p u b l i c h e a l t h 1 2 8 ( 2 0 1 4 ) 7 4 6 e7 4 8
Available online at www.sciencedirect.com
Public Health journal homepage: www.elsevier.com/puhe
Short Communication
Safety of street foods in Agartala, North East India H. Bhattacharjya*, T. Reang Department of Community Medicine, Agartala Government Medical College, Agartala, Tripura, India
article info
in order to formulate recommendations for the prevention of foodborne diseases among the consumers.
Article history: Received 26 November 2012 Received in revised form 4 April 2014 Accepted 19 May 2014 Available online 13 August 2014
Introduction The term ‘street food’ refers to a wide variety of ready-to-eat foods and beverages sold, and sometimes prepared, in public places. Street food may be consumed where it is purchased or can be taken away and eaten elsewhere.1 Foodborne illnesses are a widespread public health problem globally. Developing countries bear the brunt of the problem due to the presence of a wide range of street foods. Most street food vendors who sell both raw and cooked food items are not regulated. They operate haphazardly without any monitoring of what they prepare and how it is prepared. Recent years have seen a reversal in this trend, but food poisoning remains a high priority for the public and governments.2 In November and December 2010, high incidence rates of hepatitis A and gastroenteritis were recorded among the residents of Agartala. Teenagers, young adults and newly married couples were the main groups affected. As such, this study was conducted among 234 street food vendors in Agartala, the capital city of Tripura State, India, between 1 July and 31 August 2011 to study handwashing knowledge and food-handling practices
Methods The minimum sample size requirement for this study was determined as follows: N ¼ [(t)2 p q] ÷ (d)2, with an additional 5% to compensate for non-response: ¼ 235.2 z 236 (rounded) [N ¼ sample size; standard value of ‘t’ with 95% confidence ¼ 1.96; P ¼ 30%, the level of awareness of street food vendors regarding food safety.3 q ¼ (1 p); d ¼ margin of error, it was decided to tolerate 20% relative error in this study, here 20% of P ¼ 6]. Wardwise number of registered street food vendors for the 35 wards in Agartala municipal area was obtained from the Food Inspector of Agartala Municipality. From these 35 wards, 30 clusters were identified using the probability proportionate to size sampling technique. Finally, eight (rounded) street food vendors were chosen from each of these 30 clusters by simple random sampling. Out of 240 selected street food vendors, six met the exclusion criteria. Informed verbal consent was obtained from the street food vendors, and a pretested interview schedule was administered. Confidentiality was maintained and the interview took approximately 20 minutes. Data entry and analysis were performed using Excel 2007 (Microsoft Corp., Redmond, WA, USA) and Epi-Info Version 6.0 (Centers for Disease Control and Prevention, Atlanta, GA, USA).
Results Twenty-one percent of the street food vendors were illiterate, 45% had primary education and 33% had secondary
* Corresponding author. Department of Community Medicine, Agartala Government Medical College, P.O. Kunjavan, 799006, Tripura, India. Tel.: þ91 9436169145 (mobile). E-mail addresses: [email protected], [email protected] (H. Bhattacharjya). http://dx.doi.org/10.1016/j.puhe.2014.05.013 0033-3506/© 2014 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
p u b l i c h e a l t h 1 2 8 ( 2 0 1 4 ) 7 4 6 e7 4 8
education. This was in agreement with previous studies.4,5 Fifty-five percent of the street food vendors were using pipe water, supplied by the municipality, while 36% and 9% were using water from tube wells and ponds, respectively, for preparing food and washing dishes. This practice was more common (65%) among the street food vendors who lived in urban areas (P ¼ 0.000). Thirty-two percent and 45% of the street food vendors with primary and secondary education, respectively, knew that unclean hands and dishes can transmit diseases when serving street food. This result was comparable with the findings of previous studies.5,6 Most (86%) of the street food vendors were using either low-quality or unbranded oils, and the remaining vendors were using good-quality packaged oils for food preparation. Seventy-one percent of the street food vendors placed more emphasis upon taste, 21% were interested in maintaining the quality of food, and 8% could not express their view in this regard. Forty-two percent of the street food vendors opined that it is difficult for an ordinary street food vendor to provide quality, hygienic and nutritious food; half (50%) of the vendors felt that this would be possible if the municipal authority support them by providing pipe water and food licences; and 8% could not express their view in this regard. Ninety-six (41%) street food vendors washed dishes before serving food, and 132 (56%) did not. Shinkre Rajal et al.3 reported that 61% of street food vendors washed dishes before serving food. The majority of street food vendors with secondary and primary education (97% and 70%, respectively) washed dishes after serving food (P ¼ 0.000). Street food vendors with secondary education placed more emphasis on the quality of food compared with illiterate vendors (24% vs 10%; P ¼ 0.024).
