Food allergy knowledge, attitudes, and practices of food handlers working in the five-star hotel kitchens in Turkey

Abstract

The purpose of this study is to determine the food allergy knowledge, attitudes and practices of food handlers working in five-star hotel kitchens in Turkey and to explore the association between the obtained scores and handlers’ demographic and working characteristics. A cross-sectional survey involving 450 food handlers in the state of Istanbul, Ankara and Antalya, in Turkey, was conducted using a paper-based questionnaire. The total knowledge score of the participants was 11.89 ±2.22 (max 17), attitude score 60.63 ±10.34 (max 75) and practice score 55.60 ±8.01 (max 65). In the comparison based on demographic characteristics; the knowledge (12.10 ±2.15) and practice (56.33 ±5.91) scores of the food handlers who received food allergy training in the hotel they work were found to be significantly higher than those who did not receive food allergy training (p<0.05). Food allergy knowledge of food handlers was evaluated as "average", attitude as "positive", and practice as "low risk practice". The results obtained are expected to contribute to the development of food allergy policies, procedures, and the planning of the necessary trainings for reducing the risks of food allergies and preventing fatal allergic reactions.

Keywords

• Food allergy
• Knowledge
• Attitude
• Practices
• Food Handlers
• Hotel Kitchen

References

1. Abbot, J.M., Bryd-Bredbenner, C., Grasso, D. (2007). Know before you serve: Developing a food-allergy fact sheet. Cornell Hotel and Restaurant Administration Quarterly, 48, 274-283. https://doi.org/10.1177/0010880407302779
2. Ahuja, R., Sicherer, S.H. (2007). Food allergy management from the perspective of restaurant and food establishment personnel. Annals of Allergy, Asthma and Immunology, 98, 344-348. https://doi.org/10.1016/S1081-1206(10)60880-0
3. Ansari-Lari, M., Soodbakhsh, S., Lakzadeh, L. (2010). Knowledge, attitudes and practices of workers on food hygienic practices in meat processing plants in Fars, Iran. Food Control, 21, 260-263. https://doi.org/10.1016/j.foodcont.2009.06.003
4. Bailey, S., Kindratt, T.B., Smith, H., Readingi, D. (2014). Food allergy training event for restaurant staff; a pilot evaluation. Clinical and Translational Allergy, 4, 26-29. https://doi.org/10.1186/2045-7022-4-26
5. Baser, F., Ture, H., Abubakirova, A., Sanlier, N., Cil, B. (2017). Structural modeling of the relationship among food safety knowledge, attitude and behavior of hotel staff in Turkey. Food Control, 73, 438-444. https://doi.org/10.1016/j.foodcont.2016.08.032
6. Bock, S.A., Munoz-Furlong, A., Sampson, H.A. (2001). Fatalities due to anaphylactic reactions to food. Journal of Allergy and Clinical Immunology, 107, 191-193. http://dx.doi.org/10.1067/mai.2001.112031
7. Boyce, J.I. (2012). Food allergies in developing and emerging economies: need for comprehensive data on prevalence rates. Clinical and Translational Allergy, 2(1), 25. http://dx.doi.org/10.1186/2045-7022-2-25
8. Choi, J.H., Rajagopal, L. (2013). Food allergy knowledge, attitudes, practices and training of foodservice workers at a university foodservice operation in the Midwestern United States. Food Control, 31(2), 474-481. http://dx.doi.org/10.1016/j.foodcont.2012.10.023

