Indian Journal of Community Medicine Vol. XXVI, No.2, Apr~lun, 2001, ‘AN EVALUATION OF HEALTH STATUS OF FOOD HANDLERS OF EATING ESTABLISHMENTS IN VARIOUS EDUCATIONAL AND HEALTH INSTITUTIONS IN AMRITSAR CITY Y. Mohan, U. Mohan®, Lakshman Dass**, Manohar Lal*** Deptt. of Community Medicine, D.M.C. & Hospital, Ludhiana "Dept. of ology, D.M.C. & Hospital, Ludhiana »PHC Lopoke, Amritsar *+**Depit. of Community Medicine, G.G.S, Medical College, Faridkot Abstract: Research question: What is the health status of food handlers working in the eating establishments of educational and health institutions in Amatsar ety? (Objective: To assess the health status of food handlers, ‘Study design: Cross-sectional, Participants: All food handlers working in all the messes and kitchens of educational and health institutions in Amritsar ity ‘Method: Interview, physical examination and lb invest cs, Ress Most ofthe ood handlers (5.7) wee 30-39 years of ag group wih 61.7% as iterate. 62 of them showed evidence of ‘ome date or dficency while 45 of thm hd intestinal pars mfesatons. Periodic Rell examinaion of food pander mst be done. Key words: Food handlers, Eating establishments, Health status Introduction: Food is a basic human need for survival. Through centuries, food has been recognized as an important need for humans in health and disease. It is one of the basic requirements of man as also of all living beings. Every activity of man is aimed at procurement of food and it is only after having met with this requirement that he thinks of other less important requirements. is basically an agricultural country. tion and urbanization along with the tremendous growth in the population have promoted people {to migrate from their rural homes to the urban areas in search of employment and a better way to life which has forced them to the necessity to have their meals at any place that offers food at a price they can afford. There has been a ‘growing demand for eating places and as a result, a large number of eating establishments have mushroomed all over the cities which are manned by different categories of workers. ‘The health of people depends, toa large extent, on the food they eat. But food is frequently subjected to ‘contamination by a variety of micro-organisms resulting into human illness and has a direct extensive and important bearing on public health. These contaminations may occur ‘atany point during the journey of food from the producer to the consumer. The chances of food getting contaminated depend largely on the health status of the food handlers, their personal hygiene, their knowledge of food hygiene and above all, the proper application of that knowledge. ‘A food handler is any person who handles food, regardless whether he actually prepares or serves it. Unhealthy food handlers are potentially dangerous to the hhealth of consumers and the danger is magnified many folds if they are employed in educational and health institutions. They can transmit a number of food-borne diseases like diarrhoea, dysentery, cholera, typhoid and pparatyphoid fevers, viral hepatitis, protozoal cysts, ova of hhelminths, tuberculosis, staphylococcal and streptococcal infections, salmonellosis and many other through their hhands. Food handlers ae the most important sources for the transfer ofthe microorganisms to the food from their skin, ‘nose, bowel and also from the contaminated food prepared and served by them. Besides unhealthy food handlers, disease carriers handling the food also play an equally important role in transmitting these diseases and impose a great threat to the health of the public. Certainly, there are many other modesInjan Journal of Community Medicine Vol. XXVI, No.2, Apr-Jun, 2001 also by which the food borne diseases are transmitted. ‘These include preparation of food in the untensils infected by handling or washing in the contaminated water or Flies lighting on food after feeding on exposed infected faeces ‘or during storage of food by insects, rodents etc. The role of food handlers in the transmission of food borne diseases comes atop. Material and Methods: All the food handlers (according to the lists procured from the heads of all the institutions) working in the messes, and kitchens of all the educational and health institutions attached to hostels in Amritsar city were assessed for the evaluation of their health status. A total of 3 visits were paid to each of these institutions which were planned with the consent of theirheads. The very purpose of these visits was explained both to the food handlers as well as to the heads Of the institutions. The food handlers who could not be contacted during these 3 visits were excluded from this study. Due care was given that these visits did not distur the routine activities of the establishments. ‘The food handlers were interviewed according to the proforma