Food Safety Knowledge, Attitude, and Practice among Restaurant Food Handlers in Kerman, Iran

Journal of Environmental Treatment Techniques

2020, Volume 8, Issue 1, Pages: 535-539

J. Environ. Treat. Tech.

ISSN: 2309-1185

Journal web link: http://www.jett.dormaj.com

Food Safety Knowledge, Attitude, and Practice

among Restaurant Food Handlers in Kerman, Iran

Mohsen Mehdipour Rabori , Moayed Avazpour , Maryam Eskandarinasab , Ali Khalooei *

Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran and Department of Environmental Health,

School of Public Health, Kerman University of Medical Sciences, Kerman, Iran

Department of Environmental Health Engineering, School of Public Health, Ilam University of Medical Science, Ilam, Iran.

MSc. Student of Environmental Toxicology in Department of Environmental Health, School of Public Health, Kerman University of Medical

Sciences, Kerman, Iran

Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran

Received: 22/01/2020

Accepted: 25/01/2020

Published: 20/02/2020

Abstract

Food safety is a crucial strategy to control foodborne diseases and improve communities’ health. The study aimed to evaluate the

knowledge, attitude, and practice level of public restaurant’ food handlers. This cross-sectional study was carried out from May to July

019 in Kerman city, southeast of Iran. Data were collected using World Health Organization questionnaires on food safety. The mean

(SD) scores of knowledge, attitude, and practice of the respondents were 61.2 (16.9), 76.4 (12.3) and 63.1 (10.2), respectively. The mean

scores of knowledge, attitude, and practice were not significantly different in terms of the independent variables. There were direct

correlation between food safety knowledge and practice (r=.305, P<.0001), the knowledge and attitude (r=.271, P<.0001) (r=.415,

P<.0001) as well as between food safety attitude and practice. Thawing frozen food in the refrigerator or other cool places (44.8%),

storing any left-overs of cooked meal in a cool place within two hours (43.7%), reheating cooked food until it is piping hot throughout

(42.6%), and using separate utensils and cutting boards when preparing raw and cooked food (42.3%) were the areas with the maximum

unsatisfactory practice, respectively. as a result, the food handlers had a relatively positive attitude toward food safety but their

knowledge and practice level were not satisfactory.

Keywords: Food safety, Foodborne diseases Knowledge, Restaurants, Iran

Introduction¹

foodborne pathogens passively from contaminated sources

which themselves can be reservoirs of foodborne diseases

during or after active phases of the diseases. Furthermore, they

may be asymptomatic and transmit the pathogens as a carrier

Foodborne diseases cause million cases of illness and

thousands of death and are regarded as an important public

health problem in both developed and developing countries (1).

World Health Organization estimated 600 million cases of

foodborne diseases, 420 000 mortalit y, and 33 million healthy

life years lost in 2010 worldwide (1, 2). Foodborne diseases are

more prevalent in developing countries with 40% of all the

diseases cases as well as 125000 annual deaths occurrin g

among children under five year as a high risk group (2, 3).

Furthermore, the economic burden of food borne diseases

carries a significant cost in the world (2). It was estimated that

these diseases annually cost more than US$ 95 billion due to

lost productivity and US$ 15 billion due to medical care in low-

and middle-income countries (3). Thus, the different threats

posed to the human health and economic burden associated

with the disease make them an important challenge for the

public health (4).

Food safety is recognized as a global public health priority

to control and prevent foodborne diseases by World Health

Organization (5). By definition, food safety refers to “the

conditions and measures that are necessary during the

production, processing, storage, distribution, and preparation of

food to ensure that it is safe, sound, and wholesome and fit for

human consumption” (6). Food handlers play an essential role

in providing safer food for communities (7). They can transmit

(

7). Being armed with good knowledge about food safety such

as transmission modes of foodborne diseases, sources of food

contamination, proper storing of foodstuff, food processing

methods and handling, personal hygiene, environmental health

and clean utensils can lead to better practice for providing safer

food in the community (8).