9. Clayton, D.A., Griffith, C.J., Price, P., Peters, A.C. (2002). Food handlers beliefs and self-reported practices. International Journal of Environmental Health Research, 12(1), 25-39. https://doi.org/10.1080/09603120120110031
10. Common, L.A., Corrigan, C.J., Smith, H., Bailey, S., Harris, S., Holloway, J.A. (2013). How safe is yourcurry? Food allergy awareness of restaurant staff. Journal of Allergy and Therapy, 4, 4. https://doi.org/10.4172/2155-6121.1000140
11. Dupuis, R., Meisel, Z., Grande, D., Strupp, E., Kounaves, S., Graves, A., Frasso, R., Cannuscio, C.C. (2016). Food allergy management among restaurant workers in a large US city. Food Control, 63, 147-157. https://doi.org/10.1016/j.foodcont.2015.11.026
12. FARE (2020). Facts and statistics, available at: www.foodallergy.org/facts-and-stats (accessed 20 January 2020).
13. Gaspar-Marques, J., Carreiro-Martins, P., Papoila, A.L., Caires, I., Pedro, C., Araujo-Matins, J., Virella, D., Rosado-Pinto, J., Leiria-Pinto, P., Neuparth, N. (2014). Food allergy and anaphylaxis in infants and preschool-age children. Clinical Pediatrics, 53, 7. http://dx.doi.org/10.1177/0009922814527502
14. Güler, N. (2019). Türkiye’de her 17 çocuktan birinde besin alerjisi görülüyor!, available at: https://www.milliyet.com.tr/pembenar/turkiye-de-her-17-cocuktan-birinde-besin-alerjisi-goruluyor-2870434 (accessed 12 Jaunary 2020).
15. Kwon, J., Lee, Y.M. (2012). Exploration of past experiences: attitudes and preventive behaviors of consumers with food allergies about dining out: a focus groupstudy. Food Protection Trends, 32, 736-746. http://hdl.handle.net/2097/9791
16. Kwon, J., Lee, Y.M., Wen H. (2020). Knowledge, attitudes, and behaviors about dining out with food allergies: A cross-sectional survey of restaurant customers in the United States. Food Control, 107. https://doi.org/10.1016/j.foodcont.2019.106776
17. Lee, Y. M., Sozen, E. (2018). Who knows more about food allergies - restaurant managerial staff or employees? British Food Journal, 120(4), 876-890. https://doi.org/10.1016/j.ijhm.2016.05.004
18. Lee, Y.M., Barker, G.C. (2016). Comparison of food allergy policies and training between Alabama (AL) and National Restaurant Industry. Journal of Culinary Science and Technology, 15(1), 1-16. https://doi.org/10.1080/15428052.2016.1185071
19. Lee, Y.M., Sozen, E. (2016). Food allergy knowledge and training among restaurant employees. International Journal of Hospitality Management, 57, 52-59. https://doi.org/10.1016/j.ijhm.2016.05.004
20. Lefevre, S., Abitan, L., Goetz, C., Frey, M., Ott, M., Blay, F. (2018). Multicenter survey of restaurant staff's knowledge of food allergy in Eastern France. Allergy Journal International, 28, 57-62. https://doi.org/10.1007/s40629-018-0062-21-6
21. Lorcu, F. (2015). Örneklerle veri analizi spss uygulamalı. Ankara: Detay Publishing. ISBN: 9786054940899
22. Madsen, C. B., Crevel, R., Chan, C. H., Dubois, A. E. J., Galvin, D. A., Blok, B. M. J. F., et al. (2010). Food allergy: Stakeholder perspectives on acceptable risk. Regulatory Toxicology and Pharmacology, 57(2-3), 256-265. http://dx.doi.org/10.1016/j.yrtph.2010.03.003
23. Mandabach, K.H., Ellsworth, A., Vanleeuwen, D. M., Blanch, G., Waters, H.L. (2005). Restaurant managers knowledge of food allergies. Journal of Culinary Science and Technology, 4(2-3), 63-77. http://dx.doi.org/10.1300/J385v04n02_05
24. National Institute of Allergy and Infectious Diseases (2019). Food allergy, available at: www.niaid.nih.gov/diseases-conditions/food-allergy (accessed 2 June 2019).
25. Olivier, C.E. (2013). Food allergy. Journal of Allergy and Therapy, 4, 1-7. https://doi.org/10.4172/2155-6121.S3-004
26. Sampson, H.A. (2004). Update on Food Allergy. Journal Allergy Clinical Immunology, 113, 805-819. https://doi.org/10.1016/j.jaci.2004.03.014
27. Sapan, N., Esen, D., Tamay, Z., Akçakaya, N., Güler, N., Yazıcıoğlu, M., Karaman, Ö., Akçay, A., Öneş, U. (2013). Pediatric allergy and asthma academy, food allergy diagnosis and treatment protocol. Türk Pediatri Arşivi, 48(4), 270-274. https://doi.org/10.4274/tpa.2029
28. Seaman, P., Eves, A. (2010). Perceptions of hygiene training amongst food handlers, managers and training providers - A qualitative study. Food Control, 21, 1037-1041. https://doi.org/10.1016/j.foodcont.2009.12.024
29. Seth, D., Poowutikul, P., Pansare, M., Kamat, D. (2020). Food allergy: a review. Pediatric Annals, 49(1), 50-58. https://doi.org/10.3928/19382359-20191206-01
30. Shafie, A.A., Azman, A.W. (2015). Assessment of knowledge, attitude and practice of food allergies among food handlers in the state of Penang, Malaysia. Public Health, 129(9), 1278-1284. https://doi.org/10.1016/j.puhe.2015.03.016
31. Sicherer, S.H. (2011). Epidemiology of food allergy. Journal of Allergy and Clinical Immunology, 127(3), 594-602. https://doi.org/10.1016/j.jaci.2013.11.020
32. Sicherer, S.H., Sampson H.A. (2014). Food allergy: epidemiology, pathogenesis, diagnosis, and treatment. Journal Allergy Clinical Immunology, 133(2), 291-307. https://doi.org/10.1016/j.jaci.2013.11
33. Sogut, A., Kavut, A.B., Kartal, İ., Beyhun, E.N., Çayır, A., Mutlu, M., Ozkan, B. (2015). Food allergy knowledge and attitude of restaurant personnel in Turkey. International Forum of Allergy and Rhinology, 5(2), 157-161. https://doi.org/10.1002/alr.21427
34. Soon, J.M. (2019). Food allergen knowledge, attitude and practices among UK consumers: A structural modelling approach. Food Research International, 120, 375-381. https://doi.org/10.1016/j.foodres.2019.03.008
35. Stjernat, M.L., Vetander, M., Wickman, M., Olin Lauritzen, S. (2014). The management of situated risk: a parental perspective on child food allergy. Health, 18(2), 130-145. https://doi.org/10.1177/1363459313481234
36. Tatlı, M., Akoglu, A. (2020). Food allergy knowledge, attitude and practices of restaurant employees in Istanbul, Turkey. Academic Food, 18(2), 125-134. https://doi.org/10.24323/akademik-gida.758812
37. Ural, A., Kılıç, I. (2013). Bilimsel Araştırma Süreci ve SPSS ile Veri Analizi, Ankara: Detay Publishing. ISBN: 9789758969173
38. Wen, H., Kwon, J. (2017). Restaurant servers risk perceptions and risk communication-related behaviors when serving customers with food allergies in the U.S. International Journal of Hospitality Management, 64, 11-20. https://doi.org/10.1016/j.ijhm.2017.03.009
39. Wham, C.A., Sharma, K.M. (2014). Knowledge of café and restaurant managers to provide a safe meal to food allergic consumers. Nutrition and Dietetics, 71(4), 265-269. https://doi.org/10.1111/1747-0080.12104