4Sanitarno inženirstvo / International Journal of Sanitary Engineering Research Vol. 15  1/2022
SANITARNO INŽENIRSTVO / International Journal of Sanitary Engineering Research 2022;15(1):
4-18. DOI: 10.2478/ijser-2022-0002
A survey study to
investigate food handler’s
knowledge, attitudes and
behaviour towards food
safety and food practices
in restaurants in Liverpool 
1Public Health Institute, Faculty of Health, Education and
Community, Liverpool John Moores University
3rd Floor Exchange Station, Tithebarn Street
Liverpool L2 2QP, UK
*Corresponding author:
Mr Graeme Mitchell MCIEH CEnvH, Senior Lecturer
Public Health Institute, Faculty of Health, Education and
Community, Liverpool John Moores University
3rd Floor Exchange Station, Tithebarn Street
Liverpool L2 2QP, UK
Email: g.k.mitchell@ljmu.ac.uk
© 2022 Ben KINGSTON, Graeme MITCHELL. This is an open
access article licenced under the Creative Commons Attribution
NonCommercial- NoDerivs license as currently displayed on  
http://creativecommons.org/licenses/by-nc-nd/4.0/.
Ben Kingston, Graeme Mitchell* 
ABSTRACT
Original scientific article
Food establishments are on the rise in the United Kingdom, producing a wide
variety of cuisine to cater for a variety of tastes in a global market. However, a
significant proportion of the population will experience a foodborne illness at
some point in their lives, and in 2018 alone there were estimated to be 2.4
million food borne illness related cases in the UK [1]with a resulting 180 deaths
per year. Whilst Local Authorities monitor and inspect these establishments
periodically, the importance of those who work within food business cannot be
underestimated.  As such the aim of this research study was to explore food
handlers’ knowledge, attitudes, and behaviour towards food safety and food
handling practices in restaurants within Liverpool. Using both convenience and
snowball sampling, the research employed a quantitative online questionnaire to
gather data from the target population of food handlers. The responses from 52
participants were then analysed using a combination of Microsoft Excel and
SPSS version 28. The results of the study reveal that food handlers in Liverpool
food businesses have a generally satisfactory level of food safety knowledge;
their attitudes expressed demonstrated a strong positive approach and they
engage in safe behaviour. However, the results show some areas of concern:
knowledge surrounding harmful pathogens was lacking; behaviour in relation to
the use of mobile phones in the kitchen and attitudes towards attending work
whilst unwell. Therefore whilst the overall knowledge, attitude and behaviours of
food handlers appears acceptable that does not mean they do not pose risk to
customers. Whilst all participants had received training, this did not always
translate into improved food handling knowledge, attitudes or behaviours.
Training, therefore, must be tailored to reflect the needs to the individual with
the understanding that knowledge, attitudes and behaviours are linked.
Key words: Food safety, foodborne illness, food handler, knowledge, attitude,
practices
Received: 2. 9. 2022
Accepted: 23. 12. 2022
Published: 31. 12. 2022 
Sanitarno inženirstvo / International Journal of Sanitary Engineering Research Vol. 15  1/2022 5
Food-borne illnesses are a substantial burden to public health and the nation’s
economy [2] A large majority of the population will experience a foodborne
illness at some point in their lives, and in 2018 alone there were estimated to be
2.4 million food borne illness-related cases in the UK [1] with a resulting 180
deaths per year caused by foodborne illnesses from 11 pathogens [3] The WHO
regards Salmonella, Campylobacter, and E.Coli among the most common
foodborne pathogens that affect millions of people annually, sometimes with
severe and fatal outcomes [4]. This signifies the importance of making sure food
is not contaminated with potentially harmful bacteria, viruses, toxins, parasites,
and chemicals. Food contamination has far-reaching effects beyond direct health
consequences and has significant economic impacts on society through direct
healthcare costs and indirect costs such as lost productivity. The cost of food-
borne illness is estimated at around €1.14 billion each year, including the impact
of illness on individual well-being, loss of earnings, and the cost of hospital
admission [5].
Food has the potential to become contaminated at any point during its
production, distribution, and preparation, and the primary responsibility lies with
food producers. However, a large proportion of food-borne illness incidents are
caused by food improperly prepared in food establishments and not all food
handlers understand the roles they must play when it comes to protecting the
health of the wider community [4]. There are many opportunities for food
contamination to take place during the preparation process before the food
reaches the consumer. Contamination of food can be compounded by people's
limited knowledge of food safety practices, potentially increasing the risk of
food-borne illnesses. A large proportion of food poisoning is attributed to food
served in restaurants and is completely preventable. Reasons for its occurrence
include: negligence, ignorance, failure to implement good hygiene practices, and
in the case of commercial food premises poor management. Food businesses are
responsible for ensuring that their food is safe under food regulations. It is also
recognised that some food handlers do not always apply these practices, despite
being aware of them, and the reasons why the kitchen can become a risky place
are complex [6]Inappropriate handling practices can cause food contamination
and food-borne illness consequently, impairing the health of the consumer [6].
