Consumers’ Awareness, Knowledge and Practices Linked to Fresh Produce

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A Master Dissertation
Master’s in Public Health (Health Safety and Environment)
CONSUMERS’ AWARENESS, KNOWLEDGE AND PRACTICES LINKED TO FRESH PRODUCE (INCLUDING
PRE-PACKED FRUITS AND VEGETABLES)
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CONSUMERS’ AWARENESS,
KNOWLEDGE AND PRACTICES
LINKED TO FRESH PRODUCE
(INCLUDING PRE-PACKED FRUITS
AND VEGETABLES)
CONSUMERS’ AWARENESS,
KNOWLEDGE AND PRACTICES

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LINKED TO FRESH PRODUCE
(INCLUDING PRE-PACKED FRUITS
AND VEGETABLES)
DISSERTATION
by

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Acknowledgement:
I would like to thank my supervisor Belinda Davies for her immense support, constant
motivation, and guidance, without which It would have not been possible to complete my
dissertation. Her concern for her students is extraordinary, and her work and enthusiasm
regarding the field of Food Safety and Environmental Health s really inspiring. She has been an
amazing mentor and it was a blessing to work with her during this research report. I would also
like to thank my lovely family and all my friends for their support, understanding and patience
through this endeavor.

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Table of Contents
Abstract..........................................................................................................................................11
Purpose:....................................................................................................................................11
Design/methodology/approach:..............................................................................................11
Findings:...................................................................................................................................12
Research Limitations/Implications:.......................................................................................12
Originality/value:.....................................................................................................................12
Key Words:...............................................................................................................................12
Key Definitions:........................................................................................................................12
Fresh produce:..........................................................................................................................12
Fresh cut fruits and vegetables:..............................................................................................13
INTRODUCTION.........................................................................................................................14
Health benefit of fresh produce..................................................................................................14
Increase in consumption.............................................................................................................15
Increase in fresh produce grown................................................................................................16
Increase in Food borne illness....................................................................................................17
FBI impact and importance of customers practice.....................................................................19
Introduction of the research.......................................................................................................21
Organization of the study...........................................................................................................21
CHAPTER 2: Literature Review:..................................................................................................22
2.1 Introduction..........................................................................................................................22
2.2 Fresh produce washing practices.........................................................................................22
2.3 Demographics......................................................................................................................24
2.4 The role of education in improving knowledge and practices:............................................24
2.5 Knowledge and awareness...................................................................................................25
2.6 Knowledge of vulnerable population group:.......................................................................26
2.7 Consumers education...........................................................................................................26
2.8 Causes of Contamination of Fresh Produce.........................................................................27
Soil:........................................................................................................................................29
Water:....................................................................................................................................29
2.9 The importance of Hand hygiene linked with Foodborne illness:.......................................30
2. 10 Health belief model and their role in changing behaviour:...............................................31

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2.11 High-risk Population groups:.............................................................................................32
Chapter 3: The role of Bacterial agent’s pathogens and their association with fresh produce
producing foodborne illness..........................................................................................................36
3.1 Overview of Microbiological Data:.....................................................................................37
3.2 Previous Outbreaks Data of Foodborne illness in the previous 20 years linked to fresh
produce including pre-packed fresh produce:............................................................................40
3.3 Outbreak Critique:................................................................................................................44
3.4 Fresh test data:.....................................................................................................................45
Chapter 4: Methodology:...............................................................................................................48
Research Aim:..........................................................................................................................48
Statement of Research Objectives of the research:...............................................................48
Specific Objective 1:.............................................................................................................48
Specific Objective 2:.............................................................................................................48
Specific Objective 3:.............................................................................................................49
Specific Objective 4:.............................................................................................................49
Specific Objective 5:.............................................................................................................49
Methods:...................................................................................................................................49
Ethics Application:...............................................................................................................49
Type of Study/ Research design:.........................................................................................49
Literature search strategy:..................................................................................................50
Inclusion criteria:.................................................................................................................50
Study Quality:.......................................................................................................................50
Methods of review:...............................................................................................................51
Participants Overview:........................................................................................................51
Consumers Survey, Research design, and Implementation:................................................51
Demographics and presence of high-risk groups in the house:........................................52
People responsible for buying fresh produce:...................................................................53
Consumer’s current food handling practices:...................................................................53
Consumer’s perception of food safety risks associated with fresh produce:..................53
Consumers’ current food safety knowledge:.....................................................................53
Food safety information for pregnant women:..................................................................54
Instrument:...............................................................................................................................54
Setting and sample/ Data collection:......................................................................................54

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Analysis:....................................................................................................................................54
Prize Draw:...............................................................................................................................55
Risks associated with this project:..........................................................................................56
For participants:...................................................................................................................56
For researchers:....................................................................................................................56
How will the associated risk be minimized?..........................................................................56
For participants:...................................................................................................................56
For researchers:....................................................................................................................57
Chapter 5: Results..........................................................................................................................58
Results:...........................................................................................................................................58
Chapter 6: Discussion:...................................................................................................................68
Chapter 7: Conclusion and future recommendation:.....................................................................73
References......................................................................................................................................77
Appendix 1: Characteristics of outbreak studies included in the literature review having an
association of Consumers awareness, knowledge, behavior and food handling practices linked
with fresh produce.........................................................................................................................88
Appendix 2: Outbreak Summary linked with fresh fruits and vegetables around the globe in the
past 2 decades................................................................................................................................96
Appendix 3: Search strategy......................................................................................................106
3.1: Inclusion and exclusion criteria:.................................................................................106
3.2: Search string....................................................................................................................107
3.3: Search engines:..............................................................................................................109
Appendix 4- Ethics Approval:.....................................................................................................110
Appendix 5- Ethics Application:.................................................................................................112
Appendix 6 - Invitation email for consumer’s participation.......................................................129
Appendix 7 – Sample approach email.........................................................................................130
Appendix 8 –Facebook Advertisement.......................................................................................131
Appendix 9 – Participants Information sheet..............................................................................133
QUT Ethics Approval Number 1700000400...............................................................................133
Appendix 10: Terms and conditions of entry in the prize draw..................................................137
Appendix 11 – Online Survey.....................................................................................................139

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List of Tables
Table 1: Methods causing contamination of the fresh produce. Including both Pre-harvest and
post-harvest....................................................................................................................................29
Table 2: Approximation of the number of listeria cells linked with causes Listeriosis suggested
from the previous outbreaks..........................................................................................................33
Table 3: Most Common Pathogens, agents, and conditions linked to previous fresh produce
outbreaks recommended by experts for inclusion in Australian estimation of foodborne illness
circa 2010.......................................................................................................................................36
Table 4: Characteristics of some microbial pathogens that have been linked to outbreaks of
produce-associated illness.............................................................................................................37
Table 5: Type of Bacteria and associated fresh produce. Examples of the number of fresh
produce around the world in the past two decades that have been isolated from which particular
bacterial pathogen..........................................................................................................................39
Table 6: Summary of samples and number of fresh produce positive tests for microorganisms. .46
Table 7: Results for the samples for of fresh herbs tested for E. coli and Faecal coliforms.........46