Food For Life..

In average, it is
estimated that human
need about 2 kilogram
of food every day.
Food for sustaining life,
gain energy, promote
growth, and more..

However, not all food are

safe to eat!
Food can: Transmit disease from
person to person
Provide a favourable
condition for the growth
of microorganisms
Making the food unsafe
to eat.

The consumption of unsafe food lead

to the occurrence of FOODBORNE

THE OCCURRENCE OF FOODBORNE DISEASE AND ITS PREVENTION-

A FOCUS ON FOOD HANDLER

Present by:SITI SOFEA BINTI MD DIAH (SEQ110017)
&
SITI AZWANI BINTI MUHAMAD (SEQ110015)

Foodborne disease become a major

concern throughout the world.
Why?
Every year, millions of people throughout the world fall ill
and die as a consequence of foodborne disease due unsafe
food consumption. (WHO, 2009)
Foodborne disease outbreak affects the population,
become the most widespread health problem in the world.
This reduced economic productivity, related to lower work
productivity, hospitalization and other health care
expenses

Factors of foodborne
diseases (WHO, 2006)
Improper cooking procedures
Temperature abuse during storage
Lack of hygiene and sanitation by the food
handlers
Cross contamination between fresh ready-to-eat
foods and raw foods
Acquiring food from risky sources.

Foodborne Disease and

Food Handler
Main contributing factor of foodborne diseases cases in
Malaysia was identified as insanitary food handling
procedures which accounted for more than 50% of the food
poisoning episodes (MOH, 2007).
Salleh et al. (2007) also revealed that the foodborne
illnesses cases that were reported in Malaysia during 2007
also caused by poor hygiene practice among food handlers.
While food borne pathogens is the cause of about 30% of
human diseases (Serraino et al., 2010), Nyi et al. (2007)
highlighted that food handlers implicated about 10 to 20%
of the disease outbreaks.

OBJECTIVES
To review the role of food handlers as the agent
of foodborne disease transmission.
To review the role of food handlers as the key
player in foodborne disease prevention.

WHO IS FOOD HANDLER?

Food Act 1983 (2012), food handlers are defined
as those people who are
(1) directly participate in the food preparation,
(2) in contact with food or food contact surfaces,
and
(3) managing or
unwrapped food,

controlling

wrapped

or appliances, in any food premises.

or

AGENT OF
TRANSMISSI
ON

KEY PLAYER
IN
PREVENTION
THE ROLE
OF FOOD
HANDLER
IN
FOODBOR
NE
DISEASE

Food handler as the

agent of foodborne
disease transmission

Cross contamination by
food handler
About 10% to 20% of the foodborne disease
episodes are caused by the contamination of
food handlers (Zain & Naing, 2002).
Cross contamination occurs when the food that
initially safe to eat had comes into contact with
particularly foodborne pathogens causing the
food not safe to be eat anymore.

Health
Status
Personal
Hygiene

Knowledg
e
Factors
influence
cross
contaminati
on by food
handler

Health
Status
Personal
Hygiene

Knowledg
e
Factors
influence
cross
contaminati
on by food
handler

PERSONAL HYGIENE
Personal hygiene is a key concept of cleanliness
of an individuals body by sanitation practices in
maintaining a good health.

Personal hygiene
Hand
hygiene

Attire

Personal
behavio
ur

ASPECT OF PERSONAL HYGIENE:

1)

HAND HYGIENE

Most of the foodborne outbreaks caused cross

contamination of food handlers hands that are
potentially become a vector to transmit pathogens.
Bare hands have a great deal to do with the chances
of food contamination by food handler, causing
foodborne disease.
Fingernails had been recognized not only as a part of
hand that habour with lots of microorganism but
also is the hardest part of hand to be clean.

 Two groups of microorganisms that might present on the hands:

Microflora - lived naturally on the hands. Staphylococcus aureus are

microflora that can be found naturally on the hands of food handlers.
Foreign germs- usually harmful microoganisms that present on the skin
accidentally. The retention of the germs on food contact surfaces will
increase the chances of cross contamination of food.

