Aims: Public concerns relating to food safety remain high with most attention focused on manufactured foods and those served in catering operations. However, previous data have suggested that the home may be the main location for cases of food-borne disease. The aim of this paper is to review the microbiological risks associated with hygiene in the domestic kitchen related to food and infant formula safety.
Methods: Compared to other food sectors, research on consumer food hygiene, domestic food-handling and preparation of infant formula is relatively understudied. Behavioural and microbiological studies of consumer hygiene and the domestic kitchen have been reviewed to incorporate research relating to the safety of infant formula.
Results: Incidence data identify the home as an important location for acquiring food-borne disease. The domestic kitchen can be used for a variety of purposes and is often contaminated with potentially harmful micro-organisms such as Campylobacter and Salmonella. Consumer hygiene habits have frequently been found to be inadequate and relate both to microbial growth, survival and cross-contamination. Due to the reduced immune response of infants, the activities associated with the preparation of infant formula and associated bottles and equipment are of particular concern.
Conclusions: Cumulatively, the data suggest that more effort should be made to educate the consumer in food hygiene, especially when the kitchen is used to reconstitute infant formula. This information needs to be provided in a form appropriate for use by consumers.
consumer food hygiene; domestic kitchens; food and infant formula safety
Food-borne disease caused by microbiological hazards is an important global public health issue.1 Prevention of disease and improvement of human health is of paramount importance for governments, industry and consumers. Many foods brought into the domestic kitchen are frequently contaminated with naturally occurring pathogenic micro-organisms. Such pathogens cannot be detected organoleptically (seen, smelled or tasted) but can cause disease of varying severity, which may result in death. Foodborne illnesses are most often caused by faults during the handling and preparation of food and a substantial amount of food-borne disease occurs in the home. The domestic kitchen has been described as the 'front line in the battle against food-borne disease', however, domestic kitchens may be inadequately designed, lacking equipment for safe food preparation and may be used for a range of non-food purposes. There is a need for consumers to implement safe procedures during routine handling, preparation and storage of food and liquids, including powdered infant formula, to minimize the potential risk of infection. This is particularly important when the products may be prepared for individuals who could be more vulnerable to infection, such as young infants. Consumer food safety behaviour research studies up to 2003 have previously been reviewed2 and this paper incorporates some areas of that review as well as some information about infant formula. Furthermore, this paper aims to discuss the incidence of food-borne disease associated with the home; and review bacterial contamination in the domestic kitchen, the risks associated with food and infant formula and the issues relevant to consumer education.
INCIDENCE OF FOOD-BORNE DISEASE
Reported incidence of food-borne disease associated with the domestic environment in the UK, Europe, the USA, Canada, Australia and New Zealand is variable and is based on reported outbreaks. Outbreaks of food-borne illness occurring in private homes are less likely to be reported than those in commercial and public premises3 and it is believed that infections attributed to the private home are three times more frequent than those attributed to canteens.4 Given the substantial underreporting of food-borne disease5 and the fact that the majority (>95%) of foodborne disease cases are thought to be sporadic6 and less likely to be investigated by public health authorities, the actual proportion of food-borne disease cases that occur in the home is likely to be much larger than reported outbreak data suggests. …