Older Adult Consumer Knowledge, Attitudes, and Self-Reported Storage Practices of Ready-to-Eat Food Products and Risks Associated with Listeriosis

Impact of COVID-19 on Chinese urban consumers' food safety knowledge and behavior - A comparative study between pre and post pandemic eras

The COVID-19 pandemic caused notable changes to the food-related habits of consumers worldwide due to their concerns about the risk of infection and the requirement to follow government mandates. To investigate the impact of the pandemic on Chinese consumers' food safety knowledge, food safety behaviors, and their most recent food poisoning experiences, we compared the results from an online survey (n = 583, Dec 2019) conducted before the pandemic was officially announced with an identical survey (n = 599, Aug 2023) conducted seven months after the Chinese government downgraded restrictions related to COVID-19. Post-pandemic there was a significant decrease in consumers' food safety knowledge and self-reported food safety behaviors and a significant increase in their self-reported experiences of food poisoning. Despite respondents stating that their food safety knowledge and behaviors had improved since the start of the pandemic, the data obtained from the two surveys and the respondents self-reporting of foodborne illness suggest that in fact their safety knowledge and behaviors had decreased. These findings highlight the need to reinforce food safety education and behaviors during times when the food system is disrupted, and consumers are focusing on what they perceive to be more immediate issues.

Risk it for a biscuit: Food safety behaviours and food insecurity of older adults

Foodborne disease presents a significant public health issue, costing the UK economy £9 billion annually, with many incidences being due to food-related behaviours in the home. Adults aged 60 and over account for around a quarter of the population in England and Wales and are at a greater risk of foodborne disease and may suffer a much higher burden. Research into risky food behaviours has previously focused on larger cohorts and typically treats the over 60's as one homogenous group. The current paper aims to identify the characteristics associated with risky food-related practices related to cooking, cleaning, chilling, cross-contamination, and use-by date adherence. The current research analysed data from the Official Statistics survey, Food and You 2: Wave 6 (2022-23). A series of binary logistic regression models examined the characteristics associated with risky food-related practices. We demonstrate that the characteristics associated with risky behaviours are not uniform, with different factors being associated with specific behaviours. We suggest that risky behaviours cannot be targeted efficiently with a one size fits all approach. This research provides an evidence base for policy makers to target risky food behaviours in this understudied vulnerable group.

U.S. Consumers' Tree Nut Food Safety Knowledge, Perceptions, and Handling Practices across Demographic Groups

Tree nuts are often perceived as presenting a low risk for foodborne illness, despite their association with several foodborne outbreaks and recalls in recent years. An online survey was designed to assess how consumers' food safety knowledge, perception of risks and benefits, and preferred sources for food safety information influence their tree nut handling behavior. Participants (n = 981) who soaked tree nuts or prepared nut-based dairy analogs (NBDAs) at home completed the survey. Their responses indicated insufficient knowledge about potential contaminations of tree nuts. Only 25% of participants had heard of a tree nut-related outbreak or recall. Few (30%) participants perceived a risk of contracting a foodborne illness from tree nuts. The participants were more concerned with the health benefits than potential microbial risks of raw tree nuts and preferred government agencies for tree nut food safety information. Based on a cluster analysis, demographics with lower food safety knowledge and risk perceptions (ages 18-24 or 45 and above, female, suburban and rural communities, have less than a bachelor's degree, and earned less than USD 100,000 annually) tended to engage in risky tree nut handling practices (p < 0.05). The findings of this study support the development of audience-targeted food safety extension materials for tree nuts.

Consumer attitudes and perceptions towards chilled ready-to-eat foods: a multi-national study

Understanding consumers' behavior and their handling of high-risk foods at home is essential for reducing the number of foodborne illnesses. This study shows the results of a cross-national analysis of consumers' perception from nine countries, and the identification of customers' clusters and its characteristics in order to understand customers' behavior, and to build safe chilled ready-to-eat (RTE) foods prevention strategies. The cluster analysis resulted in two clusters: (1) "Precautious consumers" characterized by the orientation towards pre-packed RTE foods, with consumers mainly coming from Bosnia and Herzegovina, India, Poland, Portugal, Spain, and Turkey. Their attitudes and self-reported practices may be categorized as less risky in terms of food-borne illnesses connected with the consumption of RTE foods; (2) "Unconcerned consumers" preferred cutting and slicing RTE foods freshly at the point of purchase, usually sold at the delicatessen department in a supermarket or at open markets. Those consumers mostly came from Croatia, Serbia and Slovenia and their attitudes and self-reported practices were riskier. These results allow a better understating of what characterizes consumers of RTE foods in different countries.