The foreign germs can be removed through frequent and proper

hand washing.
Even though we wash our hands frequently and looked clean, the
microflora can still be there. This is why the food handlers are not
advised to use their bare hands to touch the foods.

 The pathogens transmission to the hands can happen

due to poor personal hygiene after going to toilet.
The intestinal organisms such as Escherichia coli, may
get hooked to the hands of food handlers after they go
to the toilet without washing their hands or washing
their hands inappropriately before continuing their work.
When the faeces containing intestinal organisms are on
their fingers, it will contaminate the food they handle,
affecting the consumers health.

ASPECT OF PERSONAL HYGIENE:

2)

ATTIRE

Dirty clothes can habour microorganisms, lead

to the transmission of pathogens to the food.
The pathogens cannot jump from clothes to the
food.
However, the food handlers hands are
constantly in contact with clothes, facilitate the
transmission of pathogens from one to another.

ASPECT OF PERSONAL HYGIENE:

3)

PERSONAL BEHAVIOUR

Bad habit practiced by food handler can also cause

food contamination.
For example, picking or digging their nose, and
licking their fingers while handling their foods. The
microflora on their nose and fingers that are
potentially to cause disease can be transferred to
the food.
Smoking also are bad habit that lead to the food
contamination. Smoke and ash of cigarette are
harmless. However, many smokers contaminate

Health
Status
Personal
Hygiene

Knowledg
e
Factors
influence
cross
contaminati
on by food
handler

HEALTH STATUS
Previous researches have shown that, those food handlers who
are infected or sick can cause foodborne diseases transmission.
Michaels et al. (2004) highlighted that infected food handlers
could transmit infectious intestinal diseases (IID) caused by
foodborne pathogens.
The study listed 15 organisms associated with infected food
workers during the outbreak, including: Caliciviruses (norovirus),
Salmonella spp., Hepatitis A, Shigella spp., Staphylococcus
aureus, Streptococcus pyogenes, Salmonella typhi/parathyphi,
Vibrio cholera 01, Yersinia enterocolitica, Giardia lamblia,
Campylobacter jejuni, Cryptosporidium parvum, Escherichia coli
O157:H7, Cyclospora cayetanensis, and Entamoeba histolytica.

Health
Status
Personal
Hygiene

Knowledg
e
Factors
influenced
cross
contaminati
on by food
handler

KNOWLEDGE
Food handlers with lack of food safety knowledge
had caused foodborne pathogen transmission.
This includes the transmission of Staphylococcus
aureus, Escherichia coli, Salmonella sp. and Vibrio
spp. from food handler to consumer, causing
foodborne disease.
In fact, Lambiri et al. (1995) suggested that lack of
knowledge may result in poor hygiene practices
among food handlers.

Overall pathway

- Personal
hygiene
- Health status
- Knowledge

Cross
contaminati
on

Foodborne
disease
occurrence

FOOD HANDLER AS THE KEY

PLAYER IN THE FOODBORNE
DISEASE PREVENTION

 Good health reduces the chances of food handler to

be a carrier of infectious pathogens; cleanliness
reduces the chances of spreading pathogens of
which he or she might be the source; and the
willingness to learn about sanitation optimizes the
chances of having effective sanitation practices.
3 ways of prevention:

i - Health control
ii - Cleanliness
iii - Education

(1) Health Control

Vaccination - first line of protection
Under the Malaysian Food Act 1983 and Food Hygiene
Regulation 2009, all food and beverages (F&B) handlers in
Malaysia are obligated to get typhoid vaccination.
Typhoid fever caused by human reservoir pathogen,
Salmonella Typhi, is potentially transmitted to the consumers
after the consumption of food or water contaminated with the
feces of food handlers who have the disease.
According to CDC (2013), there are two forms of typhoid
vaccines presented, which are killed (ViPS) and live-attenuated
(Ty21a) vaccines that can be taken by shot or oral.

