The Need to Implement Food Safety Education and Training for Child Care Providers in Iowa
Jennine Wolf
Environmental Health Specialist
Washington County Environmental Department
International Food Protection Training Institute (IFPTI)
2011 Fellow in Applied Science, Law, and Policy: Fellowship in Food Protection
Abstract
In 2009, more than 40 million meals were served to Iowa children ages 5 or younger child care programs. Lack of food safety education regarding food preparation, service, and sanitation puts this vulnerable population at constant risk. In order to assess knowledge of safe food preparation and serving among child care providers, 62 child care conference attendees were surveyed using a multiple-choice tool. The results of the survey confirmed that child care providers know little about food pathogens, do not understand how food can be contaminated, fail to recognize how to prevent contamination, and lack knowledge necessary to prepare foods safely. This situation needs to change for the benefit of children in Iowa. The survey results suggest that the Iowa Department of Human Services (DHS) and Iowa Department of Public Health should require mandatory annual food safety training for child care providers. Food safety education is a continual learning process, because new food-related concerns continue to emerge as food processing technology advances.
Background
In 2009, 72% of children in Iowa ages 5 or younger had one or both parents who worked, compared with 62% nationally. This family dynamic has resulted in child care facilities serving more than 40 million meals to children 0-5 years of age (Iowa Department of Education, 2009). The protection of this high-risk population, who may consume 75 to 100% of their daily food intake in child care, is quietly falling through the cracks.
Although child care programs may be ”licensed and inspected,” many of them do not have requirements for safe food handling. There have been major transformations over the past 30 years in food technology that have led to changes in food manufacturing and, in turn, have altered the type of food the public consumes and how that food is prepared (Tauxe, RV, 1997). According to the Centers for Disease for Disease Control and Prevention (CDC), this fast and innovative progress has facilitated many new food safety issues, including the emergence of 14 previously unknown food pathogens. Unfortunately, educating the public on how to protect themselves and others against these food safety concerns has not kept up with the technological progress.
The only food-related requirement in many child care facilities is that regular meals and midmorning and mid-afternoon snacks be provided that are well-balanced, nourishing, and in appropriate amounts. Even parents who send meals with the children have no assurance that the child care provider is handling that food safely.
Problem Statement
Child care programs are increasing, and many of these providers are not up to date on current safe food handling standards. Parents have no guarantee that the food their children eat will be prepared under safe and sanitary conditions.
Research Questions
The following research questions were designed to assess if Iowa child care providers have minimum knowledge to prepare and serve food safely to the susceptible population in their care:
1. Are child care providers aware of emerging pathogens and how these pathogens contaminate the food?
2. Do child care providers understand what foods are safe to serve children and have minimum knowledge to prepare food safely?
Methodology
A multiple-choice survey with 28 questions was developed to answer the two research questions. The questions were written using input from four experts in the field with extensive experience in food safety and survey administration among the targeted population. The survey was administered to child care providers who attended two conferences in October 2011: the Iowa Association for the Education of Young Children conference, held in Des Moines, Iowa, and the 4Cs Community Coordinated Child Care Fall Conference, in Iowa City, Iowa. Sixty-two child care providers participated in the survey.
Results
Research Q – 1. Approximately 50% of survey participants had heard of some of the emerging pathogens on the survey. None of the respondents knew how Norovirus, Hepatitis A, Listeria, Botulism, or Campylobacter jejuni contaminates foods, and 90% did not know what foods Shigella contaminates. (Figure 1)
Research Q – 2. A total of 30 (48%) providers answered that unpasteurized milk and juice, undercooked eggs, and raw cookie dough are safe for children to consume. None of the providers knew correct cooking temperatures for hamburger or fish sticks, and 90% did not know the correct cooking temperature for chicken. More than 90% did not know the correct parts per million (ppm) for sanitizer for use on food contact surfaces. (Figure 2).
Conclusion
The survey results demonstrate that child care providers who participated in the survey do not possess minimum food safety knowledge to prepare and serve food to a high-risk population. Knowledge of the emerging food temperature pathogens and how they contaminate foods is critical to buying, preparing, and serving safe food, especially to a high-risk population. A large number of menus in child care facilities include ready-to-eat foods, which will increase with the current emphasis to add more fresh fruits and vegetables. Eliminating bare hand contact with ready-to-eat foods is the only way to prevent the contamination these foods by Norovirus, Shigella and Hepatitis A. Unpasteurized milk and juice and undercooked eggs are foods that should never be given to children. The results of this survey support the need for child care providers to possess at least minimum food safety knowledge to provide the safest food possible to the vulnerable population in their care.
Recommendations
The Iowa Department of Human Services (DHS) must add food safety education to the list of mandatory requirements for Iowa child care providers. Updated information for safe purchasing, storing, handling, preparing, and serving of food should be incorporated annually into existing continuing education resources. Safe food handling procedures should be included in the DHS regulations for child care centers and home-based programs. In addition, the CDC, the U.S. Department of Agriculture, and other organizations that provide food safety information the general public should put more emphasis on food safety for children in child care settings. All child care providers should be able to easily access this important information.
Acknowledgements
I would like to sincerely thank the International Food Protection Institute for inviting me to participate in the 2011-12 Fellowship in Food Protection, and especially Denise, Sue, and Suzanne for making my first interaction with the Fellowship very warm and welcoming. I have the greatest respect for my mentor, Cameron Smoak, for his true southern hospitality, his support for me personally, and his assistance throughout my project. I would like to thank to Kieran Fogerty for his assistance with my project. I also would like to give special thanks to the Fellows of this cohort for the wonderful opportunity to create valuable relationships. In addition, I want to extend very heartfelt thanks to my supervisor, Jeff Thomann of the Washington County Environmental Department, who constantly challenges me to grow and achieve all I can in my career. Without his belief in my abilities and continuous support, this once-in-a-lifetime opportunity would not have been possible. A special thanks also goes to the following people, who, without their help, support, and knowledge over the last four years, the seeds of this project would not have come to fruition: Analisa Pearson, State Coordinator for Healthy Child Care Iowa; Tasha Beghtol, Henry/Washington Early Childhood; Deb Ekhoff, 4Cs Community Coordinated Child Care; Lori Bauer, Washington County Board of Health; and Virginia Bordwell, former Washington County Supervisor.
Corresponding Author
Jennine Wolf, Washington County Environmental Department (Iowa)
Email: jwolf@co.washington.ia.us
References
Iowa Department of Education, Child Nutrition Program, CACFP Meals Served. Number of Meals Served from January 2009 to December 2009. Retrieved from http://www.educateiowa.gov
State Data Center of Iowa. (2012). Iowa Quick Facts. Retrieved from http://www.iowadatacenter.org/quickfacts
Tauxe RV. Emerging Foodborne Diseases: An Evolving Public Health Challenge. Emerg Infect Dis [serial on the Internet]. 1997, Dec [date cited]. Available from http://wwwnc.cdc.gov/eid/article/3/4/97-0403.htm
U.S. Food and Drug Administration (FDA). (2005). Food Code. Retrieved from http://www.docstoc.com/docs/1024153/2005-FDA-Food-Code-(English)