Influence of education on knowledge, attitude and practices of food technical assistants of Isfahan dairy and beverage processing plants in relation to “Hazard Analysis Critical Control Point”

The growing number of food borne diseases lead to needing for implication of “Food Safety Management System” to supply the safe and qualified foods. To achieve “Food Safety Management System”, “Iran Food and Drug Organization” in Ministry of Health follows the implementation of “Pre-Requisite Programs” through checklist. The trust and loyalty of food consumers can be earned by providing high-quality food. Governmental evaluations of “Hazard Analysis Critical Control Point” principles should be undertaken as part of national strategies and health policy to prevent and control food borne diseases. Therefore, it is necessary to fulfill the checklist of Pre Requisite Programs by the food technical assistants of food processing plant as well as the food inspectors of vice chancellery of food and drug to evaluate the condition of food safety management systems. “Pre-Requisite Programs” checklist is included “Hazard Analysis Critical Control Point”, “Good Manufacturing Practices”, “Good Hygiene Practices” and “Good Laboratory Practices”. “Hazard Analysis Critical Control Point” is one of the main principles to achieve the criteria of “Pre-Requisite Programs”. “Hazard Analysis Critical Control Point” emphasizes on preventive tools by identification of critical control point to access the safe food. Attention to critical control points such as cold chain, equipment, processing and cleaning is important in producing safe dairy products. Food technical assistants working in food processing plants as representative of Ministry of Health have important roles to implement “Hazard Analysis Critical Control Point”. Milk and dairy products as perishable foods are one of the most important food sources involved in the outbreaks of food borne diseases. Hence, proper management is necessary to ensure the safety, quality and nutritional values of dairy products. Failing to follow the principles of “Hazard Analysis Critical Control Point” during production can lead to contamination by microorganisms and may result in food borne diseases. The knowledge and information of food technical assistants are important to implement “Hazard Analysis Critical Control Point” in dairy and beverage processing plants. Attitude is a measure of the extent to which an individual is satisfied or dissatisfied with a particular practices. Adequate practices and experiences of food technical assistants play a major role in the prevention of food borne diseases. Knowledge is an important tool to increase the food safety levels and to overcome on the unexpected problems in production line. Provided with food safety knowledge, food technical assistants should alter their attitudes and improve their practices toward food safety issues. For this purpose, the influence of education evaluated on the level of knowledge, attitudes and practices to “Hazard Analysis Critical Control Point” of food technical assistants working in dairy and beverage processing plant located in Isfahan.