Use of Focus Groups to Identify Food Safety Risks for Older Adults in the U.S

Older adults are vulnerable to foodborne illness; however, many do not follow safe food handling guidelines that would reduce their risk of infection. Virtual focus groups were used to explore older adults' food handling and consumption practices and to understand how to apply the Health Belief Model for food safety research with respect to older adults. Thirty-nine adults between the ages of 56 and 80 participated in the study. Most participants reported eating poultry and eggs, whereas few reported eating precut fruit or raw sprouts. The majority were not using a cooking thermometer for all types of poultry and did report washing raw poultry. Participants were generally resistant to the idea of heating deli meats. Most focus group participants did not perceive themselves as being personally susceptible to foodborne illness. They did, however, express food safety concerns related to specific foods, such as melons and bagged salads, and they reported taking precautions to limit health risks from these foods. Regarding the Health Belief Model, our results indicate that the construct of perceived susceptibility could be expanded to include perceived risk, which refers to an individual's belief about the likelihood that a food might be contaminated with a foodborne pathogen. These results should be confirmed among a nationally representative sample of older adults.

Food Safety Knowledge and Practices of Pregnant Women and Postpartum Mothers in Slovenia

Food safety during pregnancy and postpartum is important for preventing foodborne diseases, while pregnant women are considered vulnerable due to their immunomodulatory condition. The current study aimed to investigate the self-reported food safety knowledge and practices of pregnant women and postpartum mothers in Slovenia using an online questionnaire and to compare the results with nonpregnant women as a control group. The study was conducted with 426 women, of whom 145 were pregnant, 191 were not pregnant, and 90 were postpartum. The online questionnaire consisted of questions related to food safety risk perception, hand hygiene, food purchase, food storage, food preparation and handling of infant formula and breast milk. The results showed that women generally have basic knowledge of proper food handling and are aware of food safety, but some specific gaps were identified in food handling at home, especially concerning microbiological risks. However, the results showed that pregnant women performed better than the postpartum group, and both groups performed significantly better than the nonpregnant group. The media was most frequently cited as a source of food safety information, especially by the pregnant group. Trained health workers should also inform women on how to ensure food safety in the home environment.

A Proposed Theoretical Model for Sustainable and Safe Commensality among Older Adults

Eating together at the same table, i.e., commensality, is an old phenomenon among humans. Today, there is a relatively high number of people living in single households eating most meals on their own. Among adults aged 65+ years, both malnutrition and non-communicable diseases are common. These circumstances, as well as foodborne illnesses, cause health problems for the individual, as well as high societal costs. In older adults, several external factors might impact on commensality, such as living arrangements, health status, and cooking competence. Improved knowledge regarding healthy eating and food handling may improve attitudes and behaviors in relation to food safety and dietary intake. Further, commensality has been shown to influence dietary intake in multiple ways. Community-organized activities, e.g., Food Classes for Older Adults (FCOA), may lead to sustainable commensality. Participating in health-promoting activities can contribute to improved health outcomes and improved social interaction among older adults. The objective of this study was to propose a theoretical model to inspire and create networks for sustainable commensality among older adults. The model could serve as a conceptual framework when implementing FCOA in communities and research. Outcomes could be measured by investigating the frequency of commensality, health effects, and well-being.

