5.19.2012

HANDLING POULTRY & EGGS IN THE KITCHEN


Introduction

Foodborne diseases caused by microbiological agents remain a major problem in most countries that have reporting systems, with significant increases being documented in recent years (FAO/WHO, 2002). Relatively little is known about the 95% of cases that are sporadic (FSA, 2003) or the large number that go unreported (Griffith, 2000). Given the uncertainty in the statistics, care needs to be taken in their interpretation; however, it would appear that poultry meat and poultry products are common vehicles in the spread of foodborne diseases in the UK and elsewhere (ICMSF, 1998; Wong et al., 2004).
Poultry meat and poultry products were implicated as food vehicles in 27% of general outbreaks of infectious intestinal disease in England and Wales in 1995 and 1996 (Evans et al., 1998), with egg products being implicated in an additional 27%. In many studies, poultry is recognised as an important reservoir of foodborne pathogens, especially Campylobacter and Salmonella, with poultry production being considered a primary source for these organisms (Audisio et al., 1999; Denis et al., 1999). Some studies (Kramer et al., 2000) have shown that a proportion of Campylobacter isolates from chicken belong to the same subtypes as those associated with human disease.
Contamination rates and levels for poultry meat vary over time between countries and according to the nature and origin of the samples examined. Internationally, contamination of raw chicken with Salmonella has ranged between 6% and 58%, whilst contamination with Campylobacter has been between 28% and 83%. In the UK, contamination of raw chicken with Campylobacter appears to be more of a problem at present than that due to Salmonella. Campylobacter carriage rates in broiler chickens tend to peak in the spring and late summer (ACMSF, 2004). The likely sources of Campylobacter contamination in poultry and the potential for control have been reviewed (ACMSF, 2004), with the environment around the broiler house being considered particularly important. Campylobacter contamination rates have remained high (over 50%), whilst Salmonella contamination of poultry meat in England and Wales has fallen to approximately 6% overall (FSA, 2003), with regional variation in contamination rates for both pathogens.
Campylobacter contamination rates were higher in UK-produced birds, while Salmonella contamination was lower than in imported poultry meat. The decrease in Salmonella may be due, in part, to vaccination of some poultry flocks. Salmonella Enteritidis PT4 became prevalent in the 1980s and has been associated with both eggs and poultry meat (CPHLS - RMD, 2002). In the near future, however, it seems possible that carriage of this organism in poultry will be superseded by that of other subtypes. Historically, the UK position has been mirrored elsewhere in Europe (Geilhausen et al., 1996), although chicken samples in one Belgian study (Uyttendaele et al., 1999) were more often contaminated with Salmonella than Campylobacter.
In relation to human illness, it is important to know the frequency with which a particular food is contaminated with a pathogen and the level of contamination, especially with regard to the minimum infectious dose (MID), if known. In the living bird, campylobacters are found at their highest levels in the caeca, colon and cloaca, with numbers in the region of 105-109 cfu per g of intestinal content being observed (Corry and Atabay, 2001). Levels present on poultry carcasses can exceed 108 cells per carcass (Humphrey et al., 2001). This should be viewed in the context of an MID that may be as low as 500 cells (ACMSF, 2004). The number of Salmonella cells present on the surface of chicken meat is difficult to determine with available methods and therefore few studies have been carried out on this aspect (Humbert et al., 1997).
Campylobacter
Unlike poultry meat, which is typically associated with both Salmonella and Campylobacter, the main pathogen found in eggs and egg products is Salmonella (ICMSF, 1998). In the late 1980s and early 1990s, there was concern that eggs were a possible source of Salmonella food poisoning in humans (ACMSF, 1993). This was primarily due to S. Enteritidis PT4, which could contaminate the shell, the outside of the yolk membrane or the surrounding albumen. The yolk membrane, especially if the egg is stored above 20o C, can become increasingly permeable, thus allowing the Salmonella to invade the yolk, where it can multiply more readily. However, survey data from the UK suggest that egg contamination rates have now decreased. In an all-UK study carried out in 2003, Salmonella was found in only one of every 290 boxes of six eggs (FSA, 2004). This represents an almost three-fold reduction compared to 1995-1996 (England only), where one in every 100 boxes was positive.
In the 2003 study, there were no significant differences in contamination rate between production systems (caged production, free-range or organic). Contamination rates for S. Enteritidis PT4, traditionally the most common egg strain, fell from 0.58% in 1995-1996 to 0.11% in 2003. The fall is likely to reflect measures introduced in the UK to reduce egg contamination, including vaccination, and appears to have resulted in a decline in laboratory-confirmed cases of human salmonellosis. However, the reduction in Salmonella contamination may not apply to all eggs that are imported into the UK.
The USA, in its attempts to tackle the problem of S. Enteritidis in eggs, introduced an Egg Safety Action Plan in 1999. As part of this, the Food and Drug Administration published a regulation that introduced refrigeration requirements for shell eggs at the retail level. This became mandatory in June 2001 and required restaurants, caterers, retailers, etc., to keep eggs below 7.2oC. Typically, a fresh egg, contaminated internally with Salmonella, would contain less than 20 organisms. The chances of an individual becoming infected from such an egg, if handled correctly, would be small. However, some desserts and other items made with pooled eggs have been implicated in food poisoning outbreaks and have given greater cause for concern (Griffith, 2000).
Whether in eggs or poultry meat, pathogen contamination rates and levels become important in relation to how much of the product is consumed and the methods of preparation employed. In the pursuit of cheap, but nutritious food, consumers have turned increasingly to poultry meat and poultry products, and over 700 million chickens a year and 33 million eggs a day are sold in the UK. Thus, even low or declining contamination rates could still contribute significantly to human disease.
The responsibility for food safety belongs to everyone in the food chain (Griffith, 2000). If handled correctly, contaminated raw foods should not pose a problem and producers have the right to expect food handlers further down the supply chain to handle food hygienically. Nevertheless, food handlers can reasonably expect producers to implement all necessary measures to minimise contamination of poultry meat and eggs. This chapter examines the knowledge, attitudes and practices of food handlers within the framework of exposure assessment, risk management and risk communication.