 The effectiveness of each dose of vaccine lasts for three

years long and revaccination is highly recommended for
the food handlers to maintain the protection.
The significance of this vaccination (CDC, 2014):
- Decrease in typhoid cases after its implementation
- Participation of 48 countries worldwide in this
programme
which targeting the high-risk groups including food
handlers.
Therefore, it is essential for the person who handle foods to
have typhoid vaccination as a early precaution as well as
practicing the correct basic hygiene in daily routine.

(2) Cleanliness
Good hygiene, both personal or in food handling practices
acts as a fundamental prerequisite for food handlers in
preventing the transmission of pathogens.
Zain and Naing (2002) stated that hand sanitation has
become one of the most crucial parts in the daily foodproducing premises.
A correct hand washing procedures especially to the food
handling employees should be paid attention.
A food handler should wash their hands at every stage of
food preparation, before handling foods, after eating,
after using toilet and after touching contaminated
materials.

 Food handlers who are directly in-contact with ready-toeat (RTE) foods should wash their hands thoroughly
using soap under hot running water and dry their hand
with a single-use towel; use hand sanitizers and wear a
sanitized waterproof glove during food handling (CDC,
2010).
FDA Food Code (2005) suggested that hand washing
should be done under running water for at least 20
seconds with minimum water temperature of 38C.
There is a significant reduce in hand contamination when
the food handlers practiced a strict hand-washing after
using the toilet (Shojaei et al. 2006).

 Radiers (2008) emphasize on the prohibition of using

accessories during food preparation as a mean for safe
food handling.
In fact, over 90% of food makers believe that the use of
protective cloth, gloves and proper storage should be
applied in minimizing food safety risks to the consumers
(Buccheri et al., 2010)
A food handler who has a cut or wound on his or her
hand is not allowed to prepare foods until it is
completely covered with a highly secured waterproof
bandage.

(3) Education
Food handlers training is seen as one strategy to
increase the food safety awareness, thus providing
long-term benefits to the food industry.
This has been proved by Lynch et al. (2003), as they
found the improvement of knowledge regarding food
safety issues among food service employees through
food safety training.
In Malaysia, Food handlers training programme was
launched in 1996 by Ministry of Health and it is
compulsory for all food handlers as well as the
merchants to attend the courses in order to get or
renew their license (FAO/WHO, 2004).

 The module of this training contains the

information on foodborne diseases, personal
hygiene, food handling practices and the latest
recommended procedures in conserving the
quality and safety of food produced.
A continuous and periodic training on food
hygiene is essential in increasing food safety
knowledge as well as preventing the previous
information from being forgotten.

 Previous findings had revealed that there are

some improvements in hygienic conditions and
microbiological quality of foods prepared by the
trained food handlers in cafeteria (Acikel et al.,
2008; Veiros et al., 2009).
Due to this, the importance of food safety training
together with effective education has been
emphasized as a mean to create a hygienic foodhandling practices.

Conclusion
Food handlers play 2 roles in foodborne disease
occurrence.
First, they act as the agent of foodborne disease
transmission. Generally, they cause foodborne disease
via cross-contamination which is influenced by three
factors; personal hygiene, health status and knowledge.
Second, they act as key player in foodborne disease
prevention based on 3 aspects; health control,
cleanliness and education.

Limitation?
Most of the studies rely on self-reported cases
by the food handlers. It exhibits bias:
no confirmation during completing the
questionnaires
as
they
might
have
misinterpreted the statement and choices.
do no reflect the actual behaviour and
practices in the kitchen.

Recommendation?
Future research should focus more on food handlers handwashing habits especially on correct hand washing
procedures and the common error practiced by food handler
during hand washing.
Further study should focus on the actual practices of the
food handlers instead of solely depending on self-reported
data.
In addition, the effectiveness of the food handlers training
should be studied deeper in order to make sure the module
provided is good enough to improve food handlers
knowledge and food safety awareness.

THANK YOU