See discussions, stats, and author profiles for this publication at: https://www.researchgate.

net/publication/319973050

Food hygiene knowledge and practice of consumers in Poland and in Thailand

- A survey

Article  in  Food Control · September 2017

DOI: 10.1016/j.foodcont.2017.09.022

CITATIONS READS

3 585

4 authors, including:

Marzena Tomaszewska Joanna Trafiałek

Warsaw University Of Life Sciences Warsaw University Of Life Sciences
7 PUBLICATIONS   3 CITATIONS    28 PUBLICATIONS   94 CITATIONS   

SEE PROFILE SEE PROFILE

Wojciech Kolanowski
Siedlce University of Natural Sciences and Humanities
34 PUBLICATIONS   939 CITATIONS   

SEE PROFILE

All content following this page was uploaded by Joanna Trafiałek on 24 October 2017.

The user has requested enhancement of the downloaded file.

 Food Control 85 (2018) 76e84

Contents lists available at ScienceDirect

Food Control
journal homepage: www.elsevier.com/locate/foodcont

Food hygiene knowledge and practice of consumers in Poland and in

Thailand - A survey
Marzena Tomaszewska a, Joanna Trafialek a, Pornsiri Suebpongsang b,
Wojciech Kolanowski c, *
a
Warsaw University of Life Sciences, Faculty of Human Nutrition and Consumer Sciences, Nowoursynowska str. 166, PL-02-787 Warsaw, Poland
b
Chiang Mai University, Faculty of Agriculture, 239 Huay Keaw Road, Chiang Mai 50200, Thailand
c
Siedlce University of Natural Sciences and Humanities, Faculty of Natural Sciences, Department of Dietetics and Food Assessment, Prusa str. 14, PL-08-110
Siedlce, Poland

a r t i c l e i n f o a b s t r a c t

Article history: The aim of this study was to assess and compare the knowledge of Polish and Thai consumers regarding
Received 21 July 2017 the causes of food poisoning and hygienic practices during the preparation of food at home. A ques-
Received in revised form tionnaire was prepared on the basis of Codex Alimentarius guidelines. It consisted of 15 questions related
14 September 2017
to consumers' knowledge of food poisoning causes, and 20 questions related to the consumers' food
Accepted 20 September 2017
hygiene practice during the preparation of meals at home. Six hundred questionnaires were collected,
Available online 21 September 2017
300 in Poland and 300 in Thailand. The results were subjected to statistical analysis. In Thailand, con-
sumers showed significantly lower levels of food hygiene knowledge than in Poland. However, both
Keywords:
Consumers
Polish and Thai consumers had incomplete knowledge of the causes of food poisoning and, in many
Food hygiene cases, their food hygiene practice during food preparation and consumption was inaccurate. None of the
Food safety consumers responded correctly to all the questions concerning food hygiene knowledge. In the case of
Food hygiene practice food hygiene practice, nearly total correct responses were noted only in the cases of washing hands after
using the toilet, and the risk of drinking raw water from open air lakes and reservoirs. Some other el-
ements of food hygiene practice were incorrectly stated in both countries, e.g. food defrosting, storage of
cooked food at room temperature, and hand washing after handling raw, unwashed foods. Further
research on consumers' food hygiene knowledge and practice should be conducted, and better food
safety education should be organised independently of country of origin, education level and age. The
results of this study could play an important role in the prevention of food poisoning by indicating which
areas of consumers’ food hygiene knowledge and food hygiene practice during food preparation at home
should be strengthened by educational activities.
© 2017 Elsevier Ltd. All rights reserved.

1. Introduction toxins from raw molluscs.

Food poisoning is usually caused by bacteria, viruses, parasites
and chemicals entering the human body through the consumption
of contaminated food and water. Food poisoning can lead to long-
term disability and even death. The most common symptom of
food poisoning is diarrhoea, which annually affects ca. 550 million
people worldwide and causes ca. 230,000 deaths per annum (WHO,
2015). Examples of high risk food include undercooked food of
animal origin, fruit and vegetables contaminated with faeces, or
* Corresponding author.
E-mail address: wojciech.kolanowski@uph.edu.pl (W. Kolanowski).
Food-related health problems occur both in developing and
developed countries. The European Food Safety Authority indicated
that, in 2015 in the EU, 45,875 cases of food poisoning were re-
ported, which caused 3892 hospitalisations and 17 deaths (EFSA,
2016). France, followed by Poland, Germany and Lithuania re-
ported the highest number of cases (around 60% of all reported
cases). Food poisoning is even more of a problem in tropical
countries, such as in Thailand, where annually 120,000 cases were
reported (FAO/WHO, 2004; Minami et al., 2010).
Food poisoning is a serious public health problem. Martins,
Hogg, and Otero (2012) pointed out that the total costs associated
with food poisoning in the USA amounted to almost $152 billion
annually. This includes medical care costs, lower quality of life

https://doi.org/10.1016/j.foodcont.2017.09.022
0956-7135/© 2017 Elsevier Ltd. All rights reserved.
 M. Tomaszewska et al. / Food Control 85 (2018) 76e84
(including reduced labour productivity) and reduced life
expectancy.
A significant percentage of all food poisoning cases takes place
in single households (EFSA, 2016). However, more research has
focused on the knowledge and behaviour of employees involved in
food production than on those who prepare meals at home (Abdul-
Mutalib et al., 2012; Akabanda, Hlortsi, & Owusu-Kwarteng, 2017;
Al-Shabib, Mosilhey, & Husain, 2016; Burke, Young, & Papado-
poulus, 2016; Campos et al., 2009; Hassan & Dimassi, 2014; Martins
et al., 2012; Sharif, Obaidat, & Al-Dalalah, 2013). Salmonella
contamination is a great food safety problem, especially with re-
gard to food products of animal origin. Therefore consumers should
avoid consumption of raw or undercooked products such as meat