Domestic and catering kitchens: the final line of defence

Salmonella
In England and Wales, 12-17% of general foodborne disease outbreaks (multiple cases involving members from more than one family and thought to have a common route of exposure) are reported to have originated from the home (Tirado and Schmidt, 2000), and recent European data have shown the home to be the most important single location for the occurrence of foodborne disease (FAO/WHO, 2002). The majority (>95%) of cases do not occur as outbreaks, but are 'sporadic' or apparently isolated cases (FSA, 2000), and therefore less likely to be identified by public health authorities (Worsfold and Griffith, 1997). Thus, the actual number of cases occurring in the home is likely to be much larger than that suggested by the reported data.
Some estimates indicate that 50-87% of all cases of foodborne disease, involving general outbreaks, family outbreaks (multiple cases, but within the same family) and sporadic cases, may be acquired in the home (Clayton et al., 2003). Statistics from a number of countries, including the USA, Netherlands and the UK, show that the majority (up to 70%) of general outbreaks are associated with catering or food service locations (Griffith, 2000). Comparisons between countries, with respect to the origins of foodborne diseases, are difficult due to differences in interpretation, definitions, methodology, data collection, etc.
For the UK, it has been suggested that one in every 1527 catering establishments could be implicated in an outbreak of foodborne illness in any one year (Coleman et al., 2000). Whether commercial or domestic, the kitchen represents the last link in the food chain and the final line of defence, i.e. the last opportunity to eliminate previous microbial contamination and prevent further contamination before the food is eaten. In this context, both poultry meat products and eggs require appropriate handling to minimise risk, and good hygiene practices should be used in all kitchens.

