Baseline for Consumer Food Safety Knowledge and Behaviour in Canada

1. Baseline for Consumer Food Safety Knowledge and Behaviour in Canada Andrea Nesbitt, M. Kate Thomas, Barbara Marshall, Kate Snedeker, Kathryn Meleta, Brenda Watson, Monica Bienefeld Canadian Public Health Association, Toronto, Ontario May 29, 2014

2. Baseline Consumer Food Safety Practices in Canada Background • 4 million episodes of domestically acquired, food-borne illness in Canada annually1 • Costing $3.7 billion (acute gastrointestinal illness)2 • Food safety errors can occur at all points along the food continuum • Consumer is the last line of defence • Understanding consumer food safety practices is essential in prevention and control of food-borne illness 1 Thomas et al., 2013; 2Thomas et al., 2008

3. Baseline Consumer Food Safety Practices in Canada Background • Canadian Partnership for Consumer Food Safety Education (The Partnership) – identified that baseline data of Canadian food safety is a priority and would be used as a benchmark to measure progress on consumer behaviour and practices • PHAC – wanted to build on research by Nesbitt et al., 2007 examining consumer food safety practices in FoodNet Canada’s pilot Sentinel Site (Region of Waterloo, Ontario) • Public Opinion Research (POR) – CFIA, Health Canada, Agriculture and Agri-Food Canada provide valuable information about consumers attitudes, perceptions and views • Result: collaboration formed between The Partnership, PHAC and Ontario MOHLTC to establish a baseline for publication

4. Baseline Consumer Food Safety Practices in Canada Objectives • To establish a baseline of consumer food safety handling practices within the home in Canada; • To identify gaps in research knowledge; • To make recommendations for future research To date, first summary document examining Canadian survey results measuring consumer food safety practices to establish a baseline.

5. Baseline Consumer Food Safety Practices in Canada Methods • Staged Approach • Peer reviewed literature search • Public opinion reports • Search for public opinion reports included: • Library and Archives Canada • Communication with librarians • Screening of reference lists of reports • Syndicated studies: contact with market research companies Only studies pertaining to Canadian consumers and exclusively assessed individual consumer and targeted consumer groups were included

6. Baseline Consumer Food Safety Practices in Canada Food Safety Topics • Perception – Consumer perception on food quality and safety and how perceptions influence decision-making • Knowledge – General food safety awareness, source of information for food safety, high-risk groups and foods • Reported Behaviour – Self-reported consumer behaviour, organized by The Partnership’s key food safety messages: ‘Clean’, ‘Separate’, ‘Chill’, ‘Cook’

7. Baseline Consumer Food Safety Practices in Canada Canadian Partnership for Consumer Food Safety Education (The Partnership) Key Messages: • Clean– washing hands and kitchen surfaces • Separate– avoid cross-contamination in the kitchen • Chill– refrigerating items promptly and at proper temperatures • Cook- use a thermometer to measure the internal temperature of cooked foods /

8. Baseline Consumer Food Safety Practices in Canada Results: Study Types and Methods • 26 Canadian publications related to consumer food safety knowledge, perceptions and behaviours between 1998 and 2011 • 22 public opinion research • 4 scientific peer-reviewed publications • Survey administration methods: • Telephone (54%) • Focus groups (17%) • Combined telephone and focus groups (21%) • Mail or in-person interviews (8%)

9. Baseline Consumer Food Safety Practices in Canada Results: Perception Consumer Confidence in Canadian Food Supply • 61-96% of Canadians gave the Canadian food safety system a favorable or moderately confident rating (based on 10 POR studies, 2003-2011) Assigned Food Safety Responsibility • Government • CFIA, HC, AAFC • Non-government • Industry, consumer, farmers, food suppliers and retailers • Overall sense that food safety is a shared responsibility • Canadians ultimately believe it is a combination of institutions and consumers themselves that are responsible for food safety (based on 3 POR studies, 1998-2011)

10. Baseline Consumer Food Safety Practices in Canada Results: Knowledge: Food safety information sources

11. Baseline Consumer Food Safety Practices in Canada Results: Knowledge High-Risk (Vulnerable) Groups (based on 1 POR study, 2010) • 84% aware of specific groups at a higher risk for food-borne illness • Elderly – 62% • Children < 6 years old – 61% • Pre-existing health issues – 54% • Pregnant woman – 9% • Persons in high-risk groups did not tend to recognize their own group as high-risk • Only 25% of pregnant woman identified pregnant woman as a high-risk group; and 50% of seniors identified the elderly as a high-risk group High-Risk Foods (based on 7 POR and 2 peer-reviewed studies, 2001-2011) • Consumers consistently considered meats and poultry as high-risk foods, whereas produce was less frequently considered high-risk • Over time (1998-2010) identification of RTE-deli meats as a high-risk food increased