ye, and Salvat (2005) found
or eggs. Cardinale, Perrier Gros, Tall, Gue
that the risk of salmonella infection increased when fresh vegeta-
bles were not washed and peeled during meal preparation. Many
studies concerning food handling by consumers at home, ad these
often reveal non-compliance with food hygiene principles during
meal preparation were published (Badrie, Gobin, Dookeran, &
Duncan, 2006; Langiano et al., 2012). Nevertheless, the authors
have been unable to find any literature comparing knowledge of
the causes of food poisoning and good household food processing
practice among consumers from the EU and Asian countries.
Therefore, it was decided to contribute to the body of knowledge in
this area.
Poland and Thailand are often visited by foreign tourists. In
particular, Thailand is a very popular tourist destination for visitors
from all over the world, and one of its attractions is local food
(Chavarria & Phakdee-auksorn, 2017; Poolklai, 2015; Sirigunna,
2015). Nevertheless, it is generally agreed that food is one of the
health risk factors associated with international tourism (Lepp &
Gibson, 2003). Sirigunna (2015) indicated, that in Thailand there
were many cases of food poisoning among tourists caused by
consuming either unsafe food or water. It was rare for food
poisoning incidents to occur in four and five star hotels and res-
taurants, or during well organized trips; most often they were the
result of the consumption of low-priced street-vended food, pre-
pared with poor attention to adequate food hygiene practice.
Nevertheless, some tourists enjoy travelling by themselves, and
eating and drinking local e usually street-vended e food and drinks
(Wongleedee, 2013).
Reducing the risk of food poisoning depends not only on the
maintenance of adequate food hygiene practice by food pro-
fessionals, but also on the behaviour of consumers when purchas-
ing food, and their attitude to food safety and hygiene during food
preparation. Accordingly, the aim of this study was to assess and
compare Polish and Thai consumers knowledge of food poisoning
causes and food hygiene practice during the preparation of food at
home.
2. Material and method
The study was conducted using a specially designed question-
naire prepared on the basis of Codex Alimentarius (CA) general
principles of food hygiene (CCFH, 2003). The questionnaire con-
sisted of three sections: the first contained 15 statements relating
to consumers' knowledge of the causes of food poisoning. The
second section contained 20 questions relating to the consumers’
food hygiene practice during the preparation and the consumption
of meals at home (Table 1).
The third section contained questions concerning the de-
mographic and social affiliation of respondents i.e. gender, age,
education level, inhabitancy (place of origin), which characterised
those surveyed.
The scoring of questions was based on the Likert scale, with 5
77
variants of responses. In the food hygiene knowledge section, re-
spondents were asked to determine to what extent they agreed
with a particular statement e on a scale ranging from “strongly
agree” to “strongly disagree”. In the food hygiene practice section -
the scale varied from “definitely yes” to definitely not”. The re-
sponses were scored on a scale from 1 to 5. In the food hygiene
knowledge section, a score from 1 - “strongly agree” to 5 - “strongly
disagree” was to be assigned to all 15 statements. In the food hy-
giene practice section, a score ranging from 1 - “definitely yes” to 5 -
“definitely not” was to be assigned in the case of questions 1 to 7.
For questions 8 to 20 the scale direction was changed, i.e. from 1 -
“definitely not” to 5 - “definitely yes”. To verify responses some
questions were very similar e.g. questions 13 and 15 in the section
of consumers’ knowledge and questions 1 and 9 in the section of
food hygiene practice. In all questions the highest score, relating to
the most correct response, was 1 and the lowest one (the least
correct) was 5. The responses were converted into scores from 1 to
5. Scores 1 and 2 were counted as correct responses (1 e correct
with great conviction, 2 e correct without conviction). Scores 3 and
above were counted as incorrect responses. The questionnaire was
verified during a pilot test on small group of consumers in order to
eliminate mistakes and inaccuracies.
The consumers who participated in the study were randomly
selected. Questionnaires were distributed among persons
encountered in facilities open to the public such as universities,
shopping centres and chain restaurants. Questionnaires were
collected by the first and second author of this paper in Poland, and
by the second and third author of this paper in Thailand. The in-
terviewers were trained about the methodological assumptions of
the study. During the completion of the questionnaire, the in-
terviewers were present to resolve any doubts that consumers
might have. The survey was anonymous. The completed ques-
tionnaires were put into a box. Identity numbers were assigned to
each questionnaire. The study was conducted in Poland and
Thailand in the years 2016 and 2017. Six hundred questionnaires
were collected, 300 in Poland and 300 in Thailand.
2.1. Statistics
The percentage of correct responses was calculated both for the
section about hygiene knowledge and for the section about food
hygiene practice. Descriptive statistics such as mean scores, me-
dian, mode, kurtosis, and standard deviation (SD) were calculated
to interpret the results. To verify the relationship between the re-
sults obtained in both countries and to determine the impact of
factors such as country, gender, age, level of education, and place of
origin on the response scores the ANOVA-test was applied. The
Spearman correlation coefficient was calculated in order to deter-
mine the relation of the knowledge of Thai consumers and Polish
consumers and their food hygiene practice. All tests were done
using Statistica 12 software. Significance was identified when
p < 0.05.
3. Results
The demographic characteristics of consumers’ groups is given
in Table 2.
3.1. Consumers’ knowledge of food poisoning causes
The knowledge of those surveyed regarding sources of food
poisoning was imperfect. Polish consumers provided significantly
better responses than Thai consumers to 7 questions. Thai con-
sumers showed better hygiene knowledge in the case of 3 ques-
tions. Responses to 5 questions showed no significant
78 M. Tomaszewska et al. / Food Control 85 (2018) 76e84

Table 1
Questions asked consumers during survey and abbreviations of each question used in figures and tables showing the results.

Section I e consumers' food hygiene knowledge (K) Abbreviation

K1 Food poisoning is caused by pathogenic microorganisms pathogens

K2 Some toxins produced by microorganisms that cause food poisoning are resistant to heat during food heating toxins
K3 Drinking raw (unprocessed) milk poses a high risk of food poisoning raw milk
K4 Consuming raw eggs poses a high risk of food poisoning raw eggs
K5 Consuming raw or undercooked meat poses a high risk of food poisoning raw meat
K6 Consuming raw, unwashed vegetables poses a high risk of food poisoning unwashed
vegetables
K7 Consuming raw, unwashed fruits poses a high risk of food poisoning unwashed fruits
K8 Persons who come in contact with food, but not respect hygienic practices, may be the source of microbiological contamination of food hygienic practices
K9 Well-cooked food is free from pathogenic microorganisms cooked food
K10 Food consumption, which was kept at room temperature for 12e24 h after cooking, poses a high risk of food poisoning room storage
K11 Defrosting food at room temperature poses a high risk of food poisoning defrosting
K12 Drinking pasteurized milk does not pose a risk of food poisoning pasteurized milk
K13 Storage of food at refrigerator will slow down the growth of microorganisms, thereby decreases the possibility of food poisoning. cool storage
K14 Drinking raw (uncooked) water from open air reservoirs, river or lakes, without additional treatment, such as cooking or adding chlorine, poses a raw water
high risk of poisoning
K15 Consumption of food stored in the refrigerator for 2e3 days does not pose the risk of food poisoning refrigerator
Section II e consumers' food hygiene practice during food preparation and consumption (P)
P1 Do you wash raw fruits and vegetables in tap water before eating? fruits/vegetables 1
P2 Do you wash your hands with soap and water before preparing your meal? meal preparing
P3 Do you wash your hands with soap and water before eating? before eating
P4 Do you wash your hands with soap and water after handling unwashed fresh vegetables? unwashed
vegetables
P5 Do you wash your hands with soap and water after using the toilet? toilet
P6 Do you wash your hands after touching animals? animals
P7 When shopping, do you pay attention to the shelf life of the products? shelf life
P8 Do you defrost food by leaving it at room temperature? defrosting
P9 Do you eat fresh fruits and vegetables without washing them? fruits/vegetables 2
P10 Do you only wipe fresh fruits and vegetables before eating instead of washing them? wiping
P11 Do you, e.g. being on a trip, pick up vegetables or herbs from the ground and eating them without washing? picking up
P12 Do you eat raw eggs? raw egs
P13 Do you eat the soft-boiled eggs (yolk is liquid)? soft egs
P14 Do you eat raw meat? raw meat
P15 Do you eat undercooked meat (red in the middle)? undercooked
P16 Do you drink raw cow or goat milk? raw milk
P17 Do you eat cooked meals that have been stored at room temperature longer than 6 h? room temperature
P18 Do you eat food that looks stale in restaurant or street-vended? stale food
P19 Do you drink raw water from open air reservoirs, rivers or lakes without cooking? raw water
P20 Do you sometimes eat foods such as: meat, rice, pasta with hands from a large dish common to several people? hands

Table 2
Demographic characteristic of consumers’ groups, %.

