Consumer food-handling behaviors associated with prevention of 13 foodborne illnesses

To be effective in reducing the incidence of foodborne illness, consumers and food safety educators need information about behaviors that will decrease exposure to foodborne pathogens. A four-round Delphi technique was used to survey nationally recognized experts in food microbiology, epidemiology, food safety education, and food safety policy with the aim of identifying and ranking food-handling and consumption behaviors associated with 13 major foodborne pathogens. The food safety experts ranked behaviors related to keeping foods at safe temperatures as of primary importance in preventing illness caused by Bacillus cereus and Clostridium perfringens and of secondary importance in preventing illness caused by Staphylococcus aureus. The use of a thermometer to cook foods adequately was ranked as of primary importance for the prevention of illness caused by Campylobacter jejuni, Salmonella species, Escherichia coli O157:H7, Toxoplasma gondii, and Yersinia enterocolitica, with the avoidance of cross-contamination being ranked as of secondary importance for most of these pathogens. Hand washing was the top-ranked behavior for the prevention of shigellosis. The avoidance of certain foods that are likely to be contaminated was the top-ranked behavior for the prevention of illnesses caused by Listeria monocytogenes, Noroviruses, and Vibrio species. The expert panel's ranking of behaviors for the reduction of the risk of illness caused by major foodborne pathogens can enable consumers to make informed choices about food consumption and handling behaviors and can guide food safety educators in prioritizing their educational efforts.