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Food Control
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a r t i c l e i n f o a b s t r a c t
Article history: The aim of this study was to assess the hygiene practices of food handlers in municipal schools of Natal,
Received 8 May 2008 Brazil, where 27 public schools were evaluated, using a checklist and microbiological analysis of hands. It
Received in revised form 3 October 2008 was found that 74.1% of the handlers did not receive periodic training, 51.9% did not undergo annual
Accepted 12 October 2008
health examinations and 100% did not practice proper hand hygiene, a situation that reected signi-
cantly (p < 0.05) in hand contamination, in which fecal coliforms were detected on 55.6% of the hands
analyzed. It was concluded that the schools studied did not have appropriate hygienic conditions, sug-
Keywords:
gesting the need for interventions that ensure the quality of school food served to the children.
School food
Personal hygiene
2008 Published by Elsevier Ltd.
Food hygiene
are divided into ve categories based on virulence, clinical syn- 275/2002 of the National Agency of Sanitary Surveillance (ANVISA)
dromes and differences in epidemiology or in OH serotypes. One (Brasil, 2002). In total, 18 items were assessed, such as the use of a
of the categories is enter hemorrhagic E. coli, which produces tox- uniform and individual protective equipment (IPE), proper body hy-
ins that cause hemorrhagic colitis and in more serious cases hemo- giene and correct attitudes, appropriate handwashing, among oth-
lytic uremic syndrome (HUS), characterized by abdominal cramps, ers (Table 1). The checklist was lled out with information
aqueous and/or bleeding diarrhea and vomiting. The risks of this provided by the food preparers at each school, as well as direct
disease are greater in the elderly and in immunodepressed chil- observation by the interviewer of the handling practices used. The
dren under 5 years of age (Ormenese, Silveira, & Silva, 1999). results were compared with ANVISA Resolution RDC 216/2004 (Bra-
Considering that fecal coliform bacteria are not found in resident sil, 2004a, 2004b) and with Codex Alimentarius, 2003.
skin ora, their study in handlers is of extreme importance, given Data collection for microbiological analysis of the hands of food
that they may be found in transitory ora. Thus, the presence of fecal handlers was performed using a swab, previously moistened in
coliforms, when detected in handlers, characterizes a situation of sterile phosphate-buffered saline and applied to the entire surface
potential risk, owing to the interrelation of these bacteria and the of the hands and between the ngers (Chistovo, 1956). Three col-
possible occurrence of enteric pathogens (Hobbs & Roberts, 1998). lections were conducted at each school on different days to better
The important measures for preventing foodborne diseases represent the data, for a total of 81 samples.
caused by inappropriate handling include training and the aware- The most likely number (MLN) of coliforms was determined at
ness of handlers about proper techniques, correct personal hy- 45 C (AOAC/02986.33), according to the ofcial analytical method
giene, health assessment, implementation and carrying out of (AOAC, 2002). The parameter recommended by Silva Jr. (2005) was
good production practices, in addition to constant supervision. used, where a satisfactory result is the absence of fecal coliforms
Given that food handlers are the main food contamination vehi- on the hands of food handlers.
cles, the results obtained in the present study aim at contributing This study was approved by the Research Ethics Committee of
with proposals for improving the School Food Program and refor- the Federal University of Rio Grande do Norte and the data were
mulating government policies in light of the problems encoun- analyzed using Statistica 7.0 software (Statistica, 2004). Descrip-
tered. The goal is to protect and promote childrens health by tive statistics were used as well as the chi-square test to determine
providing safer foods and decreasing the cases of diarrhea caused whether there was a signicant difference between two categorical
by foodborne disease, which is one of the leading causes of child variables.
mortality in developing countries, including Brazil.
3. Results
2. Material and methods
The data obtained from the checklist applied to the food prepar-
The study was conducted with handlers responsible for the pro- ers are shown in Table 1, where it can be observed that most of the
duction of school food in 27 municipal schools in Natal, Brazil items do not meet current standards.
belonging to the north (11 schools), south (3 schools) east (3 Microbiological analyses of the handlers hands showed contam-
schools) and west (10 schools) administrative districts and corre- ination in a large number of samples. The highest percentage of
sponding to 38.6% of the total number of municipal schools (70 contamination was found in the western district, followed by the
schools). southern, northern and eastern districts, as illustrated in Table 2.
The schools were selected randomly, according to the propor-
tional stratied sampling technique (Scheaffer, Mendenhall, & Ott, 4. Discussion
1995). For data collection we used microbiological analysis of the
hands and a checklist to assess the hygienic conditions and practices Training and awareness of school food handlers is a fundamen-
used by the handlers. The checklist was based on SENACs Safe Food tal condition for avoiding contamination and ensuring the quality
Program (PAS) Table Checklist (SENAC, 2001) and Resolution RDC and safety of the food produced (Pistore & Gelinskib, 2006).
Table 1
Distribution of nonconforming practices and the hygiene conditions of food handlers in municipal public schools in Natal, Brazil.a
Observations Nonconformities
N %
Periodical training 20 74.1
Presence of proper body hygiene (covered hair, short, clean, unpolished nails, no jewelry, etc.) 22 81.5
Correct hand hygiene techniques 27 100
Presence of exclusive hand wash sink 20 74.1
Proper attitudes and gestures 24 88.9
Annual health examinations 14 51.9
Handlers with wounds or infections on their hands are temporarily removed from their function 14 51.9
Use of proper uniforms (light-colored pants and blouse/shirt, correct footwear and hair protection) 27 100
Use of individual protective equipment (IPE) 27 100
Use of disposable gloves for specic activities 20 74.1
Gloves are properly stored 0 0
Use of hair protection by visitors to the food production area 27 100
Employees work exclusively in the kitchen 6 22.2
Exclusive bathroom for the handlers 23 85.2
The bathrooms are isolated from the food production area 0 0
The bathrooms have antiseptic liquid soap and paper towels, the wastebaskets are lined with plastic bags, covered and have a foot pedal for minimal 23 85.2
contact when opening the lid
The bathrooms are kept clean 14 51.9
Personal effects of the employees are kept in lockers or other suitable areas outside the kitchen 22 81.5
a
According to Codex Alimentarius (2003) and Resolution RDC 216 of ANVISA (2004).
A.K.C. Campos et al. / Food Control 20 (2009) 807810 809
samples analyzed. This result showed an association with the ab- tional Diagnosis and Reformulation of Actions, which enabled this
sence of exclusive sinks and means for hand washing, at a signi- study to be conducted
cance level of p < 0.05. To the Department of Nutrition of the Federal University of Rio
Thus, we underscore the importance of correct hand hygiene, as Grande do Norte for support in carrying out this work.
shown by Shojou, Shoooshtaripoor, and Amiri (2006), where they
assessed the efcacy of correct hand hygiene and found a reduction References
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To the Municipal Health Secretariat for nancing the extension comercializam alimentos na cidade de Joo Pessoa, PB. Higiene Alimentar,
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