Food Protection Trends - January/February 2015 - 9

or contrived scenarios (e.g., preparation of a single pre-determined dish), rather than providing observations of actual
kitchen behaviors, which limits the observations of the
diverse ways whole meals are prepared (8, 18, 36). Further,
previous observational studies have had little ability to
record certain critical food handling practices (e.g., storage
and thawing of food products) (8, 31). Another limitation
of previous studies is that they have confined observations
to individual participants in isolation, ignoring potential
interactions of others that live within the house (e.g., roommates).
The objectives of this study were to evaluate raw poultry
handling practices and quantify the various risk factors
contributing to intrameal (within the same meal) and
intermeal (between different meals) cross-contamination,
using a study design that was both observational and
questionnaire-based. Observations were made in the
subjects' private kitchens, providing subjects with a familiar
setting to perform their typical food handling activities
(e.g., sanitizing contaminated surfaces, using dishcloths or
paper towels), as well as allowing us to observe non-food
handling practices during meal preparation (e.g., taking out
the garbage, answering phones). Additionally, subjects were
not limited to a single recipe, but rather were encouraged
to prepare any meal (including side dishes), as long as it
included handling of raw poultry. Furthermore, the current
study design allowed specific observations of how raw
poultry products were stored and thawed, as well as any
interactions of the subject with other individuals in the
kitchen.
MATERIALS AND METHODS
The research protocol and the administered
questionnaires (Attachment A) were approved by the
Institutional Review Board at the University of Washington.
Subject recruiting
A convenience sample of participants from different
households was recruited for the study. Inclusion criteria
for participants included being 18 years old or older and
self-identification as a person who regularly prepares meals
beginning with raw poultry for themselves and/or others.
Recruitment was accomplished through the posting of fliers
at the University of Washington and through e-mails sent
to students and university employees. Additional subjects
were recruited by word of mouth from the researchers'
circle of friends within and outside the university, and
family members. A written description of the study was
presented to potential participants, and researchers were
available to answer questions. Participants in the study were
told that they were participating in a food safety research
study evaluating their raw poultry handling practices.
Subjects who were interested and agreed to participate were
required to sign the consent form before they were formally

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illnesses caused by other major pathogens of concern (2,
4). Reports have estimated that 10% to 50% of foodborne
outbreaks are associated with foods prepared or consumed
in homes (27, 33). A more recent CDC report states that
7% of overall foodborne illness outbreaks and 20% of
salmonellosis outbreaks are associated with food prepared
in the home (6).
Nineteen percent of outbreaks with an identified food
vehicle implicated poultry products (6). Further, Salmonella
and poultry was the second most implicated pathogencommodity pair (6). Market prevalence studies have
consistently found significantly higher rates of Salmonella
and Campylobacter contamination in poultry products
than in other foods of animal origin, despite considerable
efforts by processors to control contamination rates in
their products (17, 26, 39). As a result, relying solely on
processors' efforts to reduce the contamination rates of
raw poultry products may not adequately mitigate the
risk of infection (40). The recent multistate foodborne
outbreaks due to Salmonella Heidelberg from raw poultry,
resulting in more than 134 illnesses and 33 hospitalizations,
underscores the importance of proper poultry handling
practices (5).
Improper food handling practices of raw poultry or
other types of meats have been identified as risk factors
for foodborne illnesses in homes (21, 31, 34). When
raw poultry products are improperly handled, crosscontamination of food and non-food contact surfaces
can readily occur within domestic kitchens (9, 11, 45).
Laboratory studies have evaluated the rates of bacterial
transfers between different surfaces, including from raw
chicken to hands (7, 28), from chicken to cutting boards
(7, 22, 42), from contaminated hands to ready-to-eat foods
(7, 28) from hand to tap and vice versa (7), and from
cutting board to salad (7, 32). These and other studies have
found bacteria are transferred between surfaces in food
preparation environments (7, 10, 11, 22, 24, 28) and are
able to persist in various environments (19), on hands (7),
and on cutting boards (9, 10). Implementation of safe food
handling practices in private homes is critical to reduce the
spread of these pathogens.
Although roughly three quarters of meals are prepared
and consumed at home in the United States, our understanding of how raw poultry products are handled in private
homes is scanty (1). Our primary understanding of how
foods are handled in private homes comes mostly from
questionnaire-based studies and a handful of observational
studies (31, 33, 34, 36, 37, 44). Questionnaire-based studies, which rely on what study subjects report, may suffer
from individual reporting bias. In contrast, reporting bias is
minimized in observational studies, since trained food safety professionals can observe food safety activities directly
and evaluate risk factors. However, previous observational
studies have commonly utilized mock/commercial kitchens

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Food Protection Trends - January/February 2015

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