Assessing microbiological quality of ready-to-eat prepacked sandwiches, in Crete, Greece

The microbiological quality of pre-packed sandwiches, prepared by a company which had implemented the Hazard Analysis Critical Control Points system, was assessed at retail level, in Crete, Greece. Totally, we analyzed 225 sandwiches (S1: ham, cheese; S2: ham, cheese, tomato; S3: tuna salad), for specific pathogens (Listeria monogytenes, Salmonella spp, Staphylococcus aureus) and hygiene indicators (Escherichia coli, Enterobacteriaceae, Aerobic Colony Count-ACC). Pathogens were not detected. The E. coli numbers enumerated in day 0 (factory level) were found within acceptable levels < 100 cfu/g; limited samples had unsatisfactory values at the 3rd day of retailing storage (7%, 7%, and 27% > 100 cfu/g for S1, S2, and S3, respectively), which were further increased at the 7th day (20%, 33% and 53% > 100 cfu/g for S1, S2, and S3, respectively). The Enterobacteriaceae numbers mean log CFU/g were in the satisfactory or acceptable category with an increase in the range of 19.5-49.5% at the 7th day, nevertheless never exceeded the borderline of 4 log CFU/g. All ACC values were satisfactory or acceptable as no value higher than 7 log CFU/g was recorded. Overall there was a difference between the three sandwiches types, with S2 and S3, exhibiting higher levels than S1, possibly due to the extra ingredients. A number of corrective actions can be applied, as i.e. revision of cooking-chilling times, sanitizing procedures, staff hygiene practices and training etc.

Tackling Food Waste: Impact of German Consumer Behaviour on Food in Chilled Storage

Since perishable food in private households is usually stored in refrigerators, both consumer knowledge of correct storage parameters and food handling have a major impact on food quality retention. Today's refrigerators provide features, such as climate-controlled compartments, to improve chilled storage performance, but former studies have shown a lack of usage and interest in such features. This paper is based on the results of an online survey with 2666 respondents from Germany. The questionnaire focused on consumer behaviour regarding the chilled storage of perishable foods, the perception of quality loss in food and consumer requirements concerning refrigerators. The novelty in the study layout was the focus on seven common refrigerator storage features. The results showed that consumers had a high awareness of food safety, resulting in short storage durations. While it was clearly indicated that the storage features were less well-known, their importance correlated with rates of food waste, underlining the potential for improvement. The survey implied that raising the awareness of storage climate parameters is a tool for nudging consumers into lower rates of food waste.

Developing a Messaging Graphic for Storage Times of Refrigerated Ready to Eat (RTE) Foods for a Consumer Food Safety Health Campaign

This study developed and evaluated risk communication messages for ready to eat (RTE) foods targeted towards consumer storage practices in a food safety health campaign. Concepts were determined from a fractional factorial design of five categories of attributes potentially present in health promotion: title, message, graphic, slogan, and icon. Consumers viewed a subset of concepts and scored how useful the concept was in remembering to throw away RTE foods that were stored too long. Regression analysis determined which combinations of message attributes were most likely to result in using the information to throw out foods, which could help prevent foodborne illness. Findings showed that for this type of information, a graphic is a critical element for the printed schematic. The slogan (i.e., a short statement similar to a jingle or tag-line in a commercial) may be important to consumers, but the icon was not important.

Food Consumer Behavior and Salmonella Exposure Self-Perception in the Central Region of Mexico

In Mexico, there is limited information regarding food consumer behaviors at home. The knowledge of food consumption and food handling practices can help to determine more realistically the exposure to different hazards, such as Salmonella spp. on the population. The main goal of this study was to characterize the food consumption habits of five food groups (fruits and vegetables, fresh meat, dairy products, processed meat products, and seafood), food handling practices, and Salmonella exposure self-perception of the population of the central region of Mexico using an online survey. A total of 1,199 surveys were analyzed. The group of fruits and vegetables is the most consumed and one of the most related to the consumer self-perception of suffering from salmonellosis. Mexican consumers regularly use refrigeration as the principal food storage method for the five food groups (42.2% to 90.8%), and generally, they store the products between 2 and 3 days (26.5% to 38.1%). A total of 86.4% of consumers reported that they always wash their hands prior to food preparation. A total of 16.9% and 13.0% use the same cutting board and knife, respectively, to cut more than one product without applying sanitization. Men, people between 20 and 24 years, and people between 60 and 64 years, had the highest risk food handling practices at home. Finally, age (P < 0.0001), education level (P = 0.0004), and suffering from gastrointestinal diseases (P = 0.0005) showed significant effects with self-perception of having salmonellosis. PRACTICAL APPLICATION: Data presented in this study could be used in future risk and exposure assessment research to evaluate the public health risk from the consumption of contaminated food. In addition, it could be used by government agencies to design education campaigns in food safety area.

