Professional Documents
Culture Documents
GRADUATE SCHOOL
Iloilo City
Kendrick A. Callao
Chapter 1
Introduction to the Study
This chapter is divided into five parts: (1) Background and Theoretical
Framework of the Study, (2) Statement of the Problem and the Hypotheses,
(3) Significance of the Study, (4) Definition of Terms, and (5) Delimitation of the Study.
Part One, Background and Theoretical Framework of the Study, outlines the
reasons for choosing the problem and theoretical framework upon which the study was
anchored.
Part Two, Statement of the Problem and the Hypotheses, identifies the main and
specific problems of the research and the hypotheses tested.
Part Three, Significance of the Study, cites the benefits that may be derived from
the results of the investigation.
Part Four, Definition of Terms, defines the important terms used in the study, both
conceptually and operationally.
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Iloilo City
Part Five, Delimitation of the Study, specifies the scope and coverage of
the study.
Background and Theoretical Framework of the Study
Food safety regulation in its current form has been part of the Philippine
landscape for decades. In 1976, the Code of Sanitation of the Philippines was passed and
just recently in September of 2013 the Food Safety Act of 2013 was signed by the
president. Both of these events were triggered by concerns with unsafe food products;
concerns which have persisted throughout the years as the food industry and consumers
are faced with food scares on a regular basis (DOH, 2011).
The Food and Drug Administration began to collect baseline data of food safety
practices in foodservice operations. The report of the FDA Retail Food Program Database
of Foodborne Illness Risk Factors was released in 2006 and focused in and explored
major risk factors that are attributed to foodborne diseases (FDA, 2004). The report
indicated that full-service restaurants were 40% out-of-compliance with overall food code
standards. Fast food restaurants were slightly better, with an overall out-of-compliance
rate of 26%. These out-of-compliance rates are higher than other noncommercial food
establishments such as hospitals, nursing homes, and elementary schools. In full-service
restaurants, the most frequent out-of-compliance practices included cooling potentially
hazardous foods to 70oF within two hours (85%), adequate hand washing (81%), and
holding potentially hazardous foods at 41oF or below (81%). The report identified 15
practices that were in need of priority attention, the most of any operation. The most
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common out-of-compliance practices in fast food restaurants included ready-toeat, potentially hazardous foods held for more than 24 hours (71%), holding potentially
hazardous foods at 41oF or below (62%) and prevention of hand contamination (58%)
(FDA, 2004). All of the top practices that are out-of-compliance in both fast food and
full-service restaurants are directly related to employee food safety knowledge, attitude,
and on-the-job practices of foodservice food handlers. Thus, these information and
findings motivated the researcher to conduct this study.
This study is anchored on Nightingales environmental theory of sanitation. This
theory stresses that good sanitation has a great impact on a persons health. One of the
fine essential elements according to Nightingale is good sanitation. The theory also
emphasizes that the main cause of any disease is the poor environment condition, and, to
be able to improve the environment, the people must learn to practice good sanitation in
every part of the globe. Likewise, proper health planning and environmental strategies
must be implemented in order to live a healthy and blissful life (Pescadera, 2013)
The theory of reasoned action (Ajzen and Fishbein, 1980) was also considered in
the study. This theory stresses that a person's attitude toward a behavior consists of a
belief that a particular behavior leads to a certain outcome and an evaluation of the
outcome of that behavior. If the outcome seems beneficial to the individual, he or she
may then intend to or actually participate in a particular behavior. Also included in one's
attitude toward a behavior is the concept of the subjective norm. People may also be
inclined (or not inclined) to participate in a behavior based upon their desire to comply
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with others. Laws or rules prohibiting a behavior may have an impact on one's
attitude toward participating in a behavior. Ultimately, one's attitude toward a behavior
can lead to an intention to act (or not to act as the case may be). This intention may or
may not lead to a particular behavior.
In this perspective, this study aimed to find out the attitude towards food safety
and sanitation of food handlers and the level of regulations compliance of fast food
restaurants.
Figure 1 shows the conceptual framework.
INDEPENDENT VARIABLE
DEPENDENT VARIABLE
Personal factors
Sex
Age
Educational
qualification
Industry
experience
Job position
Attitude towards
food safety and
sanitation
Restaurant size
Number of
food handlers
Restaurant type
Figure 1. Attitude towards food safety and sanitation and food safety and sanitation
regulations compliance as influenced by certain identified factors.
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Iloilo City
Statement of the Problem and the Hypotheses
This study aimed to ascertain the attitude of food handlers towards food safety
and sanitation, and the compliance of fast food restaurants to regulations on safety and
sanitation.
Specifically, the study aimed to answer the following questions:
1. What is the attitude of food handlers of fast food restaurants towards food
safety and sanitation when they are taken as an entire group and classified according to:
(a) sex, (b) age, (c) educational qualification, (d) industry experience, and (e) job
position?
2. What is the level of compliance to regulations of fast food restaurants taken as
entire group and classified according to: (a) restaurant size, (b) number of food handlers,
and (c) restaurant type?
3. Are there significant differences in the attitude of food handlers of fast food
restaurants towards food safety and sanitation when they are classified according to: (a)
sex, (b) age, (c) educational qualification, (d) industry experience, and (e) job position?
4. Are there significant differences in the level of compliance to regulations of
fast food restaurants classified according to: (a) restaurant size, (b) number of food
handlers, and (c) restaurant type?
5. Is there a significant relationship between the food handlers attitude towards
food safety and sanitation and the fast food restaurants compliance to regulations?
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They may also be aware of the extent of practical training they will apply so that
the students will have ample knowledge and expertise in food handling.
Future researchers. Future researchers may use this study as a springboard of
related problems they will investigate in the future.
Delimitation of the Study
This is a study on the attitude of food handlers of selected fast food restaurants in
Iloilo city towards food safety and sanitation and the compliance of selected fast food
restaurants to food safety and sanitation regulations. The study was conducted during the
second semester of academic year 2013-2014 using the survey-correlational research
design.
To gather data on the attitude towards food safety and sanitation and the
regulations compliance of selected fast food restaurants, the researcher utilized two (2)
data gathering instruments, the Sneed and Lin (2010) questionnaire on the attitudes of
food handlers towards food safety and the Sanitary Inspection of Food Establishment
Compliance Form (2012) of the Iloilo City Health Office.
The participants of the study were the 200 food handlers of randomly selected fast
food restaurants in Iloilo city. The food handlers were taken as an entire group and
classified according to (a) sex, (b) age, (c) educational qualification, (d) industry
experience, and (e) job position. The participants were selected through two-stage
sampling.
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The statistics that were employed in this study were frequency,
percentiles, mean, standard deviation, t-test, one-way ANOVA, Scheffe test, Kruskal
Wallis, Mann Whitney and Pearsons r. The data gathered for this study were subjected
to a certain computer-processed statistics. The .05 alpha level was used as the criterion
for the acceptance and rejection of the null hypotheses.
Definition of Terms
For clarity and better understanding of this study, important terms
used were given their conceptual and operational meanings:
Fast food restaurants--is a specific type of restaurant characterized both by its
fast food cuisine and by minimal table service (Sarda, 2013).
As used in this study, fast food restaurants referred to selected fast food
establishments in Iloilo city.
Food safety--is a scientific discipline describing handling, preparation, and
storage of food in ways that prevent foodborne illness (Ang & Balanon, 2010).
The same meaning was used in the study.
Food sanitation--is the hygienic measures for ensuring food safety (McSwane,
Rue & Linton, 2005).
The same meaning was used in the study.
Attitude--is a state of mind, feeling or disposition (McShane, 2010).
As used in this study, attitude referred to the viewpoint of selected fast food
restaurant food handlers in Iloilo city on food safety and sanitation.
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Regulation--a rule designed to control the conduct of those to whom it
applies; regulations are official rules and have to be followed (Morris, 2008).
As used in this study, regulation referred to the mandatory requirement for
sanitary inspection implemented by Iloilo City Health Office on food establishments
Compliance--is the act or process of complying to a desire, demand, proposal, or
regimen or to coercion (Morris, 2008).
As used in this study, compliance referred to the observance of mandatory
requirements by selected fast food restaurants for sanitary inspection as implemented by
Iloilo City Health Office.
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Chapter 2
Review of Related Literature
This chapter presents literature and studies relevant to the present study. It is
divided into four parts: (1) Food Safety and Sanitation, (2) Fast Food Restaurants, (3)
Attitude and Compliance, and (4) Summary.
Part One, Food Safety and Sanitation presents literatures related to food safety
and sanitation, most of which deals with the proper practices and some implications of
malpractice.
Part Two, Fast Food Restaurants, includes studies and topics relevant to fast food
restaurants.
Part Three, Attitude and Compliance, lists related studies on attitude and
compliance of food service establishments.
Part Four, Summary, recapitulates the important ideas, studies and literature.
Food Safety and Sanitation
Food is a product that is rich in nutrients required by microorganisms and may be
exposed to contamination with the major sources from water, air, dust, equipment,
sewage, insects, rodents and employees (Ang & Balanon, 2010). Due to the changes in
food production, handling, preparation techniques, as well as eating habits, the fact
remains that food is the source for microorganisms that can cause illness. The US Centers
for Disease Control and Prevention (CDC, 2010) revealed that the outbreaks of
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foodborne diseases which resulted from foods of animal origin had caused
approximately 76 million illnesses, 325,000 hospitalizations and 5000 deaths each year.
Data obtained from UK and USA suggest that 2040% of such illnesses are associated
with the consumption of contaminated food where catering establishments are the most
frequently cited sources of sporadic and outbreak foodborne infection. The common food
handling mistakes besides serving contaminated raw food also include inadequate
cooking, heating, or re-heating of food, consumption of food from unsafe sources,
cooling food inappropriately, and allowing too much of a time lapse.
Food safety has become an issue of special importance for the retail food industry.
There are many opportunities for food to be contaminated between production and
consumption (Ang & Balanon, 2010). Food safety is especially critical in retail food
establishments because this may be the last opportunity to control or eliminate the
hazards that might contaminate food and cause foodborne illnesses. (Ang and Balanon,
2010). Even when purchased from inspected and approved sources, ingredients may be
contaminated when they arrive at the food establishment. It is important to know how to
handle these ingredients safely and how to prepare food in such a manner that the risk of
contaminated food being served to clients or customers is reduced.