Research by Griffith and Redmond [7] report that food safety is not just a
microbiological problem but that it also has a major behavioural component. The
top three factors resulting in foodborne illness outbreaks are: poor personal
hygiene, cross-contamination, and time/temperature control. All are directly
related to food-handler error [8].
Food businesses are legally obliged under food regulations to ensure that their
practices minimise the risk of harm to the consumer. They must comply with
food safety legislation to manage food hygiene and food standards to ensure
food is safe to eat. The Food Standards Agency (FSA) [9] reported that
inspections by both Environmental Health in the public sector and audit reports
in the private sector of food businesses have identified significant degrees of
non‐compliance with either statutory requirements or industry codes of practice.
Whereas some non-compliance may only affect food quality, other areas may
have a major impact on food safety.  A more recent survey conducted by the FSA
found that 45% of consumers in England reported that the safety of food served
by UK restaurants and takeaways was a concern to them [5]. 
INTRODUCTION
B. Kingston and G. Mitchell 
Sanitarno inženirstvo / International Journal of Sanitary Engineering Research Vol. 15  1/2022
However, this has not stalled the industry. Spending on restaurants, cafes, and
similar food outlets in the United Kingdom on the rise: in 2019, consumer
spending reached approximately €114 billion [10] In recent years local
authorities have seen a decline in resources (staff, money, time) that aid the
delivery of food safety controls. According to the FSA, between 2012 – 2018
spending on food hygiene controls fell by 19% from €142 million to €114 million
[5]. This relates to staff reduction, at a time when demand for their services is
increasing.
Purpose of the study
While numerous research has identified the importance of food handling
practices [8], it is generally considered that good overall levels of knowledge of
food safety will lead to beneficial behavioural changes involving food practice
[11] Bandura [12] suggests that several constructs underlie the process of
human learning and behavioural change, and one such variable known as
“Outcome Expectations” is the judgement of the likely consequences a
behaviour will produce. In relation to food safety the importance of these
expectations may also be a driver.
However, concerns expressed by Griffith and Clayton [13] suggested that other
factors, including staff attitudes can limit or prevent improvements in staff
practices. The effective application of such knowledge with regards to
influencing attitudes and behaviours are essential in ensuring the consistent
production of safe food in restaurant operations.
This research aims to explicitly look at the knowledge, attitudes, and behaviours
(KAB) of restaurant food handlers in Liverpool to understand and identify any
limitations and inadequacies. KAB is an important theoretical model of health
education, which asserts that behaviour change is affected by knowledge and
attitude [14] Understanding the knowledge, attitudes, and behaviours of food
handlers are important for identifying where the risks to consumers’ health is
coming from and how it may be possible to prioritise actions in order to develop
more efficient training methods in food safety. 
METHODS
Study Design
The research adopted a quantitative methodology approach using a survey
design. Quantitative research has the advantage of determining how common a
phenomenon is, can detect associations between measured variables and make
generalisations [15]. Quantitative data also allows for knowledge, attitudes, and
behaviours to be quantified and the results can be generalised from the sample
population to a larger population.
 
Questionnaires
A descriptive survey design was the chosen method of data collection for this
study. Descriptive surveys can be used to gather demographic, attitudinal and
behavioural information [16] which is concerned with summarizing and
describing data [17]. This fitted in well with the aim of the study as it was also
important to gather participants’ behavioural information with the other
elements. 
6
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7Sanitarno inženirstvo / International Journal of Sanitary Engineering Research Vol. 15  1/2022
The questionnaire was constructed specifically for this research and consisted of
4 distinct sections: demographic information, food safety knowledge; food safety
attitudes and food safety behaviours.
The demographic information section captured information such as the age,
gender and role of the participants. The food safety knowledge section of the
questionnaire included 15 questions, each consisting of 4 possible options (one
option was correct and the other 3 incorrect) and participants could select one
option. The food safety attitudes section of the questionnaire consisted of 10
statements and participants indicated their strength of agreement with each
statement using a Likert scale. Similarly, the food safety behaviours section of
the questionnaire also consisted of 10 statements, with participants indicated
their strength of agreement with each statement using a Likert scale. The
questionnaire was piloted with 3 food handlers before going live to participants
and some minor amendments were made to the questionnaire to ensure greater
clarity. Those participants who took part in the piloting were not included in the
final sample for data analysis.
Sampling Process
Different types of data collection methods were reviewed before deciding upon a
combination of strategies known as convenience and snowball sampling. 
