05/01/2008

Survey Reveals Food Safety Gaps at Facilities Serving the Elderly

Writer:

Martha Filipic
filipic.3@cfaes.osu.edu
(614) 292-9833

Source:

Lydia Medeiros, Human Nutrition
lmedeiros@ehe.osu.edu
(614) 292-2699

COLUMBUS, Ohio -- Dietary managers at nursing homes and other facilities that serve high-risk clients appear to know relatively little about a rare but potentially deadly food-borne illness, according to a survey by researchers at Ohio State University and Colorado State University.

The survey, part of a larger research project on the transmission of Listeria monocytogenes, asked dietary managers about their knowledge of the bacterium and the illness it causes, listeriosis.

The bacterium is found widely in the environment and can grow at refrigerator-level temperatures (as low as 32 degrees). It is often associated with refrigerated ready-to-eat foods, such as deli meats, hot dogs eaten without heating, soft raw-milk cheeses and seafood salads. Luckily, the incidence of listeriosis is relatively rare -- but when it does strike, it can be severe. Twenty percent of those who are diagnosed with listeriosis die, and the elderly are most at risk. In one study, 96 percent of listeriosis cases among older patients required hospitalization, the researchers said.

The survey focused on dietary managers because they are responsible for food preparation for elderly people in nursing homes, assisted-living facilities, Meals on Wheels programs and other establishments, said Lydia Medeiros, professor of human nutrition in the College of Education and Human Ecology and food safety specialist with Ohio State University Extension. She collaborated with Patricia Kendall and John Sofos of Colorado State on the study.

A total of 267 dietary managers responded to the survey. Of those, 62 percent said they have heard little or nothing about Listeria, and 40 percent rated their understanding of the bacterium as low to very low. Only 63 percent of the survey respondents said elderly adults were at high risk of listeriosis.

"Most of these professionals have a good knowledge base on general food-safety issues," said Medeiros, who also has a research appointment with the Ohio Agricultural Research and Development Center. "But I think it's clear that they need to make a point to learn about issues that are especially high-risk for the populations they serve."

For example, general kitchen safety and sanitation procedures aren't enough when trying to keep Listeria at bay, she said.

"We know that Listeria tends to colonize around water sources, but less than half the respondents had a standard protocol for cleaning kitchen disposals and floor sinks," Medeiros said. "If Listeria is in the environment, it can spray right back into the food preparation area."

In addition, the survey revealed another concern, Medeiros said: Most establishments tend to serve foods that are often associated with listeriosis outbreaks, including cold lunchmeat, hot dogs, soft cheeses, and egg, seafood or coleslaw salads.

"I would avoid cold lunchmeat altogether for this population," Medeiros said. "Soft cheeses are OK as long as they are pasteurized."

The survey also revealed that dietary managers had a strong interest in learning more about minimizing the risk of listeriosis.

As part of an ongoing food safety education program, the researchers have developed an online continuing-education curriculum for dietary managers, registered dietitians, sanitarians, nurses and other professionals to learn about food-safety issues for high-risk populations. The curriculum includes a module specifically on the elderly, including information on Listeria.

The curriculum's $60 fee allows participants to take up to a year to review all six modules. Participants who score 70 percent or above on a post-tes will receive a certificate for continuing education credit to send to their professional organization. To learn more, see the Web site at http://hec.osu.edu/highriskfoodsafety/index.php.

The survey was partially funded through a grant from the National Integrated Food Safety Initiative of the Cooperative State Research, Education, and Extension Service of the U.S. Department of Agriculture. It was part of the project titled "Understanding and controlling Listeria monocytogenes transmission through ready-to-eat meat products from processing plants to consumer." Other collaborators in the project include scientists from Ohio State, the University of Nebraska, and Kansas State University.

Survey results as of Feb. 15, 2008, were published in the April issue of Dietary Manager, the official publication of the Dietary Managers Association.

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