Risk factors

Various reviews have attempted to quantify the relative importance of different food-handling practices and associated risks (Griffith, 2000). Most have been undertaken by surveillance and enforcement personnel following an outbreak and involve asking food handlers about their recollection of hygiene practices that may or may not have been used. Again, direct comparisons between countries are difficult, because the methods of investigation and terminology used may vary. One of the most variable risk factors in the different studies is cross-contamination, some studies implicating it in only 5% of cases, others in as many as 39% (Griffith, 2000).
Part of the variability can be explained by differences in methods of data collection, although it is highly likely that behavioural details relating to cross-contamination are usually forgotten or unknown. As such, cross-contamination is likely to be under-reported (Griffith, 2000) and observational studies (Worsfold and Griffith, 1997; Redmond et al., 2004; Clayton and Griffith, 2004) indicate a much greater potential or threat from cross-contamination for some pathogens than epidemiological data may suggest.
In the UK, cross-contamination was implicated as a risk factor in 39% of general outbreaks (Evans et al., 1998). However, the importance of cross-contamination is likely to vary with the pathogen and its characteristics, including survival capability, transfer rates, MID, as well as the frequency and level of contamination in different foods. Raw foods in kitchens, especially commercial ones, often undergo a lengthy series of preparative steps before becoming part of a more complex dish.
Catering and domestic kitchens, unlike larger manufacturing units, are often subject to contamination from a wide variety of sources, including many types of raw food, yet may lack strict segregation between raw- and cooked-food handling areas. Domestic kitchens may be subjected to an even wider range of contaminants from sources such as dirty laundry and pets (Worsfold and Griffith, 1997). The latter may be of particular concern in relation to Campylobacter (ACMSF, 2004). Pathogens can spread rapidly in kitchens and have been isolated from numerous sites in commercial and domestic kitchens, including working surfaces (Griffith, 2000).
Other reported risk factors include inadequate cooking, which, traditionally, has been seen as the main risk associated with poultry meat and eggs. Cooking is a step in much domestic and commercial food preparation, and makes the food more attractive, digestible and, above all, safe. However, consumers preparing food in the domestic kitchen may select cooking times and temperatures by means of guesswork.
This can be particularly true for the cooking of poultry carcasses at Christmas time, when the carcasses are usually larger than normal. Commercial kitchens are more likely to utilise probes or other thermometers to monitor the cooking process and have food safety programmes in place, so that cooking times and temperatures should be more controlled than in domestic kitchens. This may not be the case with some desserts and sauces, the production of which can involve lightly-cooked eggs. Insufficient heat processing that is inadequate to destroy Salmonella can be a problem with this type of dish in both commercial and domestic kitchens.
One difference between food manufacturing and food service establishments is that the latter normally produce to order rather than using stock. However, in event and function catering, food is often prepared for unusually large numbers of people in advance of consumption, without access to additional workspace or refrigerated storage facilities. Coupled with the length of time that elapses prior to consumption, this can combine with other risk factors and contribute to food-poisoning outbreaks. Preparation of food in advance of consumption has been reported as a risk factor in many countries and has been implicated in over 50% of general outbreaks in the UK (Griffith, 2000).

Raw poultry meat and eggs: food handlers' knowledge, attitudes and practices

Background

Studies have suggested that improper food-handling practices contribute to approximately 97% of foodborne disease incidents arising from food service establishments and the home (Howes et al., 1996). Consequently, in order to reduce foodborne disease, it is crucial to gain an understanding of the interaction between prevailing food safety beliefs, knowledge and practices of food handlers. Given the potential for contaminating food and the reported role of food handlers in causing foodborne disease, their behaviour is especially important in the preparation of poultry meat and egg dishes. It is critical to store foods properly, heat them adequately (to destroy any pathogens present) and minimise any cross-contamination of other foods, equipment and working surfaces with pathogens from poultry meat or eggs.