Most cases of food poisoning happen in foodservice establishments and usually
afflict a great number of people. Commercial food service establishments have been
identified by the Center for Disease Control as the leading source of foodborne illness
outbreaks (Bean et al., 2006). Statistics show that in the Philippines, the second highest
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spread bacteria and other diseases. That is why, it is of the utmost importance
that employees wash their hands. Fast food restaurants should have at least one sink
designated for hand washing only, with properly posted instructions, and including the
necessary soap, and paper towels. Wearing gloves when in contact with food helps as
added protection, but even gloves can touch unclean surfaces just like hands can, so they
need to be changed after coming into contact with unsanitary surfaces and items.
A safe working environment and sanitary atmosphere in the food service industry
are always important (Gonzales & Sandique, 2007). Two terms frequently assumed to be
one and the same are cleaning and sanitizing, but they have the same significant
differences. They reported that to damage the good name and image of an establishment,
an outbreak of illness can be expensive. There are possible legal costs combined with loss
of revenue that may force an establishment to close.
Alvarez (2010) asserted that food industry consists of food establishments
involved in the production, manufacture, transport and distribution of food. Food
production involves the activities taking place in farms, ranches, orchards and in fishing
operations. Food manufacturing includes the harvest of raw materials and converts them
into forms suitable for distribution. In addition, food processes must ensure food safety to
prevent food poisoning, spoilage and food borne diseases. It is imperative to practice
food safety by controlling the supply, maintaining sanitary facilities and training the
employees to work observing food safety. Therefore, refrigeration before the preparation
of foods is necessary to keep the foods internal temperature within the safe range. There
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should be separate areas for raw and cooked foods or meat and vegetable and
fruits. Likewise separate chopping boards must be used for raw and cooked foods.
Sanitized utensils and cutting boards must be used for raw and cooked foods. Sanitized
utensils and cutting boards should always be used to avoid cross-contamination, (Maya
Kitchen Culinary Arts Center, 2007).
The word food safety (Roldan & Edica, 2008) covers practices to: prevent the
growth and multiplication of bacteria; prevent food from contamination of bacteria, toxin
and other harmful substances; prevent food spoilage; prevent occurrence of food
poisoning and infection as well as the spread of disease; and retain nutritional and
aesthetic qualities of food. Food safety in food establishment is assured when all the
conditions of bacterial growth are controlled. This is done through time and temperature
control, proper housekeeping maintenance, proper maintenance of cooking or serving
equipment and facilities and consistent compliance to standards of hygiene, sanitation
and food safety.
Similarly Lee (2010) believes that food safety has increasingly gained the
attention of authorities worldwide from the cases of food borne outbreaks. An increase in
the diseases related to food borne illnesses has been seen from 2005 to 2008 in Malaysia.
Occurrence of food borne illnesses can be attributed to many factors, one of it is the
handling process of food preparation especially by food handlers. This is because hand
can be a vector of dissemination of pathogens through cross contamination. The Good
Hygiene Practices describes all practices regarding the conditions and measures
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necessary to ensure the safety and suitability of food at all stages of the food
chain, which is an important process that will eventually lead to the safety in the kitchen.
It covers proper storage of food items, maintenance of clean environment during food
preparation and assurance of all dishes served are clean and free of bacteria that can
potentially cause further contamination and prevent food borne illnesses.
Foodborne illnesses according to Scott and Herbold (2010) pose a problem to all
individuals but are especially significant for infants, the elderly, and individuals with
compromised immune systems. Personal hygiene is recognized as the number-one way
people can lower their risk. The majority of meals in the U.S. are eaten at home. Little is
known, however, about the actual application of personal hygiene and sanitation
behaviors in the home.
Roldan and Edica (2008) asserted that cases of foodborne diseases can cause
irreparable damage to the reputation of a food establishment. One single case of food
poisoning can already discourage diners from coming back to the restaurant or canteen. A
hygienic food handler can be an instrument in transmitting bacterial contamination and
food borne disease. It is therefore important for every server to understand and practice
the rules of safety in handling and serving food. Food borne diseases come from bacteria
or microorganisms. These are tiny, living and active being that rapidly multiply in
numbers under the right conditions. For example, when a kitchen or dining area is not
properly maintained in terms of cleanliness and sanitation, it becomes vulnerable to the
growth and multiplication of microorganisms or bacteria as well as pests. When this
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happens, diners suffer from typhoid fever, hepatitis and other related diseases. In
addition, bacteria breeds in unsanitary, moist and slightly acidic environment like: dirty
surroundings, wet, undisposed and uncovered garbage, stagnant and dirty water, crowded
places like storerooms that are dirty, undisposed, uncovered left-over foods and dirty and
unsanitized containers, pans and utensils.
Foodborne illness or disease is a disease carried or transmitted to people by food.
Payne and Theis (2006) further discussed that a more inclusive statement defines food
borne illness as any illness or injury that results from something that has been eaten. Any
food that is not fit for human consumption is spoiled. A spoiled food, however, does not
necessarily have the potential to cause foodborne illness. Conversely, an unspoiled food
is not necessarily safe to eat. Any food containing dangerous levels of microorganisms,
toxins, chemical or physical contaminants, has the potential to cause food borne illness.
Foodborne illness or disease is a disease carried or transmitted to people by food. A more
inclusive statement defines foodborne illness as any illness or injury that results from
something that has been eaten.
Galvez (2007) believes that foodborne disease is caused by the consumption of
food items that are contaminated by dangerous microorganisms also known as germs of
microbes. This simply means that food borne illness is an illness that is carried by the
food. This often referred as food poisoning by many professionals in the hotel and
restaurant industry. Nevertheless, this term does not only constraint to a contaminated
food but as well to contaminated beverages. Therefore, a person suffering from
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foodborne illness may experience the symptoms like diarrhea, vomiting, nausea,
muscle cramps, stomach ache, body weakness and dehydration.
Microorganism that cause food borne illness cannot travel on their own and
contaminate food, but the microorganisms are transferred through the food via a process
of cross contamination. For example, if an infected worker touches or get into contact
with a food, he/she contaminates it. Although, cross contamination from an infected
person may not be the only way that a food item may be contaminated, they could also be
contaminated through the following: exposed to unsafe temperature for a long period of
time, improper packaging of food items, poor hygiene and sanitation during the
preparation of the food, improper reheating of food, and unsafe sources and suppliers.
Cushman (2007; cited in Dirks, 2010), reported that foodborne illness outbreaks
are on the rise and food safety continues to be a major concern since foodborne illnesses
have potentials to attack patrons through a variety of ways. In a study conducted by
Hedberg et al. (2006) to investigate the differences between outbreak and non-outbreak
restaurants, researchers found that Norovirus, a RNA virus known for gastroenteritis
outbreaks and is transmitted fecally, was confirmed or suspected in 42% of all restaurant
food borne illness outbreaks. Bacteria Salmonella and Clostridium perfringens were the
next common microorganisms found in outbreaks that accounted for 19% of identified
outbreaks and suspected in 28% of outbreaks. Furthermore, the contributing factors of
these outbreaks were infected employees who handled food and bare-hand contact with
food.
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job and a basis principle in planning foodservice facilities for efficient operation
is the assembly line concept, which patterned traffic for receiving, storing and sanitation
of the features of the setup are the purpose that must be kept in mind then planned the
detailed arrangement within the food service area.
Restaurants and other retail and institutional foodservice operations have become
an integral part of todays society because dining out or purchasing food to-go or readyto-prepare has become routine for most Americans. The National Restaurant Association
(NRA, 2005) reports that more than 70 billion meal and snack occasions will be eaten
daily in restaurants and cafeterias in 2008. Given the number of people who dine out, the
potential for foodborne illness resulting from food prepared in commercial foodservice
operations is great. Therefore, foodborne illness and disease should be a significant
concern for those who manage and own foodservice operations.
The Center for Disease Control and Prevention (CDC, 2010) has estimated that
foodbornerelated illnesses cause approximately six to 76 million illnesses, 325,000
hospitalizations, and approximately 5,000 deaths each year in the United States (Mead, et
al, 2007). Both known and unknown agents attribute to the wide estimate range. Between
2003 and 2007, 50% of the illnesses caused by foodborne illness outbreaks were
associated with food consumed in restaurants and other commercial food establishments.
Some of these foodborne illnesses are mild and result in 24-hour flu-like symptoms, but
many other cases have been severe enough to require hospitalization or cause death.
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The top three factors that contribute to foodborne illnesses are improper
holding temperatures, poor personal hygiene, and cross contamination. All of which are
directly related to the food handlers knowledge of food safety (Food and Drug
Administration, 2004). Previous research has suggested that food safety training is a way
to assure that proper practices are followed in restaurants, although research relating
knowledge to behavior change has been inconsistent. Studies have found that food safety
training is effective in increasing overall sanitation inspection scores in the
microbiological quality of food and self-reported changes in food safety practices
(McElroy & Cutter, 2004). Several states now mandate food safety certification for
restaurant employees. In 2002, Schilling, OConnor, and Hendrickson reported that 16
states have state-mandated certification requirements and 34 states have some form of
voluntary requirements. Several states were in the process of adopting the 2002 food code
which requires operations to have at least one employee who can demonstrate knowledge
about food safety.
Foodborne diseases remain a major public health problem across the globe. The
problem is more severe in developing countries because of lack of personal hygiene and
food safety measures. As much as 70% of diarrheal diseases in developing countries are
believed to be of foodborne origin. Foodborne disease outbreaks in hospitals have
affected patients, staff, and visitors. Mishandling food promotes pathogen growth and
disease, especially among patients with weakened immunity or achlorhydria. Although
providing safe food to patients who are at risk of getting infections is a major duty of
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high quality meals for students, catering services need to follow the regulations
set forth by the Health Surveillance Committee. Despite the existence of specific
regulations, the safety measures taken during school meal preparation are still inadequate,
as most schools do not take into consideration the specific sanitary requirements needed
for the various stages of food preparation (Santana, Almeida, Ferreira, & Almeida, 2009)
Good personal hygiene and sanitary handling practices at work are an essential
part of any prevention program for food safety. Although the majority of food handlers
have the skills and knowledge to handle food safely, human handling errors have been
implicated in most outbreaks of food poisoning (Todd, Bartleson, & Michaels, 2007).
