The correlation between family food handling behaviors and foodborne acute gastroenteritis: a community-oriented, population-based survey in Anhui, China

BACKGROUND: Foodborne acute gastroenteritis is a significant public health concern. Food handling plays a key role in the risk of foodborne acute gastroenteritis. However, research focused on the correlation between foodborne acute gastroenteritis and food handling in the family environment is limited. The purpose of the current study was to determinate the association between food handling behaviors in the family environment and foodborne acute gastroenteritis. METHODS: A cross-sectional investigation was conducted from September 1, 2015 to August 30, 2016 in Anhui Province, China. A multistage stratified cluster sampling method was designed to select subjects. Data on foodborne acute gastroenteritis and food handling were collected via questionnaire survey. RESULTS: Of the 1516 subjects included in the study, 165 (10.9%) reported having experienced symptoms of foodborne acute gastroenteritis in the past 4 weeks. The following behaviors were more prevalent in those that experienced acute gastroenteritis: (1) infrequently thoroughly heating milk (75.6%); (2) infrequently thoroughly heating cooked food purchased from outside (71.3%); (3) infrequently thoroughly heating leftovers stored in the refrigerator (32.5%), and (4) infrequently storing leftovers in the refrigerator (41.6%). A multivariate logistic regression analysis found that foodborne acute gastroenteritis was associated with the following behaviors: (1) often eating raw seafood (P < 0.001, OR = 3.250, 95% CI = 2.136–4.946); (2) often storing raw meat and cooked meat in the same container (P < 0.001, OR = 4.291, 95% CI = 2.722–6.765); (3) infrequently thoroughly heating milk (P < 0.001, OR = 4.665, 95% CI = 2.526–8.617); (4) infrequently thoroughly heating leftovers stored in the refrigerator (P < 0.001, OR = 3.416, 95% CI = 2.139–5.454); (5) infrequently storing leftovers in the refrigerator (P < 0.05, OR = 1.775, 95% CI = 1.169–2.696); and (6) infrequently thoroughly cooking green beans (P < 0.001, OR = 2.859, 95% CI = 1.798–4.545). CONCLUSIONS: Poor food handling behaviors in the family environment are associated with foodborne acute gastroenteritis. Infrequent thorough heating and improper food storage are the most critical risk factors in foodborne acute gastroenteritis.