According to some studies, restaurants are one of important

routes of transmission of foo dborne diseases and occurrence of

food-borne outbreaks (9, 10). Studies on food safety

knowledge, attitude, and practice in restaurants’ food handlers

have reported different results (9, 11). Some Studies have

demonstrated food safety knowledge and practice gaps in

restaurants’ food handlers, while some others have observed

good knowled ge and adequate compliance with food safety

standards (9, 11). In Iran, there have been some studies

evaluating the knowledge and attitude of consumers or

university students. However, very few studies have dealt with

food handlers and to the best of our knowledge, there was only

one study on assessing food safety knowled ge and practice

amongst public restaurants’ food handlers (12, 13).

Identifying the status of food safety knowledge and practice

among food handlers is an essential step to improving the food

Corresponding author: Ali Khalooei, Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman

University of Medical Sciences, Kerman, Iran. a_khalooei@kmu.ac.ir.

Journal of Environmental Treatment Techniques

2020, Volume 8, Issue 1, Pages: 535-539

safety standards and preventing foodborne diseases (14).

Regarding the insufficient studies on food safety knowledge

and practice amongst restaurant food handlers in Iran, this study

was conducted to evaluate the knowledge, attitude, and practice

level of public restaurant’ workers in Kerman city, southeast of

Iran.

people, the questions were asked by an interviewer and the

questionnaires were completed based on the answers. For

scoring the knowledge section, score 1 was given to a correct

answer while score 0 was given to incorrect as well as “I don’t

know” answers for the knowledge questions. For scoring the

attitude section, scores 1, 2, and 3 were assigned to “agree”,

“not sure”, and “disagree” responses, respectively. Also scores

-4 were given to “never” to “always” answers of the practice

Material and Methods

section of the questionnaire. Thus, the overall raw scores of

knowledge, attitude, and practice ranged within 0-12, 11-33,

and 0-40, respectively. Finally, the raw scores of knowledge,

attitude, and practice were converted to a scale of 0 to 100

through dividing the raw score minus the minimum possible

score by the scale ranges (maximum minus minimum), and then

multiplying by 100. Also, for practice questions, we reported

the “sometimes, seldom, and never” answers as unsatisfactory

condition, while the question answered as “always” or “most

times” were considered as satisfactory status.

The SPSS version 22 was used to analyze the collected

data. The descriptive results were presented as mean, standard

deviation, percentages, and tables. We used Independent T-test

and One-Way ANOVA to compare the scores of knowledge,

attitude, and practice in terms of the independent variables. An

alpha of 0.05 was used as the cutoff for the statistical

significance.

This cross-sectional study was carried out from May to July

019 in Kerman city southeast of Iran. The study population

consisted of food handlers of public restaurants. A total of 350

restaurant staff who had direct or indirect contact with food

with at least one-year work experience as food handlers were

enrolled in the study.

Data were collected using World Health Organization

questionnaires on food safety. The questionnaire was designed

based on five core components (keys) of food safety and safer

food including “keep clean” (washing hands, surfaces and

equipment), “separate raw and cooked food”, “cook food

thoroughly, keep food at safe temperatures” and “use safe water

and raw materials” (15, 16). This questionnaire evaluates the

knowledge, attitude, and practice of staff dealing with food on

food safety according to the five keys of food safety. The first

part of the questionnaire had 12 questions to assess the

knowledge of the participants through ‘Yes/No/I don’t know’

answers. The second part included 11 items on attitude toward

food safety which were answered through ‘agree, not sure, and

disagree’. The third part had 10 items whose answers were

based on five-point Likert scale including ‘always, most times,

sometimes, seldom, and never’. The original questionnaire had

3 Results and Discussion

The mean (SD) and median of the participants’ age were

35.2(12.1) and 33 years, respectively. More than half (52.3%)

of the respondents were female and 56.6% 0f them were chef

or chef assistant. Approximately, two-thirds (66%) of the food

handlers were married, with the educational level of 25.7%

being high school or higher. The mean (SD) of work experience

of the participants was 6.4 (5.7) years, and 51.4% of them had

a work experience 5 years or less. Approximately 90% of the

respondents had a history of food safety and hygiene education

while 10.3% did not (Table 1).