Caterers

The way in which caterers perceive the importance of the food hygiene knowledge they possess can influence their intentions and practices. Unfortunately, caterers often fail to realise the risks associated with their businesses (Clayton et al., 2002). One study of caterers' attitudes showed 12% felt that no great care was required in handling poultry meat and 14% had no reservations about serving only lightly-cooked eggs (Coleman et al., 2000). In other research, caterers have admitted that they often fail to implement all the food safety procedures they know (Clayton et al., 2002). Studies based on detailed observation of caterers handling raw poultry meat (Clayton and Griffith, 2004) confirmed failures in implementing hygiene practices, especially those concerning the prevention of cross-contamination.
These deficiencies included failure to take appropriate decontamination steps, such as handwashing and cleaning of surfaces, etc., after handling raw poultry. Barriers preventing the use of food safety procedures in catering have been reported and are mainly associated with lack of sufficient time and personnel (Clayton et al., 2002). One of the challenges facing governments and the food service industry worldwide is how to introduce the Hazard Analysis Critical Control Point (HACCP) system, into catering (Mortlock et al., 1999).
The system has been shown to be effective in improving the microbiological quality of food, and widening HACCP implementation in the catering industry will be increasingly important with intended new European Union regulations (Worsfold and Griffith, 2003). Caterers are not usually hostile to the HACCP system, although there are concerns that many businesses may not have appropriate hygiene practices in place to underpin any HACCP plans. In the UK, the Food Standards Agency (FSA) is using a strategy based on a `jargon-free' approach to implementing the HACCP system in catering operations; this is known as `Safe Food: Better Business'.

Consumers

A review of 88 international studies on consumer food safety knowledge, attitudes and practices has indicated the need for improvement (Redmond and Griffith, 2003). Knowledge, attitudes, intentions and self-reported practices did not correspond to observed behaviour. Consumers lacked knowledge of certain key issues, e.g. need for cooling of cooked food, while other hygiene practices were recognised, but specific requirements for their adequate implementation were poorly understood. Salmonella was invariably recognised as a potential pathogen, although relatively few consumers were familiar with the name Campylobacter. This is of concern, given the frequency and levels with which poultry is contaminated with the organism. Overall, consumers were aware of the generic need to cook foods properly in order to reduce the risk of foodborne disease.
In many cases, however, they were ignorant of how this could be achieved and monitored for different food products and cooking methods. Consumers often failed to appreciate the importance of the home as a location for acquiring food poisoning and generally believed that their own hygiene skills were adequate (demonstrating the illusion of control), while other peoples' practices presented a greater risk (Redmond and Griffith, 2003). Although some studies showed evidence that consumers may accept the view that food safety is a shared responsibility, numerous observational studies (Redmond et al.,, 2004) have indicated a common lack of good hygiene behaviour in the handling of both poultry meat and eggs. The extent of undercooking varied with the method of cooking used, while the risk of cross-contamination from the handling of raw poultry meat and eggs was considered high.

Poultry handling and risk assessment

Background

Risk assessment is a science-based type of investigation consisting of four steps: hazard identification, exposure assessment, hazard characterisation and risk characterisation (Griffith et al., 1998; Lammerding and Fazil, 2000). Microbial risk assessment (MRA) is concerned with the hazards presented by foodborne pathogens or associated toxins and attempts to determine the levels of risk associated with particular foods (Voysey, 2000). All forms of risk assessment usually involve some degree of quantification, ranging from the simple categories of high, medium or low risk to detailed mathematical calculations.
A number of quantitative risk models have been developed to assess the risk throughout the food chain associated with specific hazards, such as S. Enteritidis in eggs and salmonellas in frozen chicken (Brown et al., 1998; Anon., 2000; FSIS, 1998). These detailed risk assessments attempt to take account of variability (heterogeneity and diversity within systems) and uncertainty arising from imperfect knowledge (Dennis et al., 2002). The effect of the former cannot be reduced by additional knowledge, the latter can. One area of variability and uncertainty relates to the dose-response relationship. This is a simplified representation of the complex relationship between a dose and the adverse effect caused by a pathogen (Dennis et al., 2002). Dose-response relationship may vary considerably between strains of a pathogen (different potential for virulence) and between affected individuals (different host susceptibility).
Most dose-response modelling has used empirical models, often involving data from young, healthy individuals, but this can be improved by the use of mechanistic models (Dennis et al., 2002). Another topic, and possibly one with the greatest uncertainty and variability, relates to exposure assessment in food service establishments and the home (Anon, 2000).