Discussion This study found that despite having a minimum level of education and food safety knowledge, many street food vendors were not following minimum food safety and personal hygiene practices. This may be due to lack of time, money and availability of water and space. Sixty-five percent of urban-dwelling street food vendors and 39% of ruraldwelling vendors in Agartala were using tap water for food preparation, but they did not have access to running water all the time. They collected water from roadside tap or mobile tankers, and stored it in a container for later use. The same water was used for cooking food, washing hands and washing dishes. Twenty-eight (58%) illiterate street food vendors, 65 (62%) vendors with a primary education and 55 (69%) vendors with a secondary education did not use soap
747
for handwashing before serving food (P ¼ 0.000) (Table 1). Similar findings have been reported previously.6 Handwashing was found to be difficult due to lack of running water at the vending site, which was in agreement with Abdalla et al.5 The majority of street food vendors, despite having a primary or secondary education, were unaware of the need for handwashing before serving food (P ¼ 0.008). The finding that 86% of the street food vendors did not clean the food preparation surface and used low-quality, locally packed oil for food preparation was comparable with the findings of Chukuezi CO4 and Bas et al.6 Sixty percent of the vendors used disposable vessels to serve food, and 58% kept the foodstuff covered at the vending sites. Very few street food vendors used detergents to wash dishes, in contrast to previous studies which found that the majority of vendors used detergents to wash dishes after each use.3,7 The majority of street food vendors stored the unsold food for the next day, and only 29% of vendors discarded the unsold food. This finding was in agreement with Muinde and Kuria.7 Fortythree percent of street food vendors stored the leftovers in poor conditions, generally in covered warmers or in cooking vessels, whereas Shinkre Rajal et al.3 found that 63% of vendors refrigerated the leftover food items. Literacy was expected to have positive impact on this issue, but many of the literate street food vendors were unaware of food safety practices. Poor socio-economic status and lack of awareness may be the limiting factors for safe food-handling practices. Food licences should be issued subject to fulfilment of basic and essential food safety and hygienic measures. Periodic training of street food vendors in safe food-handling practices may help to improve the situation. The provision of basic sanitation, water and waste management are needed to minimize the gap between knowledge and practice of safe street food vending.
Author statements Ethical approval Institutional Ethics Committee of Agartala Government Medical College.
Funding None declared.
Competing interests None declared.
Table 1 e Use of soap for handwashing by literacy of the street food vendors. Literacy status
Illiterate Primary education Secondary education
references
Use of soap for handwashing P-value Yes, n (%)
No, n (%)
20 (42) 40 (38) 26 (31)
28 (58) 65 (62) 55 (69)
0.000
1. World Health Organization. Essential safety requirements for street vended foods. WHO/FNU/FOS/96.7. Geneva: World Health Organization; 1996. 2. Umoh VJ, Odoba MB. Safety and quality evaluation of street foods sold in Zaria, Nigeria. Food Control 1999;10:9e14.
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3. Shinkre R, Naik VS. Safety and quality of food from street food units in Panaji, Goa, India. Lucknow, India: Paper presented at: concurrent session II, international conference on agribusiness and food industry in developing countries: opportunities and challenges; 2007, August 10 -12. 4. Chukuezi CO. Food safety and hygienic practices of street food vendors in Owerri, Nigeria (2010) at Owerri, Nigeria. Stud Sociol Sci 2010;1:50e7. 5. Abdalla MA, Suliman SE, Bakhiet AO. Food safety knowledge and practice of street food vendors in Atbara
city (Naheer Elneel State Sudan). Afr J Biotechnol 2009;8:6967e71. 6. Bas M, Erush AS, Kivance G. The evaluation of food hygiene, knowledge, attitude and practices of food handlers in food business in Turkey. Food Control 2006;17:317e22. 7. Muinde OK, Kuria E. Hygienic and sanitary practices of vendors of street foods in Nairobi, Kenya. Afr J Food Agricult Nutr Develop 2005;5(1). article no. 7.