1 and 10 items for knowledge and attitude sections, but in a

study for validating the Persian version of thequestionnaire, the

researchers recommended to add a question to each of the

sections. Finally, there were some questions on age, sex,

marital status, educational level, job category, work experience,

education about food safety. In a study in Iran, the Persian

version of the questionnaire showed acceptable validity and

reliability among food handlers (17).

After obtaining consent from the participants and

explaining about the goals of the study for them, the

questionnaire was completed by the participants. For illiterate

Table 1: Frequency distribution of the independent variables and comparison of mean score of knowledge, attitude, and practice in

terms of independent variables across the studied sample

Knowledge

score

Attitude

score

Practice

score

P-

*P-

value

*P-

value

Variables

category

Work

experience

Food

463

762

.363

.343

.981

.798

worker

≤ 5 year

>5 year

Never

safety

education

1-2 year ago

3 year and higher

205(57.7)

112(32.0)

.086

.656

.187

*Independent T test (for variables with two subgroups) or One way analysis of variance (for variables with more than two subgroups)

Journal of Environmental Treatment Techniques

2020, Volume 8, Issue 1, Pages: 535-539

The mean (SD) scores of knowledge, attitude, and practice

of the respondents were 61.2 (16.9), 76.4 (12.3), and 63.1

serving ,how to keep cooked meat and need to reheat cooked

food. Moreover, majority of the participants had positive

attitude toward all items of the attitude questionnaire except

one item that only 26% of them were agree to use different

knives and cutting boards for raw and cooked foods (Table 3).

At presented in table 4, thawing frozen food in the refrigerator

or other cool places, storing any left-overs of cooked meal in a

cool place within two hours, reheating cooked food until it is

piping hot throughout, and using separate utensils and cutting-

boards when preparing raw and cooked food showed the major

unsatisfactory practice areas, respectively (Table 4).

(10.2), respectively. The mean scores of knowledge, attitude,

and practice were not significantly different in terms of the

independent variables. There were direct correlations between

practice scores and knowledge (r=.305, P<.0001) as well as

attitude (r=.415, P<.0001). Also, the knowledge scores and

attitude showed a significantly positive correlation (r=.271,

P<.0001). At presented in Table 2, a significant percentage of

the participants had no knowledge about 4 items of knowledge

questionnaire including; how to detect if meat and poultry were

cooked thoroughly, Cooked food should be kept very hot before

Table 2: Frequency distribution of answers to the items of food safety and hygiene knowledge among the food handlers

correct

N (%)

Incorrect/ Don’t

know, N (%)

Item

.Washing hands with water and soap for 20 second before handling food is important

.Wiping cloths can spread microorganisms

.The same cutting board can be used for raw and cooked foods provided it looks clean

.Raw food needs to be stored separately from cooked food

. Cooked foods do not need to be thoroughly reheated.

. When meat and poultry were cooked thoroughly (e.g. for kebab and chicken barbeque) their

287(82.0)

191(54.6)

205(58.6)

281(80.3)

170(48.6)

77(22.0)

63(18.0)

159(45.4)

145(41.4)

69(19.7)

180(51.4)

273(78.0)

color should be pink.

.Cooked meat can be left at room temperature overnight then put them in the refrigerator

.Cooked food should be kept very hot before serving

. Refrigerating foods only slows Food spoilage

0.Safe and plumbing water must be used for preparing and cooking

1. Damaged or rotting fruits and vegetables should be separated and then fresh and safe ones

140(40.0)

126(36.0)

192(54.9)

295(84.3)

305(87.1)

210(60.0)

224(64.0)

158(45.1)

55(15.7)

45(12.9)

should be washed.

2. Insects (for examples flies and beetles) and rattles (e.g. mouse) can cause and spread disease. 305(87.1)

45(12.9)

Table 3: Distribution frequency of respondents' attitude towards food safety

Agree

N (%)

309(88.3)

314(89.7)

247(70.6)

91(26.0)

Not sure

N (%)

26(7.4)

27(7.7)

77(22.0)

124(35.4)

Disagree

Items

N (%)

15(4.3)

9(2.6)

26(7.4)

135(38.6)

. Frequent hand-washing during food preparation is important

. Keeping kitchen surfaces clean reduces the risk of illness

. Keeping raw and cooked food separate helps to prevent illness

. Using different knives and cutting boards for raw and cooked foods is worth the extra

effort.