Factors affecting safe and healthy diet in older adults in Italy: results of a preliminary study performed in a community-dwelling sample

OBJECTIVE

To investigate, through a questionnaire, older adults' demographic and socio-economic characteristics, knowledge, attitudes and practices in terms of food safety and healthy diet; and to develop dietary and hygiene indices able to represent participants' nutritional and food safety behaviour, exploring their association with demographic and socio-economic factors.

DESIGN

One-year cross-sectional study.

SETTING

Gemelli Teaching Hospital (Rome, Italy).

PARTICIPANTS

People aged ≥65 years, Italian speaking, accessing the Centre of Ageing Medicine.

RESULTS

Mean age of the sample was 74 (sd 7·7) years. Subjective perception of a safe diet was high: 64·2 % of respondents believed they have a balanced diet. Interviewees got informed about proper nutrition mainly from television, magazines, newspapers, Internet (29·9 %) and from health professionals (34·8 %) such as dietitians, whereas 15·4 % from general practitioners. Regarding food safety, 33·8 % of participants reported to consume expired food, even more than once per month; between 80 and 90 % of participants reported to follow food safety practices during preparation and cooking, even though 49·3 % defrosted food at room temperature. Calculated dietary and hygiene indices showed that the elderly participants were far from having optimal nutritional and food safety behaviours.

CONCLUSIONS

These results suggest it is necessary to increase the awareness of older adults in the matter of healthy diet and food safety. Specific and targeted educational interventions for the elderly and their caregivers could improve the adoption of recommended food safety practices and safe nutritional behaviours among older adults.

Domestic Kitchen Microbiological Contamination and Self-Reported Food Hygiene Practices of Older Adult Consumers

Because of increased susceptibility, older adults have an increased risk of foodborne infection, and data suggest elevated incidence; therefore, food hygiene is essential to reduce the risk. Research suggests older adults' inadequate knowledge and negative attitudes toward food hygiene may increase implementation of unsafe food practices. Data on microbiological contamination of domestic kitchens of older adults are lacking. Therefore, this study aimed to determine microbiological contamination of domestic kitchens of older adults. Food contact surfaces and equipment (n = 1,292) in domestic kitchens (n = 100) of older adults (≥60 years) were analyzed to isolate aerobic bacteria, Enterobacteriaceae, Staphylococcus aureus, and Listeria spp.; self-reported hygiene practices were also recorded. Highest contamination levels were determined on in-use cleaning equipment (dish brushes, dishcloths, sponges) with aerobic bacteria <9.3 log CFU per item, Enterobacteriaceae <8.8 log CFU per item, and S. aureus <7.0 log CFU per item. Reported usage length of dish brushes was significantly correlated (P < 0.05) with Enterobacteriaceae contamination. Significant correlations (P < 0.05) were determined between contamination and reported cleaning frequency of refrigerators. Contamination of hand towels in single-occupant households was significantly greater (P < 0.05) than in multioccupant households. The study facilitates novel comparison between reported hygiene practices with microbial contamination, suggesting older adults fail to implement adequate and regular hygiene practices that may increase the possibility of cross-contamination in the domestic kitchen and the associated risk of foodborne illness. Data from this study have determined a need for older adults to improve food hygiene practices in the domestic kitchen.

Older Adult Consumers' Attitudes and Perceptions of Risk, Control, and Responsibility for Food Safety in the Domestic Kitchen