12. Baseline Consumer Food Safety Practices in Canada Results: Behaviour Frequency of Food Preparation • Canadians often prepare meals at home • 65-84% prepared a meal/main meal almost every day (based on 2 POR and 1 peer-reviewed study, 1998-2004) • In an average week, 75% of Canadians ate fewer than 3 meals prepared outside the home (based on 1 POR study, 2004) • Primary meal preparers tended to be women http://www.hc-sc.gc.ca

13. Baseline Consumer Food Safety Practices in Canada Results: Behaviour – Clean Hand-washing(7 POR & 2 peer-reviewed studies, 2001-2011) • 85% hand-washing very important in the prevention of disease; • 98-99% reported washing their hands frequently; • 56-83% reported always washing their hands before preparing food; • 75-87% reported always washing their hands after preparing food or handling raw meat Cleaning after handling raw meat (4 POR studies, 2004-2010) • 56% always washed & disinfected cutting surfaces after handling raw meat & before preparing other food; • 51% washed & disinfected cutting boards after cutting raw meat; • 83% reported always washing items that had contact with raw meat, chicken or seafood; • 93% always washed the plate used to hold raw meat, chicken or seafood before using them Cleaning of reusable shopping bags (1 POR study, 2010) • Only 7% reported always washing reusable shopping bags, while 38% reported never washing them

14. In general, 42-51% reported never using a food thermometer to determine if foods are cooked to the correct temperature (based on 2 POR studies, 2010-2011) From a peer-reviewed study (2009) 64% visually assess the doneness of meat, followed by 33% time 14% thermometer 10% taste Focus group respondents (3 POR studies, 2007) Most did not use thermometers, only to verify food was not overcooked; Not likely to change behaviour after reading information on thermometers Baseline Consumer Food Safety Practices in Canada Results: Behaviour – Cook www.hc-sc.gc.ca

15. Baseline Consumer Food Safety Practices in Canada Results: Behaviour – Chill Cold Storage(3 POR studies, 2004-2011) • 65-95% reported refrigerating or freezing leftovers within the recommended 2-hour limit Fridge temperature(3 POR studies, 2010-2011) • 30% reported having a thermometer in their fridge; • 80% reported not using a thermometer to determine fridge temperature • However, one study showed 94-95% reported keeping their refrigerator clean and set to a temperature <4C Thawing/Defrosting Methods • Refrigerator – 51% • Microwave – 31% • Kitchen counter/room temperature - 26% • In water – 8% (based on 1 peer-reviewed study, 2009) http://www.befoodsafe.ca

16. Baseline Consumer Food Safety Practices in Canada Results: Behaviour - Separate www.hc-sc.gc.ca • Reported behaviours of separating raw meat and juices from other foods were in-line with recommended practices • 40% reported putting meat, poultry and seafood on the bottom shelf of the refrigerator • 48% reported never putting meat or poultry and fresh produce in the same shopping bag • 61% agree with keeping separate cutting boards for raw meats and vegetables • 72% reported discarding marinade used for meats, poultry, fish and seafood • 92% reported always switching to a clean plate for cooked meat after barbequing or cooking

17. Baseline Consumer Food Safety Practices in Canada Conclusions • There is a breadth of research investigating consumer food safety practices in Canada. • Despite variations in study designs, methods and scope among the studies, a summary of all the knowledge to date has provided insight into common perceptions, knowledge and behaviours of Canadian consumers. • Overall, there is a relatively high general awareness of food safety among Canadian consumers, although there remain areas that need improvements and further education.

18. Baseline Consumer Food Safety Practices in Canada Gaps and Recommendations • Gaps: • Few studies used consistent wording or a standardized set of food safety questions to allow for comparisons across studies and over time • Recommendations: • Establish standard set of survey questions in order to benefit from this existing baseline knowledge and to allow comparisons over time to assess the effectiveness of food safety interventions on the reduction of food-borne illness. • Together with government, industry and academia, critical review of questions and recommendations for standardized wording would support higher quality, more meaningful results

19. Baseline Consumer Food Safety Practices in Canada Next Steps: Foodbook – Canadian Food Exposure Study to Strengthen Outbreak Response • A national population-based telephone survey determining what Canadians eat over a seven-day period • Module on consumer food safety practices to be developed • Questions will address food safety knowledge & practices in the home • Baseline for consumer food safety knowledge and behaviour in Canada will form the basis of the consultation material • Stakeholder consultations via short online survey to prioritizes food safety themes to inform question development • Consultations with various stakeholders including The Partnership board of directors, government, academia, and industry • Survey data collection: 6 months; November 2014 – April 2015

20. Baseline Consumer Food Safety Practices in Canada Published Manuscript • Published in the journal Food Control, available by open access • http://www.sciencedirect.com/science/article/pii/S0956713513005331

21. Baseline Consumer Food Safety Practices in Canada Thank you! Questions? andrea.nesbitt@phac-aspc.gc.ca