The inappropriate handling of foods by the food service industry has been implicated in
97% of food poisoning cases (Greig, Todd & Bartleson, 2007). There is no indication that
food-borne illnesses are diminishing.
Staphylococcus aureus is considered the third most important cause of food-borne
diseases in the world (Normanno, 2005). There are two major aggravations to its
presence: the toxins production and antimicrobial resistance. S. aureus produces eatstable
enterotoxins with demonstrated emetic activity (SEs; SEA to SEE, SEG to SEI, SER to
SET). According to the authors, SEs are a main cause of food poisoning that occurs after
ingestion of foods contaminated with S. aureus by improper handling and subsequent
storage at elevated temperatures. Symptoms are of rapid onset and include nausea and
violent vomiting, with or without diarrhea. The illness is usually self-limiting and only
occasionally it is severe enough to warrant hospitalization (Argudn, Mendoza, &
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country level (WHO, 2004). Estimates of the burden of foodborne disease are
complicated by the fact that very few illnesses can be definitively linked to food. Often
these links are only made during outbreak situations (Flint, Scott & Bloomfield, 2005).
The ultimate goal for public health and food safety officials is not just stopping
foodborne disease outbreaks once they occur, but preventing them from happening in the
first place. Long-term prevention of foodborne outbreaks takes the actions of many
partners in the food production chain, stretching from farm to table (CDC, 2010)
Dr. Bryan (2004) reviewed the food handling errors that led to foodborne illness
outbreaks reported to the Centers for Disease Control (CDC) between 2001 and 2002 and
divided them into the following categories: failure to properly cool food, failure to
thoroughly heat or cook food, infected employees who practice poor personal hygiene at
home and at the workplace, foods prepared a day or more before they are served, raw,
contaminated ingredients incorporated into foods that receive no further cooking, foods
allowed to remain at bacteria-incubation temperatures, failure to reheat cooked foods to
temperatures that kill bacteria, cross-contamination of cooked foods with raw foods, or
by employees who mishandle foods, or through improperly cleaned equipment. The
factors listed above can be divided into the following broad categories: contaminated
ingredients, temperature control, personal hygiene, cross contamination, and sanitation.
In a recent review of foodborne illness outbreaks in foodservice (Greig, Todd &
Bartleson, 2007) an international group of food safety researchers reported 816 outbreaks
linked to food handler practices, resulting in 80,682 cases of foodborne illness. In the
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review, nearly 60% of food handler-related outbreaks were due to two specific
pathogens often liked to hygiene issues: norovirus and Salmonella. Despite the
investment and focus on training, researchers suggest that the impact of food handler
training programs is inconsistent and program evaluation is rarely conducted. Ideally,
food safety in foodservice establishments begins with managers who are knowledgeable
about the following: where contaminants exist, how they transfer to food, the steps to
control or eliminate hazards.
In a 2007 study (Pragle, Harding & Mack, 2007), researchers at Oregon State
University explored factors that prevented food handlers from practicing good personal
hygiene. Through focus groups, participants reported time pressures; inadequate facilities
and supplies; lack of accountability; lack of involvement of managers and coworkers; and
organizations not supportive of food safety as barriers to employing good personal
hygiene.
The U.S. Centers for Disease Control has been recently calling on food safety
communicators to design new materials aimed at increasing food safety risk reduction
practices from farm-to-fork. This priority was echoed at the Food Safety Inspection
Service/NSF food safety education conference in March 2010: new messages and media
are needed as the traditional communication tools arent getting the job done.
Ignorance, carelessness, and indifference on the part of food handlers result in
insanitary conditions. Poor practices may be found even in establishments where
considerable investment has been made in modern equipment. All food handlers should
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As the complexity of the food system grows, new safety challenges arise.
Along with the variety of food products may come a variety of biological, chemical and
physical hazards. Because of this, food production, distribution and preparation have
come under intense scrutiny from government agencies, from consumers and from the
industry itself (Berkoff, Allard, Arcand, Brazel, Joliffe & Choleva, 2008).
Providing safe food begins during the hiring process (FDA, 2004). Studies show
that many cases of foodborne illnesses can be linked directly to the lack of attention to
personal hygiene, cleanliness, and food handling procedures. The Center for
Communicable Disease issued a list of infectious and communicable diseases that are
often transmitted through food prepared by infected food handlers. Examples of
biological agents that cause these diseases are Hepatitis A virus, Salmonella typhi and
Norwalk-like viruses.
The presence of hair in food indicates unhygienic food preparation. Food handlers
must wear a hair restraint at all times to prevent hair from falling into the food. Common
hair restraints include nets, bonnets, and caps. Wearing a hair restraint also eliminates the
contact of the hands with the head, thereby preventing contamination such as: a hair
restraint must be worn before hand washing and working and a hair restraint must be
properly worn and should not let a single strand of hair show.
Work clothes that include a kitchen uniform and an apron must be worn inside the
kitchen. Street clothes should never be worn to work as they may be sources of
contamination. Apron helps reduce the transfer of microbes to exposed food.
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may be spread indirectly by hands freshly soiled by respiratory discharges.
These can be avoided by washing the hands after coughing or sneezing and after shaking
hands with an individual who has been coughing or sneezing.
Diseases may also be acquired when hands are contaminated with urine, saliva or
other moist body fluids. Microorganisms which may be transmitted by these body
substances include cytomegalovirus, staphylococcal organisms, and the Epstein-barr
virus. These germs may be transmitted from person-to-person or indirectly by the
contamination of food or inanimate objects such as toys.
As explained by McSwane, Rue, Linton, & Williams (2004), controlling
temperature of food cooked is vital in assuring that food service establishment complies
with food safety regulations. Food borne illness may be resulted from temperature abuse
while preparing a dish. Time temperature abuse occurs when food has been allowed to
stand for an extended period of time at temperatures favorable to bacterial growth.
Mcswane et al further added that the abuse of temperature also may be caused by
insufficient amount of cooking or reheating time and desired temperatures that should
eliminate the existence of harmful microorganism. The usage of devices in measuring
food temperature such as thermometers, thermocouples and infrared reading is essential
in determining whether the fod were in the danger zone or otherwise (McSwane et al.,
2004). Nott and Hall (2003) explained that the major purpose of cooking is to increase
the palatability of food, the heating of many foods is essential to kill bacteria thereby
increasing the foodstuffs safety and storage life. In practice, pasteurization and other
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sterilization processes require stringent assurance that all parts of the food
product have been heated above a certain temperature for a defined period of time (Nott
and Hall, 2003). Several studies have reported that poor holding and cooking
temperature control was a main factor contributing to food borne outbreaks (Todd, 1997).
Improper holding temperature of food can also contribute to the growth of certain
bacteria through its spores because not all of these spores will be destroyed with heating
processes (McSwane et al., 2004). Thus it is important for all food handlers to recognize
their responsibilities in ensuring that all food prepared were monitored in every stage of
its preparation.
Potentially Hazardous Food (PHF) is any food capable of allowing germs to grow
rapidly (Wiley, 2007). PHFs have the potential to cause food borne illness outbreaks.
They are usually moist, have lots of protein and dont have very high or very low acidity
(neutral acidity). Adding lemon juice or vinegar to foods slows the growth of the germs.
Potentially hazardous foods requires strict time and temperature controls to stay safe.
Food has been time/temperature abused anytime it has been in the temperature danger
zone (41oF to 135oF or 5oC to 57.2oC) for too long. Potentially hazardous foods must be
checked often to make sure that they stay safe. The caution sign includes a clock and
thermometer to stress the importance of monitoring time and temperature. The clock is
the reminder to check food at regular time intervals. The thermometer required must be
properly calibrated, cleaned and sanitized.
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The hands of food service food handlers can be vectors in the spread of
food-borne disease, mainly because of poor personal hygiene and cross-contamination
(Ehiri and Morris, 2006). It was reported in 2009 by Guzewich and Ross that in 89 % of
outbreaks caused by food contaminated by food handlers, pathogens were transferred by
workers hands. More recently, Strohbehn, Sneed, Peaz, & Meyer (2008) found in two
US Food and Drug Administration studies (FDA), that inadequate hand washing practices
by workers occurred in all types of retail food services. Inadequate hand washing was
found to be a contributory factor in 31 % of outbreaks occurring in Washington State
from 1990 to 1999 (Todd et al., 2009).
Proper hand washing was defined by the FDA Food Code for retail
establishments (2007) as an activity lasting for at least 20 seconds involving the use of
warm running water, soap, friction for 10 to 15 seconds, rinsing and drying with clean
towels or hot air. This procedure is described slightly differently in other sources and
may include a single or double wash process, depending on the activity prior to hand
washing (Sprenger, 2008). A single wash would involve using friction and soap only
while the double wash would require the use of a nail brush before re-washing with
friction. Strobehn et al. (2008) found that the correct procedure for hand washing was not
used consistently and rates of compliance ranged between 0 % and 100 %, even in frail
care and child care facilities. In another study, hand washing was reported as more likely
to occur in restaurants where workers had food safety training (Green, Selman, Baneijee,
Marcus, Medus, & Angelo, 2006). It has also been found that the hand hygiene practices
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Additionally, reducing or eliminating cross contamination will also prevent
contamination. Different bacteria have different temperatures that they need to thrive.
These temperatures can range from as low as freezing to as high as 200 (93.3 C) degrees
Fahrenheit. Most bacteria however thrive in the temperatures close to a human body's
temperature of 98.6 (37 C) degrees Fahrenheit. The food industry often refers to the
temperature range between 41 (5 C) and 135 (57 C) degrees Fahrenheit as the food
temperature danger zone or that range of temperature when most foodborne
microorganisms will rapidly grow. As food moves through the cooking, cooling and
storage stages it must pass through this zone as quickly and safely as possible. Time,
temperature, cleanliness and cross contamination are all key to keeping food safe during
these stages (CDC, 2010).