. Looking at the color of meat and poultry, touching and testing them or thermometer

are necessary for ensuring food is cooked thoroughly

226(64.6)

81(23.1)

43(12.3)

. Soups and stews should always be boiled to ensure safety

. Thawing frozen food in a cool place is safer

. it is unsafe to leave cooked food out of the refrigerator for more than two hours

. Inspecting food for freshness and wholesomeness is valuable

0. It is important to throw away foods that have reached their expiry date.

1. I think I can distinguish safe foods and spoiled ones by looking at them and this is a

212(60.6)

183(52.3)

238(68.0)

275(78.6)

154(44.0)

269(76.9)

106(30.3)

134(38.3)

92(26.3)

55(15.7)

93(26.6)

51(14.6)

32(9.1)

33(9.4)

20(5.7)

103(29.4)

30(8.6)

safe way.

Table 4: Frequency distribution food safety practice status among the studied sample

Satisfactory

N (%)

Unsatisfactory

N (%)

Items

. I wash my hands before and during food preparation

270(77.1)

262(74.4)

202(57.7)

251(71.7)

214(61.2)

80(22.9)

88(25.6)

148(42.3)

99(28.3)

136(38.8)

. I clean surfaces and equipment used for food preparation before re-using on other food.

. I use separate utensils and cutting-boards when preparing raw and cooked food.

. I separate raw and cooked food during storage.

. I check that meats and poultry are cooked thoroughly looking at the color, touching and

testing them or by using a Thermometer.

. I reheat cooked food until it is piping hot throughout

201(57.4)

193(55.2)

197(56.3)

278(79.5)

289(82.6)

149(42.6)

157(44.8)

153(43.7)

72(20.5)

61(17.4)

. I thaw frozen food in the refrigerator or other cool place.

. After I have cooked a meal I store any left-overs in a cool place within two hours.

. I check and throw away food beyond its expiry date

0. I wash fruit and vegetables with safe water before eating them

Journal of Environmental Treatment Techniques

2020, Volume 8, Issue 1, Pages: 535-539

The results the current study revealed that knowledge of the

food handlers was moderate (mean score 61.2 out of 100) with

between 41.4% and 78% of the respondents lacking any

awareness of seven items out of 12 items of the knowledge

questionnaire. A study among food handlers of public

restaurants in Alexandria found that the knowledge of food

handlers regarding food safety was below than the average with

a mean of 45.2 (11). The results of another study in Switzerland

showed that there were considerable food safety knowledge

gaps among restaurant food handlers (10). Studies in Malaysia,

Italy, and Brazil have reported knowledge mean scores among

restaurant food h and lers as 65.5, 65, and 72.7 (out of 100),

respectively (14, 18, 19). A study in Iran showed that the mean

score of food knowledge among food handlers was 21.1 out of

using the same questionnaire revealed that more than 90% of

food handlers had compliance with all practice items (12) .

The current study showed that there was a positive

correlation between the scores of practice and those of

knowledge as well as attitude. Consistent with these findings,

studies in Malaysia, Kuwait, and Brazil demonstrated the direct

influence of knowledge and att itud e level on food safety

practice among food handlers (14, 23, 24). Also consistent with

the results, a study in Indonesia found that food handlers with

good knowledge and positive attitude had a better food safety

practice (28).

In general, there are three basic lines of

interventions to prevent foodborne disease including improving

the hygienic quality of raw foodstuff, utilizing safe food

processing, and educating all food handlers to better understand

and practice the food safety (29). Indeed, improving food safety

knowledge and attitude level can lead to better practice among

food handlers and ultimately diminished incidence of

foodborne diseases.

4 reporting it as a good status (14). Although these studies

were conducted using different questionnaires, in most studies

as with as ours, there was a considerable gap in the knowledge

of food hygiene and safety among restaurants’ food handlers.