Characteristics Poland Thailand

Gender Women 60 56
Men 40 44
Age below 25 years old 25 23
26e39 28 29
40e59 24 24
over 60 years old 23 24
Education level primary and secondary 44 70
higher 56 30
Inhabitancy (place of origin) big cities (over 500,000) 42 29
medium and small cities 35 49
villages 23 22

differentiation in consumers’ food hygiene knowledge between
responders from the two countries. The average score for 15
questions in this section was slightly higher in Poland (2.03) than in
Thailand (2.34). Fig. 1 presents the percentage of correct responses
in the section of hygiene knowledge. Consumers in Poland and
Thailand showed similar and high knowledge (82e96% correct
responses) in the case of questions K1, K13 and K14 regarding
pathogens in food, cool storage of food and the risk of drinking raw
water from open air reservoirs and lakes.
Thai consumers showed a very high level of food hygiene
knowledge (over 90% correct responses), significantly higher than
Polish consumers, in the case of questions: K1, K12 and K14,
regarding pathogens in food, the safety of drinking pasteurized
milk and the risk of drinking raw water from open air reservoirs
and lakes. On the other hand, Polish consumers showed signifi-
cantly higher knowledge than Thai consumers in the case of
questions K2, K4-8 and K11 regarding the risks arising from the
heat resistance of toxins; the consumption of raw eggs, raw meat,
unwashed vegetables and fruit; and poor food hygiene during food
preparation and food defrosting at room temperature.
The results of applying descriptive statistics measures to the
consumers’ food hygiene knowledge scores are presented in
Table 3. Among consumers in Poland, the highest proportion of
correct responses was found in the case of question K8 regarding
 M. Tomaszewska et al. / Food Control 85 (2018) 76e84 79

100
* * *
90 *
*
80 * * *
*

Correct responses, %
70
60
50 95 94 96
90 8993
83 79 84 82
40 79 79 76 *
71 70
65 62 66 61 6260
30 58
Poland
47 47
20 39 37 Thailand
33
27
10 20 19
0
s s k s t s ts s e k r r
g en xin mil egg mea able rui tice food rag ting mil rage ate ato
o :t o w w e t f c d t o os d t o w e r
th a a a w d
g he pr ke a s ef r e l s aw rig
pa K2 3: r 4: r 5: r ve m riz r f
1: K K K e d was nic coo roo 1: d teu coo 14: : re
K s h un gi e 9 : : 1 a s 3 : K 5
a 0 K :p 1 1
w 7: hy K
K
1 K K
: un K 8: 12
6 K K
K
Fig. 1. Percentage of correct responses on questions regarding consumers' food hygiene knowledge (K).

Table 3
Descriptive statistics measures concerning consumers’ hygiene knowledge. ns - not significant.

No. Question abbreviation Country Mean Median Mode Mode % Kurtosis SD Gender Age Education Inhabitancy

ANOVA p value

K1 pathogens Poland 1.70 1.00 1.00 50.7 1.56 0.86 0.000 0.002 0.000 ns
Thailand 1.51 1.00 1.00 53.3 0.55 0.58 ns 0.003 0.000 0.000
K2 toxins Poland 1.81 2.00 1.00 47.3 1.07 0.97 ns ns ns ns
Thailand 2.50 3.00 3.00 51.1 0.87 0.64 ns 0.053 ns 0.000
K3 raw milk Poland 2.97 3.00 4.00 30.5 1.17 1.29 ns ns ns ns
Thailand 3.00 3.00 4.00 33.3 0.96 0.91 ns ns ns 0.000
K4 raw eggs Poland 1.91 2.00 1.00 46.6 0.61 1.12 0.000 ns 0.008 ns
Thailand 3.06 3.00 3.00 37.8 0.77 0.84 ns 0.000 ns 0.001
K5 raw meat Poland 1.73 1.00 1.00 53.0 1.52 0.97 0.041 ns ns ns
Thailand 2.99 3.00 3.00 58.5 0.72 0.75 ns ns 0.001 0.001
K6 unwashed vegetables Poland 1.84 1.00 1.00 50.3 0.93 1.08 ns ns ns ns
Thailand 2.50 3.00 3.00 45.9 0.41 0.79 ns ns ns 0.001
K7 unwashed fruits Poland 1.97 2.00 1.00 46.6 0.27 1.19 ns ns 0.034 ns
Thailand 2.43 2.00 2.00 53.3 0.68 1.00 ns ns ns ns
K8 hygienic practices Poland 1.36 1.00 1.00 73.8 9.69 0.73 0.012 0.018 0.004 ns
Thailand 2.26 2.00 2.00 48.1 0.48 0.72 0.000 0.024 0.000 0.003
K9 cooked food Poland 2.11 2.00 2.00 41.9 0.31 0.99 ns ns ns ns
Thailand 2.13 1.00 1.00 53.3 0.98 1.33 0.042 0.003 0.000 0.000
K10 room storage Poland 2.15 2.00 2.00 39.6 0.18 1.04 ns ns ns ns
Thailand 2.25 2.00 2.00 53.3 0.12 0.72 ns ns ns 0.000
K11 defrosting Poland 3.03 3.00 4.00 33.2 1.20 1.32 0.022 ns 0.008 ns
Thailand 3.36 4.00 4.00 58.5 0.19 0.87 ns ns 0.000 0.001
K12 pasteurized milk Poland 2.36 2.00 2.00 38.9 0.11 1.06 ns 0.006 ns 0.043
Thailand 1.57 2.00 2.00 48.1 0.69 0.64 ns 0.001 0.015 0.005
K13 cool storage Poland 1.55 1.00 1.00 61.4 4.00 0.84 0.042 ns 0.009 ns
Thailand 1.79 2.00 2.00 57.8 2.32 0.75 ns 0.002 ns 0.000
K14 raw water Poland 1.61 1.00 1.00 65.4 1.50 0.99 ns ns 0.002 ns
Thailand 1.39 1.00 1.00 68.9 5.03 0.67 ns ns 0.001 0.000
K15 refrigerator Poland 2.30 2.00 2.00 39.3 0.49 1.00 ns ns ns ns
Thailand 2.41 2.00 1.00 38.5 1.36 1.40 0.049 0.000 0.000 0.000