The Training Manual of National Environmental Health Association (2010) has
indicated that costs associated with preventing foodborne contamination at a restaurant
include providing employees with the proper training, equipment and tools they need to
avoid contamination. Businesses that fail to prevent foodborne disease run the risk of
losing the trust of its customers, jeopardizing its business and preventing it from
remaining competitive. If food is not cooked, cooled, and stored properly, foodborne
disease is not prevented which may lead to loss of reputation or customers. It could
additionally lead to lower profits, fines, lawsuits, and even closure of the business. One
example of one outbreak severely affecting a restaurant due to food contamination
happened in 2003 in Pittsburgh, Pennsylvania. A Chi-Chi restaurant customer contracted
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hepatitis and as a result had to have a liver transplant. The illness was traced
back to the restaurant and the customer received a settlement of $6.25 million. Failure to
meet food safety regulations, legislation and inspections could cause the establishment to
incur additional costs to correct citations. From a fiscal standpoint foodborne disease
costs in the United States are $152 billion per year according to a report from the Pew
Charitable Trust. The World Health Organization reports that in industrialized countries,
the percentage of the population suffering from foodborne diseases each year has been
reported to be up to 30%. Clearly preventing foodborne disease should be an
establishment's highest priority from both a monetary and moral viewpoint.
According to McSwane et. al. (2004), bacteria can survive as a result of
inadequate cooking. They can also multiply with prolonged cooking at low temperatures
and bacterial spores can even survive boiling. Examples of some virulent bacteria that
can be a problem in the cooking stage are Staphylococcus Aureus, Salmonella and
Bacillus Cereus. All can cause nausea, vomiting and cramping and can be avoided by
cooking food according to proper times and temperatures, preventing cross contamination
and using proper hand washing techniques. Symptoms from illnesses caused by these
bacteria starts anywhere from 30 minutes and lasting a day as in the case with Bacillus
Cereus to starting as late as 48 hours after contact and lasting three days as in the case of
the Staphylococcus Aureus bacteria. E. coli 0157:H7 is another trouble causing bacteria
that can cause diarrhea and kidney failure and can be prevented with the use of proper
sanitization methods. E. coli symptoms can show up as late as 72 hours and last for up to
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three days. Viruses, such as Hepatitis A and Norovirus, cause fever, nausea,
vomiting and cramping and can be transmitted during the cooking process by cross
contamination and poor hygiene. Norovirus symptoms appear in approximately 48 hours
and can last two days. Hepatitis A symptoms do not appear until 15 to 50 days after
contact and can last anywhere from several weeks to several months. This long period
before symptom onset makes tracing contamination difficult. Parasites such as Anisakis
spp. and Cyclospora cayentanensis can be transmitted to customers through poor hygiene
and uncooked or under cooked foods and also cause vomiting and diarrhea respectively
(CDC, 2010).
Bacteria & viruses can thrive in dry storage and survive in refrigerated storage.
Bacteria can multiply in refrigerated storage if the temperatures are too high or if foods
are allowed to spoil. Many have the misconception that freezing kills bacteria. In fact
freezing simply keeps bacteria from multiplying. Once food is thawed the bacteria is able
to grow once more. In dry storage bacteria can multiply if food becomes damp. Viruses
such as Hepatitis A can be spread from infected people to produce, salads and ready-toeat foods. Other storage related contamination problems include pests. Pests can carry
bacteria and viruses such as Salmonella, the Poliomyelitis virus and the Hantavirus. As
described previously Hepatitis A symptoms include nausea, vomiting, diarrhea and fever
while Salmonella symptoms include fever, diarrhea and cramps. Hantavirus victims may
feel fatigued, run a fever and experience muscle cramps. The Poliomyelitis virus causes
headache, fever and vomiting (McSwane et al., 2004). Refrigerated foods are stored in a
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contracted the E.coli bacteria from under cooking hamburger meat. One of the
victim's kidneys shut down as a result of the infection. Another report stated that in 1993
there were over 500 confirmed illnesses with four deaths from an E.coli outbreak
associated from eating undercooked hamburgers from just one restaurant chain. The only
safe method to determine if a food is cooked is to take its internal temperature with an
accurate thermometer. Accurate probe and bi-metal thermometers are effective tools to
prevent undercooking (WHO, 2004).
HACCP is an internationally recognized food safety assurance system that
concentrates prevention strategies on known hazards; it focuses on process control, and
the steps within that, rather than structure and layout of premises. HACCP establishes
procedures whereby these hazards can be reduced or eliminated and requires
documentation and verification of these control procedures. Whilst HACCP has been
widely adopted by the food manufacturing industry and the larger companies in the
hospitality and catering sector, there have been concerns about implementation by
smaller businesses. Barriers to the implementation of HACCP in small businesses have
been identified which include lack of expertise, absence of legal requirements, fnancial
constraints and attitudes (WHO, 2009).
According the the Center for Disease Control and Prevention (2010), poor
hygiene has also been linked to outbreaks of foodborne disease. The Center for Science
in the Public Interest or CSPI reported that one Salmonella outbreak at one quick service
restaurant sickened thirty-eight people and may have killed one. The cause was
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also known as pathogens, enter the food and water supply, they can cause foodborne illness and even death. Spoilage bacteria can cause foods to smell and taste bad.
Moreover, these bacteria can be harmful, but probably will not cause illness. Diseasecausing bacteria are more serious because they usually do not make the food smell or
taste bad, but they can cause illness. Furthermore, the food-borne infections are due to
pathogenic organisms.
Each hand washing sink must be provided with hand cleanser (soap or detergent)
in a dispenser and a suitable hand-drying device. Hand sanitizing lotions and chemical
hand washing/ Proper washing helps to remove visible hand dirt and the microorganisms
it contains. Hand sanitizing lotion must never be used as a replacement for hand washing.
Epidemiological research has indicated that the majority of reported foodborne
illness outbreaks originate in food service establishments and case control studies have
shown that eating meals outside the home is a risk factor for obtaining a foodborne illness
In addition, research on foodborne illness risk factors has indicated that most outbreaks
associated with food service establishments can be attributed to food workers improper
food preparation practices, and observation studies have revealed that food workers
frequently engage in unsafe food preparation practices. These findings indicate that
improvement of restaurant workers food preparation practices is needed to reduce the
incidence of foodborne illness. Food worker intervention programs are needed to effect
this improvement. However, health researchers have argued that an understanding of
current practices and factors affecting those practices is necessary before behavior change
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Bagel Bakeries recently contracted with sanitation experts to help establish high
standards and audit company and franchised units for compliance (Nations Restaurant
News, 2005).
Food safety and sanitation is an important public health concern. In the United
States, it is estimated that 76 million illnesses, 325,000 hospitalizations, and 5,000 deaths
are attributed to foodborne illness each year. The annual cost of foodborne illness is
estimated to be from $10 to $83 billion. For some individuals, foodborne illness may
result in a mild, temporary discomfort. Because older adults are a highly susceptible
population, foodborne illness may have serious or long-term consequences, and may be
life threatening. Older adults are vulnerable to foodborne illness for several reasons.
They have weakened immune systems. As part of the aging process, the ability of their
immune system to function at normal levels decreases. A decrease in the level of diseasefighting cells is a significant factor in making the average older adult highly susceptible
to harmful microorganisms in food. They have inflammation of the stomach lining and a
decrease in stomach acid: The stomach plays an important role in limiting the number of
bacteria that enter the small intestine. During the natural aging process, an older persons
stomach tends to produce less acid. The decrease or loss of stomach acidity increases the
likelihood of infection if a pathogen is ingested with food or water. Their sense of smell
and taste declined. Many contaminated foods do not smell or taste bad. However, for
foods like spoiled milk, a person who does not notice "off" odors and flavors is more
likely to eat the food and more likely to become ill. Older people are living on their own.
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For an older person, preparing meals may pose special challenges. A widower
who has not cooked for himself may not know how to prepare food safely. A person
receiving home-delivered meals may not be familiar with safe handling and storage
practices for meals and leftovers (Mead, et al., 2005)
The causes of foodborne illness are multifaceted. Some major risk factors of
foodborne illness are related to employee behaviors and preparation practices in food
service establishments. The principle known risk factors include: Improper holding
temperatures, Inadequate cooking, such as undercooking raw shell eggs, Contaminated
equipment, Food from unsafe sources, Poor personal hygiene, and others such as, pest
and rodent infestation and improper food storage (FDA,2003).
In the study of Green (2005) .A few workers reported unsafe hand hygiene
practices, such as not washing their hands when changing gloves and using sanitizers
instead of washing their hands. Several workers said they sanitized but did not wash and
rinse their equipment after working with raw meat and did not check the temperature of
all the meat they cooked because they believed they could determine food doneness
through other methods (e.g., appearance and feel of the food). Others said they did not
check the temperature of food being reheated or cooled. Most workers, however, reported
safe food preparation practices. For example, workers described a variety of situtions in
which they washed their hands and changed their gloves, and said they cleaned their
work surfaces and equip-ment after preparing raw meat or poultry and checked the
temperatures of held food. These findings indicate that the participants were aware of and
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communicating risks with the public. He further stresses that whether the trigger
event for a grading policy is local news coverage of food safety issues or a deliberate
vision of policy makers, the effectiveness of the system should be evaluated through a
policy analysis that seeks to understand individual perceptions and the underlying
purpose of a grading system. Therefore, the reliability and interpretation of risk
communication is not a shared value among all the players. The effectiveness of a
program could be undermined. However, the current controversy presents opportunities
as well as challenges (Journal of Environmental Health, 2008)
Labensky and Hause (2007) stresses that although local health department
regularly inspect all food service facilities, continual self-inspection and control are
essential for maintaining sanitary conditions. Therefore, one way to ensure compliance is
to frequently check and record the temperature of Potentially Hazardous Foods (PHF)
during cooking, cooling and holding. Maintaining written time and temperature logs
allow management to evaluate and adjust procedures as necessary. Furthermore,
whatever system is followed, all personnel must be constantly aware of and responsive to
risks and problems associated with the safety of the food they serve.
