1. Food Handling in the Home What are Consumers Really Doing and How Effective are the Risk Communication Messages They are Receiving? Lydia C. Medeiros, Ph.D., R.D. Professor, Human Nutrition and Food Safety Department of Human Nutrition The Ohio State University

2. Objectives for Today’s Talk What are the important consumer food handling behaviors and do they practice this behavior in the home? Where do consumers get their food safety information and do they use it effectively?

3. ...is most effective when targeted toward changing those behaviors that are most likely to result in foodborne illness. Food Safety Education...

4. Food Handling Behaviors to Control Foodborne Illnesses Food Handling Behaviors to Control Foodborne Illnesses Methods Expert Panel Web-based Delphi study Review, Revision, Reflection Application Medeiros et al. JADA 2001;101:1326-1339. Kendall et al., JADA 2003; 103:1646-1649. Hillers et al., J Food Protec. 2003;66:1893-1899.

5. Human Fecal Pathogens Norovirus Shigella spp. Hepatitis A All cause illness with small number of cells Practice Personal Hygiene Hillers et al., J Food Protec. 2003;66:1893-1899.

6. Wash hands with warm soapy water before handling food If you are ill with diarrhea, only prepare food for yourself but not others Properly bandage and glove cuts and burns on hands before handling food Practice Personal Hygiene Medeiros et al. JADA 2001;101:1326-1339.

7. Washed hands with warm soapy water before handling food Low-Income Women, Simulated Food Prep Study (n=70) Kendall t al., J Food Protec. 2004;67:2578-2586. BehaviorObservation (n, %) Yes, washed before...64 (91.4) Yes, but incorrectly washed...4 (5.7) * No, did not wash...2 (2.8) * 3 rinsed only, 1 cleaned while washing dishes

8. How often do you typically wash your hands in a day? Rural Farm and Non-Farm Homeowners (n=52) FrequencyNumber (%) Less than 5 X / day3 (5.7) 5-10 X / day24 (45.3) > 10 X / day25 (47.2) No difference farm/ non-farm (P<.05) Doorn et al. 2008, Manuscript in preparation.

9. Do you wash your hands with soap and water prior to eating? Rural Farm and Non-Farm Homeowners (n=52) FrequencyNumber (%) Never1 (1.9) Sometimes7 (13.2) Usually15 (28.3) Always29 (54.7) No difference farm/ non-farm (P<.05) Doorn et al. 2008, Manuscript in preparation.

10. Zoonotic Pathogens Campylobacter jejuni Salmonella spp. Vibrio spp. Toxoplasma gondii Yersinia enterocolitica E. coli O157:H7 Same pathogens are associated with both control factors Cook Food Adequately and Avoid Cross-Contamination Hillers et al., J Food Protec. 2003;66:1893-1899.

11. Use a thermometer to make sure that meat and poultry are cooked to safe temperatures Cook shellfish until the shell opens and flesh is fully cooked; cook fish until flesh is opaque and flakes easily with a fork If pregnant, immunocompromised, or elderly, heat hot dogs and lunch meats to steaming hot or 165 o Cook Foods Adequately Medeiros et al. JADA 2001;101:1326-1339.

12. How would you judge if the following meats are adequately cooked prior to consumption? Rural Farm and Non-Farm Homeowners (n=52) FoodThermometerTimeVisual Whole chicken (roasted) 26 (49.1)31 (58.5)29 (54.7) Ground beef (grilled)6 (11.3%)26 (49.1)37 (69.8) Beef steak (grilled)7 (13.2)25 (47.2)39 (73.6) Pork roast (roasted)25 (47.2) 20 (37.7) Doorn et al. 2008, Manuscript in preparation. No difference farm/ non-farm (P<.05)

13. Wash knives, cutting boards and food preparation surfaces with hot water and soap after contact with raw poultry, meat and seafood Clean food preparation surfaces with paper towels or clean cloths and hot soapy water before and after food preparation. Avoid Cross-Contamination Medeiros et al. JADA 2001;101:1326-1339.

14. Risk Factors for Contamination Household Listeria monocytogenes Rural Farm and Non-Farm Homeowners (n=52) Type of contaminationRisk Factors Environmental contamination (LM positive on sink, counter, or refrigerator) Model: R 2 = 0.179, P<0.001 Animal factor score Behaviors associated with factor score Contact with a pet cat House cat goes outside Location of where cat fed – household living quarters, such as kitchen Location of cat litter box – household living quarters, such as kitchen Doorn et al. 2008, Manuscript in preparation.

15. Pathogens associated with temperature abuse C. perfringens Staph aureus Bacillus cereus Cause relatively mild illnesses Keep Foods at Safe Temperatures Hillers et al., J Food Protec. 2003;66:1893-1899.

16. Store all perishable foods at or below 40⁰F (4.4⁰C) Do not prepare food more than 2 hours before serving without plans for proper cooling and reheating Keep hot food at or above 140⁰F (60⁰C) Keep Foods at Safe Temperatures Medeiros et al. JADA 2001;101:1326-1339.

17. Refrigerator Temperature Rural Farm and Non-Farm Homeowners (n=52) Statistic Temperature ( ̊F) Temperature ( ̊C) Mean (Standard error mean)39.7 (0.60)4.3 (0.33) Minimum recorded temperature30-1.1 Maximum recorded temperature *5010 Doorn et al. 2008, Manuscript in preparation. * Number of households above 40 ̊F (4.4 ̊C) = 19 (37%)

18. Defined as refrigerated, ready-to-eat foods produced or processed in some way that doesn’t kill pathogens Some foods are higher risk than others Level of risk dependent on life-stage and immune status pregnancy, childhood, elderly, immune-compromised Avoid Foods from Unsafe Sources Kendall et al., JADA 2003; 103:1646-1649.

19. Drink only pasteurized milk and fruit juices Avoid eating raw sprouts If pregnant, immunocompromised, or elderly: avoid soft cheeses, cold smoked fish, cold deli salads avoid hot dogs and lunch meats that have not been reheated to steaming hot or 165º F Avoid Foods from Unsafe Sources Kendall et al., JADA 2003; 103:1646-1649.

20. Food Preferences Pregnant Women At-Risk FoodFrequency Cold deli or lunch meats, served without reheating65% Alfalfa or other raw sprouts56% Soft cheeses42% Homemade cookie dough that contains raw eggs40% Eggs with runny yolks36% Smoked fish served cold without reheating26% Raw fish or foods containing raw fish15% Rare or medium-rare hamburger12% Raw (unpasteurized) milk 9% Athearn et al. Maternal Child Health J 2004; 8:149-162

21. Factors influencing cancer patients’ willingness to follow food safety recommendations. Medeiros et al., 2008, J Food Protec. In press

22. Acknowledgements Funded by USDA, National Research Initiative USDA, National Integrative Food Safety Initiative Research Team Ohio State University –Jeffery LeJeune –Gang Chen –Janet Buffer Colorado State University –John Sofos –Patricia Kendall –Mary Schroeder Washington State University –Virginia “Val” Hillers –Verna Bergman

23. Questions? Rooster Research, 2008