hygiene practice during food preparation. Almost all consumers
surveyed in Poland strongly agreed with this question
(mean ¼ 1.36, median ¼ 1.00, mode ¼ 1.00, mode % ¼ 73.8,
kurtosis ¼ 9.69). The high positive value of the kurtosis confirmed
that most of the responses given were close to the arithmetic mean
score. Among Thai consumers the highest proportion of correct
responses was found in the case of question K14 regarding the risk
of drinking raw water from open air reservoirs and lakes
(mean ¼ 1.39, median ¼ 1.00, mode ¼ 1.00, mode % ¼ 68.9,
kurtosis ¼ 5.03). These results aptly pointed out the main food
safety risks, about which the surveyed consumers in both countries
were aware.
In Poland, as well as in Thailand, the smallest share of correct
responses was found in the case of question K11 regarding food
defrosting at room temperature risk (37 and 19% of correct re-
sponses, respectively). In this case the mean scores were 3.03 and
80 M. Tomaszewska et al. / Food Control 85 (2018) 76e84
3.36, respectively. However, in Poland the negative kurtosis value
(1.20) indicated that many responses given were often completely
different, which was not shown in Thailand (kurtosis ¼ 0.19).
The greatest differences in consumers’ food hygiene knowledge
were found in the case of questions K4 and K5 regarding the risk of
consuming raw eggs and raw or undercooked meat. Polish con-
sumers, in most cases, responded correctly to these questions (79
and 84% correct responses, mean score ¼ 1), while Thai consumers
generally did not consider eating raw eggs or raw meat risky (27
and 20% correct responses, mean score ¼ 3). Quite surprisingly,
great similarities between the knowledge of Polish consumers and
Thai consumers about food hygiene were found in the responses to
questions: K3, K9, K10 and K15 regarding the risk of drinking raw
milk, the advisability of serving only well-cooked food, the storage
of food at room temperature, and the correct refrigerator storage of
food. However, in the case of question K3 there were only 39 (33%)
correct responses. Moreover, the negative values of kurtosis in
questions K3, K10 and K15 indicated that the responses were often
completely different.
The impact of socio-demographic characteristics on consumers'
knowledge of food poisoning causes was assessed by comparing
the summed mean scores of all questions. There was a gender
differentiation in the level of consumers’ food hygiene knowledge.
In Poland, women showed a slightly, though significant, higher
level of knowledge than men (1.97 and 2.13, respectively). In
Thailand, however, this difference was not significant (2.32 and
2.38, respectively). The ANOVA test showed that in both countries,
women were more aware of the importance of adequate food hy-
giene practice during food preparation (K8) than men. Women in
Poland gave correct responses more often than men to 5 questions:
K1, K4, K5, K11, K13 regarding pathogens in food, raw eggs and meat
consumption risks, food defrosting in room temperature risk and
refrigerator storage of food.
There were differences in the level of consumers’ hygiene
knowledge between age groups in Poland as well as in Thailand
(mean range: 1.88e2.05 and 2.15e2.51, respectively). In Thailand,
younger consumers (below 25 years old) were more likely to
respond correctly, while in Poland a correct response was more
probable from older (over 60) consumers. The ANOVA test showed
that in Poland age significantly influenced the correctness of re-
sponses to questions: K1, K8, K12, and in Thailand to questions: K1,
K2, K4, K8, K9, K12, K13, K15.
The education level of consumers significantly influenced mean
score of responses to the food hygiene knowledge questions in
Poland. Consumers with higher education responded correctly
more than others (1.94 vs. 2.14). In Thailand, however, the differ-
ence was not significant. The ANOVA test confirmed that education
level positively influenced the mean scores of Polish consumers
responses. In Poland responses to questions K1, K9, K12, S14, K15
were more often correct in the case of higher educated consumers.
However, responses to questions K5, K8, K11 were more often
correct in the case of the lower educated consumers. Whereas, in
Thailand, the differences were not statistically significant.
Inhabitancy influenced the accuracy of responses. In Poland, the
place of origin influenced the correctness of responses only to one
question, K12, regarding pasteurised milk consumption. Whereas,
in Thailand, inhabitancy influenced replies to all questions, except
K7 regarding the risk of consuming raw, unwashed fruit.
3.2. Consumers’ approach to food hygiene during food preparation
Polish and Thai consumers’ approach to food hygiene during
food preparation and consumption was often incorrect. The sum-
marized mean score of all questions in Poland and in Thailand were
1.98 and 2.38, respectively. The responses to 7 questions did not
indicate significant differences among countries. Consumers from
Poland and Thailand similarly frequently and correctly paid atten-
tion to the shelf-life of purchased food products (question P7 e 90%
and 89% correct responses, respectively) and avoided drinking raw
water from open air reservoirs and lakes (question P19 e 92% and
100% correct responses, respectively). In most cases, they washed
their hands after using the toilet (question P5 e 96% and 100%
correct responses, respectively). It was found that, in the case of 10
questions, Polish consumers responses were accurate more than
the Thai ones i.e. questions: P1-4, P6, P9, P11, P12, P18, P20 (Fig. 2).
Polish consumers more often responded correctly to questions
concerning washing fresh fruit and vegetables before eating,
washing hands before food preparation and consumption, washing
hands after contact with uncooked fresh vegetables, washing hands
after contact with animals, picking up and eating vegetables from
the ground without washing them, consuming raw eggs, eating
stale food in restaurants or from street-vendors, and eating with
hands from large dishes common to several persons. However, Thai
consumers responded more accurately in the case of 4 questions:
P5, P14, P15, P19 regarding washing hands after using the toilet, the
consumption of raw and undercooked meat, and the risks of
drinking raw water from open air reservoirs, rivers and lakes.
The application of descriptive statistics to the results on con-
sumers’ food hygiene practice is presented in Table 4. Among Polish
consumers, the highest proportion of correct responses was found
in the case of question P5 regarding hand washing after using the
toilet. Nearly all the surveyed consumers gave the correct response
(mean ¼ 1.17, median ¼ 1.00 mode ¼ 1.00, mode % ¼ 89%). The very
positive value of kurtosis (19.26) indicated that most of the scores
were close to the arithmetic mean and consistent. Although 100% of
Thai consumers gave the correct response, they often showed little
confidence in answering this question (mean ¼ 1.58,
median ¼ 2.00, mode ¼ 2.00, mode % ¼ 57.8, kurtosis ¼ 1,93). Thai
consumers showed more conviction in the case of question P19
(100% correct responses) regarding drinking raw water from open
air reservoirs and lakes (mean ¼ 1.18, median ¼ 1.00, mode ¼ 1.00,
mode % ¼ 82.2, kurtosis ¼ 0.91). Both, in Poland and in Thailand, the
lowest proportion of correct responses was obtained in the case of
question P8 regarding the risk of defrosting food at room temper-
ature risk (only 22% and 4% correct responses, mean 3.66 and 3.87,
respectively). Almost 81% of Thai and 45% of Polish consumers
defrost food by leaving it out at room temperature (mode ¼ 4.00,
mode % ¼ 80.7 and 45.0, respectively).
Comparison of the average scores obtained in Poland and
Thailand showed the biggest differences in the responses to ques-
tions P6, regarding washing hands after touching animals (mean
score ¼ 1.55 and 3.14, respectively), and P20, regarding eating with
hands from large dishes common to several people (mean
score ¼ 1.9 and 3.43, respectively). The most similar scores were
found in the case of questions P16 regarding the consumption of
raw milk (mean score ¼ 2.21 and 2.04, respectively), P19 regarding
drinking water from open air reservoirs and lakes (mean
score ¼ 1.38 and 1.18, respectively), and P17 regarding the con-
sumption of cooked food stored at room temperature (mean
score ¼ 2.63 and 2.84, respectively).
The impact of socio-demographic characteristics on consumers’
food hygiene practice was also assessed by comparing the summed
mean scores from all questions. In the case of gender it was found
that both in Poland and Thailand, women more often responded
correctly than men. The ANOVA test showed that women in Poland
responded more correctly than men in the case of all questions,
except P4, P14 and P20, where the differences were not significant.
In Thailand gender was less associated with correct responses. Thai
women responded more accurately to 7 questions i.e. P1, P2, P6, P9,
P11, P12, P20, however, men more frequently responded accurately
 M. Tomaszewska et al. / Food Control 85 (2018) 76e84 81