which was evolved and pre-tested for the purpose Of the study. Information regarding age, sex, residential address, religion, marital status, income, educational status, ‘occupation and certain personal habits like smoking, alcoholism etc. was obtained during the interview. Relevant history regarding presenU/past illness if any was obtained. General physical and systemic examinations were carried ‘out. Haemoglobin estimation (Sahli’s method) and stool ‘examination (Direct smear method and salt concentration method) of all food handlers was done. Sputum ‘examination for AFB (Zichl-Neelsen method) was carried ‘out in cases where relevant history was available. Data thus collected were compiled, analysed and valid conclusions drawn. Parameters taken for the assessment of health status were as under Morbidity: If any. ‘Nutritional status: According to the standard weight for height. ‘Good: More than 90% of the standard weight Health status of food handlers Fair: 81 to 90% of the standard weight Moderate: 71 to 80% of standard weight. Poor: Less than 70% of the standard weight. Gellife, 1966)" ‘Anaemia: Haemoglobin less than 13 grm% by Sabil’s method.(WHO, 1966)* Intestinal parasitic infestations: ‘ovaleysts of protozoa/helminths in stools. Presence of ‘Observations and Discussion: Various observations made during the study were as under. ‘Table I: Messes/Kitchens of educational and health institutions surveyed during study. Institutions No.of No. of food No. of food surveyed Messes handlers. handlers surveyed enlisted examined Educational 20 181 162 Health 4 55 52 Total 24 236 214 ‘Table I reveals that out of 236 enlisted food handlers, 214 could be examined. ‘Table II: Distribution of food handlers according to age. ‘Age group, ‘Cumulative Cumulative (years) {otal _ percentage 10-19 '56(26.16) 36 26.16 20-29 98(45.74) 154 71.90 30-39 30(14.01) 184 8591 40.49 15(7.09) 199 93.00 50-59 10(4.67) 209 97.67 >60 52.33) 214 100.00 ‘Table II reveals that maximum number (71.90%) of food handlers were below 30 years of age and only 2.33% ‘were in the age group of 60 years and above. Mohan V eta!Gupta and Ketkar (1981)* from Nagpur in their study ‘on food handlers observed that 22.3% of them were below 25 years of age. In the similar study by Chitnis (1982) from Pune, it was found that 73.87% of food handlers were below 30 years of age. ‘Table II: Distribution of food handlers according to their socio-demographic profile. Parameter (9=214) No) Sex Male 206(96.26) Female (08(03.74) Occupation Cook: 106(49.54) Waiter 542524) Dish washer 3114.46) Helper 23(10.76) Residential locality Rural 146(68.22) Urban 3817.62) Slum 30(14.16) Education status Miterate 8238.31) Sst literate 10(04.67) Primary 68(31.77) Middle 2612.18) Matric 2210.28) ‘Above matric 0602.83) Table IM reveals that a vast majority (96.2%) of food handlers were males, Maximum number (49.54%) were cooks and majority (68.22%) of food handlers were from rural areas while 30(14.16%) were from the slums, 82(38.31%) food handlers were iterate. In a study by Chitnis (1982)* there was no female food handler, while in another study by Gupta and Ketkar (1981) from Nagpur, 28.9% were females. ‘The lower literacy rate in the present study may be ‘due to the fact that majority of food handles in educational ‘and health institutions were from states like Himachal Pradesh and Utuar Pradesh where the literacy rates are relatively lower, Health status of fod handlers Indian Joumal ot Community Medicine Vol. XXVI, No.2, AprJun., 2001 ‘Table IV: Distribution of food handlers according to habits and addictions. Habits and addictions No.(%) Smokers 115(53.74) ‘consuming alcohol 52(24.30) Chewing tabacco 24(11.20) Betal chewing 2310.74) ‘Mixed/double habits 70(31.72) No addiction 52(24.30) Table TV reveals that 115(53.74%) were smokers, '52(24,30%) consumed alcohol daly, 24(11.2%) were in the habit of chewing tabscco and 23(10.74%) habituated to betal chewing. Some of the food handlers were habituated to more than one habit. Double habituation (31.72%) was mostly found in the case of smokers also being alcoholics. 52(24,30%) of the food handlers were free from any of the ‘common addictions. Thus the common habits were those of smoking and drinking. Gupta and Ketkar (1981) in their study reported that ‘50% of the food handlers were habituated to pan chewing ‘and 40.1% to chewing tabacco. This could be due to the fact that their subjects of study were from Nagpur. ‘Table V: Illnesses/injuries suffered by the study population in previous three months. Hiness/injury No%) Diarrhoea/dysentary 1547.08) ‘Cough, cold/sore throat 502.34) Febrile iliness 4(1.86) Hypertension 41.86) Injuries 41.86) ‘Conjunctivitis 341.40) Pain abdomen 20.9) Od case of tuberculosis 20.93) Bums 20.93) Osteoarthritis 1(0.46) Diabetes mellitus with hypertension 140.46) Total 432091) a Mohan Vota