Education about food safety is the basic factor to improve the

knowledge and compliance with food safety which c an finally

lead to reduced incidence of foodborne diseases (20, 21).

The result of current study showed that the food handlers

had relatively favorable attitude toward food hygiene and

safety. Mean score of food hygiene and safety attitude among

restaurants’ staff in Saudi Arabia, Kuwait and Malaysia were

reported as66.0, 69.1 and 93.9 respectively (22-24). The

attitude of the participants in the current study was relatively

closer to the results of studies in Kuwait and Saudi Arabia, but

significantly lower than the Malaysia attitude scores. Further, a

study in Iran concurring with our findings revealed that

restaurants’ staff had a relatively satisfactory attitude toward

food safety (25). Although the majority of the respondents had

a positive attitude toward of the most items of attitude, a

considerable percentage of them had poor attitude toward three

items including ‘using separate knives and cutting boards for

raw and cooked foods, throwing away foods that have reached

their expiry date, and thawing frozen food in a cool place’.

Consistent with these results, studies in Malaysia and Ghana

demonstrated that the food handlers had unsatisfactory attitude

toward defrosted and refrozen foods (8, 26). As a highlighted

result, in our study unlike most studies, the food handlers had a

poor altitude toward using expired date foodstuff and

employing separate e quip ment for processing and storing raw

and cooked foods (8, 24, 26-28). A good attitude toward food

hygiene and safety in food handlers can lead to improved

practice and diminish ed incidence and economic burden of

foodborne diseases (1, 8).

The present study revealed there were no significant

differences in knowledge, attitude, and practice mean scores in

terms of individual characteristics of the food handlers. Unlike

this result, several studies have found that the food safety

knowledge and practice were associated wit h individual factors

such as sex, age, and educational level (20, 30). Several studies

consistent with the findings of the present study have reported

no relationship between demographic variables such as age,

sex, as well as marital sta tus and food safety knowledge,

attitude, and practice (14, 31-34). It is suggested that other

factors such as working conditions, management factors,

effective and deterrent laws and regulations, and continuous

monitoring of food supply centers as more important factors

may lead to improved food safety in restaurants and should be

considered in further research. The findings of this study should

be seen in light of some limitations. Firstly, this was a cross-

sectional study so it cannot confirm any cause and effect

relationships. Secondly, the data about food safety practice of

the food handlers were collected by a self-report method;

measuring human behavior via self-reported methods usually

results in overestimation compared to the actual status.

Conclusions

This study demonstrated that although the food handlers

had a relatively positive attitude toward food safety, the statuses

of food safety knowledge and practice were not satisfactory.

Furthermore, the study revealed that food safety knowledge,

attitude, and practice had a significantly positive correlation.

Note that food safety knowledge, attitude, and practice scores

did not show a significant association with individual

characteristics such as age, sex, educational level, job category,

and professional work experience. Thus, we suggest inclusion

of the relationship between food safety knowledge, attitude,

and practice and other factors such as working place conditions,

managerial factors, the food safety inspection system, and the

food control system in future studies.

The present study found that the participants had a

moderate level of food hygiene and safety practice. Hanan et

al. reported that the mean score of food safety practice in

Egyptian restaurant staff was 49.6 out of 100 (11). Another

study in Nigeria revealed that only 24.7% of food handlers had

adequate food safety practice (20). Unlike our study, a study in

Malaysia showed that restaurant workers with a mean score of

2.9 (out of 100) had an excellent food safety practice (24).

Good compliance with food hygiene and food safety practi ce is

an essential standard to prevent food-borne diseases (8, 22).

The majority of the respondents had satisfactory practice for

most of the practice items, but more than 40% of the food

handlers did not show satisfactory performance regarding four

items including “thawing frozen food in the refrigerator or

other cool places, storing leftovers of cooked food in a cool

place, reheating cooked food adequately and using separate

knives and cutting boards for raw and cooked foods”. In

contrast to this finding, Razeaghi et al. et al. in a study in Iran

Data Availability

The data of this study are available from the corresponding

author upon request.

Conflicts of Interest

The authors declare that there is no conflict of interest.