100 Poland
* * * *
90 * * * * Thailand

80
*
*
70
Correct answers, % *
60 * *
50
93 92 93 96100 95
100
92
87 85 88 9089 89 89 88
40 81 8181 80 78 77
76 75 72
64 68
30 61 61 58
56 54
50 47
20 39 43

22 26 24
10
4
0
:t s

P1 raw p

P1 mpe ilk

0: t e r
he e e g

: f P8: helf ls

P1 kin g

7: P1 rco at
P : so gs

s
r s1

P1 0: s 2
ge g

om ra ed
et ng
its efr life
P5 able

5: ra gs

ra ood
P1 tale ure
P7 ani t

nd
2: g u
as for rin

pi pin
le
v e atin

e
e

te w m

P2 wa
ro 6 : o k
P1 14: ft e
m

eg ti

un w m
P4 P eal ble

P1 able
P6 oi

ha
s t
nw be epa

/v os

f
8: ra
1: wi
t
ta

w
c
: m ge

:s
p

de
:

ru d

3
P2 /ve

9:
d
its

: u 3:
ru
:f
P1

P9

P1
Fig. 2. Percentage of correct responses on questions regarding consumers' food hygiene practice during food preparation and consumption (P).

Table 4
Descriptive statistics measures concerning consumers’ food hygiene practice during food preparation and consumption. ns - not significant.

No. Question abbreviation Country Mean Median Mode Mode % Kurtosis SD Gender Age Education Inhabitancy

AOVA p value

P1 fruits/vegetables 1 Poland 1.50 1.00 1.00 64.4 5.37 0.84 0.001 ns 0.032 ns
Thailand 1.87 2.00 2.00 65.2 2.25 0.67 0.019 ns ns 0.001
P2 meal preparing Poland 1.41 1.00 1.00 70.8 4.73 0.75 0.048 ns ns ns
Thailand 1.96 2.00 2.00 65.9 0.02 0.58 0.003 ns 0.021 0.000
P3 before eating Poland 1.49 1.00 1.00 63.4 3.94 0.76 0.002 ns ns ns
Thailand 1.99 2.00 2.00 73.3 0.82 0.52 ns 0.026 0.020 0.000
P4 unwashed vegetables Poland 2.37 2.00 1.00 33.6 1.07 1.29 ns 0.015 ns ns
Thailand 3.23 4.00 4.00 27.4 1.40 1.46 ns 0.002 0.000 0.000
P5 toilet Poland 1.17 1.00 1.00 88.9 19.26 0.59 0.007 0.000 0.028 ns
Thailand 1.58 2.00 2.00 57.8 1.93 0.50 ns 0.000 0.003 0.000
P6 animals Poland 1.55 1.00 1.00 65.4 3.31 0.93 0.002 ns ns ns
Thailand 3.14 2.00 5.00 40.7 1.76 1.68 0.001 ns 0.000 0.000
P7 shelf life Poland 1.48 1.00 1.00 69.1 4.25 0.88 0.007 0.030 0.009 ns
Thailand 1.99 2.00 2.00 77.0 1.45 0.48 ns ns ns 0.000
P8 defrosting Poland 3.66 4.00 4.00 45.0 0.35 1.23 0.015 ns ns ns
Thailand 3.87 4.00 4.00 80.7 4.46 0.54 ns 0.021 0.006 0.000
P9 fruits/vegetables 2 Poland 1.95 2.00 2.00 42.9 0.80 1.03 0.019 ns ns ns
Thailand 2.59 2.00 2.00 44.4 1.50 1.14 0.001 ns 0.002 0.000
P10 wiping Poland 1.87 2.00 1.00 46.6 1.10 1.07 0.012 ns ns ns
Thailand 2.07 2.00 2.00 48.9 0.10 1.05 0.002 ns ns 0.011
P11 picking up Poland 2.44 2.00 2.00 36.9 0.98 1.27 0.014 ns ns ns
Thailand 3.26 3.00 5.00 44.4 1.76 1.66 0.025 0.032 0.000 0.000
P12 raw egs Poland 1.56 1.00 1.00 67.8 3.96 1.02 0.000 0.004 ns ns
Thailand 2.06 2.00 2.00 40.7 0.55 1.04 0.002 ns ns 0.000
P13 soft-boiled egs Poland 3.69 4.00 4.00 36.2 0.69 1.38 0.024 ns ns 0.012
Thailand 3.43 4.00 2.00 42.2 1.78 1.32 ns 0.016 ns 0.000
P14 raw meat Poland 1.98 1.00 1.00 53.4 0.27 1.30 ns ns ns ns
Thailand 1.62 1.00 1.00 59.2 3.52 0.97 ns ns ns 0.004
P15 undercooked Poland 1.85 1.00 1.00 55.4 0.44 1.18 0.000 0.027 ns ns
Thailand 1.42 1.00 1.00 63.0 0.17 0.59 ns ns ns 0.043
P16 raw milk Poland 2.21 2.00 1.00 48.7 0.90 1.46 0.019 ns ns ns
Thailand 2.04 2.00 1.00 40.0 0.49 1.20 0.012 0.037 ns 0.044
P17 room temperature Poland 2.63 2.00 2.00 33.6 1.08 1.24 0.002 ns ns ns
Thailand 2.84 3.00 4.00 40.7 1.36 1.11 ns ns ns 0.000
P18 stale food Poland 1.62 1.00 1.00 58.1 3.62 0.92 0.002 ns ns ns
Thailand 2.07 2.00 2.00 50.4 0.74 0.72 ns ns ns 0.004
P19 raw water Poland 1.38 1.00 1.00 77.1 6.45 0.83 0.001 0.000 0.006 ns
Thailand 1.18 1.00 1.00 82.2 0.91 0.38 ns 0.021 0.730 0.029
P20 hands Poland 1.90 1.00 1.00 57.4 0.26 1.30 ns 0.040 0.010 ns
Thailand 3.43 4.00 4.00 35.6 0.74 1.24 0.023 0.002 0.000 0.000
82 M. Tomaszewska et al. / Food Control 85 (2018) 76e84

