Evaluation of the Handling Practices and Risk Perceptions of Dried Wood Ear Mushrooms in Asian Restaurants in the United States

In late 2020, dried wood ear mushrooms, a low-moisture food ingredient that had been imported and sold to restaurants, were linked to a foodborne outbreak of Salmonella Stanley, which sickened 55 individuals across the United States. These mushrooms are commonly used in Asian cuisine. It is unclear if the contaminated dried wood ear mushrooms that caused the foodborne illnesses were improperly handled during preparation. The objectives of this study are to assess the handling practices, risk perceptions, and food recall experiences of dried wood ear mushrooms in restaurant kitchens among Asian restaurant managers and chefs. We conducted a series of telephone interviews with managers and chefs of Asian restaurants in the United States who used dried wood ear mushrooms in making dishes. After reaching information saturation, a total of 25 restaurant managers and chefs participated in the interview. Our results showed that 76% of the participants did not keep track of package information, such as expiration date and lot number, and many participants reported using cold water for rehydration. Wood ear mushrooms were blanched before being used in all cold dishes and most stir-fry dishes, but less commonly in stew or ramen. Some participants (16%) did not view dried wood ear mushrooms as a raw food ingredient, and 16% did not perceive that low-moisture food ingredients constituted microbiological food safety risks. The majority of the participants had heard of food recalls, but only 17% knew about the dried wood ear mushroom recall, and even fewer had heard of food recalls of other low-moisture foods, like nuts and seeds (9%), and flour (4%). While this study shares similarities with previously published studies evaluating the handling practices of consumers and restaurant employees with respect to meat and poultry, it makes a distinctive contribution to the field of food safety as the first-of-its-kind to study the handling practices of a low-moisture food ingredient: dried wood ear mushrooms. This unique ethnic food ingredient has been associated with a past outbreak and multiple recalls in the United States. The findings of the study show the need to develop food safety educational programs that are tailored toward Asian restaurant food handlers and provide guidance to develop risk communication strategies for this niche audience.

Food Safety Education Needs Assessment for Small-Scale Produce Growers Interested in Value-Added Food Production

ABSTRACT

Production of value-added foods is of growing interest to small-scale produce growers. However, previous studies reported that they lack sufficient food safety awareness and have limited knowledge of applicable food safety regulations. Targeted food safety education can help to address these challenges. This study used focus groups and a combination of Web-based and printed surveys to evaluate growers' attitudes toward and knowledge of value-added business and to assess their food safety education needs. In total, 136 Indiana produce growers participated in the study, including 38 focus group participants and 98 survey participants. Overall, growers were aware of the importance of food safety, with 78% of the survey participants agreeing strongly that food safety was a top priority in value-added businesses. Most survey participants (82%) self-reported being knowledgeable about food safety. Most were confident in their ability to run a successful value-added business. The top two barriers that hindered growers from learning about food safety were time limitations and an overwhelming amount of information. Growers preferred to receive additional educational materials on selling non-home-based vendor products, communication strategies with regulators and inspectors, and marketing strategies; they trusted the information from extension educators and university extension publications the most. This study guides the development of future food safety education programs for small-scale growers who are interested in establishing a value-added business.

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Assessing Existing Food Safety Resources with United Kingdom-Based Chemotherapy Patients and Family Caregivers for Future Learning Purposes

ABSTRACT

Because the incidence of foodborne infection is more prevalent among cancer patients and the domestic kitchen is a contributor to foodborne infection, appropriate domestic food safety practices are needed to safeguard this at-risk population. Although patients are aware of the increased risk of infection, previous self-reported data indicate potential food safety malpractices among patients and family caregivers, thus suggesting the need for targeted food safety information. However, existing United Kingdom resources provide inconsistent and insufficient food safety information. Involvement of intended end users in the cocreation of interventions increases potential effectiveness. Qualitative data were collated from in-depth interviews and a focus group with United Kingdom chemotherapy patients and family caregivers (n = 35) to determine perceptions and preferences for food safety information by evaluating existing food safety resources from international providers (n = 12). Although participants liked digital interventions (e.g., Web sites and videos), traditional paper-based leaflets were perceived as the most beneficial because they could be referred to on repeated occasions. Despite the drawbacks associated with some resources, combining approaches in a multiresource intervention was favored by patients and family caregivers. Ensuring patients are not overwhelmed with excessive information was important. Short, logical, engaging, educational, and entertaining information to evoke an interest in the topic was preferred. Utilization of graphics to supplement descriptive information may enhance comprehensibility. Interventions need to be appropriate for patients and caregivers, and delivery by trusted health care professionals may enhance the credibility of the message. Preferred approaches to facilitate targeted food safety communication were identified, and these findings can be utilized to cocreate targeted food safety interventions for chemotherapy patients and family caregivers.