Journal of Environmental Treatment Techniques

2020, Volume 8, Issue 1, Pages: 535-539

Attitude and Practice of Food Handlers. Journal of Payavard

Salamat. 2017;11(4):411-20.

Funding Statement

8. Dora-Liyana AL, Mahyudin NA, Rashedi M, Ismail-Fitry AA-Z,

Rasiyuddin H. Food Safety and Hygiene Knowledge, Attitude and

Practices among Food Handlers at Boarding Schools in the

Northern Region of Malaysia. Social Sciences. 2018;8(17):238-66.

9. Panchal PK, Carli A, Dworkin MS. Identifying food safety

knowledge gaps among restaurant food handlers in Bolzano, Italy.

Food Protection Trends. 2014;34(2):83-93.

0. Adebukola OC, Opeyemi AO, Ayodeji AI. Knowledge of food

borne infection and food safety practices among local food

handlers in Ijebu-Ode Local Government Area of Ogun State.

Journal of Public Health and Epidemiology. 2015;7(9):268-73.

1. Al-Khamees NA. Food safety knowledge and reported behaviour

of university students in Kuwait. International Journal of Health

Promotion and Education. 2007;45(3):93-9.

2. Adetunji H, Baothman M, Alserhan F, Almunyif A, Alsharbe G,

Samaren H. Knowledge, Attitude, and Practice (KAP) of Personal

Hygiene among Food Handlers in the South Region of Makkah,

Saudi Arabia. International Journal of Medical Research & Health

Sciences. 2018;7(5):96-102.

3. Al-Kandari D, Al-abdeen J, Sidhu J. Food safety knowledge,

attitudes and practices of food handlers in restaurants in Kuwait.

Food Control. 2019;103:103-10.

4. Rosnani AH, Son R, Mohhidin O, Toh P, Chai L. Assessment of

knowledge, attitude and practices concerning food safety among

restaurant workers in Putrajaya, Malaysia. Food Science and

Quality Management. 2014;32(20):e27.

5. Fadaei A. Assessment of knowledge, attitudes and practices of

food workers about food hygiene in Shahrekord restaurants, Iran.

World Appl Sci J. 2015;33(7):1113-7.

6. Siau AMF, Son R, Mohhiddin O, Toh P, Chai L. Food court

hygiene assessment and food safety knowledge, attitudes and

practices of food handlers in Putrajaya. International Food

Research Journal. 2015;22(5):1843.

7. Jevšnik M, Hlebec V, Raspor P. Food safety knowledge and

practices among food handlers in Slovenia. Food Control.

This study was funded by Kerman University of Medical

Sciences

Acknowledgments

We would like to thank the participants in the study.

References

Fung F, Wang H-S, Menon S. Food safety in the 21st century.

Biomedical journal. 2018;41(2):88-95.

Havelaar AH, Kirk MD, Torgerson PR, Gibb HJ, Hald T, Lake RJ,

et al. World Health Organization global estimates and regional

comparisons of the burden of foodborne disease in 2010. PLoS

medicine. 2015;12(12):e1001923.

Shonhiwa AM, Ntshoe G, Essel V, Thomas J, McCarthy K. A

review of foodborne diseases outbreaks reported to the outbreak

response unit, national institute for communicable diseases, South

Africa, 2013–2017. International Journal of Infectious Diseases.

019;79:73.

Odeyemi OA. Public health implications of microbial food safety

and foodborne diseases in developing countries. Food & nutrition

research. 2016;60.

Organization WH. WHO global strategy for food safety: safer food

for better health: WHO; 2002.

Murwira TS, Amosu A, Nemathaga L. The level of compliance of

food handlers with national regulations on food hygiene and safety

practices: a case of selected fast food outlets in Thohoyandou,

South Africa: University of Venda; 2015.

Baş M, Ersun AŞ, Kıvanç G. The evaluation of food hygiene

knowledge, attitudes, and practices of food handlers’ in food

businesses in Turkey. Food control. 2006;17(4):317-22.

Akabanda F, Hlortsi EH, Owusu-Kwarteng J. Food safety

knowledge, attitudes and practices of institutional food-handlers in

Ghana. BMC Public Health. 2017;17(1):40.