to questions P10 and P16. For the remaining 11 questions, the
response scores were not significantly different between sexes.
In the case of age, it was found that in Thailand, the difference in
mean scores between age groups was lower (range: 2.28e2.58)
than in Poland (range: 1.91e2.51). Depending on the country,
different age groups were characterised by different responses. In
Thailand, younger consumers (below 25 years old) were less likely
to respond correctly, while in Poland correct responses were more
frequent in the older group (over 60 years old), which was opposite
than the correlation observed in the section of consumers’ hygiene
knowledge.
Applying the ANOVA test shows that in Poland the age of re-
spondents significantly influences the responses to 7 questions (P4,
P5, P7, P12, P15, P19, P20) and in Thailand e to 9 questions (P3-5,
P8, P11, P13, P16, P19, P20). In Poland, in the case of 6 of 7 questions
identified as age-dependent, the oldest consumers (over 60 years)
responded incorrectly (except in the case of question P4 regarding
washing hands after handling fresh, unwashed, vegetables) in
comparison with the other age groups. However, in Thailand the
youngest consumers (below 25 years old) responded correctly to 5
(P3-5, P11, P20) among 9 age-dependent questions.
In Poland and Thailand, consumers that had attended a higher
education institution responded more correctly than those that had
not. The ANOVA test showed that education level significantly in-
fluences responses to 9 questions in Thailand (P2-6, P8, P9, P11,
P20) and 5 in Poland (P1, P5, P6, P19, P20). There were no significant
difference between education groups in the case of questions P7,
P10, P12-19 in Thailand and P2-4, P6, P8, P12-18 in Poland.
The significant influence of the inhabitancy on the responses
was differentiated. In Poland, it influenced only the response to one
question (P13), however in Thailand it influenced the response to
all questions. The mean scores for each group in Thailand indicated
that the inhabitants of large cities more frequently responded
incorrectly than consumers from villages and small towns, which
was the opposite result than that obtained in Poland.
3.3. Hygiene knowledge and food hygiene practice dependencies
during food preparation and consumption at home (Fig. 3). In
Poland, only in the case of question K14 regarding drinking raw
water from open air reservoirs and lakes, was there a strong posi-
tive correlation between consumers' food hygiene knowledge and
food hygiene practice (question P19). Along with increased number
of correct responses to question K14, the number of correct re-
sponses to question P19 also increased (R ¼ 0.53). The results
indicated a greater degree of correlation between the knowledge of
Thai consumers about food hygiene knowledge and their food hy-
giene practice in comparison to Polish consumers. However, the
knowledge of Thai consumers not always corresponded to their
food hygiene practice. A positive correlation indicated the use of
correct hygiene knowledge in food preparation and consumption.
This was found in the case of 4 questions from the hygiene
knowledge section (K7, K8, K10, K11) and 8 questions from the food
hygiene practice section (P4-6, P8-11). For example, knowledge of
the risk of food defrosting at room temperature (question K11) had
an positive impact on correct practices in this area (question P8)
(R ¼ 0.50). Question K11 was also positively correlated with 3 other
questions: P4 regarding washing hands after handling unwashed
fresh vegetables as well as the need to wash hands after contact
with raw uncooked vegetables (P4) (R ¼ 0.53), eating fresh vege-
tables and fruit without washing them (P9) (R ¼ 0.55) and picking
up vegetables from the ground and eating them without washing
(P11) (R ¼ 0.59).
On the other hand, a negative correlation with a different di-
rection of responses was found in the case of 6 questions from the
food hygiene knowledge section (K1, K9, K12-15) and 8 questions
from the food hygiene practice section (P4-6, P8-11, P20). In these
cases, incorrect responses with respect to food hygiene practice
were given. Examples of a different direction of responses indi-
cating lack of food hygiene knowledge in food preparation practice
were: knowledge that food poisoning is caused by pathogens (K1)
and hand washing after handling unwashed fresh vegetables (P4)
(R ¼ 0.54), hand washing after using the toilet (P5) (R ¼ 0.51), and
picking up vegetables from the ground and eating them without
washing (P11) (R ¼ 0.53) (Fig. 3).

The calculated Spearman's correlation coefficients showed that 4. Discussion

in the both countries, consumers' knowledge of food poisoning
causes were to some extent influenced by food hygiene practice The two countries not only have different distinct cultures, but

Thailand Poland

K11: 0.53 K10: 0.57 K8: 0.51 K11: 0.50 K8: 0.57 K7: 0.54 K11: 0.59 K14: 0.53
K11: 0.51 K11: 0.55

P4: P5: P6: P8: P9: P10: P11: P20: P19:

hands hands hands food fresh fruits fresh fruits eating eating food drinking
washing washing washing ater defrosting at and and picked up from a large raw water
after after toilet animals room vegetables vegetables vegetables dish comon from open
unwashed touching temperature eating only wiping without to several air reservoirs
vegetables without before eaing washing people
handling washing them

K1: -0.54 K1: -0.50 K1: -0.51 K13: -0.50 K1: -0.53 K15: -0.67
K9: -0.50 K15: -0.70 K9: -0.60 K9: -0.68
K12: -0.60 K12: -0.56 K12: -0.62
K15: -0.50 K15: -0.70 K14: -0.54
K15: -0.75