Exposure assessment

Exposure assessment is an estimation of the likelihood that an individual or population will be exposed to a microbial hazard and the number of organisms likely to be ingested (Lammerding and Fazil, 2000). Accurate exposure assessment requires data on the occurrence of the hazard in raw ingredients, the circumstances under which the food is prepared and consumed, and the consumption patterns involved (Griffith et al., 1998; Lammerding, 1999). This type of data is more likely to be available for manufactured food items than for foods consumed in the home or in food service establishments. It is no surprise, therefore, that the majority of risk assessment models are based only on data obtained from the farm through to retail level (Anon., 2000). It is important to identify exposure pathways and assess their associated risk in order to inform both risk management and risk communication.
When food-service establishments or domestic food-preparation areas have been considered in the past, risk was usually associated with the adequacy of cooking. The need for data on cross-contamination in the kitchen environment and re-contamination of cooked and ready-to-eat foods has largely been neglected (Anon.,2000). Furthermore, cross-contamination is likely to be under-reported in the documented incidence of foodborne disease (Griffith, 2000). Most information available on domestic food handling is based upon self-reporting, and this may be misleading, with actual practices being quite different (Redmond and Griffith, 2003). An additional problem is that foodborne disease often results from a combination of errors or mal practices associated with specific foods, and this is not usually determined in self-reporting (Griffith et al., 1998).
Direct observational studies, in conjunction with microbiological testing, offer a more reliable data source in order to inform exposure assessment and hence the risk associated with food handling and preparation by consumers or caterers (Redmond and Griffith, 2003).

Exposure pathways

Although some studies have indicated that packaging could be a source of pathogens within the kitchen. In the UK, the rate for Campylobacter ranged from 3% (Harrison et al., 2001a) to 6% (Jùrgensen et al., 2002), with lower rates for Salmonella. More recently, data from New Zealand showed contamination rates for external packaging of 24% for Campylobacter and 0.3% for Salmonella (Wong et al., 2004). External contamination of raw chicken packaging has implications for food handlers in retail stores as well as in food service establishments and the home. Overall contamination of packaging material, taking both outer and inner surfaces (where the latter is in direct contact with the product), can be higher, up to 34% for Campylobacter and 11% for Salmonella (Harrison et al., 2001a).
The cooking stage for raw poultry meat is a Critical Control Point (Dillon and Griffith, 2001), and whether or not it is carried out correctly is likely to depend on the method of cooking used (Clayton and Griffith, 2004; Harrison et al., 2001b). Research has shown that domestic preparation of some chicken meals, such as curries and roast dinners, means that these are more likely to be cooked thoroughly and will ensure pathogen destruction. Other cooking techniques employed in the home, such as stir-frying and the use of barbecues, were more likely to allow survival of pathogens (15% and 20% undercooked respectively). Prior to meal preparation, only the poultry meat had been positive for Campylobacter and Salmonella, with all other foods and work surfaces being negative. This and other findings (ACMSF, 2004) highlight the need for careful handling of food, effective cleaning of surfaces, etc., and handwashing in kitchens.
The requirements of good hygiene practice are well described (Worsfold and Griffith, 1997; Redmond and Griffith, 2003), yet excessive generalisation, misunderstanding and confusion remain about key elements. For example, the washing of raw foods, as recommended by the Institute of Food Science and Technology (IFST, 2004) would increase the potential for cross-contamination of poultry meat, spreading Campylobacter, and other pathogens around the sink area (Griffith et al., 1999).

