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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 personProvide 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 DISEASE.THE OCCURRENCE OF FOODBORNE DISEASE AND ITS PREVENTION- A FOCUS ON FOOD HANDLERPresent 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 expensesFactors of foodborne diseases (WHO, 2006)Improper cooking proceduresTemperature abuse during storageLack of hygiene and sanitation by the food handlersCross contamination between fresh ready-to-eat foods and raw foodsAcquiring food from risky sources. Foodborne Disease and Food HandlerMain 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. OBJECTIVESTo 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 controlling wrapped or unwrapped food, or appliances, in any food premises. Food handler as the agent of foodborne disease transmissionCross contamination by food handlerAbout 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.

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

ASPECT OF PERSONAL HYGIENE:

1) HAND HYGIENEMost 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) ATTIREDirty 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 BEHAVIOURBad 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 their fingers with saliva while taking the cigarette from their lips or when loose pieces of tobacco from mouth.HEALTH STATUSPrevious 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. KNOWLEDGEFood 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 pathwayFOOD HANDLER AS THE KEY PLAYER IN THE FOODBORNE DISEASE PREVENTIONGood 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 controlii - Cleanlinessiii - Education

(1) Health ControlVaccination - 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.

28(2) CleanlinessGood 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 food-producing 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-to-eat (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) EducationFood 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 food-handling practices.

ConclusionFood 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 hand-washing 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