Fig. 3. Correlation between consumers' food hygiene practice during food preparation and consumption questions (P) e in the middle of diagram and consumers' food hygiene
knowledge (K) - positive correlations in the upper part and negative ones in the lower part of the diagram. Spearman's test.
 M. Tomaszewska et al. / Food Control 85 (2018) 76e84
also different regulations regarding food. Generally Thai consumers
showed significantly lower level of food hygiene knowledge than
Polish consumers. However, in some areas, they displayed a higher
level of knowledge. These were: the risk of drinking raw water from
open air lakes and reservoirs, and the need to store food under
refrigerated conditions. Therefore e compared to the results ob-
tained by Cuprasitrut, Srisorrachatr, and Malai (2011) who con-
ducted a study of Thai food store and street food vendors, wherein
only 13% of showed food hygiene knowledge e the knowledge of
Thai consumers, as evaluated in this study, can be regarded as good.
The explanation of the of poorer results of Thai consumers
compared to Polish consumers can be attributed to the level of
education of the respondents. Many authors have indicated a
positive correlation between education level and knowledge of
food hygiene and safety (Akabanda et al., 2017; Carbas, Cardoso, &
Coelho, 2013; Martins et al., 2012). The predominant group of
surveyed consumers in Poland were consumers with higher edu-
cation, whereas in Thailande the predominant group was con-
sumers with the primary and secondary levels of education.
The results showed that in both countries, women were more
aware of the fact that people handling food and not complying with
hygiene rules might increase food poisoning risk. Accurate re-
sponses to questions in this area may suggest that women had
better food hygiene knowledge than men. Sharif and Al-Malki
(2010) and Carbas et al. (2013) pointed out that in many societies,
women are responsible for preparing meals for the whole family. As
in other studies it was found that women in Poland had more food
hygiene knowledge than men (Burke et al., 2016; Mullan, Wong,
Todd, Davis, & Kothe, 2015; Sun, Wang, & Huang, 2012). That was
not the case in Thailand, where the mean hygiene knowledge level
was equal for women and men, which may be related to different
culture and eating habits.
Although Feng, Jian, Weisong, Zetian, and Xiaoshuan (2009) and
some other authors suggested that the level of food hygiene
knowledge increases with the age of respondents, this was not
observed in the present study. Annor and Baiden (2011), and Sun
et al. (2012) also found that the level of food hygiene knowledge
and the correct application of food hygiene practice did not in-
crease with age. In this research, especially in Thailand, it was found
that the youngest consumers (below 25 years old) were more likely
to respond correctly than the other groups. This phenomenon can
be explained by younger Thais having better access to information
on websites or through social media. However, this was not the case
with Polish consumers, where food hygiene awareness across all
ages is probably greater because of EU food regulations.
Byrd-Bredbenner, Maurer, Wheatley, Cottone, and Clancy
(2007), Ergo€ nül (2013) as well as Hassan and Dimassi (2014) and
others showed that a high level of food hygiene knowledge did not
always correspond to the actual adoption of food hygiene practice
during food production or preparation. In both countries it was
found that the percentage of correct responses to questions
regarding food hygiene practice was slightly higher than to the
questions regarding food hygiene knowledge, which was similar to
results of Sharif and Al-Malki (2010) and Woh, Thong, Behnke,
Lewis, and Zain (2016). This was probably due to the fact that
consumers usually learn basic food hygiene techniques from the
observation of food preparation in their family homes, often
without any other source of knowledge about food hygiene.
In both countries, the consumers’ gender significantly impacted
on the correctness of responses. Women scored better with respect
to food hygiene practice than men. A similar effect had been also
shown by other authors (Siow & Sani, 2011; Sun et al., 2012; Tan,
Bakar, Karim, Lee, & Mahyudin, 2013). This could be explained by
the more frequent involvement of women in preparing meals at
home than men. However, in Thailand the levels of correct food
83
hygiene knowledge and practice during food preparation among
women and men were similar.
Many published studies have revealed the poor knowledge of
consumers in respect of food hygiene regarding food preparation
and storage temperature (Abdul-Mutalib et al., 2012; Burke et al.,
2016; Ergo €nül, 2013; Langiano et al., 2012). Failure to adhere the
recommended temperature values in food preparation and storage
may cause microbial growth and food poisoning (WHO, 2006).
Polish and Thai consumers generally knew that the storage of food
at refrigerator temperatures can slow down the growth of micro-
organisms, thereby decreasing the risk of food poisoning. Despite
this, they generally did not recognize food defrosting at room
temperature as a potential source of food poisoning risk i.e. the risk
of the growth of pathogens growth and the generation of toxins
(Anderson, Sun, Erdogdu, & Singh, 2004; Shrestha, Schaffer, &
Nummer, 2009). For this reason, defrosting is recommended un-
der controlled refrigeration temperature, in cold water or or in a
microwave oven (defrost option). Incorrect knowledge and practice
in terms of frozen food was demonstrated not only among con-
sumers but also professionals in the production and marketing of
food (Abdul-Mutalib et al., 2012; Ergo €nül, 2013; Sharif et al., 2013;
Parry-Hanson Kunadu, Ofosu, & Aboagye, 2016).
Polish consumers, in comparison to Thai consumers, were more
aware of the risks of eating raw or undercooked meat, raw eggs or
fresh, unwashed fresh vegetables and fruit. Cuprasitrut et al. (2011)
noted that meals prepared from vegetables that were not properly
washed may be contaminated with faecal bacteria. Thai consumers,
despite their overall very poor knowledge of food hygiene, scored
better in this question. Microbial infections can be also reduced by
maintaining adequate hand washing (Campos et al., 2009).
Malhotra, Lal, Prakash, Daga, and Kishore (2006) found the pres-
ence of faecal bacteria in the nails of over 70% of food handlers in
India, which was probably a consequence of improper hand
washing. Rodmanee, Srayut, and Wen-Chi (2013) and Jenpanich,
Unger, Alter, and Chaisowwong (2016) stated that food sellers in
Thailand often did not wash their hands after contact with money.
However, in other studies, it was shown that the vast majority of
consumers, as well as food professionals, took care to wash their
hands properly (Liu et al., 2015; Low, Jani, Halim, & Abd, 2016;
Sharif & Al-Malki, 2010; Woh et al., 2016). In the present study
some discrepancies between hand washing hygiene knowledge
and practice were found. Thai consumers were less likely than
Polish consumers to wash their hands before food preparation and
consumption, after handling unwashed fresh vegetables and
touching animals. Cuprasitrut et al. (2011) also reported similar
problems with proper hand hygiene in Thailand. In addition,
Takeuchi and Boonprab (2006) pointed out that, besides improving
hands washing practice, Thais should be better educated regarding
the proper heat treatment of food and refrigerated food storage.
The possibility that some consumers might provide false re-
sponses was a weakness of the research methodology. This was
pointed out, e.g. in the study of Tan et al. (2013), which showed that
in Malaysia more than 95% of surveyed food sellers declared that
they washed their hands after using the toilet. However, on the
basis of the observation of these employees, it was found that in
fact only 4.7% of them washed their hands after using the toilet.
Byrd-Bredbenner et al. (2007) found that although young adults
self-rate their food safety knowledge and practice relatively posi-
tively, this does not necessarily correspond to their actual safe food
hygiene practice. The hygiene questions are questions concerning
the personal behaviour. A tendency to answer in a the desired
manner can be expected. The study of Tan et al. (2013) confirms
this. The use of additional methods, such as consumer observation
or microbiological studies, could be useful. However, the awareness
of being watched might make consumers not behave as they would
84 M. Tomaszewska et al. / Food Control 85 (2018) 76e84
in everyday life.
5. Conclusions
Both, Polish and Thai, consumers had incomplete knowledge of
the causes of food poisoning and, in many cases, their food hygiene
practice during food preparation and consumption was incorrect.
However, in Thailand, respondents generally showed a significantly
lower level of food hygiene knowledge than in Poland. Neverthe-
less, in both countries, nobody responded correctly to all the
questions about the causes of food poisoning. The use of descriptive
statistic methods allowed a detailed characterization of food hy-
giene knowledge and practice of those surveyed, as well as the
identification of differences between the two countries with
respect to factors affecting the knowledge level and correctness of
practice during food preparation and consumption.
There is a need to conduct further research on consumers' food
hygiene knowledge and practice as well as constant food safety
education independently of country of origin, education level and
age. The results of this study may play an important role in the
prevention of food poisoning by indicating which areas of con-
sumers’ food hygiene knowledge and food hygiene practice during
food preparation at home should be strengthened by educational
activities.
Acknowledgements
The study was supported by a Ministry of Science and Higher
Education subsidy for statutory scientific activities and a Warsaw
University of Life Sciences scholarship.
References
Abdul-Mutalib, N. A., Abdul-Rashid, M. F., Mustafa, S., Amin-Nordin, S., Hamat, R. A.,
& Osman, M. (2012). Knowledge, attitude and practices regarding food hygiene
and sanitation of food handlers in Kuala Pilah, Malaysia. Food Control, 27,
289e293.
Akabanda, F., Hlortsi, E. H., & Owusu-Kwarteng, J. (2017). Food safety knowledge,
attitudes and practices of institutional food handlers in Ghana. BMC Public
Health, 17, 40.
Al-Shabib, N. A., Mosilhey, S. H., & Husain, F. M. (2016). Cross-sectional study on
food safety knowledge, attitude and practices of male food handlers employed
in restaurants if King Saud University, Saudi Arabia. Food Control, 59, 212e217.
Anderson, B. A., Sun, S., Erdogdu, F., & Singh, R. P. (2004). Thawing and freezing of
selected meat products in household refrigerators. International Journal of
Refrigeration, 27, 63e72.
Annor, G. A., & Baiden, E. A. (2011). Evaluation of food hygiene knowledge attitudes
and practices of food handlers in food businesses in Accra, Ghana. Food and
Nutrition Sciences, 2, 830e836.
Badrie, N., Gobin, A., Dookeran, S., & Duncan, R. (2006). Consumer awareness and
perception to food safety hazards in Trinidad, West Indies. Food Control, 17,
370e377.
Burke, T., Young, I., & Papadopoulus, A. (2016). Assessing food knowledge and
preferred information sources among 19-29 year olds. Food Control, 69, 83e89.
Byrd-Bredbenner, C., Maurer, J., Wheatley, V., Cottone, E., & Clancy, M. (2007).
Observed food safety behaviours of young adults. British Food Journal, 109,
519e530.
Campos, A. K. C., Cardonha, A. M. S., Pinheiro, L. B. G., Ferreira, N. R., de
Azevedo, P. R. M., & Stamford, T. L. M. (2009). Assessment of personal hygiene
and practices of food handlers in municipal public schools of Natal, Brazil. Food
Control, 20, 807e810.
Carbas, B., Cardoso, L., & Coelho, A. C. (2013). Investigation on the knowledge
associated with foodborne diseases in consumers of northeastern Portugal.
Food Control, 30, 54e57.