Available online at www.sciencedirect.com
Public Health journal homepage: www.elsevier.com/puhe
Short Communication
Safety of street foods in Agartala, North East India H. Bhattacharjya*, T. Reang Department of Community Medicine, Agartala Government Medical College, Agartala, Tripura, India
article info
in order to formulate recommendations for the prevention of foodborne diseases among the consumers.
Article history: Received 26 November 2012 Received in revised form 4 April 2014 Accepted 19 May 2014 Available online 13 August 2014
Introduction The term ‘street food’ refers to a wide variety of ready-to-eat foods and beverages sold, and sometimes prepared, in public places. Street food may be consumed where it is purchased or can be taken away and eaten elsewhere.1 Foodborne illnesses are a widespread public health problem globally. Developing countries bear the brunt of the problem due to the presence of a wide range of street foods. Most street food vendors who sell both raw and cooked food items are not regulated. They operate haphazardly without any monitoring of what they prepare and how it is prepared. Recent years have seen a reversal in this trend, but food poisoning remains a high priority for the public and governments.2 In November and December 2010, high incidence rates of hepatitis A and gastroenteritis were recorded among the residents of Agartala. Teenagers, young adults and newly married couples were the main groups affected. As such, this study was conducted among 234 street food vendors in Agartala, the capital city of Tripura State, India, between 1 July and 31 August 2011 to study handwashing knowledge and food-handling practices
Methods The minimum sample size requirement for this study was determined as follows: N ¼ [(t)2 p q] ÷ (d)2, with an additional 5% to compensate for non-response: ¼ 235.2 z 236 (rounded) [N ¼ sample size; standard value of ‘t’ with 95% confidence ¼ 1.96; P ¼ 30%, the level of awareness of street food vendors regarding food safety.3 q ¼ (1 p); d ¼ margin of error, it was decided to tolerate 20% relative error in this study, here 20% of P ¼ 6]. Wardwise number of registered street food vendors for the 35 wards in Agartala municipal area was obtained from the Food Inspector of Agartala Municipality. From these 35 wards, 30 clusters were identified using the probability proportionate to size sampling technique. Finally, eight (rounded) street food vendors were chosen from each of these 30 clusters by simple random sampling. Out of 240 selected street food vendors, six met the exclusion criteria. Informed verbal consent was obtained from the street food vendors, and a pretested interview schedule was administered. Confidentiality was maintained and the interview took approximately 20 minutes. Data entry and analysis were performed using Excel 2007 (Microsoft Corp., Redmond, WA, USA) and Epi-Info Version 6.0 (Centers for Disease Control and Prevention, Atlanta, GA, USA).
Results Twenty-one percent of the street food vendors were illiterate, 45% had primary education and 33% had secondary
* Corresponding author. Department of Community Medicine, Agartala Government Medical College, P.O. Kunjavan, 799006, Tripura, India. Tel.: þ91 9436169145 (mobile). E-mail addresses: [email protected], [email protected] (H. Bhattacharjya). http://dx.doi.org/10.1016/j.puhe.2014.05.013 0033-3506/© 2014 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
p u b l i c h e a l t h 1 2 8 ( 2 0 1 4 ) 7 4 6 e7 4 8
education. This was in agreement with previous studies.4,5 Fifty-five percent of the street food vendors were using pipe water, supplied by the municipality, while 36% and 9% were using water from tube wells and ponds, respectively, for preparing food and washing dishes. This practice was more common (65%) among the street food vendors who lived in urban areas (P ¼ 0.000). Thirty-two percent and 45% of the street food vendors with primary and secondary education, respectively, knew that unclean hands and dishes can transmit diseases when serving street food. This result was comparable with the findings of previous studies.5,6 Most (86%) of the street food vendors were using either low-quality or unbranded oils, and the remaining vendors were using good-quality packaged oils for food preparation. Seventy-one percent of the street food vendors placed more emphasis upon taste, 21% were interested in maintaining the quality of food, and 8% could not express their view in this regard. Forty-two percent of the street food vendors opined that it is difficult for an ordinary street food vendor to provide quality, hygienic and nutritious food; half (50%) of the vendors felt that this would be possible if the municipal authority support them by providing pipe water and food licences; and 8% could not express their view in this regard. Ninety-six (41%) street food vendors washed dishes before serving food, and 132 (56%) did not. Shinkre Rajal et al.3 reported that 61% of street food vendors washed dishes before serving food. The majority of street food vendors with secondary and primary education (97% and 70%, respectively) washed dishes after serving food (P ¼ 0.000). Street food vendors with secondary education placed more emphasis on the quality of food compared with illiterate vendors (24% vs 10%; P ¼ 0.024).
