Evaluation of Food Safety and Handling Knowledge and Practice among Students Studying in Jordan University

This thesis evaluates the current levels of knowledge and practice of food safety and handling among university students in Jordan, and provides useful insights for future research and educational interventions to improve their food handling knowledge and practice.

Running head: FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
THESIS: EVALUATION OF FOOD SAFETY AND HANDLING KNOWLEDGEAND
PRACTICE AMONG STUDENTS STUDYING INJORDAN UNIVERSITY
Name of the Student:
Name of the University:
Author note:

2FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
Chapter 1: Introduction
1.1. Research Background
As researched by Lammie and Hughes (2016), the intake of food which is nutritionally
balanced and wholesome is essential for acquiring the ability, energy and skill required to
perform activities of daily living. Taking insights from Griffith, Jackson and Lues (2017), in
order to gain the nutritious qualities of food items in the most optimum forms for utilization in
daily life, it is equally important to indulge in the intake of food which is devoid of
contamination from spoilage causing microbial sources and is hence, safe.
In order to prevent acquisition of food borne illnesses and its associated symptoms which
are highly likely to be fatal, the need of the hour is to maintain and conduct food safety and
handling practices of acceptable standards and credibility. As researched extensively by Green
and Knechtges (2015), procedures which are related to preparing, consuming and serving food
which is safe and nutritious, collectively comprise of food safety and handling practices and
must be implemented with the aim to improve the confidence level associated with it regarding
the presence of any dangers of food borne disease associated with the food. Taking insights from
Oliveira et al. (2019), a number of internationally accepted and certified standards of safe food
handling to reduce pathogenic contamination are followed by commercial industries associated
with food processing and manufacturing, namely: Standard Operating Procedures (SOP), Good
Manufacturing Practices (GMP) and Hazard Analysis Critical Control Point (HACCP). As
researched by Liu and Niyongira (2017), equal responsibility also lies upon consumers to indulge
in safe and hygienic practices during handling of food at the household. Authors Machariaet al.
(2018), noted that such food handling practices at the household level, comprises of maintaining

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correct temperatures during cooking and handling of food, disinfecting utensils and counters
used for preparing food, preventing cross contamination of different foods and utensils used for
cooking varied foods, along with maintaining domestic standards of hand hygiene.
As researched by Nik Hussain et al. (2016), current incidence and prevalence rates of
diseases caused due to food borne pathogens and food spoilage are increasing at dangerous levels
even though adequate standards of food safety and handling practices as well as educational
resources of foods continue to exist in most commercial food manufacturing industries and
organizations. The Food and Agricultural Organization (FAO) and World Health Organization
(WHO), report that a total of 2.2 million deaths worldwide are caused due to food borne illnesses
(Farahat, El-Shafie and Waly 2015.).Further, as researched by Hasaan and Dimaassi (2014), an
estimated 1.8 million deaths worldwide across children have been caused due to food borne
illnesses, hence necessitating the need to take immediate action to address their severity. It has
been further estimated that almost 40% of disease cases have been caused at the household level
due to inadequate handling of food and lack of adherence to hygiene, which further decreases
their possibilities of being reported. Further, taking insights from Evans and Redmond (2016),
consumers and household inhabitants are at a greater risk of suffering from food borne diseases
since such populations largely lack awareness on the standard procedures for hygienic food
handling, such as disinfecting areas required for preparing food, personal hand hygiene, cleaning
of kitchen counters, replacing and sanitizing food preparation equipment and maintaining
optimum temperatures while cooking food. Alim and Workneh (2016), also postukated that
consumers also may lack information on the harmful consequences associated with food borne
diseases and the services as well as resources which may be available for treatment, diagnosis
and management of food borne illness which further results in their higher susceptibility to report

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or receive optimum interventions during incidences of such illnesses. Thus, this thesis is
important and needed for the purpose and its existing scope to inform and evaluate on the
awareness of consumer populations like students who are studying in a university, on the need
and strategies underlying food handling and safety, as well as paving the way for future research
on increasing knowledge and abilities of such consumers on gaining control in the management
of global illnesses associated with food contamination.
As researched by Beavers, Murphy and Richards (2015), illnesses caused due to food
borne pathogens as a result of following inadequate food hygiene and handling practices,
currently to be on the rise in industries dealing with food manufacturing, processing and
preparation, even though there continues to be in place, standardized and certified procedures for
food handling and safety. Further expanding on the above by highlighting the findings reported
by Flint (2016), it may be possible to prevent and manage if there is establishment and
implementation of an extensive and holistic training and learning module concerning food safety
and handling practices, not just in industries but also among common households. This implies
that along with joint efforts by food manufacturing organizations and industries, consumers must
also seek to display enthusiasm and attempts at acquiring knowledge on importance of safe food
handling as well as strategies for optimum conductance of the same.
This thesis aims to shed light on the consumer group of students studying in a university
and their levels of knowledge and practice associated with food safety and handling. Thus, this
thesis is important due to its scope of providing information on the aspects of food handling and
safety which consumers like young adults and university students need to focus upon in order to
improve their existing knowledge and levels of awareness. Additionally, providing useful
insights on the food handling areas requiring future research as well as the determining factors

5FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
which influence existing strategies of food safety and handling followed by university students is
another aspect upon which the usefulness of this research rests upon. Taking insights from the
findings from this study, this thesis can be further use to identify the salient gaps of food safety
and handling knowledge which must be considered while the providing food handling education
and training to students studying in a university.
1.2. Problem Statement of the Research
The Word Health Organization (WHO) and the Food and Agricultural Organization
(FAO) in its findings reported that an estimated 2.2 million individuals have succumbed to
illnesses caused by food borne illnesses, of which, 1.9 million victims were found to be children.
Further findings also report that the 40% of diseases caused due to consumption of contaminated
food sources are widely prevalent in households and hence, have reduced chances of undergoing
adequate or timely reporting (Farahat, El-Shafie and Waly 2015).
There is at present, ample evidence and informative sources on the importance of
adhering to safe and hygienic practices, there is however, a dearth of evidence on the consumer
group of university students and their rates of knowledge, attitude and practice on optimum food
handling hence emerging to be major cause of concern requiring urgent management. An
individual who possessesinadequate knowledge on food safety and handling is likely to be
susceptible to acquiring food borne disease in the future – for the prevention of which it is
absolutely necessary to the train and educate individuals concerning this issue, most notably at
academic organizations providing education to citizens from an early age (Low et al. 2016).
Upon conducting further research, a dearth of available research has been found which
address knowledge of food safety and handling among the citizens of Jordan as well as students

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who are undertaking education in the universities located in Jordan. Compared to the alarmingly
high rates of incidences of food borne disease occurring in Jordan as well as in countries of the
Middle East, the amount of research on the exploration of food handling strategies in these
countries is significantly limited (Ma'moun et al. 2018). Authors Osaili, A-Nabulsi and Krasneh
(2018), in the paper exploring knowledge of handling and food safety in university staff dealing
with food service in Jordan, noted that the report of the World Health Organization, which was
published in the year 2015, noted that the developing countries were inflicted with aggravated
rates of diseases due to food borne pathogens, most notably in Middle Eastern nations along with
a deficit of food safety and handling policy frameworks implemented by the government for the
purpose of screening such food borne illness incidences. Nations in the Middle Eastern and
Northern African regions, that is, countries belonging to the eastern section of the Mediterranean
region, have been estimated to be in possession of alarmingly high rates of disease burden
associated with contaminated food consumption.
The European Food Safety Authority reported in the year 2011, that almost 36.4% of
incidences associated with food borne illnesses, have been calculated to be caused across due to
improper handling of food across domestic levels, followed by 20.6% incidences occurring
across commercial food preparation establishments like cafes, restaurants and hotels and 5.5%
incidences occurring in kindergarten and schools (Gong et al. 2016).Hence, expounding on this
research, as well as from the study conducted by Faour-Klingbeilet al. (2016), the nature of food
handling and hygiene procedures followed by households and consumers are crucial to the
contribution of the worldwide rates of illnesses caused due to food borne diseases. Thus,
emphasizing on the current global issue of insufficient knowledge on practices and knowledge of
food safety and handling – the point of focus of this thesis - the benefits associated with the

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execution of eradicating food borne diseases across communities and nations, will be evaluated
upon administration and revision of awareness of food handling and food safety among such
population groups.
As postulated Farahat, El-Shafe and Waly (2015), diseases caused due to food borne
illnesses occur majorly due to avoidance of appropriately following optimum standards of
hygienic food handling and safe food processing during preparation of various cooked food
items. As emphasized by preceding sections, consumers being in possession of inadequate
information on handling food in a safe and hygienic manner is a prime determinant of
conductance of food preparation procedure which are inadequate and unfit for consumption
across households. As researched by Wilcock and Ball (2017), prevalent distinctions lie between
the rates of knowledge and awareness of food handling and safety practices among commercial
manufacturers of food and the general population of consumers. These fast differences highlight
the severity of the issue and the need to take prompt management procedures considering that
domestic households harbor varied groups of individuals with critical health concerns such as
pregnant women, lactating mothers, children and aged citizens. Thus, this thesis will focus
critically on the existing issue of consumer adherence to inappropriate practices of food handling
and safety which will further pave the way for the need to administer future research highlighting
the need for consumers possessing optimum knowledge on hygienic food handling practices.
Thus, emphasizing on the above identified issues on consumer’s lack of awareness associated
with the performance of food hygiene and safety practices, the following these will focus
extensively on these issues prevalent across students studying in a university - a group of
consumers with high susceptibilities of acquiring food bore diseases.

8FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
1.3. Research Significance
At present, current scientific studies discuss extensively on the importance and necessity
of inculcate education on strategies underlying food hygiene and safety practices across
households, due to the consumers possessing insufficient knowledge regarding this issue, there is
however, inadequate research which explore rates of awareness on safe food handling amidst
university and college going students. This lack of sufficient scientific evidence is alarming and
emphasizes on the need to immediate manage the same since lacking adequate knowledge on
hygienic and safe food handling will increase one’s susceptibility to acquire negative health
outcomes (Diplock et al. 2018). As researched by Low et al. (2016), the present concerned is to
immediately disseminate adequate educational information on hygienic and safe food preparation
and handling in the academic courses directed at teaching students studying in college,
universities or additional centers of extensive learning –keeping in mind that one’s ignorance
concerning these issues will enhance susceptibilities to acquire food borne diseases in the future.
As postulated by Moy et al. (2018), policies and programs which emphasize on enhancing the
general public’s knowledge on conductance of safe handling and food preparation practices must
also target students studying across colleges and universities. This need also necessitates the
administration of further scientific exploration on the current levels and quality of food safety
and handling knowledge prevalent across this group of consumers.
Author Sivaramalingam et al. (2015), researched that students who involved in colleges
and universities pose a high risk of being inflicted with food borne disease considering that this
group of consumers prevalently revert to preparation and consumption of easy-to-prepare,
convenience foods instead of engaging in wholesome and nutritionally balanced food preparation
which will be significantly free from pathogenic contamination and are hygienic and safe for

9FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
consumption. The author also notes that such student are also in possession of inadequate
information on hygienic food handling strategies such as indulging in personal cooking methods
resulting in production of hygienic and uncontaminated foods. Authors Mullan et al. (2015)
noted that evaluating the existing of hygienic food handling prevalent across students studying in
universities is essential taking insights from the rising incidences of food borne diseases and the
associated harmful symptoms. It is worthwhile to note that such individuals, this is university
students are involved in managing individuals with special health needs at home, such as those
who are elderly, are infant or are pregnant mothers and thus, adherence to food preparing
practices which are inappropriate will result in increased risk of acquiring food borne diseases,
across the concerned consumer group as well as across these critical population groups (Xiong
2017). Thus, the findings of this thesis is significant since it explores extensively the existing
levels of knowledge, attitude and practices associated with food safety and handling in university
students considering a background of scientific evidence highlight inadequacy of the same
among these groups as well as limited studies highlighting further research in Middle Eastern
countries like Jordan. This research on food handling practices across Jordanian university
students is also significant considering the increased risk of acquiring food borne diseases and
lack of sufficient food safety knowledge and practice conductance across this target group of
young consumers.
At present, an insufficiency of research which target on exploration of levels of
knowledge and practices of safe and hygienic handling of food among students studying
universities across countries of the Middle East. The foods safety and handling knowledge
among Jordanian students has been reflected in the study by Osaili et al. (2011), who explored
the levels of food safety knowledge and handling practices among female students living in

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dormitories in North Jordan,. With the aid of a self-administered questionnaire, the authors
examined the association between students’ performance of practices of food hygiene and safety
and their socio-demographic profile. High scores were obtained on aspects of knowledge
associated with avoidance of cross contamination and engagement in practices of disinfection,
whereas low scores were observed on aspects of knowledge on contamination by food borne
pathogenic strains and engagement in safe and hygienic cooking practices. Such results indicate
the inadequate knowledge of food handling and safety prevalent across the students of Jordan.
This further signifies the importance for governmental bodies and for academic organizations in
Jordan to immediately implement food safety and handling educational policies and
dissemination of academic subjects associated with the same in curriculum of the university.
Further information on the inadequacies of food safety and handling knowledge and
practices among the consumers and especially young adults of Jordan can be implied indirectly
from the data of food poisoning presented by the Ministry of Health of Jordan. It has been
estimated that the highest concentration of cases occur in the capital Amman (84) and Irbid (256)
– both of which are major metropolitan cities of the region. Further, in 2016, an alarmingly high
number of incidences of food poisoning and food borne illnesses have been caused due to
consumption of contaminated food, of which, households hold the highest number of incidents
(89%) as compared to restaurants (11%). The reporting of similar findings in 2017 as well as
2018 indicating increased susceptibility of acquisition of food borne illness among households
(95%) as compared to restaurants (5%), indicating a continuation of the public health problem of
high rates of food poisoning events in the nation of Jordan, and hence, a lack of attempt by
governmental bodies to address these issues at the consumer level. The highest levels of
incidences of food borne illness have been reported among individuals aged 20 years and above

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(55%) as compared to other age groups – indicating the population of young adults who are
most probably undergoing higher level of education in universities and colleges. Further, the
highest rates of occurrences of food borne illnesses have been observed during the months of
June (3%), August (4%), September (4%) and October (4%) in Jordan. There has however, been
no report of significant differences in gender pertaining to the occurrences of food borne
illnesses in males (51%) and females (49%) (Ministry of Health, 2019).
Thus, it can be implied that this study is important considering that the prevalence of the
dearth of research available on the level of knowledge, attitude and practice associated with food
safety across students studying in the university of Jordan along with the high rates of possessing
insufficient knowledge on safe handling of food in this target population associated further with
administration of unhygienic preparation and storage of food and elevated risk of acquiring
future detrimental symptoms of diseases associated with the consumption of safe food.
1.4. Research Questions
Hence, the primary quantitative study associated with this thesis will seek to address
solutions to the following research questions:
1. What is the existing level of knowledge pertaining to practices on safe and optimum
handling of food among Jordan University students?
2. What existing practices of safe and optimum handling of food are adhered to by Jordan
University students?
3. What is the relationship between current levels of knowledge, attitude and practices on
safe and optimum handling of food and demographic details among Jordan University
students?

