited 2015 November 26]; 33(4): 394-404. Available from: http://onlinelibrary.wiley.com/doi/ 10.1111/jfs.12063/abstract
- Woldt M, Moy Literature Review on Effective Food Hygiene Interventions for Households in Developing Countries. USAID [online] 2015 Aug [cited 2017 July 7]. Available from: . http://pdf.usaid.gov/pdf_docs/ PA00M1CH.pdf
- Ramees TP, Dhama K, Karthik K, Rathore R, Kumar A, Saminathan M, Tiwari R, Malik YS, Singh RK, Acrobacter: an emerging food borne zoonotic pathogen, its public health concerns and advances in diagnosis and control- a comprehensive Vet Q abstract [online] 2017 Dec [cited 2017 July 8]; 37(1): 136-161. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28438095
- Cavanagh K, Johnstone T, Huhtinen E, Naiiar Z, Lorentzos P, Shadbolt C, Shields J, Gupta Foodbrne Illness Outbreak Investogation in a High Profile Sports Club. NCBI. [abstract online] 2017 Jun [cited 2017 July 1]; 3(1): 24. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28647923
- Langiano E, Ferrara M, Lanni L, Viscardi V, Abbatecola AM, Vito ED. Food safety at home: knowledge and practices of Journal of Public Health. [online] 2012 Feb [cited 2017 July 2]; 2 0 ( 1 ) : 4 7 – 5 7 . A v a i l a b l e f r o m : https://link.springer.com/article/10.1007/s10389- 011-0437-z#Sec2
- Stratev D, Odeyemi OA, Pavlov A, Kyuchukova R, Fatehi F, Bamidele Food safety knowledge and hygiene practices among veterinary medicine students at Trakia University, Bulgaria. Journal of Infection and Public Health. [online] 2017 Feb [cited 2 0 1 7 J u l y 5 ] . A v a i l a b l e f r o m : http://www.sciencedirect.com/science/article/pii/S 1876034117300126?np=y&npKey=d8214c9bee3 91d910227afc704b220c50bbbb0e267c69226d2a 2905a8a1f967e
- Mas JJ, Bryant A review of foodborne bacterial and parasitic zoonoses in Vietnam. Ecohealth. [online] 2013 Oct [cited 2017 July 5]; 10(4): 465-
- Available from: . https://www.ncbi.nlm. nih.gov/pmc/articles/PMC3938847/
- World Health Five keys to safer food manual. [online] 2006 [cited 2016 September
2 5 ] . A v a i l a b l e f r o m : http://www.who.int/foodsafety/publications/consu mer/manual_keys.pdf
- Mazengia E, Fisk C, Liao G, Huang H, Meschke J. Direct observational study of the risk of cross contamination during raw poultry handling: practices in private homes. International Association for Food Protection. [online] 2015 [cited 2017 June 5]; 35(1):8-23. Available from: . http://www.foodprotection.org/files/food- protection-trends/JAN-FEB-15-mazengia.pdf
- Amoako B, Greenwood SJ, Dixon BR, Barkema HW , Mcclure Foodborne illness associated with cryptosporidium and giardia from livestock. J Food Prot. [online] 2011 Nov [cited 2017 June 5]; 74(11):1944-55. A vailable from: https://www.ncbi.nlm.nih.gov/pubmed/22054199
- Baluka SA, Miler R, Kaneene Hygienic practices and food contamination in managed food service facilities in Uganda. African Journal of Food Science. [online] 2015 Jan [cited 2017 June 2]; 9 ( 1 ) : 3 1 – 4 2 . A v a i l a b l e f r o m : http://www.academicjournals.org/article/article14 21323495_Baluka%20et%20al.pdf
- Ahmed Mothers knowledge regarding preventive measures of food poisoning in Yemen. Food and Nutrition Sciences. [online] 2015 [cited 2017 June 5 ] ; 6 : 4 9 – 5 3 . A v a i l a b l e f r o m : http://file.scirp.org/pdf/FNS_2015011215580546. pdf