This project was an interventional study with participation of all food technical assistants (56 personnel) working in dairy and beverage processing plants located in Isfahan through census method. The processing plants were classified with grades of A, B, C and D based on the scores in “Pre-Requisite Programs” checklist with the range of 180-200, 160-179, 140-159 and less than 140, respectively. The self-administered questionnaire used in this study was based on the definitions of “Hazard Analysis Critical Control Point” principles in “Pre-Requisite Programs” checklist. The eleven principles of “Hazard Analysis and Critical Control Point” are “assemble the “Hazard Analysis Critical Control Point” team”, “describe the product”, “identify the intended use and consumers”, “construct flow diagram to describe the process”, “on-site confirmation of flow diagram”, “conduct a hazard analysis”, “determine critical control points”, “establish critical limits for each critical control points”, “establish a monitoring system for each critical control points”, “establish corrective actions”, “establish verification procedures “and “establish documentation and record-keeping”. The validity and reliability of the questionnaire were evaluated by professors of School of Nutrition and Food Science as well as food supervisors of Food and Drug Administration of Isfahan University of Medical Sciences. The beginning part of the questionnaire focused on the respondents’ demographic information such as sex, age, educational background, health status, and job satisfaction level. The knowledge section was to evaluate the knowledge of food technical assistants through 12 multiple-choice questions. A score of “1” was given to each correct answer, and the incorrect answers did not receive any point. The next part of the questionnaire was designed to assess the food technical assistants’ attitudes toward “Hazard Analysis and Critical Control Point” concepts and included 11 questions. The level of agreement of food technical assistants was defined using 5 rating scales of “strongly agree”, “agree”, “no idea”, “disagree” and “strongly disagree”. A score of “1” was assigned to positive attitudes, and no score was given to negative attitudes or “No idea” responses. The final part of the questionnaire evaluated the practices of food technical assistants about implementation of “Hazard Analysis and Critical Control Point” principles by using 11 questions. The answers categorized within 5 responses including “always”, “often”, “sometimes”, “seldom” and “never”. The scores assigned to respondents were based on a total of 100. Scores in the ranges of 0-33, 33-66 and 66-100 specified food technical assistants with “poor”, “moderate” and “food” food safety practices, respectively. In the primary stage, respondents were asked to complete the questionnaire. Afterwards, every respondents received an education about the principles of “Hazard Analysis and Critical Control Point” and delivered a pamphlet through an email. For evaluation of influence of education, it was used the same questionnaire to complete by food technical assistants within two months. Descriptive statistics obtained from 56 questionnaires were calculated using SPSS with version 22. The obtained results were reported as Mean ± Standard deviation and percentage. The performed tests were in the form of independent t-test (comparing the knowledge, attitudes and practices scores between sexes), spearmanchr('39')s correlation coefficient (relationship between knowledge, attitudes and practices scores and age,  “Pre-Requisite Programs” checklist scores, education and job satisfaction levels), variance analysis (relationship between knowledge, attitudes and practices scores and health status), and Pearson correlation coefficient (relationship between three knowledge, attitudes and practices scores). P value less than 0.05 was considered as statistically significant.

The majority of the participants in this study were females and in the age range of 31-40 years old. Before education, the average scores for knowledge, attitudes and practices were 72.9 ± 16.6, 68.23 ± 11.6 and 79.65 ± 14, respectively. The scores increased to 81.16 ± 15.1, 76.33 ± 10.5 and 87.02 ± 12.2 after education. Significant difference was observed in the scores of the knowledge, attitudes and practices after educational intervention (p <0.05). There were significant correlations between knowledge, attitudes and practices scores and age (knowledge: r ₌ 0.182, P ₌ 0.06; attitude:  r ₌ 0.256, P ₌ 0.014; practice: r ₌ 0.225, P ₌ 0.029) and knowledge, attitudes and practices scores and job satisfaction level (knowledge: r ₌ 0.272, P ₌ 0. 01; attitude: r ₌ 0. 229, P ₌ 0.025; practice: r ₌ 0.277, P ₌ 0.009). There was no significant correlation between educational background and knowledge, attitudes and practices scores. Furthermore, no significant correlation was found in terms of gender. There were significant correlations between food safety knowledge and practices of food technical assistants and the Pre-Requisite Programs scores of food technical assistants, while no significant correlation was found for the attitudes.

This study provides the information about the level of knowledge, attitudes and practices of food technical assistants toward “Hazard Analysis Critical Control Point” as the basis of food safety management systems. The results of this survey can be utilized for the designing of educational courses with emphasis on observed weakness points of food technical assistants. Considering the importance of determining and monitoring critical control points in the implementation of “Hazard Analysis Critical Control Point” principles and the weakness of food technical assistants in such matters, specific training courses should be provided on this subject. Totally, it was observed the positive influence of education on increasing the knowledge, attitudes and practices to “Hazard Analysis Critical Control Point” of food technical assistants working in dairy and beverage processing plants. The proposed intervention strategy was useful in increasing the knowledge, making a positive attitude and improving the food safety practices of food technical assistants. In fact, the model of knowledge, attitudes and practices can be beneficial to the process of certifying food safety and quality. Effective and ongoing education about food safety concept and subject must be given to all employees of food processing plants to assure the safety of food. Additionally, educational training on food safety issues should concentrate on theoretical aspect as well as practical subjects.