Food safety act of 2013. With the signing into law on August 23, 2013 of the
Republic Act (RA) 10611 otherwise known as the Food Safety Act of 2013 by H. E.
Benigno S. Aquino III, President of the Republic of the Philippines, the food safety
regulatory system in the country including the Good Manufacturing Practices (GMP) and
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Eating away from home is becoming more common, and fast food
restaurant use in particular is growing even more rapidly (Schlosser, 2004). In 1970,
money spent on away-from-home foods represented 25% of total food spending; by
1995, it comprised 40% of total food spending and by 1999 it reached a record 47.5% of
total food spending. It is projected that, by 2010, 53% of the food dollar will be spent
away from home.3 Fast food has been defined as food purchased in self-service or carryout eating places without waiter service. Between 1977 and 1995, the percentage of
meals and snacks eaten at fast food restaurants increased 200%, while other restaurant
use increased 150%. Fast food outlets are especially popular among adolescents. The
average adolescent visits a fast food restaurant twice a week and fast food outlets provide
about one-third of the away-from-home meals consumed by adolescents. As away-fromhome foods represent an ever-larger proportion of total energy intake, their nutrient
profile becomes more important to examine. Away-from-home foods are higher in fat
and energy compared with foods eaten at home. In 1995, away-from-home foods
accounted for 27% of eating occasions, but 34% of energy intake. At-home foods
comprised 31% fat; by contrast, away-from-home foods comprised 38% fat energy.
Although about a quarter of Americans eat fast food every day, with 2001 sales
reaching over $110 billion in the United States alone (Schlosser, 2004), few worry about
the safety of the food. Most consumers operate under the assumption that health
inspectors' visits to fast-food restaurants prevent and correct risks that can arise from
unsafe practices that food handlers are trained to avoid. Yet, little data are available that
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document the extent to which hazardous practices occur. Research in this area
generally focuses on managerial strategies to improve inspection scores, rather than on
everyday behind-the-scenes operations. In fact, consumers possess very limited
knowledge about the practices of employees who actually prepare the food, which details
the observations of a college student with extensive work history in the fast-food industry
(Dundes & Swan, 2008)
In the Wall Street Jourmal, fast food restaurants are taking a new course. In the
hope of appealing to more-sophisticated consumers, fast-food chains are moving beyond
simple cheeseburgers and tacos, adding fancier ingredients such as portabella
mushrooms, citrus-herb marinated chicken and pepper bacon. The move is driven by a
growing foodie culture as well as the success of chains like Chipotle Mexican Grill Inc.
CMG -0.42% and Panera Bread Co. PNRA -1.64% , a category known as "fast casual,"
where customers still order at a counter but are paying for something up a notch from a
burger, fries and a shake. Both Chipotle and Panera did well during the economic
downturn by attracting customers who were trading down from full-service restaurants
but still wanted freshly prepared food at affordable prices. Long criticized for selling prepackaged, frozen and made-in-advance sandwiches, fast-food chains are trying to steer
away from the perception of processed food by emphasizing the freshness of their
products. While fresh ingredients cost more than canned and frozen ones, chains say it is
worth it for brand building, and higher quality gives them more pricing power. Early
signs indicate it is working. Taco Bell, a unit of Yum Brands Inc., YUM +0.29% recently
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introduced a "Cantina Bell" line of Chipotle-like burritos and salad bowls made
with fresh avocados and cilantro dressing. (Jargon, 2012)
People everywhere love to go to restaurants, whether it is fast food, pizza or a
sizzling steak dinner. Restaurants compete for customers every day. They realized that an
adequate staff scheduling is critical to providing the kind of quality customer service that
brings people to the establishment and keeps them coming back (Clavel, 2012).
Restaurant operation depends on its size and various management levels. Restaurants
range from unpretentious lunching or dining places catering to people working nearby,
with simple food served in simple settings at low prices, to expensive establishments
serving refined food and wines in a formal setting. Typically, customers sit at tables, their
orders are taken by a waiter who brings the food when it is ready, and the customers pay
the bill before leaving.
Every establishment according to Stone (2011) should go above and beyond the
norm to ensure that food is properly handled. Customers, before ordering their next meal
at the restaurant, are these days taking a close look at the employees and the environment
if they can. They may not be able to spot what goes on behind the scenes, but they trust
their instincts for what they are able to observe. This is one more reason why it is better
not to understaff. Operators should ensure that the expectations of employees are
reasonable, and they should hold regular training programs. Even taking a few hours out
of a day between meal time to conduct a food safety drill, involving the whole team ,
will go a long way to promoting healthy practices in the kitchen. Dropping in for a spot
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check every now and then will also be effective. To prevent employees from
resenting surprise inspection, must be done to help out for an hour or so during the shift.
Through this, there is an opportunity to set a good example, as well as boost morale by
showing the staff that the boss work beside them as equals.
Attitude and Compliance. Presidential decree 856 Code of Sanitation Section 18
(2007) states that owners, managers, and operators of food service should secure a
sanitary permit from the local health authority before establishing and operating their
business trade. Moreover, Section 19 stipulated that no person should be employed in any
food establishments without health certificate issued by the local health authority.
Individual attitudes towards compliance have been shown to be a function of
social or cultural norms (Naylor, 2009). If such attitudes would carry over to actual
compliance, enhancing these norms, as through increasing overall trust in government, is
a desirable policy instrument to compliment the usual enforcement options.
Askarian, Kabir, Aminbaig, Memish & Jafari (2006) presented findings that
strong associations were found among knowledge, attitude, and practice. Attitude has a
lot of influence on compliance, as shown in the study of Armonio, et al (2002) and
Suchitra and Devi (2007). Such also was the case supported by Askarian, et al (2006), as
it indicated that attitude mediated the relationship between knowledge and compliance.
Pittet (2004) supported this statement and aptly termed it behavior modification. It was
vital, therefore, to find ways to improve attitude in order to improve compliance.
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On the other hand, attitudes vary greatly in how strong they are
(Converse, 1970). Strong attitudes are especially important to understand as they have
greater resistance to change and greater impact on behavior (Krosnik & Petty, 1995).
However, when something substantially affects people, their attitude towards it
are likely to be strong (Crano, 1995). Managers of these businesses must comply with
regulation and deal with inspectors. Therefore we assume that their attitudes towards
them are likely to be strong.
In a study conducted by Kaplowitz & Eyck (2006), The greatest predictor of
managers attitudes towards regulation is how safe they perceive the food supply to be.
The belief that their customers are concerned about safety also indirectly affects this
attitude, but less that their own beliefs. This is surprising, as majority ordinarily think of
business people as having their policies driven primarily by the demands of the market
rather than by their personal preferences and beliefs.
The Report of the FDA Retail Food Program Database of Foodborne Illness Risk
Factors was the Food and Drug Administrations (FDA, 2004) first attempt to develop
baseline data about compliance of retail foodservice operations risk factors for
foodborne illness. Only 60% of full-service and 74% of quick service restaurants were
found to be in compliance with current health code requirements. These are lower
percentages than found in non-commercial foodservice operations, such as hospitals,
nursing homes, and elementary schools.
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A follow-up study by the FDA (2004) found that 13% of full-service
restaurants were out of compliance for purchasing food from unsafe sources, 42.7% for
poor personal hygiene, and 63.8% for improper holding time and temperature. The
percentages of quick service restaurants out of compliance with these risk factors were
lower with 2.3%, 31.2%, and 41.7%, respectively. Because of the relatively high
incidence of restaurants that are out of compliance with risk factors and food safety,
restaurant managers should focus on those behaviors that are known to cause foodborne
illnesses and emphasize them in training.
According to Mohammad (2009) the Foodborne Diseases Active Surveillance
Network (FoodNet) of CDC's Emerging Infections Program collects data from 10
American states regarding diseases caused by pathogens commonly transmitted through
food. In 2005 data, Foodnet sites reported 205 foodborne disease outbreaks to the
national Electronic Foodborne Outbreak Reporting System; 121 (59%) were associated
with restaurants. Etiology was reported for 159 (78%) outbreaks; the most common
etiologies were norovirus (49%) and Salmonella (18%). In 1998, the Food and Drug
Administration (FDA) conducted a study to ascertain the rate at which food handlers
were in compliance with standards established in the food code.
Summary
The review of the related literature aimed at finding support for the present study
on food safety and sanitation: attitude and regulations compliance of fast food
restaurants. It was likewise the purpose of the review to offer a clear investigation of the
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Attitude and employee perceptions about food safety and sanitation have
been well researched and it has been found that employees attitudes impact the success
of food safety programs and decrease the number of foodborne illness outbreaks (Howes
et.al., 2005).
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Chapter 3
Research Design and Methodology
This chapter is divided into three parts: (1) Purpose of the Study and Research
Design, (2) Method, and (3) Data Analysis Procedure.
Part One, Purpose of the Study and Research Design, outlines the objectives and
hypotheses of the study and identifies the theories related to food safety and sanitation.
Part Two, Method, introduces the participants and research instruments and
outlines the procedure followed in the conduct of the study.
Part Three, Data Analysis Procedure, provides the statistical tools used to analyze
and interpret the data.
Purpose of the Study and Research Design
This descriptive-correlational research aimed to ascertain the food handlers
attitude towards food safety and sanitation and the fast food restaurants compliance with
safety and sanitation regulations.
The survey-correlational method of research was employed in this investigation.
Fraenkel and Wallen (2003) explained that the major purpose of survey research is to
describe the characteristics of a population. In essence, information is collected from a
group of people in order to describe some aspects or characteristics (such as abilities,
opinion, attitudes and or knowledge) of the population of which the group is part. In
correlation research, sometimes called associative research, the relationships among two
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or more variables are studied without any attempt to influence them. In their
simplest form, correlational studies investigate the possibility of relationships among the
two variables, although in investigations of more than two variables are common.
Method
Participants. The participants of this investigation were the 200 randomly
selected food handlers in fast food restaurants in Iloilo City. The food handlers were
taken as an entire group and classified according to sex, age, educational attainment,
industry experience, and position. The participants were selected through two-stage
sampling. The names of the 59 fast food restaurants in Iloilo City were written on slips of
paper, rolled and placed inside a box. Then the lottery technique was employed, whereby
12 fast food restaurants were drawn and served as basis of where the participants were
chosen.