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1.5. Research Hypothesis
Jordan university students are in possession of insufficient awareness associated with
optimum food safety and handling knowledge, attitudes and practices hence leading to high risk
of acquiring food borne disease and need of obtaining further educational information on
strategies of optimum food hygiene and preparation.
1.6. Study Aims and Objectives
Hence, this aim of this study is to examine current levels of knowledge, attitude and
practices of safe food handing among Jordan university students. Hence, considering the same,
the following are the objectives of this thesis:
1. To examine the current level of knowledge associated with safe food handling among
Jordan University students.
2. To explore the current practices associated with safe food handling among Jordan
University students.
3. To understand the nature of relationship between the current levels of knowledge,
attitudes and practices of safe food handling and demographic data across Jordan
University students.
Chapter 2: Review of Literature
2.1. Search Strategies
An extensive review of literature was conducted in this thesis, for which, a detailed
strategy of screening of studies was administered electronically. An extensive set of databases
such as PubMed, ScienceDirect, COCHRANE, Medline and BioMed were screened for articles

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with the help of keywords such as ‘knowledge’, ‘food safety’, ‘university students’, ‘Jordan’,
‘practice’ and ‘attitudes’ along with Boolean operators. After completing the research screening,
approximately 4700 studies were acquired, put of which, a number of articles were included and
excluded in accordance to the criteria for exclusion and inclusion. Studies which were peer
reviewed and scholarly, as well as those showing adherence to the chosen keywords and
published between the years ranging from 2009 to 2019 were used in this study (McGowan et al.
2016). Studies which did not show relevance to the provided keywords and were found to be
published older than the specified range of years were not taken into consideration for this study.
Studies which addressed knowledge, attitude and practices associated with safe food handling
cross individuals and consumers who did not fall under the category of students studying in
universities, such as trained food staff recruited in organizations dealing with commercial
handling, preparation and manufacturing of food were not included in this research (McKeever et
al. 2015).
2.2. Food Safety Concepts
As noted by the World Health Organization, concepts associated with food hygiene
included a variety of processes and frameworks aimed at ensuring that manufacturing of food
which is safe and free from microbial contamination, from the first stages of processing to the
food table of citizens. It must be noted that food is highly prone to spoilage and being exposed to
a variety of climatic surroundings is associated with high risk of being contaminated during
primary food processing and handling steps such as plantations, production of harvests, storing
food, slaughter, transporting, cooking, retail and immediately before intake of food (Word Health
Organization 2019). The Food and Agricultural Organization (FAO), also postulated concepts of
food safety by highlighting that it comprises of a range of steps associated with food handling,

14FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
storing, preparing food, which is required to be adhered to as per certified standards with the aim
to eradicate spoilage by microbes and disease associated with the same, along with maintaining
nutritional balance of the concerned food item (Food and Agricultural Organization 2019).
Expounding on the preceding sections, the European Food Information Council (EUFIC), there
is a need to adopt an approach which is collaborative as per its concepts of food safety, and
emphasizes the need to maintain optimum procedures of safe food handling underlying food
production and the same is reliant on each member of the workforce who is concerned with food
processing such as, retailers, agriculturalists, caterers, policy makers, food handlers, consumers
and even transporters of food (European Food Information Council 2019). Following a similar
approach associated with collaborative procedures, the World Health Organization elaborated
further on concepts associated with food handling and safety by emphasizing on the
interrelatedness prevalent amongst food security, food nutrition and food safety and hence, it is
for this reason that inadequate compliance to standardized practices of safe food handling will
lead to a vicious cycle associated with malnutrition, disease conditions, malnutrition and
disturbances to normal rates of development and growth. It must also be noted that with
increased emergence of cross culturing and globalization across various nations, the functions of
food processing systems are now intersecting nationalities and borders, and hence the need of the
hour is for governments, food production strongholds as well as consumers, to work
collaboratively to eradicate the worldwide burden of diseases caused due to food borne
pathogens (World Health Organization 2019).
2.3. Practices of Food Safety and Handling
There are various processes which can be undertaken for the preparation and processing
of food which is wholesome and free from pathogens. Among a wide range of strategies

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pertaining to safe and hygienic food handling resulting in preparation of food which is
microbiologically safe, one of the most traditionally acceptable food safety processes include
boiling or maintaining optimum temperatures when cooking food (Burns, Katayama and Roberts
2019). In addition to this, national level and governmental strategies pertaining to production of
safe and hygienic food free from pathogens, includes provision of water which has undergone
disinfection by the concerned municipalities. Commercial industries also ensure avoidance of
illnesses associated with food borne pathogens pertaining especially to contaminated water
intake, by producing packaged drinking water with the aid of technological advancements such
as disinfection, mineralization and filtration (Kim, Jang and Noh 2019).
Commercial organizations associated with the production of food at the industrial scale,
also adhere to guidelines associated with avoidance of illnesses caused by food borne pathogens
by adhering to standards of hygienic packaged food production such as quality food preparation
procedures like drying, irradiation, curing, smoking, usage of additives and preservatives,
adherence to ultra-high cooking or pasteurization temperatures (UHT) and techniques of vacuum
packaging and form-fill-seal (Ruiz et a, 2017). Additionally, industries and commercial food
manufacturing organizations are required to follow standardized procedures of food production
such as Good Manufacturing Practices (GMP), Hazard Analysis Critical Control Points
(HACCP) and Standard Operating Procedures (SOP) (Nummeret al. 2015). Despite all of the
above forming the cornerstones of ensuring the production of food which is safe and free from
contamination, manufacturing of such food can also be performed with the aid of policies and
programs targeted to improving the levels of awareness and safe food production information
across the public (Allan et al. 2018).

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Taking insights from the fact that households hold a strong risk of acquiring food borne
illnesses, consumers also lie at the forefront of food illness prevention through the conductance
of simple, safe and effective strategies of food preparation. According to the World Health
Organization, the ‘Five Keys to Safe Food’, can be used as strategies which consumers can
adhere to as well as small-scale handlers of food for the domestic production of food which is
free from microbial contamination. Some of these strategies comprise of: separating raw food
from food which is cooked, using clean water for washing of foods and utensils, disinfecting and
sanitizing surfaces used for preparing foods as well as equipment such as cutlery and crockery
immediately after their usage, usage of clean food ingredients and maintaining optimum internal
temperatures during food preparation (World Health Organization 2019).
2.4. Foodborne illnesses Worldwide
According to the World Health Organization, the prevalent occurrence of foodborne
illnesses is a significantly detrimental health issue pertaining to public health and is an umbrella
term considering a wide variety debilitating disease conditions caused due to pathogenic
contamination of food and water. As the name suggests, food borne illnesses occur due to the
consumption of food which has undergone spoilage or has been infiltrate by microbial strains or
harmful chemical components. Further, the WHO notes that such illnesses caused via intake
mechanisms underlying food and water ingestion, can occur during any stage of the lengthy food
processing procedures further implying that, from agricultural harvest to a consumer’s plate,
contamination of food can take place at any cost. Food can undergo contamination via
environmental exposure as well as via pollution occurring in water, air and land. Administration
of gastrointestinal symptoms continue to remain one of the most common clinical symptoms of
foodborne illnesses coupled with additional life threatening implications such as immunological,

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gynecological, neurological symptoms as well as multiple organ effects. Due to the wide
spectrum of symptoms exerted, food borne illnesses continue to contribute significantly to a
major section of morbidity and mortality rates amidst the global population (World Health
Organization 2019).
According to the Food and Drug Administration (FDA), food borne illnesses administer
their symptoms within a timeframe of 12 to 72 hours commencing from contamination of food
but may also exert the same within a time as soon as 30 minutes or as prolonged as 4 weeks.
Common symptoms of food borne illnesses include diarrhea, abdominal pain, vomiting, nausea
as well as additional symptoms similar to flu such as headache, body ache and fever. The FDA
also notes that the consumption of specific types of food items present higher susceptibility of
food borne illness acquisition, namely: inadequately cooked meat products, inadequately cooked
or processed sea food, milk and milk products which have not been pasteurized, soft cheeses
which have been prepared from milk devoid of pasteurization, eggs and associated dishes
containing eggs which have not been cooked, inadequately cleaned vegetables, unpasteurized
juices prepares from vegetables and fruits, sprouts and salad preparations fully raw and cold cuts
of meats and meat products unless they have undergone reheating till significantly hot (Food and
Drug Administration 2019),
Despite the fact that food borne illnesses can affect individuals at all stages and age
groups, the Centers for Disease Control and Prevention have recognized certain population
groups to possess high susceptibility to food borne disease acquisition. These include: the
elderly, the infant population, pregnant women and individuals being in possession of disease
conditions resulting in compromised immunity, such as HIV/AIDS, cancer, renal diseases,
diabetes, organ transplantation and hepatic diseases. While young adults studying in colleges and

18FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
universities have been not been adequately recognized as group at risk, it is worthwhile to remain
that such groups may actively be involved in caring for the above high-risk populations at home,
which is why, evaluating and disseminating education and training on strategies underlying food
safety is of utmost importance (Centers for Disease Control and Prevention 2019).
Taking insights from Corteseet al. (2016), a food item’s risk of being contaminated by
pathogenic strains and hence, increasing acquisition of food borne illnesses, increases due to the
performance of hygiene procedures which are unclean. Such inadequate practices also contribute
to the loss of beneficial nutritional components in the food. The researched conducted by Meleko
et al. (2015), postulated that the causative factors underlying foodborne illnesses include:
conductance of inappropriate handling practices of food safety by food manufacturers and food
manufacturing organizations, which include: inadequate adherence to required internal cooking
temperature, non-compliance to standardized practices of cleaning and sanitation of food
preparation surfaces and lack of maintenance of acceptable procedures of personal hygiene by
workers employed in food handling and processing establishments.
Foodborne illnesses continue to contribute to a major proportion of mortality and
morbidity rates in the world, despite the presence of and adherence to established accredited
procedures of food safety and handling such as HACCP, GMP and SOP. Authors Hassan and
Dimassi (2014), in their research evaluating the practices of food safety and handling among
university students studying in Lebanon, explored the WHO’s findings in 2007, which reported
that food borne illnesses contribute to over 1.8 mortalities across the world. The majority of this
deaths were associated with severe symptoms of diarrhea especially after consumption of water
and food sources which have been contaminated.

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In accordance to the findings in 2005 reported by the WHO as well as the Food and
Agricultural Organization, explored extensively in the research conducted by Farahat, El-Shafie
and Way (2015), disease due to consumption of foodborne illnesses attribute to over 2.2 million
on a global scale, with over 1.9 victims being children. Additionally, the authors also reported
that food borne illnesses occurring at home, contribute to approximately 40% of this cases, and
hence, are generally susceptible to not being reported adequately.
A large number of countries in the world, are inflicted with high rates of food borne
illnesses. Taking insights from the research conducted by Mullanet al. (2015), the National
Health and Medical Research Council’s findings in the year 2003, indicated that the incidence of
food borne illnesses have increased at alarming rates over the last ten years, especially in
countries such as Australia. During the year 2009, data presented by the New South Wales Food
Authority indicated that food borne illnesses were contributing to over an approximate average
of 120 mortalities per year, which have further resulted in excessive medical finances estimated
to be 1.25 million dollars. Further, as researched by authors Teislet al. (2016) in their research
evaluating the practices of safe food handling at the household level, it has been estimated that
approximately 128, 000 hospitalization cases, 3000 deaths and 48 million disease cases have
been implicated to be caused due to consumption of food contaminated by pathogenic microbial
strains.
Developing countries are also susceptible to acquisition of illnesses caused due to food
borne pathogens. Authors Webb and Morancie (2015) reported the WHO’s findings in the year
2011, that infections of diarrhea caused due to intake of unclean water and food, contributed to
33, 000 deaths and a high mortality rate of 5.9 deaths per 100, 000 in developing countries such
as the Latin American continent and the Caribbean. Further, taking insights from the findings

20FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
reported by Wohet al. (2016), the Ministry of Health in Malaysia indicated that illnesses caused
due to food borne microbes contribute a major portion of deaths occurring in the nation, resulting
in a mortality rate of 0.3 among 100, 000 citizens and 56.25 incidence rates.
Households contribute to the highest prevalence of diseases caused due to food borne
pathogenic microbial strains. Taking insights from the research conducted by Wilcock and Ball
(2014), mentioned extensively in their book, ‘Practical Food Safety: Contemporary Issues and
Future Directions’. United Kingdom nations such as England and Wales have been reported to
contribute to approximately 1.7 million cases of household associated food borne illnesses
annually. Further critical scenarios have been estimated innations like United States, where
approximately 9.4 million cases of household level illnesses caused due to food borne illnesses
have been reported to occur on an yearly basis, coupled with the identification of 31 strains of
pathogenic microbes as the contributing factors. Further taking insights from Wilcock and Ball
(2014), where the widespread nature and transmission of food borne illnesses have been
researched extensively, it has been estimated that the Public Health Agency of Canada calculated
the prevalence of 4 million food borne illness scenarios occur on an annual basis at the
household level. From these, it has been estimated that 2.4 million of these cases are due to the
emergence of diseases of the gastrointestinal type caused due to factors which are unspecified.
Additionally, the causative factor underlying the occurrence of 1.6 million of such scenarios
were reported to be 30 identifiable food borne pathogenic strains.
Thus, taking insights from the above researches, it can be implicated that despite the
extensive prevalence of globalised internationally established standards on food safety and
standards of hygiene in commercial industries, the worldwide issue of food borne illnesses and
diseases continue to be a detrimental and prevalent global disease problem across countries in

21FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
particular and households in general. As researched by Hassan and Dimassi (2014), such
alarming statistics highlight that despite the prevalence and widespread adherence to impressive
food handling strategies such as the ‘farm to fork’ and ‘farm to table’ concepts in Europe and the
United States, even developed countries are not spared from the transmission of diseases caused
due to food borne illnesses. Additionally, another key observation which can be identified from
the above data is the widespread occurrence of food borne illnesses at the household level. Such
data implies the explicit role which consumers must undertake for the prevention of such
illnesses at the domestic level and the need for public, national and international food safety
policy frameworks and organizations to assess and disseminate education to consumers to
enhance their levels of awareness concerning the same.
Taking insights from the findings reported in the 2011 report by the European Food
Safety Authority, an estimated 95% of illnesses pertaining to food borne microbial strains have
been characterized to be sporadic in nature due their high susceptibility to undergo transmission
at the household level. Such information is indicative of the alarming extent to which consumers
are relatively unaware of the required strategies to be undertaken for the purpose of ensuring safe
handling and processing of food. Hence the need of the hour is to implement educational
frameworks on food safety and handling at the community, household and local levels for the
purpose of enhancing the public’s levels of awareness concerning the same. Without such
strategies, the existence and implementation of such internationally standardized food safety and
handling standards would be implicated to be meaningless and ineffective.
2.5. Foodborne illnesses in the Middle East
Taking insights from the research on assessment of knowledge concerning food safety
and handling practices among staff dealing with foodservice in universities based in Jordan

22FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
conducted by Osaili, Al-Nabulsi and Krasneh (2018), a 2015 reported published by the World
Health Organization reported an increased prevalence and risk of acquisition of food borne
illnesses in developing countries such as those of the Middle East, due to the presence of
difficulties associated accessibility to food related surveillance, control and safety assessment
frameworks and policies. On a global scale, countries belonging to the Eastern Mediterranean
region, such as the Middle East and Northern Africa, have been estimated to rank third in the
prevalence of illnesses caused due to food borne pathogenic strains.
According to the researched by Al-Shabib, Hussain and Khan (2017), a report in 2010 by
the Health Ministry of the Kingdom of Saudi Arabia, has estimated the incidence of
approximately 1647 cases caused due to illnesses which are food borne in the year 2003. Further,
another report published again by the Health Ministry, estimated approximately 255 diseases out
of the total occurrence of 2066 incidence of diseases across the country, were caused due to
citizen’s consumption of foods contaminated by pathogenic food borne microbial strains.
2.6. Food Borne Illnesses in Jordan
The following of data has been obtained from the Ministry of Health in Jordan and provides key
insights on the nature and distribution of food borne illnesses in Jordan.
Table 1: Distribution of Food Poisoning by Governorate in Jordan, 2017 (Ministry
of Health 2019)
The following table highlights the distribution of food borne illnesses in Jordan, of which, the
largest concentration of cases can be observed in the capital Amman and Irbid – both of which
are major metropolitan cities of the region. Such high rates may due to the fact that both these

23FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
cities are major metropolitan areas of the nation where the concentration of population,
households and educational institutions are estimated to be higher. Considering that these regions
are concentrated in populations comprising of high risk populations like households and
university students who have low levels of awareness concerning food safety and hygiene
practices, the reporting of high rates of illness events in these areas does not come as a major
surprise (Ma'moun, Al-Shakhsheer and Al-Ababneh 2017).
GovernorateEventCases
Amman1384
Irbid25256
Al-Balqa9104
Al-Mafraq429
Madaba316
Zarqa315
Jerash114
Al-Ramth214
Tafeileh135
Total61567
Figure 1: Distribution of Food Poisoning by Source of Food, Jordan, 2017
(Ministry of Health 2019)
From the following pie chart it can be observed that an alarmingly high number of incidences of
food poisoning and food borne illnesses have been caused due to consumption of contaminated
food, of which, households hold the highest number of incidents. The findings from this case
validate the previously discussed studies which indicate that households are susceptibility of
acquisition of food borne illnesses. As highlighted previously, this may be due to the fact that
household populations generally comprise of individuals with reduced health literacy and
scientific knowledge, hence resulting in reduced levels of awareness concerning strategies of

24FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
food safety and hygiene practices as compared to schools, hospitals, factories or restaurants
where stringent standardized food processing practices are followed (Al-Nasraween et al. 2018).
%98
%11
esuoHtnaruatseR
Table 2: Distribution of Food Poisoning by Governorate in Jordan, 2018 (Ministry
of Health 2019)
Compared to Tables 1, it can however be observed that there has a reported decrease in food
borne illness events in the country, with however, high rates still persisting in metropolitan
regions. However, such reductions in the incidence of illnesses is indicative of the growing body
of awareness associated with the need to undertake large scale practices and policy frameworks
to tackle the national scale burden of diseases attributed to food poisoning and food borne
illnesses. There is however, still a need to further infiltrate such efforts towards enhancing levels
of food safety and hygiene awareness among households in Jordan (Ma'moun, Al-Shakhsheer
and Al-Ababneh 2017).
GovernorateEventCases
Amman417
Irbid1079
Madaba12
Zarqa28
Jarash115

25FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
Ramtha16
Maan112
Aqaba16
Total21145
Figure 2: Distribution of Food Poisoning events by source of Food, Jordan
2018 (Ministry of Health 2019)
The reporting of similar findings in 2017 as well as 2018 indicating increased susceptibility of
acquisition of food borne illness among households as compared to restaurants, indicating a
continuation of the public health problem of high rates of food poisoning events in the nation of
Jordan. The continued prevalence of this problem is indicative of a lack of the administration of
adequate educational frameworks of public health promotion policies by governmental bodies
which may aim to educate and inculcate among the common citizens of Jordan, the importance
of conducting basic household strategies of food safety and hygiene for the purpose of cooking
food which is safe for consumption and free from contamination (de Andrade et al. 2019).
Figure 3: Distribution of Food Poisoning by Age Groups, Jordan, 2018
(Ministry of Health 2019)
From the following figure, it is evident that the highest rates of food borne illness occurrence
have been reported among individuals aged 20 years and above – indicating the population of
young adults who may be undergoing higher level of education in universities and colleges.
95%
5%
House Restaurant

26FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
Hence, this validates the previously identified research problem of the high risk of being inflicted
with food borne illness by young adults studying in universities due to their comparatively low
levels of awareness associated with the conductance of strategies underlying safe food and
hygiene production. As discussed previously, coupled with the lack of adequate levels of food
safety and hygiene awareness, most young adults studying in universities live alone and hence
are unable to adhere to adequate food safety, storage or cooking practices (Alananbeh and
Hayajneh 2018).
sraey 5< sraey 9 ot 5 sraey 41 ot 01 sraey 91 ot 51 sraey +02
0
01
02
03
04
05
06
2.6.7. Figure 4: Distribution of Food Poisoning events by source of Food, Jordan
2018(Ministry of Health 2019)
The reporting of similar findings in 2017 as well as 2018 indicating increased
susceptibility of acquisition of food borne illness among households as compared to restaurants,
indicating a continuation of the public health problem of high rates of food poisoning events in
the nation of Jordan. The continued prevalence of this problem is indicative of a lack of the
administration of adequate educational frameworks of public health promotion policies by
governmental bodies which may aim to educate and inculcate among the common citizens of

27FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
Jordan, the importance of conducting basic household strategies of food safety and hygiene for
the purpose of cooking food which is safe for consumption and free from contamination (de
Andrade et al. 2019).
95%
5%
House Restaurant
2.6.8. Figure 5: Distribution of Food Poisoning by Age Groups, Jordan, 2018 (Ministry of
Health 2019)
From the following figure, it is evident that the highest rates of food borne illness
occurrence have been reported among individuals aged 20 years and above – indicating the
population of young adults who may be undergoing higher level of education in universities and
colleges. Hence, this validates the previously identified research problem of the high risk of
being inflicted with food borne illness by young adults studying in universities due to their
comparatively low levels of awareness associated with the conductance of strategies underlying
safe food and hygiene production. As discussed previously, coupled with the lack of adequate
levels of food safety and hygiene awareness, most young adults studying in universities live

28FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
alone and hence are unable to adhere to adequate food safety, storage or cooking practices
(Alananbeh and Hayajneh 2018).
<5 years 5 to 9 years 10 to 14 years 15 to 19 years 20+ years
0
10
20
30
40
50
60
2.6.9. Figure 6: Distribution of Food Poisoning by Sex, Jordan 2018 (Ministry of Health
2019)
From the following figure it can observed that there is not much difference between
genders in the acquisition of food borne illnesses, indicating that food borne illnesses do not
recognize gender oriented boundaries. However, the slight difference in illness acquisition
maybe due to the fact that females have been reported to comprise of the majority of students
engaging in science courses like nutrition, food science and microbiology hence resulting in their
greater levels of knowledge concerning food safety and hygiene practices (Al-Shabib, Husain
and Khan 2017).

29FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
49%
51%
Females Males
2.6.10. Figure 6: Distribution of Food Poisoning events by Month, Jordan, 2018 (Ministry
of Health 2019)
From the following graph it can be observed the highest rates of occurrences of food
borne illnesses have been observed during the months of June, August, September and October
in Jordan. It is worthwhile to mention that the months ranging from June to October highlight the
time of summer in Jordan when temperatures rise unbearably high. Food borne illnesses are
caused due to consumption of foods contaminated by pathogenic microbes which are
thermophilic – that is, are compatible to proliferate in warmer climatic conditions with
temperatures at 35C or higher. Hence, such microbes which are responsible for causing food
borne illnesses are likely to grow and proliferate abundantly during summer hence resulting in
higher susceptibilities of food borne illnesses during this period as indicated in the graph. Hence,
to protect themselves, households must seek to implement adequate food storage practices at
lower temperatures (Lin et al. 2016).

30FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
Jan Feb March April May June July August Sept Oct Nov Dec
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
2.7. Food Safety and Handling Practices Worldwide
The cross sectional study by Corteseet al. (2015), studied the level of compliance and
safety by vendors of street foods towards international food processing standards, during the
process of mass street food production in Florianopolis, Brazil with the aim to highlight the need
to implement food safety associated legislative frameworks. During the process of selling street
foods and during critical points of production, the authors critically performed an evaluation of
street vendor’s demographic characteristics and engagement in hygienic practices, using direct as
well as structured interviews. The study sample consisted of 43 vendors of which a majority
were male and had undertaken limited education since elementary school. Of these, 95% did not
follow basic hand hygiene principles during money collection and food distribution, 33% did not
undertaken any food handling course, 12% did not follow cold storage principles during
transportation, 91% did not cover their hair and 24% engaged in using only water for hand
hygiene and none of the food handlers obtain access to potable water supply. Hence, this

31FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
research reflected a lack of awareness on basic food safety and handling practices among
handlers as well as outlined the need for stringent governmental legislation on standardization of
safe food handling practices among handlers for consumer safety.
The descriptive, cross sectional study by Afolaranmiet al. (2015, aimed to assess food
safety hygiene knowledge levels and practices among primary school food vendors in North
Central Nigeria. In accordance to the results, 60.9% or 166 participants possess adequate food
safety and hygiene knowledge along with indicating that the mean work experience of all
vendors was 7.8 ± 1.3 years. Hence, this highlighted that engagement in quality food safety and
hygiene practices was statistically significantly related with vendor’s years of work experience.
Thus, it can be implied from this study that a major demographic characteristic determining an
individual’s levels of food safety knowledge and handling practices is work experience.
The cross sectional study by Wohet al. (2016), aimed to evaluate basic levels of food
safety and handling knowledge among migrant Malaysian food handlers. The participants
consisted of 383 food handlers, who were required to fill a questionnaire and provide
demographic information. The results obtained indicated overall low levels of food safety
knowledge and handling practices. Factors found to contribute to such results included:
attendance in food training programs, educational level and country of origin, of which the first
factor of attendance indicated significant contribution. Hence, form this study, it can be implied
that the establishment of strict regulations on compulsory food safety training program
attendance coupled with presence of food safety and handling policies, are essential to ensure
consumption and production of food which is hygienic and safe.
The research by Lee et al. (2015), aimed to assess self-reported levels of microbiological
hand hygiene and food safety knowledge and hygiene practice engagement among 85 university

32FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
participants in Kuala Lumpur, Malaysia using a KAP questionnaire. According to the results,
university food handlers possessed moderately positive levels of self-reported practices
(53.2/60), attitudes (51.9/60) and knowledge (61.7%) associated with safe food handling. The
results also indicated ≥ 20 CFU/cm2 of microbial counts from hands of 65% food handlers while
acquired slabs indicated presence of Salmonella in 48% of handler’s hands. Hence, from this
research it can be implied that in addition to the possession of adequate levels of food safety and
hygiene knowledge, engagement in practical application of the same is essential for safe food
production and consumption.
The review by Ababio and Lovatt (2015) aimed to assess the conductance of food safety
and hygiene practices in Ghana. The results indicated that the nation’s capital was the primary
center for execution of food safety research. Majority of research targeted the commercial food
processes underlying production of street foods and the prevention of pathogens in food. There
was however negligible research on the hazards associated with current food production
practices conducted in catering institutions. Food born incidences underwent reporting majorly
by the media and indicated high prevalence in commercial food institutions, restaurants,
households and vendors of street food. There were also shortcomings in the execution of food
safety procedures in establishments of food production. As per these results, the authors
highlighted the need to administer HACCP, basic hygiene practices, screening of food handler
health by the government and execution of workshops and training programs educating food
handlers on strategies of safe food handling and production for the prevention of food borne
illness occurrence in food institutions operating commercially.
The cross sectional, descriptive study conducted by Akabanda, Hlortsi and Owusu-
Kwarteng (2017), aimed to assess the levels of food safety and handling knowledge, attitudes

33FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
and practices in Ghana among institutional food handlers. Using personal interviews and
questionnaires, the authors examined 235 subjects. The questionnaire so utilized, consisted of
five components evaluating workers job satisfaction, demographic characteristics, knowledge on
food safety as well as attitudes concerning the same. The authors obtained results indicating that
the food handlers were in possession of awareness on basic sanitation, hygiene and food
practices at significant levels, such as utilization of detergents (72.8%), hand washing habits
(98.7%), utilization of gloves (77.9%) and optimum sanitation of equipment used for food
preparation. However, the results also reported that 76.2% and 70.6% of the food handlers lacked
awareness on the knowledge that pathogenic microbes such as Salmonella and Hepatitis A were
associated with food borne transmissions. However, 81.7% and 87.7% of the food handlers were
aware of the relationship between typhoid, bloody diarrhea and engagement in inadequate food
handling practices. Hence, from this study it can implied that in addition to presence of adequate
food safety and handling knowledge and attitude levels, there is a need to address the lack in
applying principles of the same in practical situations.
Authors Grace et al. (2015) in their study, reviewed the rates food safety occurring in
countries with low and middle income group populations. As per the findings of the author, it
was observed that negligible research on existing practices of safe food handling had been
conducted in these countries, as compared to a large section of food borne disease incidences
which were associated with the intake of fresh and perishable foods present in informal,
commercial markets, prepared within unhygienic conditions. The review also indicated an
association between increased rates of food borne illness incidences and the high intake of foods
which are at risk of consumption such as livestock and fish. Unfortunately, an absence of
optimum food safety practice implementation practice was reported in the study despite the

34FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
presence of advanced technological usage in terms of agricultural production of food. An
absence pertaining to the usage of food hygiene and safety intervention improvements practice
was also reported by the study in domestic as well as commercial industries concerned with food
production. Hence, as postulated by the authors in this study, the rates of food safety, adequate
handling and reduction of food borne illnesses can be accomplished through the administration
of polices, program and educational frameworks aimed at improving knowledge and practices of
safe food preparation among consumers and food handlers alike. Additionally, improved
technological advancements in the food manufacturing sector can beneficial for the monitoring
of food borne illness incidences.
2.8. Food Safety and Handling Practices in the Middle East
The survey conducted by Faour-Klingbeil, Kutri and Todd (2015) aimed to assess the
levels of food safety knowledge, attitudes and practices among food handlers working in food
manufacturing businesses in Beirut, Lebanon. The findings presented by the authors indicated
inadequate food safety knowledge coupled with discrepancies in the adherence to adequate
temperatures of food storage and preparation, which contributes to high risk of consumers
acquiring food borne illnesses. The results also indicated improved quality in the conductance of
food safety and handling practices in food preparation establishments belonging to corporate
organizations as compared to food manufacturing establishments which were informal. Taking
insights from the relationships between the administration of optimum food safety practices and
the nature of establishment of the food manufacturing industry, the authors postulated the need
for both private and public food manufacturing organizations for the implementation of food

35FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
safety and handing programs and frameworks along with provision of technical assistance for
overall maintenance of food safety and hygiene.
Meleko et al. (2015) conducted a cross sectional study with the aim to evaluate
maintenance of sanitation levels as well as food handling and safety knowledge, attitudes and
practices among cafeteria food handlers residing in Addis Ababa, using questionnaires and
checklists as well as examination of microbiological content in the environment of catering
operations as compared to operating procedures which are standardized. The study consisted of
302 participants of which, the results indicated that almost all the food handlers were in position
of optimum levels of food literacy along with 65.2% of the handlers being in possession of
experiences and training associated with food handling. The results also indicated the presence of
adequate lighting, clean walls and optimum levels of ventilation among cafeterias across 12
universities. It was also however, reported that inadequate knowledge of food safety practices
were prevalent across 52.3% of these food handlers. Thus, from the findings of the study, the
authors indicated that the need of the hour is to implement food safety polices and training
programs which will target improvement of food safety knowledge and practices among food
handlers in university cafeterias despite the presence of hygienic environments prevalent in the
area of catering operations.
2.9. Food Safety and Handling Practices in Jordan
Authors Osaili et al. (2017) implemented a cross sectional study which aimed to evaluate
the knowledge of food safety across staff employed in the department of food safety across
Jordan hospitals. A total of 532 subjects were recruited in the study which consisted of cooks,
dietitians and food handlers across 37 hospitals. The result indicated a total score of 56.3 out of
90 in terms of knowledge of food safety as well as the prevalence of food safety awareness on

36FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
concepts like safely storing food, maintenance of optimum temperatures of holding and
reheating, thawing, cooking, adherence to optimum personal hygiene habits as well as
information regarding health effects of inadequate food handling practices. Further, participants
who believed that adhering to Hazard Analysis and Critical Control Points were not required to
be followed, exhibited poor knowledge levels considering safe handling of food. These poor
levels of knowledge and food handling beliefs were found to exist extensively across workers
who were in possession of a working experience of less than 2 years as well as across workers
employed in hospitals managed by public sectors as compared to those managed by private
sectors. Thus, such results indicate the need to administer personalized food safety and handling
training across workers employed in hospitals across Jordan based on their levels of experience
and competency.
Authors Osaili, Al-Nabulsi and Krasneh (2018) conducted another study which evaluated
the food safety knowledge across food service staff employed in food preparation departments
across Jordan universities, using a questionnaires. Poor levels of knowledge associated with food
safety were reported as evident from an average result of 67.1%. Higher scores were observed in
terms of food safety concepts like acquiring knowledge on food borne illnesses (74.3%),
maintenance of strict standards of personal hygiene (74.9%), adherence to sanitations for
avoidance of cross contamination (71.9%). The concept of practices associated with standards
associated with temperatures of thawing, cooking and reheating obtained a poor knowledge score
of 53.5% along with inadequate levels of knowledge on the importance of Hazard Analysis and
Critical Control Points (HACCP) were also reported by the authors of the study. Thus, as per
these results, the need of the hour is to administer training on enhancing knowledge of food

37FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
safety and handling as well as on the adequate usage of HACCP among food handlers employed
in commercial food establishments.
2.10. Food Safety and Handling Practices among Consumers Worldwide
Taking insights from previous sections, incidences of food borne illnesses have been
reported the highest in domestic households, prevalently due to lack of reporting of spontaneous
disease occurrences as well as inadequate level of knowledge and awareness among consumers
on the strategies pertaining to safe food handling and preparation. Prolonged lack of mitigation
concerning the prevalence of inadequate food preparation knowledge among consumers will
render even the most effective food safety handling policy, educational and training framework
as ineffective. Young and Waddell (2016) performed a systematic review which aimed to
identify and understand the key influencers, determinants and obstacles pertaining to optimum
food preparation practices among consumers with the aid of thematic analysis from the selective
studies. The prevalent themes which were reported by the authors as influencers of consumer
food safety behavior: the role of practices and habits in consumer practices of food handling and
preparation, a lack of concern among consumers on the need to modify their existing food
handling practices for the avoidance of food borne illness at the domestic level, the importance
of social influence and pressures as influencers of consumer behavior associated with safe food
handling and preparation. Hence, taking insights from the same, the authors noted that immediate
need to implement hygienic and safe food safety handling and preparation at the commercial as
well as the consumer level for the overall prevention of infections and diseases pertaining to
pathogenic food borne strains.
In terms of the attempts by governmental organizations in the implementation of
legislations associated with the performance of safe and hygienic food handling among

38FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
consumers, the greatest challenge posing as barriers to successful implementation is the
prevalence of inadequate knowledge and awareness concerning the same among consumers
(Evans and Redmond 2016). Authors Asiegbu, Lebelo and Tabit (2016) performed a cross
sectional study with the aim to evaluate the level of consumer knowledge on the microbial safety
associated with the intake of street food in a municipality of Johannesburg, South Africa. The
participants of the study consisted of a total of 402 consumers who indulged in buying and intake
of foods prepared in street based food preparation establishments, whose responses were
evaluated using personal interviews. The findings indicated the role of cost effectiveness,
accessibility and palatability as key influencers in consumer’s preferences towards intake of
street food. The results also indicated the presence of awareness among consumers on the role of
pathogenic strains in the occurrence of food borne illnesses, with however, an absence of
information on the harmful role of microbial strains like Listeria monocytogenes, Salmonella spp
and Eschericia coli and Campylobacter jejuni. The research also reported the presence of
consumer awareness on the harms associated with consumption of street food with however also
noting a high level of motivation and interest among consumers to engage in the same. The
demographic characteristics of consumers which played a key role in consumption and desire to
purchase street food among consumers were found to be level of education, monthly income,
gender and race. Hence, the authors postulated the need to target inadequate level of consumer
knowledge pertaining to safe preparation and handling of food for the prevention of illness
pertaining to food borne pathogenic strains.
The study conducted by Gong et al. (2016) aimed to evaluate the knowledge of food
safety and handling among food handlers residing in Chinese food handlers with the aid of a
national survey using a questionnaire consisting of the7 questions examining demographic data

39FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
as well as 26 questions examining food preparation knowledge concepts. As per the findings, it
was reported that the participants levels of knowledge associated with food safety were poor and
inadequate. The findings reported two groups of participants with particularly poor level of
knowledge associated with food safety and hence a high risk of acquiring food borne illnesses.
Such groups included food handlers who were male, with an annual income of 30, 000 CNY as
well as food handlers who were females with an annual income of less than 30, 000 CNY.
Hence, as per the findings, it can be implied that the Chinese governmental institutions must aim
to administer consumer based food handling and safety educational training programs as well as
prioritize the above identified high risk groups for prevention of food borne illnesses.
The study conducted by Naeem et al. (2018), assessed the levels of knowledge, attitude
and practices associated with safe food handling within participants comprising of women across
1000 households belonging to 10 towns in Lahore. The findings obtained reported differences
which statistically significant in terms of food safety food safety, attitudes and knowledge.
Emphasizing on the role of safe household food preparation practices in the prevention of food
borne illnesses at the domestic level, the authors postulated on the importance of future research
in the assessment of health risks prevalent in the female subjects recruited for the study. Thus,
taking note from the findings the authors must postulated the importance of implementation of
domestic food safety and handling educational practices for the improvement of existing levels
of food safety knowledge among female household food handlers and hence prevention of food
borne illnesses. There is a need however to evaluate the current levels of food safety knowledge
and handling practice among such household participants prior to administration of educational
frameworks aiming to improve the same.

40FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
Authors Abuga, Nyamari and Njagi (2017), with the help of a cross sectional study aimed
to assess the practices of safe and hygienic food handling followed by consumers in Langata
Sub-County and Nairobi County, Kenya. With the help of an interview and questionnaire, the
authors assessed the practices of food handling and safety as well as socio-demographic
characteristics among 385 participants. The findings reported a key role of factors like water
accessibility and status of employment influencing consumers practices of safe food handling.
The results obtained by the authors reported a positive attitude towards adhering to optimum
food safety and handling practices among 79.5% and the prevalence of sufficient knowledge
associated safe food handling among 64% of the consumers recruited for the study. Such results
imply the need to administer training programs associated with food handling and safety among
consumers for ensuring safe food handling as well as prevention of food borne illness.
Odeyemi et al. (2018) performed an international survey with the aim to assess consumer
levels of knowledge, attitudes and practices considering food safety in consumers belonging to
developing countries. The subjects of the study consisted of a total of 453 participants
comprising of 265 Africans and 188 Asians. The results also indicated Cameroon, Nigeria and
Ghana As African countries with the least levels of food safety knowledge while in Asia,
countries like Pakistan and Malaysia reported poor levels of knowledge concerning food safety.
The results also indicated that prevalence of knowledge associated with food safety among 89%
of consumers as well as engagement in intake of food stored for long hours at room temperatures
among 67.1% of the consumers. While countries of Asia reported higher levels of knowledge
associated with food safety as compared to Africa, the inadequate results reported in countries of
the Middle East like Iron emphasis the need to address food safety knowledge and safety
concerns in these countries with greater concern.

41FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
2.11. Food Safety and Handling Practices among Consumers in Jordan
Similarly, limited studies assessing food safety and handling knowledge and practice
levels across young adults in Jordan were obtained during article screening for the literature
review. Authors Alrabadi, Massad and Alboqai (2013) investigated the food safety and handling
knowledge of 300 consumers selected randomly in Jordan. The study was conducted with the aid
of a questionnaire based on a Likert scale of 5 points. The results indicated mixed responses
where the consumers scored adequately on certain aspects of food safety and handling practices
while certain aspects yielded low responses from students. The study indicated that factors
associated with product expiry date, nutritional value, level of cleanliness in the surrounding
food preparation area and details of packaging were the key determinants influencing food
purchasing behaviors among the consumers of Jordan. The results indicated that the participants
were unlikely to monitor the product’s nutritional information, material used for packager, list of
ingredients, prevalence of additives and temperature requirements of the food prior to
purchasing. A negligible number of customers admitted to monitor cooking temperatures and
awareness on information regarding the transmission of food borne illnesses, despite possessing
adequate knowledge on personal hygiene and practices of storing and handling raw food.
Considering consumers, it was also observed that citizens in Jordan had mixed levels of
knowledge and adherence to practices pertaining to safe food handling. Alrabadi, Al-Massad and
Alboqai (2013), aimed to investigate the level of knowledge and practices of food safety which
were self reported among consumers of Jordan, using questionnaire. The authors analyzed a total
of 208 responses, where it was reported that consumers of Jordan, reported correct responses on
aspects of purchasing and preparing of food, while incorrect responses were recorded in some
aspects of storage and contamination by food borne illnesses. The authors also reported food

42FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
safety knowledge and practice results which were statistically significantly different in terms of
food purchasing and handling between male and female consumers, and consumers across
different ages and incomes. The microbial content reported in Mansaf, a traditional food
preparation of Jordan, reported low levels of bacterial strains obtained from a number of
households. Hence, the authors implied from the study, that consumers across Jordan possessed
satisfactory results on knowledge and practices associated with safe food handling which still
necessitated the need to administer food safety training at the household level.
2.12. Food Safety and Handling Practices among Consumers in the Middle East
Authors Farahat, El-Shafie and Waly (2015) conducted a cross sectional study to evaljate
the levels of food safety knowledge and handling among women residing in the households of
Saudi Arabia. Except for procedures like cooking, positive levels of knowledge concerning safe
food handling practices were reported by the results of this study. Additional results reported that
food safety concepts associate with personal hygiene scored high in terms of knowledge (63.4%)
and practice (73.8%) whereas concepts associated with cleaning of cooking utensils and cooking
reported poor scores of 49.8% and 60.2%. Higher scores on safe food handling knowledge and
practices were reported among subjects who were aged more than 60 years. Thus, the findings of
this study necessitate the administration of food safety handling and educational frameworks
across domestic and household levels.
The cross sectional study by Hassan, Dimassi and Karam (2018), aimed to evaluate self-
reported levels of knowledge and practices associated with safe food handling across households
in Lebanon, among resident food handlers, using questionnaires on perceptions of food hygiene
and demographic profiles. The results indicated that a score of 67.4% in usage of clean kitchen
equipment, 55.6% associated with handling of food and 89.1% on personal habits of hygiene

43FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
during food preparation. Demographic details of participants such as sex, age, marital status,
income and education were found to heavily influence the results associated with food safety and
handling perceptions.
2.13. Need for Food Safety and Handling among Young Adults
Upon conducting an existing literature review, it was found that a number of international
studies have assessed the levels of knowledge concerning food handling and safety among
students as compared to the number of studies conducted in the Middle East and in Jordan in
particular.
2.14. Food Safety and Handling Practices among Students Worldwide
The literature search revealed an extensive array of international studies assessing the
knowledge and practices of students associated with food preparation and handling as compared
to those conducted in the Middle East.
Authors Luo et al. (2019), researched the knowledge and practice of Chinese students
studying education, medical and nursing in colleges, pertaining to safe food handling and
preparation. According to the findings obtained, lowest and highest scores on attitudes regarding
food safety were found to be prevalent in college students studying medical and education. The
highest scores on conducting safe practices of food handling were observed in college students
studying nursing. Regarding scores of knowledge associated with food safety, the highest scores
were observed among medical students and lowest scores on nursing students respectively.
Additional findings by the author indicated that 30% of the students admitted to be place
requests to the food preparation institutes regarding practicing hygienic food handling practices
while 70% of the students admitted to be concerned about the toxins and pollutants present in

44FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
food products. Cheng et al. (2017), similarly executed another cross sectional study among
students of Beijing studying in high school, regarding their knowledge and perceptions on food
handling safety. The results obtained indicated that 69.4% students continued to engage in
purchasing food from street peddlers whereas the 95.3% of the students expressed concern
regarding the health risks concerning consumption of foods from the streets. Academic
performance, type of residence and school, educational level of the children’s parents,
consumption of alcohol and engagement in behaviors like smoking were researched to be the jet
factors which influenced existing practices of safe food handling and purchasing among Chinese
students.
Studies evaluating safe food handling knowledge and practice among students of Canada
were also obtained during exploration of articles for reviewing. Authors Courtney, Majowicz and
Dublin (20160, performed a survey online in order to evaluate the knowledge and practices
associated with food safety and handling across undergraduate students in universities in Canada.
According to the findings, it was found that students who were studying in senior year, presented
consistent scores on knowledge regarding safe handling and preparation of food. Additional
demographic factors associated with student’s consistency in scores were: prevalence of past or
existing food handling experiences, engagement in self-cooking practices, experiences of
working at food production units such as hospitals and eateries and belonging to the science
department. A similar study was performed by Majowicz et al. (2017), consisting of a
longitudinal survey to assess the knowledge of safe food handling among students studying in
high schools of Ontario, after being encouraged to participate in a program aimed to provide
training on food handling. The results indicated improved levels of concepts of food handling
such as, prevention of food cross contamination, maintenance of adequate storage and cooking

45FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
temperatures and engagement towards disinfection practices after participation in the training
program. Additionally, the study by Burke, Young and Papadopoulos (2016), revealed
inadequate levels of knowledge on food safety among Canadians aged between 19 to 20 years of
age, along with prevalence of strategies of practices for prevention of food borne illnesses which
increases the risk of negative health outcomes within this group.
Authors Ferk, Calder and Camire (2016), evaluated the current knowledge on food safety
among students of Maine, by conducting as survey using the Food Safety Knowledge
Questionnaire. The results obtained reported 50% of incorrect answers associated with
identification of foods with higher susceptibility of pathogenic food strain contamination while
the remaining 60% of students answered correctly. Such high rates of incorrect responses
indicated high risk of acquisition of food borne illnesses among this group of young adults.
Authors Mullan, Wong and Kothe (2015), evaluated 475 students in the United Kingdom and
Australia studying in universities and schools, on their existing levels of food safety and
handling knowledge. The results of the study indicated an alarmingly low score of 38% across
school going students and 54% across students studying in universities. Factors which were
found to be positively associated with high scores of knowledge on food safety, included:
females, students studying in senior years, students studying in Australia and students who were
living alone.
The cross sectional study conducted by Low et al. (2015), evaluated food safety and
handling practices across Malaysian students. The study findings indicated direct association
between adequate knowledge on food safety and handling and presence of factors like higher
educational levels of the student’s fathers, studying in departments of science and studying in
senior of undergraduate years of academics. Authors Moy et al. (2018), conducted a study

46FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
assessing factors determining existing practices of safe food handling across young adults in
Kuala Lumpur, Malaysia. The results indicated that only 15.7% of young adults observed and
evaluated the levels of hygiene in the food preparation area of the cafeterias which they are
visiting while only 40% of students were reported to adequate levels of knowledge pertaining to
food hygiene.
Authors Lazou et al. (2012), assessed the levels of knowledge, attitudes and practices of
safe food handling and preparation self reported by Greek university students. The research
included a survey conducted used a questionnaire comprised of 16 questions each for assessment
of knowledge pertaining to safe food handling which further comprised of sub categories of 4
areas of food microbiology, food preparation, hygiene and storage of food. The results indicated
the presence of correct responses at rates of 38% and 37% across students regarding fields of
practice and knowledge of safe food handling respectively. A large number of participating
students reported being unaware of the need to maintain adequate storage and cooking
temperatures as well as common microbial strains responsible for causing contamination and
food borne illnesses, despite reported on awareness concerning the need for personal hygiene,
prevent cross contamination and freezing food for storage. Higher number of correct survey
responses were observed among students who were female and were studying subjects associated
with healthcare and food safety.
2.15. Food Safety and Handling Practices among Students in the Middle East
As compared to the vast number of studies conducted internationally, limited number of
studies were obtained which assessed the level of food safety and handling knowledge, attitudes
and practices pertaining to Middle Easter students. Authors Al-Shabib, Hussain and Khan
(2017), assessed Saudi Arabian university students for levels of food safety and handling

47FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
knowledge with the aid of a questionnaire which can be self-administered and used for the
collection of food safety knowledge and aspects of students socio-demographic and academic
data. The study consisted of a total of 808 students. Textural adequacy of the food, appearance
of the individuals handling the food, hygiene of the area used for cooking and the food’s
temperature and tastes were factors influencing student’s knowledge and practice of safe food
handling and consumption. While levels of knowledge were observed concerning adherence to
hygiene, cleanliness of cooking environments and prevention of cross contamination, the
students’ responses indicated inadequate levels of knowledge pertaining to the need to maintain
optimum temperatures for cooking.
The study performed by Hassan and Dimassi (2014), aimed to assess food handling and
safety knowledge among students studying in a university in Lebanon. With the aid of a food
safety and handling questionnaire, the students levels of knowledge, attitudes and practices
associated with the same, as well as presence of associations between demographic
characteristics were evaluated. The findings of the study indicated average survey results of
44.7% and 53.6% regarding students’ levels of practice and knowledge on safe food handling.
Demographic factors like being female, studying in senior years were found to yield high survey
scores. Additional factors contributing to the same included students who were living with their
parents and students who were involved in cooking food at home. Such results hence imply the
necessity of implementing educational and training policies aimed at targeting inadequate levels
of knowledge and practices of safe food handling and preparation among students in the Middle
East.
Authors Dehgan et al. (2017), with the aid of a cross sectional study and a questionnaire
which is reliable and valid, evaluated the attitudes and knowledge of health and food safety

48FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
among students of Iran, studying in Tabriz University of Medical Sciences. The results obtained
indicated the immediate necessity for academic organizations to enhance the existing educational
curriculum with courses and subjects teaching safe food handling and preparation. As per the
results obtained, practices of regular hand washing and adequate knowledge of food safety and
health were present across 50% of the participating students. Inadequate levels of food safety and
handling knowledge such as the need to maintain optimum cooking temperatures of food and
usage of food additives were reported across 50% and 60% of the students. The findings also
indicated the presence of significantly high levels of knowledge on food contamination and food
borne illnesses across 87.3% of the participating students. Such findings indicate the need to not
only incorporate education and training to students on enhancement of food handling and safety
strategies but also the need for emphasizing upon the factors which may determine the levels of
the same across such students.
Authors Sanlier and Konaklioglu (2012) performed a research for the evaluation of the
levels of knowledge, attitudes and practices of safe food handling and knowledge using face-to-
face administration of a questionnaire across 1340 students studying in a number of universities
in Turkey. The findings reported statistically and significantly different results across female and
male students (p < 0.001) in terms of results indicating overall levels of food safety and handling
knowledge, attitude and practices. Results obtained across different universities also indicate
statistically significant differences (p < 0.001). The results also indicated that student’s food
safety and handling attitudes and practices were correlated between each other.
2.16. Food Safety and Handling among Food Handlers in Jordan
Similarly, Osaili et al., (2013) engaged in the performance of another significant research,
which examined the knowledge of food safety among workers engaged in food handling and

49FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
preparation across restaurants in Jordan. The authors recognized the significance of this research
by evidencing on the prevalence of strong association between food handlers working in
restaurants and the dissemination of food borne illnesses. The authors engaged in the usage of a
survey based study comprising of a questionnaire monitoring food safety and handling
knowledge and practices across a sample size of 1084 handlers of food employed in 297
restaurants serving fast food in Jordan. The results indicated that food handlers possessed a fairly
satisfactory knowledge of safe food handling. Overall, a total score of 46.47 out of 67 was
obtained which indicated that the 69.4% of the participants reported correct answers to the
survey questions. Low scores were obtained in terms of food safety aspects like safely cooking,
storing, thawing and reheating of foods and on the pathogenic strains responsible for causing
food borne illnesses. However, credible scores were observed in terms of maintaining personal
standards of hygiene and symptoms which indicated the presence of food borne illness in
individuals. Higher scores of food safety and knowledge were observed in food handlers who
had previously undertaken a training course on food safety as compared to those who had no
similar experiences in participation of the same. However, the authors obtained no association
between workers’ scores on food safety knowledge and workers’ previous experience of food
handling and preparation. Further, the authors also did not observe any association between the
demographic details of the food workers and the score obtained from the questionnaire. Hence,
from the results of this study, the authors implied the need for administering optimum courses on
food safety training and education among food handlers and monitoring the same at routine
intervals to ensure deliverance of comprehensive training frameworks. Further improving the
remuneration of food handlers may also motivate them to engage in practices of food safety.

50FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
Another study assessing the knowledge of food safety among workers was performed by
Al-Nasraween et al., (2018), where the authors conducted a study based on evaluation of the
same among chicken shawerma food handlers in Jordan. This research was conducted upon a
background of a number of outbreaks of food poisoning in Jordan for which, Salmonella,
isolated from chicken shawerma, was held accountable. Hence, the authors randomly selected
120 handlers of food, working across 40 restaurants serving chicken shawerma in Jordan, with
the aid of an interview, conducted using a structured questionnaire. The food handlers comprised
of individuals belonging to various ethnicities, of which 26% were Jordanians, 19% were Syrians
and 53% were Syrians. The authors assessed the food handlers’ level of knowledge concerning
food safety using multivariate and descriptive statistical analytical methods. The results obtained
indicated a poor score of overall food knowledge of 40%, where the average scores of each of
the concepts of food safety are as follows: receiving chicken shawerma (63%), storage (54%),
preparation (45%), selling (31%) and preparation (26%). It was further observed that almost 90%
of the food handlers had no training or experience in concepts of food safety. Higher scores were
observed in food handlers who had higher levels of education, were of Jordanian nationality and
had previous training in food safety. Hence, the authors implied from this study, that there is a
need to educate and train food handlers of Jordan with a comprehensive program on food safety
concepts based on their levels of competence using evidence based practices and continuous
evaluation to ensure food safety knowledge improvement.
The practices of food safety among food handlers were also explored by Ma'moun, Al-
Shakhsheer and Al-Ababneh (2017), who assessed the same across employees of Irbid City,
Jordan through an exploration of the determining factors underlying the same. The study was
conducted across a toltal of 245 restaurants where employees reported the required data with the

51FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
aid of a self-administered questionnaire. The authors noted that a number of demographic factors
influenced the practices of food handling across restaurant employees such as, education, age,
cultural backgrounds as well as occupational factors such as size of the restaurants and the usage
of standardized protocols like HACCP. The authors postulated that the need of the hour for food
safety and handling improvement across Jordanian restaurants, is to implement compulsory
HACCP standards of practice across all food preparation establishments and provision of food
safety training to employees of non-Jordanian backgrounds.
The association between educational levels and nature of food handling can be observed
in the research by Sharif, Obaidat and Al-Dalalah (2013), who evaluated the levels of knowledge
attitude and practices of food handlers who were employed in military hospitals of Jordan. It has
been evidenced that a key contributing factor underlying occurrences and transmission of food
borne illnesses, is food handlers’ inadequate knowledge on appropriate food handling practices.
The authors in this research, explored the levels of knowledge attitude and practices among 200
employees, 50 civilian employees and 150 military employees using a self-completed
questionnaire, employed in 7 military hospitals which were selected randomly from three
provinces and one from the capital Amman. As per the findings, it was reported that mean
percentages of knowledge was 84.82%, attitude was 88.88% and practice was 89.43% with
87.88% being the overall score of knowledge, attitude and practice (KAP). Significant
differences were observed between military employee KAP scores (88.5%, 93.2%, 91.4%) and
civilian employee KAP scores (73.7%, 75.8%, 83.5%) respectively. Significant differences in
KAP scores were also sobered across genders, educational level and occupation of the food
handlers. Average KAP scores of males was 86.6% and of females was 90%, while a college
based employee had a KAP score of 91.6% as compared to a school educational employee

52FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
having 79.7% as the mean score. Further, while cooks and nutritionists reported scores of 91.6%,
waiters reported 84.4% and cleaners’ KAP score of 80.2%. Hence, these results indicate the key
contributions of gender, education and occupation to an individual’s knowledge of food safety
which necessitates administration of food safety training programs in terms of demographic
characteristics of food handlers.
2.15. Food Safety and Handling Practices among Students in Jordan
Authors Osaili et al. (2011), assessed the levels of food safety knowledge and handling
practices across students living in North Jordan, who were female with their residences in
dormitories. Using a self-administered questionnaire, the authors assessed the relationship
between students engagement in food hygiene practices and their socio-demographic
characteristics. The highest scores were observed on knowledge associated with cross
contamination avoidance and disinfection practices whereas the lowest scores were observed on
contamination by food borne pathogens and engagement in cooking practices which were safe.
Such results imply the insufficiency of food handling and safety knowledge across the students
of Jordan. This further implies the need for academic organizations to consider deliverance of
courses associated with food safety and handling in the university curriculum.
2.16. Literature Gap
The extensive literature review, as evident from the preceding sections is indicative of the
significant dearth of literature on studies evaluating the levels and factors of safe food handling
and preparation across young adults and university students residing in the Middle East in
general and in Jordan in particular. Gaps in literature were also observed in the previous

53FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
Jordanian studies as evident in the inclusion of only female students in the previous study. Thus,
considering the same, this thesis engaged in enhancing existing literature through the evaluation
of current levels of food safety and handling knowledge and practice among students belonging
to the departments of Jordan University, along with an exploration of possible relationships
between the same and demographic details of the participating students. Jordan University is one
of the most esteemed, traditional and renowned academic organizations in Jordan which harbors
a variety of students across numerous department and academic years and backgrounds. Thus,
based on the identified gaps, this thesis aligned its objectives to the revise upon these existing
dearth of literature through the inclusion of both females and males, across three major academic
departments and academic years for provision of comprehensive information on students’ food
safety handling knowledge and practice behaviors.

54FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
Chapter 3: Methodology
3.1. Introduction
Research methodology is of utmost importance for adequately conducting research and
forms and integral part of the overall research. The process of research methodology comprises
of the salient procedures employed for the purpose of collecting data, synthesizing its major
components and analyzing the same with the aim to reconstruct and formulate the information
obtained into relevant themes or insights which will further assist the researcher in answering the
identifies research questions and thus, fulfilment of the objectives identified prior to conductance
of research (Bresler and Stake 2017). A research methodology is importance since its helps to
organize a large amount of obtained data into categories, structures and summarized forms, that
is, extraction of the required data from infinite sources, such as the population. The importance
of methodology in the research conducted for this thesis, rests upon its ability to scale large
number of data components into concise values of convenience which will assist in appropriately
analyzing and discussing the research and hence, achieving the identified research objectives.
This chapter of this thesis will seek to elaborate on the procedures of methodology used and
screening tools for recruiting the concerned participants for the study which assisted in
answering the identified research questions. The succeeding sections of this chapter will also
seek to highlight the process of primary research, selection of required sample and methods of
collection and analysis of information utilized for this research.
3.2. Research Design and Rationale
An observational study was the preferred research design chosen for this thesis and
included an evaluation of the variables of knowledge, attitude and practice associated with food

55FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
handing and safety along with the assessment of the prevalence of any relationship between these
chosen variables and demographic features of the sample of subjects recruited, which comprised
of gender, field status, age group, year of academics such as sophomore, senior and junior, status
of residence, practice of self-preparation of foods, intake of foods from restaurants, enrollment in
courses of microbiology, food science and nutrition and incidences of food poisoning
experienced.
An observational study design and a cross sectional research methodology was opted for
collecting data and the primary research associated with this thesis, keeping in mind the above
identified variables and demographic characteristics of subjects. Cross sectional, observation
based research designs are particularly useful in exploring prevalence rates of various diseases,
behaviors and attitudes but is unable to assess the consequences as a result in administration of
any methods of intervention or determinants which are the key influencers of such rates
(Hripcsakeet al. 2015). Selecting a cross sectional, observational study design for conducting the
primary research of this thesis is justified considering its primary aim to assess the particular
variables of food safety and handling knowledge, attitudes and practice across students studying
in Jordan University, for a fixed period of time. Usage of a cross sectional, observational
research is also justified since this study, due to time and financial difficulties, was unable to
evaluate the consequences of training or educational efforts directed at improvement of the
identified food safety and handling variables (VanderWeele and Ding 2017).
3.3. Study Period
The study period, throughout which the researcher extensively engaged in conducting the
research associated with this thesis ranged from the month of February 2019 to the month of
May 2019.

56FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
3.4. Study Setting: Jordan University
The study setting chosen for this thesis was the state of Jordan, since it has been
mentioned in the preceding sections concerning the dearth of literature available on food safety
and handling knowledge, attitude and handling practices among consumers as well as university
students in Jordan. Additionally, the settings selected to conduct the research for this study, was
the University of Jordan – an academic institution regarded to deliver education in the state with
prestige, esteem and advancement. This was the chosen study setting considering the fact that the
aim of the research so identified was to assess the levels knowledge, attitude and practice
associated with food safety and handling across students residing in Jordan and studying in the
University of Jordan. Hence, to conduct this research, the researcher engaged in the distribution
of questionnaires across the classrooms within this educational institute where the participating
students were asked to provide answers and hence complete filling the tool, after they had
finished undertaking their lectures and classes. The setting for this research consisted of a sample
group comprising of subjects who were students of Jordan University belonging to a wide range
of academic sections, majorly including three broad study categories of health facilities,
humanitarian facilities and science facilities. Since one of the major aims identified for this
study, included evaluation of the relationship between food handling and safety variables and
demographic features of participants, inclusion of students from a variety of academic fields
paved the way for conducting a research which is demographically comprehensive.
3.5. Study Population: Undergraduate Students
The population selected for study in the research for this thesis, comprised of
undergraduate settings studying in the University of Jordan. This was due to the fact that
previous sections identified the significant insufficiency in food safety and handling information

57FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
among students studying in universities as well as the identified research objectives of assessing
the food safety and handling knowledge, attitude and practice variables among Jordan University
students. The students belonging to undergraduate sections who were selected for this study,
were recruited randomly from three major academic fields of humanitarian, science and health.
3.6. Sample Size
The sample of students targeted for this study comprised of undergraduate students from
Jordan University, and was selected with the aid of the Z formula using Z2*(p)*(1-p)/c2, from
which Z is equivalent to the Z value, p is equivalent to a percentage of a choice and estimated in
the form of a decimal and c is confidence level, which is estimated with the help of a decimal
number (de Bekker-Grobeet al. 2015). The study sample for this thesis comprised of students
across three primary academic fields of Jordan University that is the departments of science,
humanitarian and health.
Thus, after applying the above mentioned Z formula along with the associated statistical
values of sample selected from Jordan University, the estimated sample size was calculated to be
381. In addition, 10 % of the sample size was incorporated further to cancel the effect of missed
responses which lead to obtaining 420 students as the final sample size, ultimately used to
conduct the pilot study. This sample of 420 students comprised of the major three educational
departments resulting in 140 students from each field of health, science and humanitarian.
3.7. Inclusion Criteria
For selecting the sample of this study, the inclusion criteria consisted of Jordan
University students, studying in either of the three academic years of sophomore, junior and
senior and in either of the academic fields of science, health and humanitarian.

58FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
3.8. Exclusion Criteria
For selecting the sample for this study, the exclusion criteria comprised of students who
were not undergraduates and did not study in Jordan University. Additionally, people associated
with Jordan University, who were not students, such as professors and the non-teaching staff
were excluded from the research of this thesis. After completing the step of data collection in this
study using the selected questionnaire, incomplete responses were excluded prior to data
analysis.
3.9. Sampling Method
A multistage method of sampling, which involves categorizing the samples into specific
groups or clusters, was utilized for the purpose of sampling the subjects recruited for this study
(Alvi 2016). Jordan University students studying at the undergraduate level were recruited for
the study conducted in this thesis using a three step method of multistage sampling. The first
consisted of selecting students across the faculty departments of science, humanitarian and health
using multistage sampling following which, a second stage of sampling ensued in which single
random sampling method was used comprising of selecting one faculty from each of the above
identified departments. Engineering was recruited from the science department. Nursing faculty
was recruited from the health department. Business faculty was recruited from the department of
humanitarian of Jordan University. The last sampling step comprised of recruiting students using
convenient sampling methods which consisted of selecting 140 students from each faculty
resulting in a total sampling size of 420 students.
3.10. Instrument Questionnaire already used in other study
Adopting a questionnaire which is valid and reliable, is of utmost importance for any
research and hence for this thesis, the questionnaire which was developed by Hassan and

59FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
Dimassi (2014) was used, which was used for the evaluation of behaviors and knowledge related
to food handling and safety across Lebanese University students. The authors used the
questionnaire developed by Osailiet al. (2010), which was used for the evaluation of knowledge
and practices pertaining to food safety across college students who were female and living in
north Jordan. The authors developed this questionnaire by taking insights from the reliable and
valid questionnaire used by Byrd-Bredbenneret al. (2007), used for the assessment of self-rated
knowledge, attitude and practice (KAP) on safe food handling across young adults. The
questionnaire used for this thesis consisted of a section evaluating the demographic details of the
participants, which included: gender, age group, field status, status of residence, academic year
of sophomore, senior, engagement in preparing food personally and enrolling oneself in courses
like microbiology, nutrition and food science, as well as rate of consuming food from restaurants
and incidences of food poisoning.
3.11. Pilot Study and Reliability Analysis
The pilot study was performed across a total of 420 students, categorized into 140
students from each of the three faculties of business, nursing and engineering. SPSS 23.0
software was utilized for the purpose of testing the reliability in the responses obtained in this
research. Using this software, the reliability test was performed with the help of Cronbach’s
Alpha test using 0.6 as the alpha value. The importance of conducting a reliability analysis lies in
its ability to evaluate the presence of consistency across the responses obtained in a survey.
Results of reliability analysis found to be greater than the alpha value, indicates consistency
across responses of a survey hence implying statistical significance and reliability (Bonett and
Wright 2015).

60FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
3.12. Instrument Validity
Using methods of data collection which is reliable, valid and obtained from scholarly
studies is of importance by the researcher for ensuring that the overall research has high
significance and validity (Miller et al. 2017). For successfully completing this thesis, studies
used for the review of literature as well as discussion of data, studies which were peer reviewed,
scholarly and engaged in research conducted within a recent time period and with relevance to
the objectives identified was included. Including studies which are from scholarly and peer
reviewed journals ensure that the research is valid and reliable. To further ensure reliability and
validity, the questionnaire utilized by Hassan and Dimassi (2014), was used for this thesis, which
was from a valid, reliable, peer reviewed and scholarly research. To further ensure validity, it
must be noted that the questionnaire developed by Hassana and Dimassi (2014), was developed
from the other valid, reliable, peer reviewed and scholarly studies such as the KAP
questionnaires used by Byrd-Bredbenneret al. (2007) and Osailiet al. (2011). Hence, adequate
reliability and validity was maintained in this research, by ensuring the inclusion of valid and
scholarly studies and data collection tools.
3.13. Data Collection
The valid and reliable questionnaire used in the research by Hassan and Dimassi (2014),
which evaluated the levels of practice and knowledge of food handling and safety among
Lebanese University students was the major tool used for collecting data in this study. The first
part of this questionnaire aimed to evaluate the demographic features of the participants, namely
gender, age group, field status, status of residence, academic year of sophomore, senior,
engagement in preparing food personally and enrolling oneself in courses like microbiology,
nutrition and food science, as well as rate of consuming food from restaurants and incidences of

61FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
food poisoning. The second part of this questionnaire consisted of 30 questions in total which
evaluated in detail using multiple choice questions on knowledge and practice of food handling
and safety across Jordan university undergraduate students.
3.14. Data Entry
The results of the demographic section as well as the KAP survey was obtained from the
participants and entered manually using spreadsheet based computer software such as SPSS and
Microsoft Excel.
3.15. Statistical Analysis
The analyzing the results of this research, quantitative methods such as statistical analysis
was utilized, for which the software SPSS version 23.0 proved to be useful. The dependent
variables comprised of the participant’s knowledge and practice variables pertaining to food
handling and safety, while independent variables comprised of the demographic details of the
participants. The responses obtained from the survey was analyzes using Analysis of Variance
(ANNOVA) table and student t test. The value indicating significance level was chosen to be
0.05 for analyzing the responses.
3.16. Ethical Considerations
The research must comply to certain ethical standards and measures for ensuring
successful and credible research (Hariss, MacSween and Atkinson 2017). Taking insights from
the major of this research, recruiting undergraduate students studying in Jordan University was
an absolute necessity. Hence to ensure ethical compliance, it was required to obtained, aapproval
and permission from Jordan University. Additionally, obtaining consent from the students
required in this research was the next ethical consideration adhered to (Salari and Maxwell

62FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
2016). Thus, before conducting steps of selecting the sample and collecting responses for the
survey, students were requested to take part in the study, as per their choice without any force in
case they expressed no interest. The students who were finally selected, were assured that their
identities will be kept as confidential along with the researcher also explaining them in detail the
reasons and significance of this thesis. Finally, ethical compliance was also followed during
writing the literature review by acknowledging the authors whose studies were chosen, using
correct referencing and in-text citations as well as by paraphrasing to prevent plagiarized content
(Wilson Kenny and Dickson-Swift 2018).

63FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
Chapter 4: Data analysis and findings
4.1 Descriptive statistics of demographics and practice
Table 3: Gender
Frequenc
y Percent
Valid
Percent
Cumulative
Percent
Valid a.male 166 39.5 39.5 39.5
b.female 254 60.5 60.5 100.0
Total 420 100.0 100.0
From Table 3, it can be observed that the study sample comprised majorly of female subjects
(60.5%) as compared to males (39.5%).
Table 4: Age_group
Frequenc
y Percent
Valid
Percent
Cumulative
Percent
Valid a.18-20 212 50.5 50.5 50.5
b.21-23 208 49.5 49.5 100.0
Total 420 100.0 100.0
From Table 4, it can be observed that the study sample did not have significant differences in
terms of distribution between the age group of 18-20 years (50.5%) and 21-23 years (49.%).
Table 5: University year
Frequenc
y Percent
Valid
Percent
Cumulative
Percent
Valid 1 4 1.0 1.0 1.0
2 104 24.8 24.8 25.7
3 127 30.2 30.2 56.0
4 185 44.0 44.0 100.0
Total 420 100.0 100.0

64FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
From Table 5, it can be observed that the study sample comprised majorly of senior year students
(44 %), followed by sophomore students (30.2 %), junior students (24.8 %) and freshmen (1.0
%).
Table 6: Field study
Frequenc
y Percent
Valid
Percent
Cumulative
Percent
Valid a.engineering 140 33.3 33.3 33.3
b.business 140 33.3 33.3 66.7
C.nursing 140 33.3 33.3 100.0
Total 420 100.0 100.0
From Table 6, it can be observed that in the study sample, students were distributed equally
across the three departments of Engineering, Business and Nursing (33.3 %).
Table 7: Residence
Frequenc
y Percent
Valid
Percent
Cumulative
Percent
Valid A.with family 335 79.8 79.8 79.8
B.with roomate 74 17.6 17.6 97.4
C.alone 11 2.6 2.6 100.0
Total 420 100.0 100.0
From Table 7, it can be observed that the majority of the participants live with their
family (79.8 %), followed by living with a roommate (17.6 %) and living alone (2.6 %).
Table 8: Self-preparation
Frequenc
y Percent
Valid
Percent
Cumulative
Percent
Valid A.never 75 17.9 17.9 17.9
b.rarely 88 21.0 21.0 38.8
c.sometimes 145 34.5 34.5 73.3

65FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
D.always 112 26.7 26.7 100.0
Total 420 100.0 100.0
From Table 8, it can be observed that a majority of subjects sometimes engaged in
preparing food on their own (34.5 %), followed by participants always engaging in the practice
(26.7 %), rarely engaging in the practice (21.0%) and never engaging in self-preparation cooking
practices (17.9 %).
Table 9: Enrolment in food science
Frequenc
y Percent
Valid
Percent
Cumulative
Percent
Valid B.No 299 71.2 71.2 71.2
A.Yes 121 28.8 28.8 100.0
Total 420 100.0 100.0
From Table 9, it can be observed that a majority of subjects never enrolled themselves in
a food science course (71.2 %).
Table 10: Weekly food restaurant
Frequenc
y Percent
Valid
Percent
Cumulative
Percent
Valid A 384 91.4 91.4 91.4
B 34 8.1 8.1 99.5
C 2 .5 .5 100.0
Total 420 100.0 100.0
From Table 10, it can be observed that a large number of participants engage in weekly
consumption of food from fast food restaurants (91.4 %).
Table 11: Poisoning

66FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
Frequenc
y Percent
Valid
Percent
Cumulative
Percent
Valid A 182 43.3 43.3 43.3
B 238 56.7 56.7 100.0
Total 420 100.0 100.0
From Table 11, it can observed that almost half of the study sample participants have
experienced at least one incidence of food poisoning.
4.2 Correlation among demographic, behavior and perceptions
Table 12: Correlations
Gender
Age_gro
up
Universit
y_year
Field_st
udy
Residen
ce
Self_pre
peration
Enrolmen
t_in_food
science
Weekly_fo
od_restura
nt Poisoning
Gender Pearson
Correlation 1 -.017 .005 .066 -.001 .651** .116* -.080 -.019
Sig. (2-
tailed) .722 .919 .180 .991 .000 .017 .101 .698
N 420 420 420 420 420 420 420 420 420
Age_gr
oup
Pearson
Correlation -.017 1 .798** -.309** -.045 -.039 -.125* .050 -.056
Sig. (2-
tailed) .722 .000 .000 .355 .425 .010 .307 .249
N 420 420 420 420 420 420 420 420 420
Univers
ity_year
Pearson
Correlation .005 .798** 1 -.322** -.070 -.044 -.145** .013 -.083
Sig. (2-
tailed) .919 .000 .000 .154 .371 .003 .788 .090
N 420 420 420 420 420 420 420 420 420
Filed_st
udy
Pearson
Correlation .066 -.309** -.322** 1 -.091 -.036 .438** .000 .035
Sig. (2-
tailed) .180 .000 .000 .061 .460 .000 1.000 .470
N 420 420 420 420 420 420 420 420 420
Residen
ce
Pearson
Correlation -.001 -.045 -.070 -.091 1 .023 -.029 .137** -.125*
Sig. (2-
tailed)
.991 .355 .154 .061 .642 .551 .005 .011

67FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
N 420 420 420 420 420 420 420 420 420
Self_pr
eperatio
n
Pearson
Correlation .651** -.039 -.044 -.036 .023 1 .102* -.079 -.053
Sig. (2-
tailed) .000 .425 .371 .460 .642 .037 .104 .277
N 420 420 420 420 420 420 420 420 420
Enrolm
ent_in_f
oodscie
nce
Pearson
Correlation .116* -.125* -.145** .438** -.029 .102* 1 -.016 .079
Sig. (2-
tailed) .017 .010 .003 .000 .551 .037 .737 .107
N 420 420 420 420 420 420 420 420 420
Weekly
_food_r
esturant
Pearson
Correlation -.080 .050 .013 .000 .137** -.079 -.016 1 -.056
Sig. (2-
tailed) .101 .307 .788 1.000 .005 .104 .737 .252
N 420 420 420 420 420 420 420 420 420
Poisoni
ng
Pearson
Correlation -.019 -.056 -.083 .035 -.125* -.053 .079 -.056 1
Sig. (2-
tailed) .698 .249 .090 .470 .011 .277 .107 .252
N 420 420 420 420 420 420 420 420 420
Q1 Pearson
Correlation .019 .079 .060 .011 -.071 -.008 -.058 -.298** .054
Sig. (2-
tailed) .690 .107 .221 .824 .146 .862 .239 .000 .271
N 420 420 420 420 420 420 420 420 420
Q2 Pearson
Correlation .032 .020 .011 0.000 .164** .037 -.024 .077 -.003
Sig. (2-
tailed) .518 .679 .824 1.000 .001 .451 .626 .116 .956
N 420 420 420 420 420 420 420 420 420
Q3 Pearson
Correlation .003 .002 .011 .129** -.022 .098* .135** .097* .059
Sig. (2-
tailed) .948 .969 .825 .008 .647 .045 .006 .047 .228
N 420 420 420 420 420 420 420 420 420
Q4 Pearson
Correlation -.044 -.004 -.027 .157** -.113* -.090 .073 -.044 .098*
Sig. (2-
tailed) .370 .940 .584 .001 .021 .065 .137 .372 .045
N 420 420 420 420 420 420 420 420 420

68FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
Q5 Pearson
Correlation .046 -.044 -.055 -.024 -.040 .047 .021 -.086 -.021
Sig. (2-
tailed) .342 .369 .257 .623 .416 .336 .674 .079 .663
N 420 420 420 420 420 420 420 420 420
Q6 Pearson
Correlation .060 .038 .055 -.104* .098* .068 .110* .062 -.084
Sig. (2-
tailed) .223 .442 .258 .033 .045 .163 .024 .204 .084
N 420 420 420 420 420 420 420 420 420
Q7 Pearson
Correlation .017 .043 .041 -.065 .130** -.087 -.030 .101* .000
Sig. (2-
tailed) .727 .380 .402 .181 .008 .073 .534 .039 .995
N 420 420 420 420 420 420 420 420 420
Q8 Pearson
Correlation -.047 .083 .042 -.088 -.057 .019 .026 .055 .129**
Sig. (2-
tailed) .339 .089 .386 .071 .244 .700 .600 .258 .008
N 420 420 420 420 420 420 420 420 420
Q9 Pearson
Correlation -.021 .011 .041 -.043 .075 -.038 -.062 -.020 .002
Sig. (2-
tailed) .662 .826 .404 .378 .124 .441 .202 .681 .961
N 420 420 420 420 420 420 420 420 420
Q10 Pearson
Correlation -.001 -.015 -.048 -.005 -.015 .030 -.019 .045 -.093
Sig. (2-
tailed) .986 .759 .322 .919 .753 .534 .701 .358 .056
N 420 420 420 420 420 420 420 420 420
Q11 Pearson
Correlation -.090 .032 .047 -.217** .074 -.035 -.206** -.148** -.031
Sig. (2-
tailed) .066 .512 .340 .000 .129 .477 .000 .002 .521
N 420 420 420 420 420 420 420 420 420
Q12 Pearson
Correlation .134** .043 .015 -.114* -.001 .072 .110* -.009 .011
Sig. (2-
tailed) .006 .379 .765 .019 .985 .138 .025 .849 .821
N 420 420 420 420 420 420 420 420 420

69FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
Q13 Pearson
Correlation -.091 .084 .110* -.127** -.027 -.032 -.174** -.003 -.071
Sig. (2-
tailed) .061 .086 .024 .009 .579 .519 .000 .951 .146
N 420 420 420 420 420 420 420 420 420
Q14 Pearson
Correlation -.057 .025 .039 -.116* -.020 -.046 -.075 -.106* -.018
Sig. (2-
tailed) .246 .616 .426 .017 .680 .346 .124 .030 .718
N 420 420 420 420 420 420 420 420 420
Q15 Pearson
Correlation .282** -.043 -.036 .041 -.121* .138** .095 -.070 .021
Sig. (2-
tailed) .000 .383 .457 .404 .013 .004 .051 .152 .670
N 420 420 420 420 420 420 420 420 420
Q16 Pearson
Correlation .082 -.047 -.036 .053 -.132** .028 .055 -.101* -.009
Sig. (2-
tailed) .092 .334 .461 .278 .007 .564 .260 .038 .851
N 420 420 420 420 420 420 420 420 420
Q17 Pearson
Correlation .085 .008 -.054 .072 -.035 .034 .015 -.160** .111*
Sig. (2-
tailed) .082 .876 .266 .139 .477 .486 .758 .001 .023
N 420 420 420 420 420 420 420 420 420
Q18 Pearson
Correlation .115* .019 -.003 .060 -.243** .031 .045 -.144** .058
Sig. (2-
tailed) .018 .696 .954 .222 .000 .520 .360 .003 .236
N 420 420 420 420 420 420 420 420 420
Q19 Pearson
Correlation .060 -.053 -.040 .073 .005 .075 .042 -.041 .024
Sig. (2-
tailed) .223 .279 .410 .137 .921 .127 .396 .401 .630
N 420 420 420 420 420 420 420 420 420
Q20 Pearson
Correlation -.108* .072 .091 -.185** .140** -.077 -.058 .117* -.122*
Sig. (2-
tailed) .027 .140 .062 .000 .004 .115 .238 .016 .012
N 420 420 420 420 420 420 420 420 420

70FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
Q21 Pearson
Correlation .009 -.058 -.080 .067 .002 .037 .120* -.002 .097*
Sig. (2-
tailed) .852 .234 .101 .170 .969 .447 .014 .961 .048
N 420 420 420 420 420 420 420 420 420
Q22 Pearson
Correlation .081 .086 .055 -.042 -.043 -.012 -.027 .106* .094
Sig. (2-
tailed) .096 .077 .264 .392 .375 .801 .578 .029 .055
N 420 420 420 420 420 420 420 420 420
Q23 Pearson
Correlation -.070 .015 -.012 -.083 .089 -.022 -.036 -.081 -.061
Sig. (2-
tailed) .150 .762 .805 .091 .069 .650 .459 .099 .212
N 420 420 420 420 420 420 420 420 420
Q24 Pearson
Correlation .062 .024 .008 .044 -.191** .064 .013 -.143** .001
Sig. (2-
tailed) .201 .623 .875 .371 .000 .189 .785 .003 .985
N 420 420 420 420 420 420 420 420 420
Q25 Pearson
Correlation -.144** -.022 -.021 -.049 .079 -.124* -.073 .071 .094
Sig. (2-
tailed) .003 .654 .673 .317 .104 .011 .134 .147 .055
N 420 420 420 420 420 420 420 420 420
Q26 Pearson
Correlation .059 -.032 -.035 -.008 .105* .081 .000 -.057 .050
Sig. (2-
tailed) .228 .510 .471 .874 .032 .099 .996 .240 .309
N 420 420 420 420 420 420 420 420 420
Q27 Pearson
Correlation -.134** .035 .031 -.012 -.067 -.079 -.085 -.012 .062
Sig. (2-
tailed) .006 .478 .531 .805 .167 .105 .083 .813 .208
N 420 420 420 420 420 420 420 420 420
Q28 Pearson
Correlation -.030 -.083 -.044 .161** -.022 .003 .089 .104* -.062
Sig. (2-
tailed) .542 .091 .365 .001 .646 .956 .070 .033 .203
N 420 420 420 420 420 420 420 420 420

71FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
Q29 Pearson
Correlation .043 .030 .048 .036 -.066 .119* .081 .023 .004
Sig. (2-
tailed) .382 .536 .329 .458 .178 .014 .096 .639 .930
N 420 420 420 420 420 420 420 420 420
Q30 Pearson
Correlation -.051 -.030 -.018 -.052 .030 -.005 -.010 .046 -.040
Sig. (2-
tailed) .293 .535 .708 .290 .542 .911 .845 .352 .413
N 420 420 420 420 420 420 420 420 420
**. Correlation is significant at the 0.01 level (2-tailed).
*. Correlation is significant at the 0.05 level (2-tailed).
From Table 12, it can be observed that a significant correlation exists between food
safety knowledge and practice responses from the questionnaire, and demographic characteristics
of participants especially in terms of self-preparation of food, enrolment in food science courses,
field of study, university year, age group, experience of food poisoning and type of residence.
4.3 Percentage Distribution analysis of 30 dependent questions
Table 13: Percentage Distribution analysis of 30 dependent questions
Question Option A Option B Option C Option D
Frequency Percentage Frequency Percentage Frequency Percentage Frequency Percentage
Q1 59 14.0 98 23.3 107 25.5 156 37.1
Q2 27 6.4 104 24.8 123 29.3 166 39.5
Q3 275 65.5 145 34.5
Q4 67 16.0 145 34.5 97 23.1 111 26.4
Q5 209 49.8 140 33.3 26 6.2 45 10.7
Q6 36 8.6 139 33.1 202 48.1 43 10.2
Q7 95 22.6 193 46.0 33 7.9 99 23.6
Q8 257 61.2 0 0 70 16.7 93 22.1
Q9 19 4.5 35 8.3 320 76.2 46 11.0

72FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
Q10 85 20.2 56 13.3 94 22.4 185 44.0
Q11 121 28.8 11 2.6 168 40.0 120 28.6
Q12 312 74.3 18 4.3 1.7 83 19.8
Q13 196 46.7 80 19.0 121 28.8 23 5.5
Q14 58 13.8 254 60.5 79 18.8 29 6.9
Q15 0 0 0 0 205 48.8 215 51.2
Q16 2 .5 369 87.9 49 11.7
Q17 99 23.6 43 10.2 278 66.2
Q18 137 32.6 28 6.7 200 47.6 55 13.1
Q19 7 1.7 71 16.9 342 81.4
Q20 277 66.0 143 34.0
Q21 215 51.2 31 7.4 174 41.4
Q22 36 8.6 66 15.7 318 75.7
Q23 4 1.0 0 0 364 86.7 52 12.4
Q24 40 9.5 51 12.1 223 53.1 106 25.2
Q25 147 35.0 273 65.0
Q26 149 35.5 127 30.2 59 14.0 85 20.2
Q27 13 3.1 176 41.9 183 43.6 48 11.4
Q28 8 1.9 227 54.0 55 13.1 130 31.0
Q29 59 14.0 287 68.3 74 17.6
Q30 331 78.8 76 18.1 0 0 13 3.1
From Table 13, the highest percentage of answers for each question were recorded in the
following options: Question 1: Option D (37.1 %), Question 2: Option D (39.5 %), Question 3:
Option A (65.5 %), Question 4: Option B (34.5 %), Question 5: Option A (49.8 %), Question 6:
Option C (48.1 %), Question 7: Option B (46.0 %), Question 8: Option A (61.2 %), Question 9:
Option C (76.2 %), Question 10: Option D (44.0%), Question 11: Option D (40.0 %), Question
12: Option A (74.3 %), Question 13: Option A (46.7 %), Question 14: Option B (60. 5 %),
Question 15: Option D (51.2 %), Question 16: Option B (87.9 %), Question 17: Option C (66.2
%), Question 18: Option C (47.6 %), Question 19: Option C (81.4 %), Question 20: Option A

73FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
(66.0 %), Question 21: Option A (51.2 %), Question 22: Option C (75.7 %), Question 23: Option
C (86.7 %), Question 24: Option C (53.1 %), Question 25: Option B(65.0 %), Question 26:
Option A (35.5 %), Question 27: Option C (48 %), Question 28: Option B (54.0 %), Question
29: Option B (68.3 %) and Question 30: Option A (78.8 %). Of these, the highest number of
correct responses were observed in terms of Questions 6, 7, 8, 10, 13, 15, 16, 18, 20, 22, 23, 26,
28, 29 and 30.

74FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
References
Ababio, P.F. and Lovatt, P., 2015. A review on food safety and food hygiene studies in Ghana.
Food Control,47, pp.92-97.
Abuga, M. M., Nyamari, J., and Njagi, J. M., 2017. Evaluation of consumer food hygiene
andsafety practices in households in Langata sub-county, Nairobi county, Kenya.
InternationalJournal of Scientific and Research Publications, 7(5), pp.585-592.
Afolaranmi, T.O., Hassan, Z.I., Bello, D.A. and Misari, Z., 2015. Knowledge and practice of
food safety and hygiene among food vendors in primary schools in Jos, Plateau State, North
Central Nigeria. J Med Res, 4(2), pp.016-22.
Akabanda, F., Hlortsi, E.H. and Owusu-Kwarteng, J., 2017. Food safety knowledge, attitudes
and practices of institutional food-handlers in Ghana. BMC public health, 17(1), p.40.
Alananbeh, K. and Hayajneh, F., 2018. Pesticide Residue Awareness among Students and
Employees in the University of Jordan, Jordan. Journal of Agricultural & Food Information,
pp.1-35.
Alimi, B.A. and Workneh, T.S., 2016. Consumer awareness and willingness to pay for safety of
street foods in developing countries: A review. International journal of consumer studies, 40(2),
pp.242-248.
Allan, P.D., Palmer, C., Chan, F., Lyons, R., Nicholson, O., Rose, M., Hales, S. and Baker,
M.G., 2018. Food safety labelling of chicken to prevent campylobacteriosis: consumer
expectations and current practices. BMC public health, 18(1), p.414.

75FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
Al-Nasraween, M., Al Omari, L., Al-Jaghbeer, M., Al-Qutob, R., Berggren, V. and Taha, H.,
2018. Food Safety Knowledge among Chicken Shawerma Food Handlers in Amman-Jordan.
Arab Journal of Nutrition and Exercise (AJNE), 3(3), pp.119-135.
Al-Nasraween, M., Al Omari, L., Al-Jaghbeer, M., Al-Qutob, R., Berggren, V. and Taha, H.,
2018. Food Safety Knowledge among Chicken Shawerma Food Handlers in Amman-
Jordan. Arab Journal of Nutrition and Exercise (AJNE), 3(3), pp.119-135.
Alrabadi, N.I., Massad, M.A. and Alboqai, O., 2013. Food safety: A Study of Jordanian
consumers knowledge and practices. World Appl Sci J, 22, pp.35-40.
Alrabadi, N.I., Massad, M.A. and Alboqai, O., 2013. Food safety: A Study of Jordanian
consumers knowledge and practices. World Appl Sci J, 22(1), pp.35-40.
Al-Shabib, N.A., Husain, F.M. and Khan, J.M., 2017. Study on food safety concerns, knowledge
and practices among university students in Saudi Arabia. Food Control, 73, pp.202-208.
Alvi, M., 2016. A manual for selecting sampling techniques in research.
Asiegbu, C.V., Lebelo, S.L. and Tabit, F.T., 2016. The food safety knowledge and microbial
hazards awareness of consumers of ready-to-eat street-vended food. Food Control, 60, pp.422-
429.
Beavers, A.S., Murphy, L. and Richards, J.K., 2015. Investigating Change in Adolescent Self‐
Efficacy of Food Safety Through Educational Interventions. Journal of Food ScienceEducation,
14(2), pp.54-59.

76FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
Bonett, D.G. and Wright, T.A., 2015. Cronbach's alpha reliability: Interval estimation,
hypothesis testing, and sample size planning. Journal of Organizational Behavior, 36(1), pp.3-
15.
Bresler, L. and Stake, R.E., 2017. Qualitative research methodology in music education.
In Critical Essays in Music Education (pp. 113-128). Routledge.
Burke, T., Young, I. and Papadopoulos, A., 2016. Assessing food safety knowledge and
preferred information sources among 19–29 year olds. Food Control, 69, pp.83-89.
Burns, C., Katayama, K. and Roberts, R.E., 2019. Consumer Co-Operatives and Perceptions of
Food Safety: Shaping Markets in Post-Fukushima Japan. In Urban Agriculture and Food
Systems: Breakthroughs in Research and Practice (pp. 210-231). IGI Global.
Byrd-Bredbenner, C., Maurer, J., Wheatley, V., Schaffner, D., Bruhn, C. and Blalock, L., 2007.
Food safety self-reported behaviors and cognitions of young adults: results of a national
study. Journal of food protection, 70(8), pp.1917-1926.
Centers for Disease Control and Prevention (2019). Foodborne Illnesses and Germs. [online]
Centers for Disease Control and Prevention. Available at:
https://www.cdc.gov/foodsafety/foodborne-germs.html [Accessed 3 Apr. 2019].
Cheng, Y., Zhang, Y., Ma, J. and Zhan, S., 2017. Food safety knowledge, attitude and self-
reported practice of secondary school students in Beijing, China: A cross-sectional study. PloS
one, 12(11), p.e0187208.

77FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
Cortese, R.D.M., Veiros, M.B., Feldman, C. and Cavalli, S.B., 2016. Food safety and hygiene
practices of vendors during the chain of street food production in Florianopolis, Brazil: A
crosssectional study. Food Control, 62, pp.178-186.
Courtney, S.M., Majowicz, S.E. and Dubin, J.A., 2016. Food safety knowledge of undergraduate
students at a Canadian university: results of an online survey. BMC public health, 16(1), p.1147.
da Silva Farias, A., Akutsu, R.D.C.C.D., Botelho, R.B.A. and Zandonadi, R.P., 2019. Good
Practices in Home Kitchens: Construction and Validation of an Instrument for Household Food-
Borne Disease Assessment and Prevention. International journal of environmental research and
public health, 16(6), p.1005.
de Andrade, M.L., Rodrigues, R.R., Antongiovanni, N. and da Cunha, D.T., 2019. Knowledge
and risk perceptions of foodborne disease by consumers and food handlers at restaurants with
different food safety profiles. Food Research International.
de Oliveira, C.A.F., da Cruz, A.G., Tavolaro, P. and Corassin, C.H., 2016. Food Safety: Good
Manufacturing Practices (GMP), Sanitation Standard Operating Procedures (SSOP), Hazard
Analysis and Critical Control Point (HACCP). In Antimicrobial Food Packaging (pp. 129-139).
Academic Press.
deBekker-Grob, E.W., Donkers, B., Jonker, M.F. and Stolk, E.A., 2015. Sample size
requirementsfor discrete-choice experiments in healthcare: a practical guide. The Patient-
Patient-CenteredOutcomes Research, 8(5), pp.373-384.
Dehghan, P., Pournaghi-Azar, F., Azami-Aghdash, S., Sohraby-Silabi, Y., Dadkhah, H. and
Mohammadzadeh-Aghdash, H., 2017. Knowledge and attitude towards health and food safety

78FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
among students of Tabriz University of Medical Sciences, Tabriz, Iran. Journal of Analytical
Research in Clinical Medicine, 5(2), pp.62-68.
Diplock, K.J., Dubin, J.A., Leatherdale, S.T., Hammond, D., Jones-Bitton, A. and Majowicz,
S.E., 2018. Observation of High School Students' Food Handling Behaviors: Do They Improve
following a Food Safety Education Intervention?. Journal of food protection, 81(6), pp.917-925.
Diplock, K.J., Jones-Bitton, A., Leatherdale, S.T., Rebellato, S., Dubin, J.A. and Majowicz,
S.E.,2017. Over-confident and under-competent: exploring the importance of food safety
educationspecific to high school students. Environmental Health Review, 60(3), pp.65-72.
European Food Information Council (2019). What is Food Safety? : (EUFIC). [online] Eufic.org.
Available at: https://www.eufic.org/en/food-safety/article/what-is-food-safety [Accessed 20 Mar.
2019].
Evans, E.W. and Redmond, E.C., 2016. Older adult consumer knowledge, attitudes, and self-
reported storage practices of ready-to-eat food products and risks associated with
listeriosis. Journal of food protection, 79(2), pp.263-272.
Evans, E.W. and Redmond, E.C., 2016. Older adult consumer knowledge, attitudes, and self-
reported storage practices of ready-to-eat food products and risks associated with listeriosis.
Journal of food protection, 79(2), pp.263-272.
Faour-Klingbeil, D., Kuri, V. and Todd, E., 2015. Investigating a link of two different types of
food business management to the food safety knowledge, attitudes and practices of food handlers
in Beirut, Lebanon. Food Control, 55, pp.166-175.

79FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
Farahat, M.F., El-Shafie, M.M. and Waly, M.I., 2015. Food safety knowledge and practices
amongSaudi women. Food Control, 47, pp.427-435.
Ferk, C.C., Calder, B.L. and Camire, M.E., 2016. Assessing the food safety knowledge of
university of Maine students. Journal of Food Science Education, 15(1), pp.14-22.
Fletcher, A.J., 2017. Applying critical realism in qualitative research: methodology meets
method. International Journal of Social Research Methodology, 20(2), pp.181-194.
Flint, S., 2016. Food safety training-getting this into perspective. Food New Zealand, 16(6), p.30.
Food and Agriculture Organization (2019). Food & Nutrition: A Handbook for Namibian
Volunteer Leaders. [online] Fao.org. Available at: http://www.fao.org/3/a0104e/a0104e08.htm
[Accessed 20 Mar. 2019].
Food and Drug Administration (2019). Food Safety: Importance for At-Risk Groups. [online]
Fda.gov. Available at:
https://www.fda.gov/Food/FoodborneIllnessContaminants/PeopleAtRisk/ucm352830.htm
[Accessed 3 Apr. 2019].
Glymour, M.M. and Bibbins-Domingo, K., 2019. The Future of Observational Epidemiology:
Improving Data and Design to Align With Population Health. American Journal of
Epidemiology.
Gong, S., Wang, X., Yang, Y. and Bai, L., 2016. Knowledge of food safety and handling in
households: A survey of food handlers in Mainland China. Food control, 64, pp.45-53.
Grace, D., 2015. Food safety in low and middle income countries. International journal
ofenvironmental research and public health, 12(9), pp.10490-10507.

80FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
Green, E.J. and Knechtges, P.L., 2015. Food safety knowledge and practices of young adults.
Journal of Environmental Health, 77(10), pp.18-25.
Griffith, C.J., Jackson, L.M. and Lues, R., 2017. The food safety culture in a large South African
food service complex: Perspectives on a case study. British Food Journal, 119(4), pp.729-743.
Harriss, D.J., MacSween, A. and Atkinson, G., 2017. Standards for ethics in sport and exercise
science research: 2018 update. International journal of sports medicine, 38(14), pp.1126-1131.
Hassan, H.F. and Dimassi, H., 2014. Food safety and handling knowledge and practices
ofLebanese university students. Food Control, 40, pp.127-133.
Hassan, H.F., Dimassi, H. and Karam, Z.N., 2018. Self-reported food safety knowledge
andpractices of Lebanese food handlers in Lebanese households. British Food Journal,
120(3),pp.518-530.
Hripcsak, G., Duke, J.D., Shah, N.H., Reich, C.G., Huser, V., Schuemie, M.J., Suchard, M.A.,
Park, R.W., Wong, I.C.K., Rijnbeek, P.R. and Van Der Lei, J., 2015. Observational Health Data
Sciences and Informatics (OHDSI): opportunities for observational researchers. Studies in health
technology and informatics, 216, p.574.
Kim, H., Jang, S.M. and Noh, G.Y., 2019. Is it good to blame the government for food safety
concerns? Attributions of responsibility, new media uses, risk perceptions, and behavioral
intentions in South Korea. Journal of Food Safety, 39(1), p.e12570.
Lammie, S.L. and Hughes, J.M., 2016. Antimicrobial resistance, food safety, and one health: the
need for convergence. Annual review of food science and technology, 7, pp.287-312.

81FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
Lazou, T., Georgiadis, M., Pentieva, K., McKevitt, A. and Iossifidou, E., 2012. Food safety
knowledge and food-handling practices of Greek university students: A questionnaire-based
survey. Food Control, 28(2), pp.400-411.
Lee, H.K., Abdul Halim, H., Thong, K.L. and Chai, L.C., 2017. Assessment of food safety
knowledge, attitude, self-reported practices, and microbiological hand hygiene of food handlers.
International journal of environmental research and public health, 14(1), p.55.
Lin, S., Sun, M., Fitzgerald, E. and Hwang, S.A., 2016. Did summer weather factors affect
gastrointestinal infection hospitalizations in New York State?.Science of The Total Environment,
550, pp.38-44.
Liu, A. and Niyongira, R., 2017. Chinese consumers food purchasing behaviors and awareness
of food safety. Food Control, 79, pp.185-191.
Low, W.Y., Jani, R., Halim, H.A., Alias, A.A. and Moy, F.M., 2016. Determinants of food
hygiene knowledge among youths: a cross-sectional online study. Food Control, 59, pp.88-93.
Luo, X., Xu, X., Chen, H., Bai, R., Zhang, Y., Hou, X., Zhang, F., Zhang, Y., Sharma, M., Zeng,
H. and Zhao, Y., 2019. Food safety related knowledge, attitudes, and practices (KAP) among the
students from nursing, education and medical college in Chongqing, China. Food Control, 95,
pp.181-188.
Macharia, T.N., Ochola, S., Mutua, M.K. and Kimani-Murage, E.W., 2018. Association between
household food security and infant feeding practices in urban informal settlements in Nairobi,
Kenya. Journal of developmental origins of health and disease, 9(1), pp.20-29.

82FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
Majowicz, S.E., Hammond, D., Dubin, J.A., Diplock, K.J., Jones-Bitton, A., Rebellato, S. and
Leatherdale, S.T., 2017. A longitudinal evaluation of food safety knowledge and attitudes among
Ontario high school students following a food handler training program. Food Control, 76,
pp.108-116.
Ma'moun, A., Al-Shakhsheer, F. and Al-Ababneh, M.M., 2017. Restaurant Employees’ Food
Handling Practices in Irbid City, Jordan. Journal of Tourism and Hospitality Management, 5(1),
pp.81-89.
Ma'moun, A., Al-Shakhsheer, F. and Al-Ababneh, M.M., 2017. Restaurant Employees’ Food
Handling Practices in Irbid City, Jordan. Journal of Tourism and Hospitality Management, 5(1),
pp.81-89.
Ma'moun, A.H., Al-Shakhsheer, F.J., Al-Sabi, S.M. and Masadeh, M.A., 2018. Food Safety
Training: A Study of Food Handlers Working in Hotels in the North of Jordan. European
Scientific Journal, ESJ, 14(26), p.127.
McGowan, J., Sampson, M., Salzwedel, D.M., Cogo, E., Foerster, V. and Lefebvre, C., 2016.
PRESS peer review of electronic search strategies: 2015 guideline statement. Journal of clinical
epidemiology, 75, pp.40-46.
McKeever, L., Nguyen, V., Peterson, S.J., Gomez-Perez, S. and Braunschweig, C., 2015.
Demystifying the search button: a comprehensive PubMed search strategy for performing an
exhaustive literature review. Journal of Parenteral and Enteral Nutrition, 39(6), pp.622-635.
Meleko, A., Henok, A., Tefera, W. and Lamaro, T., 2015. Assessment of the sanitary conditions
of catering establishments and food safety knowledge and practices of food handlers in Addis
Ababa University Students’ Cafeteria. Science Journal of Public Health, 3(5), p.733.

83FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
Miller, J.D., Crowe, M., Weiss, B., Maples-Keller, J.L. and Lynam, D.R., 2017. Using online,
crowdsourcing platforms for data collection in personality disorder research: The example of
Amazon’s Mechanical Turk. Personality Disorders: Theory, Research, and Treatment, 8(1),
p.26.
Ministry of Health (2019). Ministry of Health. [online] Jordan.gov.jo. Available at:
https://jordan.gov.jo/wps/portal/Home/GovernmentEntities/Ministries/Ministry/Ministry%20of
%20Health?nameEntity=Ministry%20of%20Health&entityType=ministry [Accessed 9 Apr.
2019].
Moy, F.M., Alias, A.A., Jani, R., Abdul Halim, H. and Low, W.Y., 2018. Determinants of self-
reported food safety practices among youths: A cross-sectional online study in Kuala Lumpur,
Malaysia. British Food Journal, 120(4), pp.891-900.
Mullan, B., Wong, C., Todd, J., Davis, E. and Kothe, E.J., 2015. Food hygiene knowledge in
adolescents and young adults. British Food Journal, 117(1), pp.50-61.
Mullan, B.A., Wong, C. and Kothe, E.J., 2013. Predicting adolescents' safe food handling using
an extended theory of planned behavior. Food Control, 31(2), pp.454-460.
Naeem, N., Raza, S., Mubeen, H., Siddiqui, S.A. and Khokhar, R., 2018. Food safety
knowledge,attitude, and food handling practices of household women in Lahore. Journal of Food
Safety,38(5), p.e12513.
Nik Husain, N.R., Wan Muda, W.M., Noor Jamil, N.I., Nik Hanafi, N.N. and Abdul Rahman,
R.,2016. Effect of food safety training on food handlers’ knowledge and practices: A
randomizedcontrolled trial. British Food Journal, 118(4), pp.795-808.

84FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
Nummer, B., Gump, D., Wells, S., Zimmerman, S. and Montalbano, A., 2015. Hazard Analysis
and Critical Control Points (HACCP). In Regulatory Foundations for the Food Protection
Professional (pp. 163-178). Springer, New York, NY.
Odeyemi, O.A., Sani, N.A., Obadina, A.O., Saba, C.K.S., Bamidele, F.A., Abughoush,
M.,Asghar, A., Dongmo, F.F.D., Macer, D. and Aberoumand, A., 2018. Food safety
knowledge,attitudes and practices among consumers in developing countries: An international
survey. FoodResearch International.
Oliveira, J.D.S.C. and de São José, J.F.B., 2019. Food Handling Practices and Microbial Quality
in Street Food. Journal of Food and Nutrition Research, 7(4), pp.319-324.
Osaili, T.M., Al-Nabulsi, A.A. and Krasneh, H.D.A., 2018. Food safety knowledge among
foodservice staff at the universities in Jordan. Food Control, 89, pp.167-176.
Osaili, T.M., Jamous, D.O.A., Obeidat, B.A., Bawadi, H.A., Tayyem, R.F. and Subih, H.S.,
2013. Food safety knowledge among food workers in restaurants in Jordan. Food Control, 31(1),
pp.145-150.
Osaili, T.M., Obeidat, B.A., Hajeer, W.A. and Al-Nabulsi, A.A., 2017. Food safety knowledge
among food service staff in hospitals in Jordan. Food control, 78, pp.279-285.
Osaili, T.M., Obeidat, B.A., Jamous, D.O.A. and Bawadi, H.A., 2011. Food safety knowledge
andpractices among college female students in north of Jordan. Food Control, 22(2), pp.269-276.
Ruiz, L., Aertsen, A., Gänzle, M.G. and Alvarez-Ordóñez, A., 2017. Industrial and Host
Associated Stress Responses in Food Microbes. Implications for Food Technology and Food
Safety. Frontiers in Microbiology, 8, p.1522.

85FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
Salari, S. and Maxwell, C.D., 2016. Lethal intimate partner violence in later life:
Understandingmeasurements, strengths, and limitations of research. Journal of elder abuse &
neglect, 28(4-5),pp.235-262.
Sanlier, N. and Konaklioglu, E., 2012. Food safety knowledge, attitude and food handling
practices of students. British Food Journal, 114(4), pp.469-480.
Sharif, L., Obaidat, M.M. and Al-Dalalah, M.R., 2013. Food hygiene knowledge, attitudes and
practices of the food handlers in the military hospitals. Food and Nutrition Sciences, 4(03),
p.245.
Sivaramalingam, B., Young, I., Pham, M.T., Waddell, L., Greig, J., Mascarenhas, M.
andPapadopoulos, A., 2015. Scoping review of research on the effectiveness of food-safety
educationinterventions directed at consumers. Foodborne pathogens and disease, 12(7), pp.561-
570.
Teisl, M.F., Lando, A.M., Levy, A.S. and Noblet, C.L., 2016. Importance of cohorts in analysing
trends in safe at-home food-handling practices. Food Control, 62, pp.381-389.
VanderWeele, T.J. and Ding, P., 2017. Sensitivity analysis in observational research: introducing
the E-value. Annals of internal medicine, 167(4), pp.268-274.
Webb, M. and Morancie, A., 2015. Food safety knowledge of foodservice workers at a university
campus by education level, experience, and food safety training. Food Control, 50, pp.259-264.
Wilcock, A. and Ball, B., 2017. Food safety: consumer perceptions and practices.
Wilson, E., Kenny, A. and Dickson-Swift, V., 2018. Ethical challenges in community-
basedparticipatory research: a scoping review. Qualitative health research, 28(2), pp.189-199.

86FOOD SAFETY KNOWLEDGE AND HANDLING PRACTICES
Woh, P.Y., Thong, K.L., Behnke, J.M., Lewis, J.W. and Zain, S.N.M., 2016. Evaluation of basic
knowledge on food safety and food handling practices amongst migrant food handlers in
Peninsular Malaysia. Food Control, 70, pp.64-73.
World Health Organization (2019). WHO | Foodborne diseases. [online] Who.int. Available at:
https://www.who.int/topics/foodborne_diseases/en/ [Accessed 3 Apr. 2019].
World Health Organization (2019). Food safety. [online] Who.int. Available at:
https://www.who.int/news-room/fact-sheets/detail/food-safety [Accessed 20 Mar. 2019].
World Health Organization (2019). Food Safety: What you should know. [online] South-East
Asia Regional Office. Available at:
http://www.searo.who.int/entity/world_health_day/2015/whd-what-you-should-know/en/
[Accessed 20 Mar. 2019].
Xiong, J., 2017. Food safety knowledge and practices of college students.
Young, I. and Waddell, L., 2016. Barriers and facilitators to safe food handling among
consumers:a systematic review and thematic synthesis of qualitative research studies. PloS one,
11(12),p.e0167695.