Rebouças LT, Santiago LB, Martins LS, Menezes ACR, Araújo

MdPN, de Castro Almeida RC. Food safety knowledge and

practices of food handlers, head chefs and managers in hotels'

restaurants of Salvador, Brazil. Food Control. 2017;73:372-81.

008;19(12):1107-18.

8. Sihombing J, Padmawati RS, Kristina SA. Knowledge, attitude,

and practices regarding food safety among food employees in

Ambon City, Indonesia. Malaysian Journal of Nutrition.

018;24(2):293-9.

0. Panchal PK, Bonhote P, Dworkin MS. Food safety knowledge

among restaurant food handlers in Neuchatel, Switzerland. Food

Protection Trends. 2013;33(3):133-44.

1. El Gamal HM, Ismaeel NM, Shehata M. Food Safety Knowledge

and Practices of Catering Employees at Some Public Restaurants

in Alexandria.

9. Scott E. Food safety and foodborne disease in the 21st century.

Canadian Journal of Infectious Diseases and Medical

Microbiology. 2003;14(5):277-80.

0. Admasu M, Kelbessa W. Food Safety Knowledge, Handling

Practice and Associated Factors among Food Handlers of

Hotels/Restaurants in Asosa Town, North Western Ethiopia. SM J

Public Health Epidemiol. 2018;4(1):1051.

2. Fariba R, Gholamreza JK, Saharnaz N, Ehsan H, Masoud Y.

Knowledge, attitude, and practice among food handlers of semi-

1. Madhup1

Saurabh1,Shalini

N1Sarla1,Ms.

Y1,Sharon

Anjana

industrial catering:

a cross sectional study at one of the

,Sheetal,Shefalir1,Shilpi1,Shweta

governmental organization in Tehran. Journal of Environmental

Health Science and Engineering. 2018;16(2):249.

Williams2mrs. Shiwani Verma. Level of Knowledge Regarding

Food Hygiene Among food Handlers Working in Restaurants of

Doiwala, Dehradun. IOSR Journal of Nursing and Health Science

3. Mirzaei A, Nourmoradi H, Zavareh MSA, Jalilian M, Mansourian

M, Mazloomi S, et al. Food safety knowledge and practices of male

adolescents in west of Iran. Open access Macedonian journal of

medical sciences. 2018;6(5):908.

(

IOSR-JNHS). 2017;6(3):114-8.

2. Rahman MM, Arif MT, Bakar K, bt Talib Z. Food safety

knowledge, attitude and hygiene practices among the street food

vendors in Northern Kuching City, Sarawak. Borneo Science.

4. Souza CVSd, Azevedo PRMd, Seabra LMAJ. Food safety in

Brazilian popular public restaurants: Food handlers’ knowledge

and practices. Journal of food safety. 2018;38(5):e12512.

5. Organization WH. Five keys to safer food manual. WHO

Department of Food Safety, Zoonoses and Foodborne Diseases.

WHO Press, Geneva, Switzerland; 2006.

6. Fontannaz-Aujoulat F, Frost M, Schlundt J. WHO Five Keys to

Safer Food communication campaign-Evidence-based simple

messages with a global impact. ELSEVIER SCI LTD THE

BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD

OX5 1GB …; 2019.

016;31.

3. Abdul-Mutalib N-A, Abdul-Rashid M-F, Mustafa S, Amin-Nordin

S, Hamat RA, Osman M. Knowledge, attitude and practices

regarding food hygiene and sanitation of food handlers in Kuala

Pilah, Malaysia. Food control. 2012;27(2):289-93.

4. Rostami R, Nafez H, Falahi F, Mohammadi MM, Jamshidi K, Lotfi

S. Surveying awareness of the students of Kermanshah university

of medical sciences about nutrition and storing food stuff in crises

(2016). Medicine. 2016;88(172.98):0.001.

7. Razeghi F, Yunesian M, Nedjat S, Jahed Khaniki G. Translation

and Standardization of World Health Organization Questionnaires

about Five Principles of Food Safety to Assess Knowledge,