HIGHLIGHTS

Motivators and Barriers to Cooking and Refrigerator Thermometer Use among Consumers and Food Workers: A Review

Temperature control prevents the rapid growth of foodborne pathogens during food storage and assures adequate heating to destroy pathogens prior to consumption. The use of thermometers is a recognized best practice among consumer and food worker guidelines; however, compliance with this recommendation is quite low. Eighty-five studies from the past 21 years were reviewed and an analyzed for the knowledge, attitudes, and behaviors associated with thermometer use and the motivators and barriers to cooking and refrigerator thermometer use among consumers and food workers. Barriers to thermometer were categorized into two major groups: "the belief that a thermometer is not necessary" and "the difficulty of selecting and using a thermometer." Each group has its unique aspects. Four barriers were recognized in the "not necessary" group: (i) preference for alternative techniques, (ii) mainstream media and food professionals seldom serve as role models and often negate the need for food thermometers, (iii) limited awareness of potential health issues associated with current practices, and (iv) limited knowledge and awareness related to thermometer usage for specific food groups. Six barriers were recognized in the "difficult to select and use" group: (i) difficulties in selecting the type of food thermometers, (ii) availability of food thermometers, (iii) lack of skills related to the usage of food thermometers, (iv) limited knowledge related to endpoint temperatures, (v) inability to calibrate food thermometers, and (vi) lack of knowledge about food thermometer cleaning and sanitation. These findings will facilitate the development and adoption of effective strategies to increase thermometer use and increase food safety education efficacy with a positive impact on public health.

Observation of High School Students' Food Handling Behaviors: Do They Improve following a Food Safety Education Intervention?

Youth are a key audience for food safety education. They often engage in risky food handling behaviors, prepare food for others, and have limited experience and knowledge of safe food handling practices. Our goal was to investigate the effectiveness of an existing food handler training program for improving safe food handling behaviors among high school students in Ontario, Canada. However, because no schools agreed to provide control groups, we evaluated whether behaviors changed following delivery of the intervention program and whether changes were sustained over the school term. We measured 32 food safety behaviors, before the intervention and at 2-week and 3-month follow-up evaluations by in-person observations of students ( n = 119) enrolled in grade 10 and 12 Food and Nutrition classes ( n = 8) and who individually prepared recipes. We examined within-student changes in behaviors across the three time points, using mixed effects regression models to model trends in the total food handling score (of a possible 32 behaviors) and subscores for "clean" (17 behaviors), "separate" (14 behaviors), and "cook" (1 behavior), adjusting for student characteristics. At baseline, students ( n = 108) averaged 49.1% (15.7 of 32 behaviors; standard deviation = 5.8) correct food handling behaviors, and only 5.5% (6) of the 108 students used a food thermometer to check the doneness of the chicken (the "cook" behavior). All four behavior score types increased significantly ∼2 weeks postintervention and remained unchanged ∼3 months later. Student characteristics (e.g., having taken a prior food handling course) were not significant predictors of the total number of correctly performed food handling behaviors or of the "clean" or "separate" behaviors, working or volunteering in a food service establishment was the only characteristic significantly associated with food thermometer use (i.e., "cook"). Despite the significant increase in correct behaviors, students continued to use risky practices postintervention, suggesting that the risk of foodborne disease remained.

An Economic Evaluation of Food Safety Education Interventions: Estimates and Critical Data Gaps

The economic evaluation of food safety interventions is an important tool that practitioners and policy makers use to assess the efficacy of their efforts. These evaluations are built on models that are dependent on accurate estimation of numerous input variables. In many cases, however, there is no data available to determine input values and expert opinion is used to generate estimates. This study uses a benefit-cost analysis of the food safety component of the adult Expanded Food and Nutrition Education Program (EFNEP) in Ohio as a vehicle for demonstrating how results based on variable values that are not objectively determined may be sensitive to alternative assumptions. In particular, the focus here is on how reported behavioral change is translated into economic benefits. Current gaps in the literature make it impossible to know with certainty how many people are protected by the education (what are the spillover effects?), the length of time education remains effective, and the level of risk reduction from change in behavior. Based on EFNEP survey data, food safety education led 37.4% of participants to improve their food safety behaviors. Under reasonable default assumptions, benefits from this improvement significantly outweigh costs, yielding a benefit-cost ratio of between 6.2 and 10.0. Incorporation of a sensitivity analysis using alternative estimates yields a greater range of estimates (0.2 to 56.3), which highlights the importance of future research aimed at filling these research gaps. Nevertheless, most reasonable assumptions lead to estimates of benefits that justify their costs.

Cold Chain and Consumers' Practices: Exploratory Results of Focus Group Interviews

The aim of this qualitative survey was to gain an insight into the ways consumers purchase, transport and storage fresh and frozen food. In particular, this paper considered consumers' behaviour and the knowledge they have about cold chain. An explorative study was held using focus group interviews (n. 4) as the method for data collection. The sampling group was composed of 24 consumers (4 males and 20 females) and the age ranged from 33 to 78. Data revealed that food safety knowledge is at a fairly good level, however consumer practices in certain cases were inappropriate particularly with respect to transport from the store to home, storage and thaw. Consumers were particularly concerned about frozen food that should not be thawed during shopping or transportation. Knowledge about eggs storage seemed to be dodgy as well. Due to the restricted extent of the sample survey the results cannot be generalized to the whole Italian population; still, this method is particularly useful for discovering not only what people think but why they think that way.