Raw Meat and Poultry-Specific Knowledge Gaps amongMeat and Poultry Chicago Restaurant Food Handlers

Patpong Udompat, MS, Li Liu, PhD, Mark S. Dworkin, MD MPH&TM University of Illinois at Chicago School of Public Health, Chicago, IL

k

Background

Objectives

MethodsWe analyzed data derived from a 41-question survey of 508 food handlers from 125 participating restaurants in Chicago. Only the 372 meat and poultry handlers were included in the analysis. The survey had true-false or multiple-choice format (incorrect responses or ”do not know” were assigned to 0) and included 13 questions specific to meat or poultry handling or cooking processes (Figure 1). Only these 13 meat and poultry-specific knowledge questions were analyzed to determine the knowledge score. For comparison, these 372 food handlers scored 72% overall on the general knowledge survey.The percentage of incorrect responses among meat and poultry handlers was compared and the frequency distributions of meat and poultry specific knowledge questions was determined.

Figure 1: Percentage of Incorrect Responses to Each Meat and Poultry-Specific Knowledge Question

Food Handler Characteristics N (%)

Gender Male 271 (73) Female 101 (27) Language English 183 (49) Spanish 163 (44)

Other 26 (7) Race/Ethnicity White 83 (23) Hispanic/Latino 205 (55) Black 50 (13) Other 33 (9) Education Lower high school 78 (21) High school 106 (28) Higher high school 188 (51) Certification

Yes and a manager 150(40) Certified, not manager 95 (26) Not certified, not manager 127 (34)Restaurant Characteristics of the Food Handlers Size Small 135 (36)

Medium 97 (26)

Large 140 (38)

Service Style Fast Food 111 (30)

Informal 161 (43)

Formal 100 (27)

Type of Cuisine American 220 (59)

Mexican 52 (14)

Italian 53 (14)

Other 47 (13)

Average Entrée Price <$10 215 (58)

$10-20 100 (27)

>$20 57 (15)

Table 1: Food Handler and Restaurant

Characteristics (N= 372)

Results DiscussionEven though we limited the subanalysis to meat and poultry handlers responses to meat and poultry-specific questions (and 66% of them surveyed were certified), the mean knowledge score (72%) was not substantially higher than the mean score using a more general food safety knowledge survey (72%).

There were also important knowledge gaps related to knowledge of proper storage of raw meat, appropriate defrosting of beef and poultry, and of cross contamination.

More than 1/3 of these food handlers did not know about the severity of illness that may result from eating incompletely cooked beef. This raises the concern that they may not appreciate the rationale for the recommendations for checking temperatures in a menu item such as meatloaf.

We recommend that local health departments should focus on educating meat and poultry handlers because almost 50% of food handlers and almost 35% of certified food handlers had a knowledge score below 70% .

Food safety certification should require a higher level of knowledge to be considered certified or more frequent verification that knowledge is retained with an emphasis on knowledge of proper storage, cooking temperatures, severity of illness, and prevention of cross contamination.

Acknowledgements•Palak Panchal, MPH•IDPH Division of Food, Drugs and Dairies and City of Chicago Health Department

Contact•Mark Dworkin, MD MPH&TMUniversity of Illinois at ChicagoDivision of Epidemiology and Biostatisticsmdworkin@uic.eduPatpong Udompat, PhD studentUniversity of Illinois at ChicagoDivision of Epidemiology and Biostatisticspudomp2@uic.eduResearch Funded By: Cooperative State Research, Education, And Extension Service (CSREES), US Department of Agriculture(Grant no. USDA 2008-01691)

Raw meat and poultry are potentially hazardous commonly handled and cooked foods in restaurants. In a knowledge survey of 508 restaurant food handlers performed in Chicago restaurants in 2009, the overall mean knowledge score was only 72%.However, this knowledge score may be underestimated because the survey included some questions that may not be relevant to each food handler’s specific duties. We analyzed knowledge data concerning meat and poultry food handling only among the subset of food handlers that work with meat and poultry.

The objective of this study was to determine if the knowledge score of food handlers would be much higher than previously recorded if the score was based only on questions relevant to their food handling duties.

Number of correct questions

0.0 0.3 0.31.1

3.0

5.9 6.5

14.015.6

20.4

15.914.3

3.0

0.0

5.0

10.0

15.0

20.0

25.0

1 2 3 4 5 6 7 8 9 10 11 12 13

Overall mean score= 72% (9.4 correct/13 questions)Standard deviation= 16%Range= 15%-100%

~ 50 % of food handlers scored below 70 %

Percent

3

7.5

9.1

16.1

16.4

16.9

24.5

30.1

31.2

36.8

56.2

65.3

45.4

0 20 40 60 80 100

Percent

Beef may be placed in the microwave to defrost (True)

Raw meat can be stored on foil-lined shelves to prevent dripping onto other foods (False)

Raw meat can be stored anywhere in a refrigerator as long as it is wrapped in plastic (False)

Eating ground meat that is not completely cooked can cause bloody diarrhea (True)

Raw meat can be stored below ready to serve food (True)

Beef may be placed in cold water to defrost (True)

It is safe to put frozen chicken breast on the counter to thaw (False)

Beef may be placed on the counter to defrost (False)

Vegetables for a salad splashed with a few drops of raw chicken juice should not be rinsed, but instead must be thrown away (True)

Beef may be placed in the refrigerator to defrost (True)

Uncooked beef is potentially contaminated with germs that can cause people to be hospitalized or die (True)

Raw meat can be stored above ready to serve food (False)

Uncooked chicken is potentially contaminated with germs that can cause people to become very ill (True)

Figure 2: Frequency Distribution of Meat and Poultry-Specific Knowledge Questionsamong Meat and Poultry Food handlers (N =372)

3.3 3.7

12.2

14.3

21.2

19.220.4

4.5

1.2

0.0

5.0

10.0

15.0

20.0

25.0

1 2 3 4 5 6 7 8 9 10 11 12 13

Figure 3: Frequency Distribution of Meat and Poultry-Specific Knowledge Questionsamong Certified Meat and Poultry Food Handlers (N= 245)

~ 35% of certified food handlers scored below 70 %

Overall mean score= 77% (10 correct/13 questions)Standard deviation= 13.8%Range= 38%-100%