HACCP and food hygiene in hospitals: Knowledge, attitudes, and practices of food-services staff in Calabria, Italy

OBJECTIVES: To determine adherence to Hazard Analysis and Critical Control Points (HACCP) methods and to evaluate knowledge, attitudes, and practices of food-services staff with regard to food hygiene in hospitals. DESIGN: A survey. PARTICIPANTS: Hospital medical directors and food-services staff of 36 hosp itals in Calabria, Italy. METHODS: A questionnaire about hospital characteristics, food-services orga nization, and measures and procedures for the control and prevention of foo dborne diseases was sent to medical directors; a questionnaire about demogr aphic and practice characteristics, knowledge, attitudes, and behaviors abo ut control and prevention of foodborne diseases was sent to food-services s taff. Multiple logistic regression analysis was performed. RESULTS: Only 54% of the 27 responding hospitals were using the HACCP syste m and, of those using HACCP, 79% adopted a food-hygiene-practice manual; mo re than one half already had developed written procedures for food storage, personal hygiene, cleaning and disinfection; one half or less performed mi crobiological assessment of foods and surfaces. Of the 290 food-services st aff who responded, 78.8% were aware of the five leading foodborne pathogens ; this knowledge was significantly higher among those with a higher educati onal level and those who worked in hospitals that had implemented the HACCP system. Younger staff and those who had attended continuing educational co urses about food hygiene and hospital foodborne diseases had a significantl y higher knowledge of safe temperatures for food storage. A positive attitu de toward foodborne-diseases prevention was reported by the great majority, and it was significantly higher in older respondents and in those working in hospitals with a lower number of beds. Only 54.9% of those involved in t ouching or serving unwrapped raw or cooked foods routinely used gloves duri ng this activity; this practice was significantly greater among younger res pondents and in those working in hospitals using HACCP. CONCLUSION: Full implementation of the HACCP system and infection control p olicies in hospital food services is needed.