Discussion This study found that despite having a minimum level of education and food safety knowledge, many street food vendors were not following minimum food safety and personal hygiene practices. This may be due to lack of time, money and availability of water and space. Sixty-five percent of urban-dwelling street food vendors and 39% of ruraldwelling vendors in Agartala were using tap water for food preparation, but they did not have access to running water all the time. They collected water from roadside tap or mobile tankers, and stored it in a container for later use. The same water was used for cooking food, washing hands and washing dishes. Twenty-eight (58%) illiterate street food vendors, 65 (62%) vendors with a primary education and 55 (69%) vendors with a secondary education did not use soap
747
for handwashing before serving food (P ¼ 0.000) (Table 1). Similar findings have been reported previously.6 Handwashing was found to be difficult due to lack of running water at the vending site, which was in agreement with Abdalla et al.5 The majority of street food vendors, despite having a primary or secondary education, were unaware of the need for handwashing before serving food (P ¼ 0.008). The finding that 86% of the street food vendors did not clean the food preparation surface and used low-quality, locally packed oil for food preparation was comparable with the findings of Chukuezi CO4 and Bas et al.6 Sixty percent of the vendors used disposable vessels to serve food, and 58% kept the foodstuff covered at the vending sites. Very few street food vendors used detergents to wash dishes, in contrast to previous studies which found that the majority of vendors used detergents to wash dishes after each use.3,7 The majority of street food vendors stored the unsold food for the next day, and only 29% of vendors discarded the unsold food. This finding was in agreement with Muinde and Kuria.7 Fortythree percent of street food vendors stored the leftovers in poor conditions, generally in covered warmers or in cooking vessels, whereas Shinkre Rajal et al.3 found that 63% of vendors refrigerated the leftover food items. Literacy was expected to have positive impact on this issue, but many of the literate street food vendors were unaware of food safety practices. Poor socio-economic status and lack of awareness may be the limiting factors for safe food-handling practices. Food licences should be issued subject to fulfilment of basic and essential food safety and hygienic measures. Periodic training of street food vendors in safe food-handling practices may help to improve the situation. The provision of basic sanitation, water and waste management are needed to minimize the gap between knowledge and practice of safe street food vending.
Author statements Ethical approval Institutional Ethics Committee of Agartala Government Medical College.
Funding None declared.
Competing interests None declared.
Table 1 e Use of soap for handwashing by literacy of the street food vendors. Literacy status
Illiterate Primary education Secondary education
references
Use of soap for handwashing P-value Yes, n (%)
No, n (%)
20 (42) 40 (38) 26 (31)
28 (58) 65 (62) 55 (69)
0.000
1. World Health Organization. Essential safety requirements for street vended foods. WHO/FNU/FOS/96.7. Geneva: World Health Organization; 1996. 2. Umoh VJ, Odoba MB. Safety and quality evaluation of street foods sold in Zaria, Nigeria. Food Control 1999;10:9e14.
748
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3. Shinkre R, Naik VS. Safety and quality of food from street food units in Panaji, Goa, India. Lucknow, India: Paper presented at: concurrent session II, international conference on agribusiness and food industry in developing countries: opportunities and challenges; 2007, August 10 -12. 4. Chukuezi CO. Food safety and hygienic practices of street food vendors in Owerri, Nigeria (2010) at Owerri, Nigeria. Stud Sociol Sci 2010;1:50e7. 5. Abdalla MA, Suliman SE, Bakhiet AO. Food safety knowledge and practice of street food vendors in Atbara
city (Naheer Elneel State Sudan). Afr J Biotechnol 2009;8:6967e71. 6. Bas M, Erush AS, Kivance G. The evaluation of food hygiene, knowledge, attitude and practices of food handlers in food business in Turkey. Food Control 2006;17:317e22. 7. Muinde OK, Kuria E. Hygienic and sanitary practices of vendors of street foods in Nairobi, Kenya. Afr J Food Agricult Nutr Develop 2005;5(1). article no. 7.