Although vast amounts of consumer food safety knowledge and self-reported data exist, attitudinal data detailing perceptions of risk, control, and responsibility are lacking. Such data relating to vulnerable groups, including older adults, are particularly scarce. Perception determination is essential in consumer food safety research to facilitate a comprehensive understanding of the cognitive factors that may impact behavior. Previous research has indicated a relationship between food safety perceptions and behavior. Perceptual data can inform the development of targeted food safety educational interventions. This study was conducted to ascertain older adult consumers' cognitive perceptions regarding food safety. Older adults (≥60 years, n = 100) participated in a computer-assisted personal interview to determine perceived risk, control, and responsibility associated with food safety. Although the potential severity of foodborne illness may be understood, the association between foodborne illness and domestic food preparation may be underestimated. Significant differences were found between perceived personal risk, control, and responsibility and the risks, control, and responsibilities of others ( P > 0.001). Older adults perceived themselves to have lower levels of risk than other individuals have, suggesting perceptions of optimistic bias and personal invulnerability. Perceived greater levels of personal control and responsibility, compared with those of others, suggest perceptions associated with the illusion of control. Correlations were evaluated between personal perceptions of risk, control, and responsibility ( P < 0.05). Low levels of risk were correlated with high levels of control. Those respondents ≥80 years of age perceived higher levels of risk and lower levels of control and responsibility. Cumulatively, older adult consumers expressed perceptions of invulnerability, optimistic bias, and the illusion of control regarding food safety. Such perceptions may undermine attempts to provide education regarding food safety. Food safety messages for this audience must be tailored to overcome such perceptions.

Listeria monocytogenes sepsis in the nursing home community: a case report and short review of the literature

OBJECTIVE AND IMPORTANCE

Listeria monocytogenes is a rare foodborne pathogen, causing both outbreaks and sporadic infections. Severe, systemic infections are more prevalent in at-risk populations, such as pregnant women, but occur mostly in older people and immunocompromised individuals. In this case report, we describe the presentation, diagnosis, and treatment of Listeria monocytogenes sepsis in an older patient, and we briefly review the literature about listeriosis and the importance of safe food practices.

CLINICAL PRESENTATION

We report the case of a nursing home resident with multiple co-morbidities who presented with abdominal complaints and fever. We found diffuse tenderness on abdominal examination without guarding or rebound pain. No other neurologic symptoms were reported and neurologic evaluation showed a normal mental status, no movement disorders, no neck stiffness, and no focal neurologic deficit. Intervention (& Technique): Blood results revealed moderate inflammation, but a CT scan of the abdomen showed no abdominal focus of infection. Hemocultures became positive with Listeria monocytogenes the day after admission, indicating a diagnosis of Listeria sepsis. The patient was admitted to the hospital for intravenous rehydratation with a tentative diagnosis of viral gastroenteritis. After receipt of the positive hemocultures, treatment was initiated with aminopenicillin (amoxicillin 4 × 1 g per day) with good clinical result.

CONCLUSION

Listeriosis occurs more frequently in older patients than in pregnant women and still has a high mortality despite adequate treatment. Physicians, in particular geriatricians, should be aware of this potentially severe foodborne infection. In older adult consumers and long-term care facilities, recommendations for safe food handling and storage should be emphasized.

Food Safety Knowledge and Practices among Saudi Mothers

This study examines food safety knowledge and practices of mothers in Saudi Arabia. A total of 979 respondents participated in the study and completed a questionnaire that assessed their knowledge of food storage, food handling, usage, and maintenance of kitchen facilities, personal hygiene, and food poisoning. Results showed that mothers in Saudi Arabia had moderate knowledge of food storage (passing rate 64.9%) and usage and maintenance of kitchen facilities (passing rate 66.5%). While they had good knowledge of personal hygiene (passing rate 83.8%) and food poisoning (passing rate 78.5%), their knowledge with regard to food handling was poor (passing rate 30.4%). Results also highlighted that food safety knowledge and practices amongst mothers in Saudi Arabia improved with the level of education, while their age, employment status, monthly income, and number of children had no significant association with their food safety knowledge and practices. This research revealed the importance of education and that advance education and training program can further improve mothers' food safety knowledge and practices and thereby result in reducing the risks of foodborne illnesses at homes.