As shown in Table 1, in terms of sex, 71 or 36% were males, while 129 or 64%
were females. In terms of age, 80 or 40% were below 20 years old, 85 or 41% were
between 20-30 years old, 28 or 14% were 31-40 years old and 10 or 5% were over 40
years old. When grouped according to educational attainment, 41 or 20% were high
school graduates, 153 or 77% were college graduates and 6 or 3% were post-graduates. In
terms of industry experience, 87 or 43% had less than a year of experience, 86 or 44%
had 2-5 years of experience, 17 or 8% had 6-10 years of experience and 10 or 5% had
more than 10 years of experience. When grouped according to job position, 178 or 89%
were line/staff and 22 or 11% were managers.
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Table 1
Distribution of Participants
Category
A. Entire group
200
100
Male
Female
71
129
36
64
C. Age
< 20
20-30
31 and above
40 and above
80
85
28
10
40
41
14
5
D. Educational attainment
High School
College
Post Graduate
41
153
6
20
77
3
E. Industry experience
1 year and less
2-5 years
6-10 years
Over 10 years
87
86
17
10
43
44
8
5
F. Job position
Line/staff
Manager
178
22
89
11
B. Sex
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A. Entire group
12
100
7
5
58
42
C. Restaurant size
< 40 seats
40-80 seats
> 80 seats
6
4
2
50
33
17
D. Type of restaurants
Chain
Independent
9
3
75
25
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determined the level of attitude towards food safety and sanitation of food
handlers of the randomly selected fast food restaurants in Iloilo City. The items were
measured using a five-point Likert scale.
To interpret the mean scores obtained, the following scale and interpretation were
used:
Mean Scores
Interpretation
3.01 - 5.00
Positive
1.00 - 3.00
Negative
Interpretation
90-100
70-89
50-69
Below 50
Not complied
Procedure. Prior to the actual data gathering, the researcher secured permission
from the office of the managers of the chosen fast food restaurants to conduct the study.
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After which, the researcher explained to them the purpose and the mechanics of
the study. The data for the compliance of sanitary inspection of food was taken from City
Health Office of Iloilo City.
Data Analysis Procedure
The data gathered for this study were subjected to certain computer-processed
statistics.
Frequency count. Frequency count was used to determine the number of
participants and restaurants belonging to a class or category.
Percentage analysis. To determine which portion of the participants and
restaurants that belong to a class or category of the variables, the percentage analysis was
used.
Mean. The mean score was used to determine the food handlers attitude towards
food safety and sanitation.
Standard deviation. The standard deviation was employed to find out the
homogeneity or heterogeneity of the participants attitude towards food safety and
sanitation and restaurants compliance to regulations.
t-test for Independent samples. The t-test for independent samples set at .05
alpha level was used to determine the significant difference that existed between twolevel categories.
One-way analysis of variance (ANOVA). To find out the significant differences
among three or more categories, the one-way ANOVA was employed.
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Chapter 4
Results
Chapter 4 is divided into two parts: (1) Descriptive Data Analysis, and (2)
Inferential Data Analysis.
Part One, Descriptive Data Analysis, reports the descriptive data and their
respective analyses and interpretations.
Part Two, Inferential Data Analysis, presents the inferential data and their
respective analyses and interpretations.
Descriptive Data Analysis
Attitude towards food safety and sanitation of food handlers of fast food
restaurants. Data in Table 3 revealed that, generally, the food handlers had positive
attitude toward food safety and sanitation whether taken as entire group or classified
according to certain categories. This was revealed by the obtained mean scores which fell
within 3.01 5.00 scale.
The obtained deviations which ranged from 0.26 0.49 revealed the narrow
dispersion of the obtained means, indicating homogeneity of the food handlers attitude
towards food safety and sanitation.
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Table 3
Attitude Towards Food Safety and Sanitation Among Food Handlers
in Fast Food Restaurants
Category
Description
SD
4.54
Positive
0.34
Male
Female
4.53
4.55
Positive
Positive
0.33
0.34
Less than 20
21-30
31 and above
40 and above
4.52
4.52
4.60
4.72
Positive
Positive
Positive
Positive
0.31
0.35
0.40
0.26
D. Educational attainment
High school
College
Post graduate
4.47
4.56
4.54
Positive
Positive
Positive
0.36
0.32
0.49
E. Experience
1 year and less
2-5 years
6-10 years
Over 10 years
4.57
4.47
4.58
4.76
Positive
Positive
Positive
Positive
0.29
0.37
0.36
0.26
F. Job Position
Line/staff
Manager
4.53
4.63
Positive
Positive
0.33
0.37
A. Entire group
B. Sex
C. Age
Mean Scores
Interpretation
3.01 5.00
Positive
1.00-3.00
Negative
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Level of food safety and sanitation regulations compliance among
fast food restaurants. Data in Table 4 showed that with the exception of fast food
restaurants with more than 80 seating capacity who had high extent (M = 90.00) of
compliance, the fast food restaurants had complied with food safety and sanitation
regulations to a moderate extent whether taken as an entire group and classified
according to number of food handlers and type of restaurant. These were revealed by the
obtained scores which fell between 79-89 scale.
The obtained standard deviations which ranged from 0.00-5.00 revealed the
narrow dispersion of the means indicating the homogeneity of fast food restaurants in
terms of regulations compliance.
80
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Table 4
Level of Compliance to Food Safety and Sanitation Regulations among Fast Food
Restaurants
Category
Description
SD
A. Entire group
86.67
Moderate extent
3.26
85.71
88.00
Moderate extent
Moderate extent
3.45
2.74
C. Restaurant size
Less than 40 seating capacity 85.83
40-80
86.25
More than 80 Seating capacity 90.00
Moderate extent
Moderate extent
High extent
3.76
2.50
0.00
D. Type of restaurant
Chain
Independent
Moderate extent
Moderate extent
2.64
5.00
87.22
85.00
Total Points
Interpretation
90-100
High extent
70-89
Moderate extent
50-69
Low extent
Below 50
No compliance
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Table 5
t-test Results for the Difference in the Attitude Towards Food Safety and Sanitation
Among Food Handlers of Fast Food Restaurants when Grouped According to Sex and
Job Position
Category
A. Sex
df
t-value
Sig.(2 tailed)
Male
Female
4.53
4.55
198
0.309
0.76
Line/staff
Manager
4.53
4.63
198
1.341
0.182
E. Position
The one-way Anova in Table 6 revealed that significant differences existed in the
attitude towards food safety and sanitation among food handlers in fast food restaurants
classified according to educational attainment (f (3,196) = 3.56), p = .015), and industry
experience. (f (3,196) = 71.32), p = .00).
No significant difference existed in the attitude towards food safety and sanitation
among food handlers of fast food restaurants classified according to age (f (3,196) = 1.45)
p = .23).
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Table 6
One-way ANOVA Results for the Differences in the Attitude Towards Food Safety and
Sanitation Among Food Handlers of Fast Food Restaurants Classified According to
Educational Attainment, Industry Experience and Age
df
Category
Educational
attainment
Industry
Experience
Age
Sum of squares
Mean square
Between
groups
Within
groups
Total
Between
groups
Within
groups
Total
Between
groups
Within
groups
Sig.
196
199
2.11
38.77
40.88
.70
.20
3.56
0.015
196
199
68.63
62.87
131.50
22.88
.32
71.32
0.00
199
.49
22.22
22.71
0.16
0.11
1.45
0.23
196
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fast food restaurants when grouped according to number of food handlers and
type of restaurant. (W = 39.00, p = .24) (W = 15.50, p = .411)
Table 7
Mann-Whitney Test Results for the Differences in the Level of Food Safety and Sanitation
Regulations Compliance Among Fast Food Restaurants in Iloilo City Classified
According to Number of Food Handlers and Type of Restaurant
Category
Mean Rank
Sum of Ranks
Sig.
< 30
> 30
5.57
7.80
39
39
39.00
0.240
Chain
Independent
6.94
5.17
62.50
15.50
15.50
0.411
Number of
food handlers
Type of
restaurant
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Table 8
Kruskal-Wallis Test Results for the Differences in the Level of Food Safety and Sanitation
Regulations Compliance Among Fast Food Restaurants in Iloilo City Classified
According to Restaurant Size
Category
Mean rank
6
4
2
5.75
5.88
10.00
Chisquare
df
Sig.
2.804
0.246
Restaurant
Size
< 40
40-80
> 80
Table 9
Relationship between Attitude towards Food Safety and Sanitation of Food Handlers and
Regulations Compliance among Fast Food Restaurants.
Variable
Attitude
r
-.157
Regulations
compliance
p
.626
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Chapter 5
Summary, Conclusions, Implications and Recommendations
This chapter is divided into four parts: (1) Summary of the Problems, Method and
the Findings, (2) Conclusions, (3) Implications, and (4) Recommendations.
Part One, Summary of the Problems, Method, and Findings, presents the
important points of the study and the findings.
Part Two, Conclusions, cites the conclusions drawn from the results of the
investigation.
Part Three, Implications, delineates the relationships between the findings of the
present study and the existing theories related to attitude towards food safety and
sanitation and compliance to regulations.
Part Four, Recommendations, gives recommendations based on the findings,
conclusions, and implications.
Summary of the Problems, Method, and Findings
This study aimed to ascertain the attitude of food handlers towards food safety
and sanitation, and the regulations compliance of fast food restaurants to regulations on
safety and sanitation.
Specifically, the study aimed to answer the following questions:
1. What is the attitude of food handlers of fast food restaurants towards food
safety and sanitation when they are taken as an entire group and classified according to:
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(a) sex, (b) age, (c) educational qualification, (d) industry experience, and (e) job
position?
2. What is the level of compliance to regulations of fast food restaurants taken as
entire group and classified according to: (a) restaurant size, (b) number of food handlers,
and (c) restaurant type?
3. Are there significant differences in the attitude of food handlers of fast food
restaurants towards food safety and sanitation when they are classified according to: (a)
sex, (b) age, (c) educational qualification, (d) industry experience, and (e) job position?
