Food safety certification and its impacts.

Introduction

It has been nearly a century since Upton Sinclair first focused public attention on conditions in the food industry with his book The Jungle. As a new millennium approaches, there is still a great deal of speculation about the roles that the industry and the regulators play in food safety - and about how those roles may change. Because of mounting concerns about foodborne illnesses, both the food industry and the food service regulators have been compelled to develop new methods of ensuring food safety and compliance with health codes. One method has been the establishment of courses that educate about food safety (1,2).

In Philadelphia, in response to the need for a better informed food service industry, the city health department leadership sought and won the support of the mayor and the city council for a new food safety ordinance; since 1996, all food establishments where potentially hazardous foods are handled must have at least one food safety-certified person present during each shift. Food safety certification is obtained through participation in a department-approved training course and a satisfactory score on the ensuing test.

To evaluate the impact of the training, this study surveyed food service representatives about knowledge gained from the training. The results of the survey are reviewed in this paper, and the implications for current programs are discussed. It was hypothesized that the educational requirement would cause food handlers to assimilate knowledge about the hazards associated with improper handling of perishable foods and ultimately to change improper and unsafe behaviors and practices (3,4).

Method

To study the effectiveness of the training component of the Philadelphia Food Safety Certification Program, a survey was developed (5). The survey posed questions about key issues covered in the food safety courses, including handwashing, equipment cleaning and usage, utensil sanitization, cross-contamination, thawing, processing, and the hazard analysis critical control point (HACCP) method. Ten establishments were randomly selected from each of the 10 geographical districts in the city. Each establishment was telephoned, and the person who answered was asked to voluntarily participate in the survey. Each participant was asked 14 multiple-choice questions. If the participant was not certified, the interviewer then asked to speak to a certified employee from the same establishment and asked the certified participant the same 14 questions. If the initial participant was certified, the second interview was conducted with a noncertified employee.

There are approximately 14,500 licensed food establishments in the city of Philadelphia. At the time of the survey, 38 percent of inspected food establishments were found to have complied with the requirement that a food safety-certified person be present during hours of operation (6). Because the population of establishments in compliance with the certification requirement was limited, 50 certified and 50 noncertified participants were deemed sufficient for this pilot survey.

The survey was developed with help from the staff of the Philadelphia Department of Public Health. Survey questions addressed issues that should have been emphasized in the training courses. The questions were developed from information in a book called SERVSAFE (7). Participants who had taken the food safety certification course had received this book at the time of their training. Some of the survey questions tested basic knowledge. Others tested specifics. The questions were designed to assess retention of critical information covered in the training course. At least one question addressed each of the sections of the SERVSAFE curriculum. Out of consideration for food handlers who were being asked to participate in the survey and to encourage participation, the survey was kept short and the questions were clearly defined.

Table 1 presents the 13 questions each participant was asked, and Table 2 displays the results of the survey Figures 1 and 2 show the percentages of certified and noncertified respondents who knew the correct internal cooking temperature for beef, as well as percentages of respondents who chose higher and lower temperatures. Figures 3 and 4 show how certified and noncertified participants chose among cooking temperatures for chicken.

Discussion

The results of the survey were tabulated, and a t-test was performed for each question to access the statistical significance of the responses. A cut-off p-value of .05 was established to determine whether the respondent could have randomly selected the right answer. If the calculated p-value was below .05, it was concluded that the training course did have an effect. If the calculated p-value was above .05, the course was considered not to have had an impact on the respondent.

Although the survey consisted of 14 questions, only 13 of the questions were analyzed. Question 14 was asked to distinguish food safety-certified individuals from those who were not certified. Figure 5 graphs the numbers of participants from the certified and noncertified groups who answered each question correctly. Of the 13 questions that were [TABULAR DATA FOR TABLE 2 OMITTED] analyzed, only four questions were found not to have been affected by the training: questions 1, 7, 11, and 12. All 100 participants answered Question 7 correctly. Ninety-four percent of the noncertified group and 100 percent of the certified group answered Question 1 correctly. Questions 11 and 12 tested knowledge of proper cooking temperatures for ground beef and chicken. The certified group did well with the ground-beef cooking temperature; however, both groups did poorly with the cooking temperature for chicken. While there seems to be a positive correlation between food safety training and proper food handling procedures, there is also a need for further training and education.

Conclusion

Except Question 7, each question received more correct answers from the certified group than from the noncertified group. The survey did, however, highlight areas of the training that need improvement. The correct internal cooking temperatures of potentially hazardous foods should receive more emphasis. The concept of HACCP and the importance of regular self-inspections also should be reinforced.

At the time of this study, the Food Safety Certification Program had been in effect in Philadelphia for approximately one year. Results from this initial survey indicate that the training courses are having a positive impact; the survey was, however, too limited to determine with any accuracy whether the lessons taught in the courses are being applied. This study, along with other research into the effects of regulatory changes, HACCP, and technical advances, is just a beginning.

Results from this study have several practical implications. There is a need to survey larger sample populations to obtain conclusive results. Needs assessment surveys should be conducted with respect to the materials taught in the courses so that the courses can better address issues of concern in a very diversified food industry (8). Food service regulators should be surveyed about their experiences in the field. Most of all, close scrutiny will be required to determine whether food establishments are really applying the information imparted in the training courses. A more comprehensive follow-up study is presently in its inception. The hypothesis for the follow-up study is that as the number of certified food handlers in Philadelphia increases, the level of understanding of food safety issues and techniques for the prevention of foodborne disease also will increase. The follow-up survey will assess the knowledge of food handlers who have received training, as well as the adequacy of the training programs. Still, as the new millennium approaches, the field will need more research into methods of changing behavior to promote safe food handling practices.

Acknowledgements: The authors would like to acknowledge the support and encouragement provided by the Environmental Health Services Division of the Philadelphia Department of Public Health - and especially the support of Randall B. Hirschhorn, without whom this endeavor would not have been successful.

Corresponding Author: Palak Raval-Nelson, Sanitarian Specialist, Environmental Health Services, Philadelphia Department of Public Health, 321 University Ave., 2nd Floor, Philadelphia, PA 19104.

REFERENCES

1. Notermans, S., and M. Borgdorff (1997), "A Global Perspective of Foodborne Disease," Journal of Food Protection, 60(11): 1395-1399.

2. Tauxe, R. (1997), "Emerging Foodborne Diseases: An Evolving Public Health Challenge," Dairy, Food and Environmental Sanitation, 17(12):788795.

3. Flickinger, B. (1997), "The Coming Year in Food QA," Food Quality, Nov/Dec:22-28.

4. Garrett, E.S. (1997), "Food Safety in the 21st Century," The Standard of Excellence, 3rd Quarter:8.

5. The Educational Foundation (1995), Serving Safe Food - -A Practical Approach to Food Safety, National Restaurant Association.

6. Regulations Governing Food Establishments (1996), Philadelphia: The City of Philadelphia Department of Public Health, pp. 46-48.

7. The Educational Foundation (1995), SERVSAFE: Serving Safe Food Certification Course Book, National Restaurant Association.

8. Bloom, A. (1997), "Communicating - A Timeless Art," Journal of Environmental Health, 60(3):4.