Behavioral Observation and Microbiological Analysis of Older Adult Consumers' Cross-Contamination Practices in a Model Domestic Kitchen

The incidence of foodborne illness is higher in older adults because of their increased susceptibility; therefore, food safety practices are important. However, inadequate knowledge and negative attitudes toward food safety have been reported, which may increase use of unsafe food handling practices. Data on the actual food safety behaviors of older adults are lacking. In this study, food safety practices of older adults were observed and linked to microbiological analysis of kitchen surfaces to identify suspected routes of contamination. Older adults (≥60 years, n = 100) prepared a set meal in a model domestic kitchen sanitized according to a validated protocol to ensure minimal and consistent microbiological loads. Food safety behaviors were observed using ceiling-mounted cameras and recorded using a predetermined behavioral checklist. Surface microbiological contamination also was determined after food preparation. Overall, older adults frequently implemented unsafe food handling practices; 90% failed to implement adequate hand decontamination immediately after handling raw chicken. For older adults who used a larger number of adequate hand decontamination attempts, microbiological contamination levels in the kitchen following the food preparation session were significantly lower ( P < 0.001). The novel utilization of behavioral observation in conjunction with microbiological analysis facilitated identification of potentially unsafe food handling practices as suspected routes of microbiological cross-contamination in a model domestic kitchen. Findings indicate the potential impact on domestic food safety of unsafe food handling practices used by older adult consumers. This innovative approach revealed that a large proportion of older adults implement behaviors resulting in microbiological cross-contamination that may increase the risk of foodborne illness in the home.

Listeria monocytogenes contamination of ready-to-eat foods and the risk for human health in the EU

Food safety criteria for Listeria monocytogenes in ready-to-eat (RTE) foods have been applied from 2006 onwards (Commission Regulation (EC) 2073/2005). Still, human invasive listeriosis was reported to increase over the period 2009-2013 in the European Union and European Economic Area (EU/EEA). Time series analysis for the 2008-2015 period in the EU/EEA indicated an increasing trend of the monthly notified incidence rate of confirmed human invasive listeriosis of the over 75 age groups and female age group between 25 and 44 years old (probably related to pregnancies). A conceptual model was used to identify factors in the food chain as potential drivers for L. monocytogenes contamination of RTE foods and listeriosis. Factors were related to the host (i. population size of the elderly and/or susceptible people; ii. underlying condition rate), the food (iii. L. monocytogenes prevalence in RTE food at retail; iv. L. monocytogenes concentration in RTE food at retail; v. storage conditions after retail; vi. consumption), the national surveillance systems (vii. improved surveillance), and/or the bacterium (viii. virulence). Factors considered likely to be responsible for the increasing trend in cases are the increased population size of the elderly and susceptible population except for the 25-44 female age group. For the increased incidence rates and cases, the likely factor is the increased proportion of susceptible persons in the age groups over 45 years old for both genders. Quantitative modelling suggests that more than 90% of invasive listeriosis is caused by ingestion of RTE food containing > 2,000 colony forming units (CFU)/g, and that one-third of cases are due to growth in the consumer phase. Awareness should be increased among stakeholders, especially in relation to susceptible risk groups. Innovative methodologies including whole genome sequencing (WGS) for strain identification and monitoring of trends are recommended.

The European Union summary report on trends and sources of zoonoses, zoonotic agents and food-borne outbreaks in 2016

This report of the European Food Safety Authority and the European Centre for Disease Prevention and Control presents the results of the zoonoses monitoring activities carried out in 2016 in 37 European countries (28 Member States (MS) and nine non-MS). Campylobacteriosis was the most commonly reported zoonosis and the increasing European Union (EU) trend for confirmed human cases since 2008 stabilised during 2012-2016. In food, the occurrence of Campylobacter remained high in broiler meat. The decreasing EU trend for confirmed human salmonellosis cases since 2008 ended during 2012-2016, and the proportion of human Salmonella Enteritidis cases increased. Most MS met their Salmonella reduction targets for poultry, except five MS for laying hens. At primary production level, the EU-level flock prevalence of target Salmonella serovars in breeding hens, broilers, breeding and fattening turkeys decreased or stabilised compared with previous years but the EU prevalence of S. Enteritidis in laying hens significantly increased. In foodstuffs, the EU-level Salmonella non-compliance for minced meat and meat preparations from poultry was low. The number of human listeriosis confirmed cases further increased in 2016, despite the fact that Listeria seldom exceeds the EU food safety limit in ready-to-eat foods. The decreasing EU trend for confirmed yersiniosis cases since 2008 stabilised during 2012-2016, and also the number of confirmed Shiga toxin-producing Escherichia coli (STEC) infections in humans was stable. In total, 4,786 food-borne outbreaks, including waterborne outbreaks, were reported. Salmonella was the most commonly detected causative agent - with one out of six outbreaks due to S. Enteritidis - followed by other bacteria, bacterial toxins and viruses. Salmonella in eggs continued to represent the highest risk agent/food combination. The report further summarises trends and sources for bovine tuberculosis, brucellosis, trichinellosis, echinococcosis, toxoplasmosis, rabies, Q fever, West Nile fever and tularaemia.