Guidelines

Hygiene guidelines for poultry meat and eggs usually consist of a list of `do's and don'ts', and what is often missing is the requirement for food handlers to think first about the practices they will use, i.e. an element of planning is required for hygienic handling, and raw poultry meat should be treated with respect. For example, if both hands are used or needed to unwrap the pack, then clean, hot soapy water should already be available in a sink or bowl for handwashing. Alternatively, unwrapping poultry portions can be undertaken, with relatively little additional effort, in such a way that only one hand is in contact with the raw meat and becomes contaminated. This leaves the other hand free to touch taps or appliances, thus avoiding contamination of kitchen surfaces.
Given the high initial levels of microbes on raw poultry meat and possible transfer rates of 10%, care needs to be taken to minimise the spread of any pathogens present during handling. Some individuals take more than three times the number of food-handling steps as others to prepare the same meal. The greater the number of activities, the greater the opportunity for cross-contamination, which could, in turn, be reduced by a little forethought and care. Although guidelines recommend cleaning of the kitchen after the handling of raw foods, this is often done poorly in both the home and commercial kitchens. Microbial counts from working surfaces, etc., are often higher after cleaning than beforehand (Griffith et al., 2002). Reasons for this include insufficient time for disinfectants to function properly, use of contaminated water, cloths or equipment and failure to rinse adequately.

Educating food handlers: training

Education and legislation have been advocated as part of a dual strategy to reduce food poisoning. Current UK legislation now contains a requirement for food handlers to be trained or supervised in accordance with their work activities. This was introduced in 1995, but, although industry considers training important, levels of training are variable, particularly with regard to different types of employee and food industry sector (Mortlock et al., 2000). The food service sector, in particular, lags behind, and there may be specific reasons for this. For example, it is recognised that there are many part-time food handlers, there is a high turnover of staff in some businesses and, for many, English is not their first language (Griffith, 2000).
Although more than four million people have been trained already, it has been estimated that this figure represents only 46% of all food handlers. However, even if food handlers are trained, there is no guarantee that their behaviour will always ensure that hygiene requirements are satisfied. Generally, there is a lack of information on the efficacy of staff training, although individual studies have produced mixed results, some showing an improvement in knowledge and others no improvement (Clayton and Griffith, 2004). In cases where knowledge improved, this did not necessarily change behaviour. Therefore, it has been suggested that training should include consideration of behavioural theory (Griffith, 2000). Continuing high levels of foodborne disease (Mortlock et al., 1999), coupled with repeated, basic errors in food handling, should act as a spur to make learning more effective and realise the need for improved food safety attitudes and culture.
Most studies of food hygiene learning have concentrated on the formal approach, as opposed to work-based learning (defined as learning at work, linked to a job requirement), although the two differ. Companies should try to develop training strategies that embrace both types of learning. Suggestions have been made for improving the quality of current formal courses, including changes to syllabuses, examinations and pass marks, as well as recognising the need for more HACCP training. The legislation itself has also been criticised. At present, the proprietor of a food-service establishment need not necessarily be trained and, whilst guides to the implementation of legal requirements provide a definition of a 'food handler', they are not themselves legal documents.
The following should be considered in purchasing or delivering formal training.
· Training should be targeted, specific and geared to the needs of the audience, using work-related examples.
· Information should be delivered within a hazard and risk framework.
· The content should be simple, accurate and jargon-free, delivered at an appropriate level that would promote understanding. It is important to cover both practice and theory - what to do and why.
· Trainers should have the respect of the trainees, i.e. be considered reputable and trustworthy, and have `street credibility'.
· The trainer should examine, with trainees, likely barriers to implementation of good practice in their workplace and how these can be overcome.
· Trainers should assess available facilities and equipment, and ensure that implementation of good practices is possible. If inadequate, the management should be informed.
· The correct management `culture' should be in place. Trainees must work in an environment where implementation of all good practices is the norm and inappropriate practices are not tolerated.
· A motivational framework should be provided to encourage training and implementation of learned behaviour.
· Training should address costs (including those of failure) as well as benefits. The latter may be financial, social or medical.
· The regular training programme requires updating periodically and the maintenance of training logs and records.
· The effectiveness of training should be evaluated as appropriate and improvements made where necessary.