ye, E. F., & Salvat, G. (2005). Risk factors
Cardinale, E., Perrier Gros, C. J. D., Tall, F., Gue
for contamination of ready-to-eat street-vended poultry Aes in Dakar, Senegal.
International Journal of Food Microbiology, 103, 157e165.
CCFH. (2003). Recommended international code of practice. General principles of food
hygiene. CAC/RCP 1e1969, Rev. 4 (pp. 1e31). Retrieved 02.03.2017 from www.fao.
org/input/download/standards/23/CXP_001e.pdf.
Chavarria, L. C. T., & Phakdee-auksorn, P. (2017). Understanding international
tourists' attitudes towards street food in Phuket, Thailand. Tourism Management
Perspectives, 21, 66e73.
Cuprasitrut, T., Srisorrachatr, S., & Malai, D. (2011). Food safety knowledge, attitude
and practice of food handlers and microbiological and chemical food quality
View publication stats
assessment of food for making merit for monks in Ratchathewi District,
Bangkok. Asia Journal of Public Health, 2, 27e34.
EFSA. (2016). The European Union summary report on trends and sources of zoo-
noses, zoonotic agents and food-borne outbreaks in 2015. European Food Safety
Authority Journal, 14, 4634.
Ergo€nül, B. (2013). Consumer awareness and perception to food safety: A consumer
analysis. Food Control, 32, 461e471.
FAO/WHO. (2004). Regional conference on food safety for Asia and the Pacific. Country
Report Foodborne Diseases: Situation of Diarrheal Diseases in Thailand.
Retrieved 18.06.2017 from ftp://ftp.fao.org/docrep/fao/meeting/006/ad703e/
ad703e00.pdf.
Feng, W., Jian, Z., Weisong, M., Zetian, F., & Xiaoshuan, Z. (2009). Consumers'
perception toward quality and safety of fishery products, Beijing, China. Food
Control, 20, 918e922.
Hassan, H. F., & Dimassi, H. (2014). Food safety and handling knowledge and
practices of Lebanese university students. Food Control, 40, 127e133.
Jenpanich, C., Unger, F., Alter, T., & Chaisowwong, W. (2016). Food safety knowledge,
attitudes and practices among food handlers in Chiang Mai Province, Thailand.
In The first joint conference of the association of institutions for tropical veterinary
medicine and the society of tropical veterinary medicine. Berlin, Germany, 4e8
September 2016.
Langiano, E., Ferrara, M., Lanni, L., Viscardi, V., Abbatecola, A. M., & De Vito, E.
(2012). Food safety at home: Knowledge and practices of consumers. Journal of
Public Health, 20, 47e57.
Lepp, A., & Gibson, H. (2003). Tourist roles, perception risk and international
tourism. Annals of Tourism Research, 30, 606e624.
Liu, S., Liu, Z., Zhang, H., Lu, L., Liang, J., & Huang, Q. (2015). Knowledge, attitude and
practices of food safety amongst food handlers in the coastal resort of Guang-
dong, China. Food Control, 47, 457e461.
Low, W. Y., Jani, R., Halim, H. A., & Abd, A. (2016). Determinants of food hygiene
knowledge among youth: A cross-sectional online study. Food Control, 59,
88e93.
Malhotra, R., Lal, P., Prakash, S. K., Daga, M. K., & Kishore, J. (2006). Study of hand
hygiene and enteroparasite infestation among food handlers working in a
medical college of North India. Indian Journal of Pathology and Microbiology, 49,
296e301.
Martins, R. B., Hogg, T., & Otero, J. G. (2012). Food handlers' knowledge of food
hygiene: The case of a catering company in Portugal. Food Control, 23, 184e190.
Minami, A., Chaicumpa, W., Chongsa-Nguan, M., Samosornsuk, S., Monden, S.,
Takeshi, K., et al. (2010). Prevalence of foodborne pathogens in open markets
and supermarkets in Thailand. Food Control, 21, 221e226.
Mullan, B., Wong, C., Todd, J., Davis, E., & Kothe, E. J. (2015). Food hygiene knowledge
in adolescents and young adults. British Food Journal, 117, 50e61.
Parry-Hanson Kunadu, A., Ofosu, D. B., & Aboagye, E. (2016). Food safety knowledge,
attitudes and self-reported practices of food handlers in institutional foodser-
vice in Accra, Ghana. Food Control, 69, 324e330.
Poolklai, S. (2015). Food safety in Thailand: A case of international senior tourists.
Procedia - Social and Behavioral Sciences, 197, 2120e2124.
Rodmanee, S., Srayut, T., & Wen-Chi, H. (2013). Food safety knowledge and practices
of floating food vendors in Amphawa Floating Market, Thailand. Advanced
Science Letters, 19, 3093e3096.
Sharif, L., & Al-Malki, T. (2010). Knowledge, attitude and practice of Taif University
students on food poisoning. Food Control, 21, 55e60.
Sharif, L., Obaidat, M. M., & Al-Dalalah, M. R. (2013). Food hygiene knowledge, at-
titudes and practices of the food handlers in the military hospitals. Food and
Nutrition Sciences, 4, 245e251.
Shrestha, S., Schaffer, D., & Nummer, B. A. (2009). Sensory quality and food safety of
boneless chicken breast portions thawed rapidly by submersion in hot water.
Food Control, 20, 706e708.
Siow, O. N., & Sani, N. A. (2011). Assessment of knowledge, attitudes and practices
(KAP) among food handlers at residential colleges and canteen regarding food
safety. Sains Malaysiana, 40, 403e410.
Sirigunna, J. (2015). Food safety in Thailand: A comparison between inbound senior
and non-senior tourists. Procedia - Social and Behavioral Sciences, 197,
2115e2119.
Sun, Y. M., Wang, S. T., & Huang, K. W. (2012). Hygiene knowledge and practices of
night market food vendors in Tainan City, Taiwan. Food Control, 23, 159e164.
Takeuchi, M. T., & Boonprab, K. (2006). Food safety situation in Thailand with regard
to their Thai's food safety knowledge and behaviors. Kasetsart Journal, 40,
222e228.
Tan, S. L., Bakar, F. A., Karim, M. S. A., Lee, H. Y., & Mahyudin, N. A. (2013). Hand
hygiene knowledge, attitudes and practices among food handlers at primary
schools in Hulu Langat district, Selangor (Malaysia). Food Control, 34, 428e435.
WHO. (2006). Five keys to safer food manual. Geneve: World Health Organization.
Retrieved 12.02.2017 from http://www.who.int/foodsafety/publications/
consumer/manual_keys.pdf.
WHO. (2015). Food safety. Fact sheet No. 399. Geneve: World Health Organization.
Retrieved 18.06.2017 from http://www.who.int/mediacentre/factsheets/fs399/
en/.
Woh, P. Y., Thong, K. L., Behnke, J. M., Lewis, J. W., & Zain, S. (2016). Evaluation of
basic knowledge of food safety and food handling practices amongst migrant
food handlers in Peninsular Malaysia. Food Control, 70, 64e73.
Wongleedee, K. (2013). Food safety management: Concerns from EU tourists in
Thailand. International Scholarly and Scientific Research & Innovation, 7, 94e97.