An assessment of food safety information provision for UK chemotherapy patients to reduce the risk of foodborne infection

OBJECTIVES

Given the increased risk of foodborne infection to cancer patients receiving chemotherapy treatment, and the risk of listeriosis reportedly five-times greater to this immunocompromised patient group, there is a need to ensure the implementation of domestic food safety practices among chemotherapy patients and their family caregivers. However, information regarding the adequacy of resources to inform and enable patients to implement domestic food safety practices to reduce the risk of foodborne infection is limited. Consequently, this study aimed to evaluate the provision of food safety information available to UK chemotherapy patients.

STUDY DESIGN

In-depth semi-structured interviews and content analysis of online patient information resources.

METHODS

Interviews with patients and family caregivers (n = 15) were conducted to explore food-related experiences during chemotherapy treatment. Online food-related information resources for chemotherapy patients (n = 45) were obtained from 35 of 154 National Health Service chemotherapy providers in England, Scotland, and Wales, the Department of Health (DoH) and three of 184 identified UK cancer charities. Identified food-related information resources were reviewed using a content-analysis approach to assess the inclusion of food safety information for chemotherapy patients.

RESULTS

In-depth interviews established that many patients indicated awareness of immunosuppression during treatment. Although patients reported practicing caution to reduce the risk of communicable diseases by avoiding crowded spaces/public transport, food safety was reported to be of minimal concern during treatment and the risk of foodborne infection was often underestimated. The review of online food-related patient information resources established that many resources failed to highlight the increased risk of foodborne infection and emphasize the importance of food safety for patients during chemotherapy treatment. Considerable information gaps exist, particularly in relation to listeriosis prevention practices. Cumulatively, information was inconsistent, insufficient, and varied between resources.

CONCLUSION

The study has identified the need for an effective, standardized food safety resource specifically targeting chemotherapy patients and family caregivers. Such intervention is essential to assist efforts in reducing the risks associated with foodborne infection among chemotherapy patients.

Time-Temperature Profiling of United Kingdom Consumers' Domestic Refrigerators

Increased consumer demand for convenience and ready-to-eat food, along with changes to consumer food purchase and storage practices, have resulted in an increased reliance on refrigeration to maximize food safety. Previous research suggests that many domestic refrigerators operate at temperatures exceeding recommendations; however, the results of several studies were determined by means of one temperature data point, which, given temperature fluctuation, may not be a true indicator of actual continual operating temperatures. Data detailing actual operating temperatures and the effects of consumer practices on temperatures are limited. This study has collated the time-temperature profiles of domestic refrigerators in consumer kitchens (n = 43) over 6.5 days with concurrent self-reported refrigerator usage. Overall, the findings established a significant difference (P < 0.05) between one-off temperature (the recording of one temperature data point) and mean operating temperature. No refrigerator operated at ≤5.0°C for the entire duration of the study. Mean temperatures exceeding 5.0°C were recorded in the majority (91%) of refrigerators. No significant associations or differences were determined for temperature profiles and demographics, including household size, or refrigerator characteristics (age, type, loading, and location). A positive correlation (P < 0.05) between room temperature and refrigerator temperature was determined. Reported door opening frequency correlated with temperature fluctuation (P < 0.05). Thermometer usage was determined to be infrequent. Cumulatively, research findings have established that the majority of domestic refrigerators in consumer homes operate at potentially unsafe temperatures and that this is influenced by consumer usage. The findings from this study may be utilized to inform the development of shelf-life testing based on realistic domestic storage conditions. Furthermore, the data can inform the development of future educational interventions to increase safe domestic refrigeration practices.