4. Are there significant differences in the level of compliance to regulations of
fast food restaurants classified according to: (a) restaurant size, (b) number of food
handlers, and (c) restaurant type?
5. Is there a significant relationship between the food handlers attitude towards
food safety and sanitation and the fast food restaurants compliance to regulations?
In view of the preceding problems, the following hypotheses are advanced:
1. There are no significant differences in the attitude of food handlers of fast food
restaurants towards food safety and sanitation when they are classified according to: (a)
sex, (b) age, (c) educational qualification, (d) industry experience, and (e) job position.
2. There are no significant differences in the level of compliance to regulations of
fast food restaurants classified according to: (a) restaurant size, (b) number of food
handlers, and (c) restaurant type.
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3. Sex, age and job position were factors found not to significantly
influence food handlers attitude towards food safety and sanitation. It may therefore be
construed that regardless of whether one is a male or female; young, mid-adult or older; a
line staff or a manager, ones attitude remains comparable.
Educational attainment and industry experience are factors found to significantly
influence the attitude towards food safety and sanitation. This seems to show that those
who have higher education have more understanding of the importance of providing safe
food. On the other hand, foodhandlers who have worked longer in the industry have
internalized and appreciated the value of food safety and sanitation and its impact in the
industry they work in.
4. Number of food handlers, restaurant size, and type of restaurant were factors
found not to significantly influence the level of regulations compliance of fast food
restaurants. It may therefore be construed that regardless of whether fast food restaurants
have few or many food handlers; have small, medium or big seating capacity; and is a
chain or independent restaurant, the level of regulations compliance remain comparable.
5. Ones attitude towards food safety and sanitation is not a factor that
significantly affect the regulations compliance of fast food restaurants. Therefore, a
positive or a negative attitude does not guarantee adherence to certain food safety and
sanitation regulations.
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Implications
The results of the study have important implications both for theory and practice.
The present investigation found out that food handlers of fast food restaurants have a
positive attitude towards food safety and sanitation. This result is similar with the
findings of the study conducted by Sneed (2004) where food handlers got mean scores
ranging from 4.2 to 4.8 out of 5 points.
Furthermore, Parcel (2003) stressed that a persons behavior is influenced by
his/her beliefs and attitudes. Also, Rahman et al. (2012) found in their study that positive
attitude formation leads to positive behavior. Attitude is an important factor that ensures a
reduction trend of foodborne diseases. Howes et al. (2006) found the correlation among
positive behaviour, attitude and continued education of food handlers towards the
maintenance of safe food handling practices. On the other hand, Bas et al. (2004) in their
study found that the attitude scores of the food handlers toward foodborne diseases
prevention and control was poor and their scores on safety practice were very low.
A positive attitude towards food safety and sanitation of food handlers of fast
food restaurants in Iloilo City provides evidence that the food handlers perceive
positively their responsibility to ensure the safety of their customers. Food handlers are
responsible in maintaining a high standard of personal hygiene, and must be equipped
with proper knowledge, skills, and training in maintaining food safety and sanitation in
the food and beverage they serve (Pescadera, 2013).
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managers should focus on those behaviors that are known to cause foodborne
illnesses and emphasize them in training.
Labensky and Hause (2007) stressed that although local health departments
regularly inspect all food service facilities, continual self-inspection and control are
essential for maintaining sanitary conditions. Therefore, one way to ensure compliance is
to frequently check and record the temperature of potentially hazardous foods during
cooking, cooling and holding. Maintaining written time and temperature logs allows
management to evaluate and adjust procedures as necessary. Furthermore, whatever
system is followed, all personnel must be constantly aware of and responsive to risks and
problems associated with the safety of the food they serve.
Results also revealed that the attitude towards food safety and sanitation of food
handlers is not significantly related to the level of regulations compliance of fast food
restaurants. This contradicted studies of Roup et al. (2009) where attitude has a lot of
influence on compliance, as shown in the studies of McGovern (2000); Armonio, et al
(2002); Chan and associates (2007); Suchitra and Devi (2007); and Gammon and
associates (2008).
Such also was the case supported by Askarian et al. (2006), as it indicated, that
attitude mediated the relationship between knowledge and compliance. Pittet (2004)
supported this statement and aptly termed it behavior modification. It was vital,
therefore, to find ways to improve attitude in order to improve compliance.
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Recommendations
In view of the findings, conclusions and implications, the following are
recommended:
1. Fast food restaurant owners and managers should continue to encourage their
food handlers to update themselves about food safety and sanitation thru trainings and
seminars.
2. Aware of the level of regulations compliance among fast food restaurants,
owners, managers and staff should continue to work for better compliance ratings.
Attention should be focused on requirements not complied.
3. Replication of this study to a wider scope is highly recommended. Aside from
the food handlers attitude towards food safety and sanitation and regulations, researchers
may include other variables such as knowledge and practices and other participants may
be included other than food handlers.
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REFERENCES
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REFERENCES
Adams, M., & Moss, M., (2008). Food microbiology. Royal Society of Chemistry.
Traverse Press, Canada.
Ajzen, I., & Fishbein, M. (1980). Understanding attitudes and predicting social
behavior. NJ: Prentice Hall, Englewood Cliffs.
Ajzen, I .(1991). The theory of planned behavior. Organizational Behavior and Human
Decision Processes 50 (2): 179211.
Alvarez, H.& Cabuhal G.M. (2010). Food sanitation and hygiene. Intramuros, Manila:
Mindshapers Co. Inc.
Ang. M., Balanon, A., (2010). Food safety and sanitation. Philippines. C&E Publishing,
Inc.
Argudn, M.A., Mendoza, M.C., & Rodicio, M.R. (2013). Real-time PCR in Food
Science: Current Technology and Applications. Norfolk, UK: Caister Academic
Press.
Armonio, Y., Dmitir, S., Rikul, G., (2002). An assessment of hygienic conditions in
nursery schools kitchens. Nutrition & Food Science, 37,(6),419-426.
Askarian M, Kabir G, Aminbaig M, Memish ZA, and Jafari P (2006). Knowledge,
attitudes, and practices of food service staff regarding food hygiene in Shiraz, Iran
J. Health Popul. Nutr. 25(1): 16-20.
Aycicek, H., Aydogan, H., Kucukkaraaslan, A., Baysallar, M. & Basustaoglu, A.C.
GRADUATE SCHOOL
Iloilo City
98
Bas, M., Ersun, A.O. and Kavan, G. (2006), The evaluation of food hygiene
knowledge, attitudes and practices of food handlers in food businesses in
Turkey, Food Control, Vol. 17, pp. 317322.
Bean, N., Gepeti, A., & Griffin, P., (2006). Foodborne disease outbreaks in the United
States: pathogens, vehicles, and trends. Journal of Food Protect. 53(9);804817.
Bender, J. & Bender M., (2005). Food handlers beliefs and self-reported practices.
International Journal of Environmental Health Research, 12, 25-39.
Berkoff F, Allard JP, Arcand JA, Brazel S, Joliffe C, Choleva M,. (2005). Education by
a dietitian in patients with heart failure results in improved adherence with a
sodium-restricted diet: a randomized trial. American Heart Journal.
Block, S., (2004). Risk assessment model to predict food borne illness outbreaks at
restaurants. Dissertation Abstracts International
Buzby, J., (2002) Valuing Food Safety and Nutrition. Westview Press, Boulder CO.
Centre for Disease Control and Prevention. (2010). Estimates of Foodborne Illness in the
United States. Georgia: CDC Author
Chartered Institute of Environmental Health. (2002). Food safety first principles for
food handlers (3rd ed.). Canada
GRADUATE SCHOOL
Iloilo City
99
Cardiology.
41(7):1227-1228
Dirks, R., (2010). The Anthropology of food. Illinois State University
Dowler, F., (2007). Clients safe food-handling knowledge and risk behavior in a homedelivered meal program. Journal Of The American Dietetic Association, 107(5),
816-21.
GRADUATE SCHOOL
Iloilo City
100
Dundes, J., Swann, T., (2008). Journal of Human Resources in Hospitality &
Tourism Volume 7, Issue 2, Mc-Daniel College.
Ebbin R. Americans Dining-out habits. Restaurants USA. 2001;20:3840.
Effler P., Ieong M-C., Kimura A., Nakata M., Burr R., Cremer E., & Slutsker L. (2001).
Sporadic Campylobacter jejuni infections in Hawaii: associations with prior
antibiotic use and commercially prepared chicken. The Journal of Infectious
Diseases, 183, 1152-1155.
Ehiri, J. and Morris, G. (2006), Hygiene training and education of food handlers: does it
work?, Ecology of Food Nutrition, 35, pp. 243251.
Fairman R & Yapp C (2003) Education or Enforcement: Improving standards in food
SMEs, Environmental Health Journal, 111, 1, 16-19.
Flint J, Scott, E., & Bloomfield, S., (2005). Estimating the burden of acute gastroenteritis,
foodborne disease, and pathogens commonly transmitted by food: an international
review. Clinical Infectious Diseases, 41:698704.
Food and Drug Administration. (2006). Nutraceutical and Functional Food
Regulations in the United States. FDA. U.S.A Elsevier.
Fraenkel, J., & Wallen., N. (2006). How to Design and Evaluate Research in Education.
McGraw-Hill Companies, Inc.
French M and Neighbours D (1991) A model of firm costs of compliance with food
labelling regulations, in J. Caswell, Economics of Food Safety, New York:
French, S., Fulkerson J. (2006) Fast food restaurant use among adolescents:
GRADUATE SCHOOL
Iloilo City
associations
101
for
na
GRADUATE SCHOOL
Iloilo City
102
Greig, J., Todd, E., & Bartleson, C. (2007). Outbreaks where foodworkers have
implicated in the spread of foodborne disease. Journal of Food
been
Protection.25
156-157
Griffith, C., & Clayton, D. (2005). Food safety knowledge, attitudes and practices of
caterers in the UK. Dairy Food Environmental Sanitation, 3, 208214.