Educating consumers: health education and social marketing

Until recently, educating the consumer about food hygiene has been largely ignored. The publicity concerning food poisoning in the UK in the late 1980s led to the production of different leaflets that provided generalised food safety advice for consumers. However, findings from other areas of health education suggest that, whilst leaflets can play a role in raising awareness, generally, they do not result in any behavioural change. Understanding the behaviour of food handlers is a complex process, with the use of behavioural scientists being recommended (Griffith et al., 1995) and subsequently used (Clayton et al., 2002; Clayton and Griffith, 2004).
Studies have been undertaken on the value of different sources of food safety information for the consumer (Griffith et al., 1994; Redmond et al., 2000), including TV, press, etc. Leaflets can provide people with information that will enable them to change, if they are motivated to do so. The largest, coordinated food safety campaign for UK consumers is National Food Safety Week, first launched by the Food and Drink Federation some ten years ago. In many countries, studies on consumer aspects of food safety have mostly relied upon self-reporting of behaviour. Fewer studies have focused on actual behaviour and, when these have been carried out, they have shown that consumers often do not know or understand hygiene principles and may not implement known hygiene practices when they do understand (Redmond and Griffith, 2003).
Difficulties in improving food safety practices among consumers have been reviewed and more recent attempts, using a social marketing approach, have had some success in changing behaviour (Redmond et al., 2000). Social marketing is the application of marketing techniques used in the commercial sector, to promote voluntary changes in socially important public health behaviour, e.g. drug use, smoking. Social marketing is a consumer-orientated approach that starts and ends with the target customer - the person whose behaviour needs to be changed. This requires the use of formative research, a careful evaluation of consumer behaviour and the identification of target risk groups, using audience segmentation.
A precise message is identified and the response to and beliefs about the message among the target audience are assessed, as well as the likelihood that individuals will change their behaviour. Results from these preparatory stages are then used to plan an initiative based upon marketing principles and involving the `4 Ps' or marketing mix. Social marketing initiatives are evaluated during planning and development, as well as after the implementation of the initiative.
Since the aim of social marketing is to achieve voluntary behavioural change, observation of targeted behaviour to evaluate initiative techniques is a preferable method of summative evaluation. This type of approach is more comprehensive and expensive than traditional approaches used in health education. Generally, the latter are more concerned with a top-down planning approach, imparting and receiving fact-based messages to increase consumer knowledge. Social marketers argue that an increase in knowledge is only important if it results in the desired, voluntary, behavioural change. Whilst there are differences between marketing commercial products and improving food handling, not least in terms of available budgets, there are potential benefits in adopting the marketing approach. Relatively small improvements in behaviour could significantly reduce the incidence and cost of foodborne disease.

Future trends

Poultry meat and eggs are relatively cheap, versatile and nutritious food products, and the demand is likely to increase further. Producers have a responsibility to ensure that these products are as free as possible from pathogens during production. However, a substantial proportion of all food poisoning is related to deficiencies in food service establishments and the home, and the role of food handlers and associated good food-handling practices, is paramount. Legislation for commercial organisations is becoming more stringent. This does not normally apply in the home; however, elements of good kitchen practice that are relevant to the home should be linked to risk-based consumer advice as part of public health protection. Achieving desirable food handling practices is likely to be of major importance to UK bodies such as the FSA, although this is only partly dependent on providing the relevant information.

Good food handling requires an understanding of the factors that influence human behaviour, and greater efforts need to be made to promote good handling practices, including those of consumers. There have been considerable achievements with respect to food safety training in the UK, but further improvements are required. A greater percentage of the workforce in the food industry requires training, and this training needs to be made more effective. In the future, more training will be needed, particularly with respect to the HACCP system; also, it is paramount that individual businesses provide the correct cultural framework and context for food safety to be practised. It is not only a food company's obligation to provide training, but also to allow the learning to be implemented in the workplace. Ultimately, failure to do so could cost a business money or even its survival; however, of possibly greater importance is the fact that it may cost someone their life.

By C. J. Griffith and E. C. Redmond, (University of Wales Institute Cardiff, UK), in the book "Food Safety Control in the Poultry Industry", edited by G. C. Mead, Published by Woodhead Publishing Limited, Cambridge,England, excerpts from pages 524 to 540. Adapted and illustrated to be posted by Leopoldo Costa.

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