Hedberg CW., Lynch MF,, Tauxe RV,. (2009). The growing burden of
foodborne
GRADUATE SCHOOL
Iloilo City
Jones, S.L., Parry, S.M., OBrien, S.J., & Palmer, S.R. (2008). Are staff
management practices and inspection risk ratings associated with foodborne
disease outbreaks in the catering industry in England and Wales? Journal of
Food Protection, 71 (3), 550-557.
Jones TF, Pavlin BI, LaFleur BJ, Ingram LA, Schaffner W. Restaurant inspection scores
and foodborne disease. Available from:
http://wwwnc.cdc.gov/eid/article/10/4/03-0343.htm Date Accessed January 12,
2014
Kferstein, F. (2003) Actions to reverse the upward curve of foodborne illness. Food
Control, 14 (2), 101-109.
Kaplowitz S, Eyck T. (2006). Human Ecology Review. Attitudes of the Food
Industry towards Safety Regulations: Descriptive Statistics and Some Major
Predictors. 13,(1) , 43-46.
Knowles, T., (2003). Attitudes Towards Food Safety within Selected Countries of the
European Hotel Industry, Unpublished Phd thesis, Luton University, Luton.
Krosnik, J.A. and Petty R. (1995). Attitude Strength: Antecedents and Consequences, 124. Mahwah, NJ: Erlbaum
Lee, H., Chik, W., Bakar, F.A., (2012). Sanitation practices among food handlers in a
military food service institution, Malaysia. Food and Nutrition Sciences, 3(11),
1561-1566.
Lee, K. I., Renig, V. M., Shanklin, C. W., (2007). Competencies and attributes required
103
GRADUATE SCHOOL
Iloilo City
104
violations.
GRADUATE SCHOOL
Iloilo City
105
GRADUATE SCHOOL
Iloilo City
106
international social work. International Social Work July 2006 52: 485498.
Moines, D. (2005). Food Protection Trends,Vol. 25, No. 12, Pages 981990
International Association for Food Protection Atlanta, GA, USA
Montville, R., Y. Chen, and D. Schaffner. (2001). Glove barriers to bacterial crosscontamination be-tween hands to food. J. Food Prot. 64:845849.
Morris, J. (2008). Global Business Regulation. Cambridge University Press.
Mortlock, M.P., Peters, A.C. and Griffith, C. (1999). Food Hygiene and HACCP in the
UK food industry: Practices, Perceptions and Attitudes. Journal of Food
Protection. Vol. 62, pp. 786-792.
Mortlock, M.P., Peters, A.C. and Griffith, C. (2000). A national survey of food hygiene
training and qualification levels in the UK food industry. International Journal of
Environmental Health, 10, pp. 111-123.
Mukhopadhay A. (2012). Application of emerging technologies to control salmonella in
foods: a review. Food Res Int 45(2):666-677
National Environmental Health Association. (2010). Certified Professional Food
Manager, Food Safety Training. Canada
National Restaurant Association. Industry at a glance. National Restaurant Association.
10-8-2001. (2001). Available from:http://www.restaurant.org/research/ind_
glance.cfmExternal
National Restaurant Association. National industry fact sheet (2005). Washington,
GRADUATE SCHOOL
Iloilo City
107
2005factsheet.pdf.
Naylor, S., (2006). The management of food safety- the role of food hygiene training in
the UK service sector. Hospitality Management, 25, 278-296.
Normanno, N., (2005). Exposure: A Guide to sources of Infection. ASM Press
Nott, K.P., and Hall, L.D. (2003). Advances in temperature validation of foods. Trends in
Food Science and Technology. Journal of Food Technology. 12 (5), 325
Olsen, S., MacKinon, L., Goulding, J., Bean, N., Slutsker, L., (2000). Surveillance
for foodborne disease outbreaks- United States, 1993-1997. Morbidity and
Mortality Weekly Report, 49, 1-51
Oteri,T., and E. Ekanem. (2009). Food hygiene behavior among hospital food handlers.
Public Health 103:
Owen, S., & Hotfield, T. (2000). Grading systems of retail food facilities: A risk based
analysis. Journal of Environmental Health 2, (5), 43-46
Payne, E., & Theis, G., (2006). Food and beverage service, (9th ed.) NJ: Prentice Hall.
Pescadera, L., (2013). Food Sanitation Practices and Compliance with Health-Related
Regulations Among Selected Restaurants. Unpublished Master in Hospitality
Management Thesis, College of Business & Management, West Visayas State
University.
Perdign, G. (2005). Proposed model: Mechanisms of immunomodulation
GRADUATE SCHOOL
Iloilo City
108
GRADUATE SCHOOL
Iloilo City
consumers buying habits in Nagpu City. Journal of Application or
Innovation in Engineering & Management.
Schilling, B., OConnor, J., Hendrickson, V. (2002) State mandated food safety
certification requirements for restaurants: A 2002 review of states. New
Brunswick, NJ
Schlosser, B., (2008). Health concerns drive food service packaging. New Food,
5(3),80-82.
Schmidt R.H.. (1997). Basic Elements of Equipment Cleaning and Sanitizing in Food
Processing and Handling Operations. Florida: University of Florida
Scott, E., & Herbold, N. (2010). An in-home video study and questionnaire survey of
food
109
GRADUATE SCHOOL
Iloilo City
Sprenger, R. (2008), Hygiene for Management A Text for Food Safety
Courses, Highfield.co.uk Limited, 264321.
Stone, J. (2011). All about restaurant sanitation. Retrieved from
http://EzineArticle.com/?expert= JStone.
Stellman, J., & Mager, M., (2011). Food Industry Processes. Encyclopedia of
Occupational Health and Safety. International Labor Organization, Geneva
Strohbehn, C., Sneed, J., Peaz, P. and Meyer, J. (2008), Hand washing frequencies and
procedures used in retail food services, Journal of Food Protection, 71,
(8), 16411650.
Suchitra, H., Devi, A., (2007). The Impact of Training on Knowledge and Standards of
Food HygieneA Pilot Study. International Journal of Environment Health
Research, Vol. 7, No. 5, pp. 329- 334.
Todd, E.C. (2007). Epidemiology of Foodborne Diseases: A worldwide review. World
Health Stat Q, 50, 12
Todd, E.C.D., Greig, J.D., Bartleson, C.A. & Michaels, B.S. (2009). Outbreaks where
food workers have been implicated in the spread of food borne disease. Part 6.
Transmission and survival of pathogens in the food processing and preparation
environment, Journal of Food Protection, 72, 1, 202219.
Trainor, G., (2012). Surveillance for food-borne disease outbreak in United States, 19931997. Retrieved from: http//www.dc.gov/epc/mmwr/preview/
mmwrhtml/ss4901a1.htm
110
GRADUATE SCHOOL
Iloilo City
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Tull, A. (2004). Food and nutrition (3 ed.), Oxford University Press, p. 154
Walker, E., Pritchard, C. & Forsythe, S. (2003), Food handlers hygiene
knowledge in
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APPENDICES
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Appendix A
Data Gathering Instruments
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Appendix A
Data Gathering Instruments
Dear Respondents:
This data-gathering instrument is intended to gather data for a graduate research
entitled, Food Safety and Sanitation: Attitude and Compliance of Fast Food Restaurant.
You are in the best position to supply the needed data for the purpose.
In this regard, kindly supply the information required on the space provided.
Please do not leave any item unanswered.
Thank you very much.
KENDRICK CALLAO
Researcher
Part 1 Respondents Profile
Name (Optional): _______________________________________ Date: _____________
Name of Establishment (Optional): ___________________________________________
Sex: Male
[ ]
Female [ ]
[
[
[
[
]
]
]
]
[ ]
College Level [ ]
Post-Graduate [ ]
[
[
[
[
]
]
]
]
[ ]
[ ]
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2. Suitability of Kitchen
3. Cleanliness of Utensils
4. Construction of Premises
5. Maintenance of Premises
6. Toilet Provision
7. Handwashing Facilities
8. Water Supply
9. Liquid Waste Management
10. Solid Waste Management
11. Wholesomeness of Food
12. Vermin Control
13. Cleanliness and Tidiness
14. Protection of Food
15. Personal Cleanliness
16. Housekeeping and Management
17. Condition of Appliances and
Utensils
18. Sanitary Condition of Appliances
and Utensils
19. Disease Control (Health Card)
20. Miscellaneous (Issuance of
Sanitary Permit)
TOTAL DEMERITS ---
DEMERIT
RECOMMEND
CORRECTIVE MEASURES
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Note: Non complying items are indicated with an (x). Every item is weighted a demerit
of 5. The rating of the establishment is therefore 100 (Number of demerit x 5).
The result expressed as a percentage (5) rating.
PERCENTAGE RATING
100% Less demerit score
Inspected by:
_________________________________
Sanitation Inspector
__________________________________
Date
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Appendix B
Letter to the City Health Officer
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Appendix B
Letter to the City Health Officer
January 22, 2014
MR. URMINICO M. BARONDA, JR. M.D.
City Health Officer
Iloilo City
Sir:
Warm Greetings!
I am presently writing a masters thesis entitled, Food Safety and Sanitation: Attitude and
Regulations Compliance among Fast Food Restaurants, in partial fulfillment of the
requirements for the degree, Master in Hospitality Management, at West Visayas State
University.
In connection with this, I would like to request for the results of compliance required by
the City Health on Sanitary Inspection of Food Establishment. These results will be used
as data for the above mentioned study.
Your favorable action regarding this request will be highly appreciated. Thank you very
much.
Noted:
(SGD.) PROF. LOURDES F. ESPESOR
Dean, College of Business and Management
GRADUATE SCHOOL
Iloilo City
Appendix C
Letter to the Managers
120
GRADUATE SCHOOL
Iloilo City
121
Appendix C
Letter to the Managers
Warm Greetings!
I am presently writing a masters thesis entitled, Food Safety and Sanitation: Attitude and
Regulations Compliance among Fast Food Restaurants, in partial fulfillment of the
requirements for the degree, Master in Hospitality Management, at West Visayas State
University.
In this connection, may I respectfully request permission from your office to allow me to
administer my instrument among your food handlers.
I am hoping for your favorable response regarding this request. Thank you very much.
Noted:
(SGD.) PROF. LOURDES F. ESPESOR
Dean, College of Business and Management