According to Denscombe [18] convenience sampling is a type of nonprobability
sampling strategy that allows the researcher to gather information from
participants that are easily accessible and when there are time and cost
limitations in collecting feedback. Snowball sampling was also used to encourage
respondents to refer the survey on to other potential participants - in theory the
sample then snowballs in the process of accumulation as each located subject
suggests other subjects [19]. Each person that completed the survey was asked
to nominate some other person who they felt would be relevant for the purposes
of the study. This technique is effective for building up a reasonably sized
sample, especially when used as part of a small-scale research project [18]. The
target population was food handlers, aged 18 years and over, and currently
working within the hospitality sector in Liverpool was chosen.
Data Collection
As this research was undertaken as part of the BSc (Hons) Environmental Health
degree programme, prior to collection of any data, ethical approval was obtained
from Liverpool John Moores University. Whilst the secondary researcher is a
qualified Environmental Health practitioner and is currently programme leader
for the degree programme, the primary researcher has a background within the
food industry and has worked extensively in the hospitality sector within
Liverpool. Therefore using existing contacts within the hospitality industry to act
as gatekeepers, a link to the questionnaire was circulated to the employees of
four different food businesses. Participants could then access the link to the
questionnaire, which enabled them to complete it online. The questionnaire was
available in October 2021 for two weeks, and initially the researchers received
forty responses. As previously stated, all participants were asked to forward the
link on to any other food handlers and so a further twelve participants took part
in the survey, as a result of this snowball sampling. In all there were 52
participants in the research. The design of the questionnaire did not allow the
researcher to determine which responses were from convenience sampling
compared to snowball sampling. 
B. Kingston and G. Mitchell 
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Data Analysis
Descriptive data from the questionnaires was analysed using Microsoft Excel. In
order to undertake a statistical analysis of the data, SPSS was used to perform a
chi squared test, which explore the relationship between variables. In these
tests, a p value was generated and if the p value was less than 0.05, it was held
that the relationship between the variables was statically significant.
RESULTS
Demographic data
In total 52 participants were recruited to the research. The majority of
respondents were male 71% (n=37) with female (n=13) and 4% (n=2) preferring
not to say. 
In terms of age distribution, 25 – 34 years olds represent the largest percentage
with 50% (n=26). The second largest age group was the 35 – 44-year-olds with
21% (n=11); the third largest age group was the 18 – 24 year olds with 17%
(n=9) and fourth age group was 45 – 54 year olds with 10% (n=5) and finally the
last group was 55 year olds at 2% (n=1).
For participants, 44% (n=23) are employed in chef de partie roles, 21% (n=11)
are managers in food handling businesses, 11% (n=6) are currently in head chef
roles, 11% (n=6) are sous chefs, 6% (n=3) work as prep chefs and 6% (n=3) are
kitchen porters.
Figure 1 shows the years of experience gained by the participants, with over half
(55%, n=34) having over 10 years’ experience within the industry.
Figure 1: Participants Years of experience as a food handler
Figure 2 shows the most recent training experience the participants have gained.
This training was provided in house by each of the food business involved and
consisted of short online courses for employees to complete
B. Kingston and G. Mitchell 
Question asked  Correct response % Incorrect response %
Food contaminated with food poisoning
bacteria would most likely? 47% 53%
In which of these will bacteria multiply
fastest? 94% 6%
What is the best method of controlling
bacterial growth on food? 33% 67%
Which one of these statements about bacteria
is true? 81% 19%
Which pathogenic bacteria is most commonly
associated with chicken and eggs? 97% 3%
Food poisoning bacteria will multiply readily
between what temperatures? 100% 0%
Food regulations require that you cool hot
food ready for refrigeration within how long? 65% 35%
In the UK, food businesses must inform you
under food law if they use any of the __
allergens as ingredients in the food and drink
they provide.
84% 16%
The temperature in your freezer should be? 92% 8%
Which of the following is not a high-risk food? 85% 15%
A refrigerator has 3 shelves; on which shelf do
you think raw meat should be placed? 97% 3%
At what temperature should food be hot-held
for service? 75% 25%
The best way to wash your hands is by using? 92% 8%
At work, the best way to dry your hands after
washing is? 90% 10%
Food should not be left at room temperature
for more than? 89% 11%
9Sanitarno inženirstvo / International Journal of Sanitary Engineering Research Vol. 15  1/2022
Figure 2: Time since participants’ last food safety training
Participants Food Safety Knowledge
Table 1 below shows participants responses to a range of food safety knowledge
questions. For each question the participant was asked to select one answer
from a number of possible responses, with only one of the responses being
correct. The table shows the percentage of participants who answered each
question correctly (total number of respondents n=52)
Table 1: Participants responses to food safety knowledge questions
B. Kingston and G. Mitchell 
10Sanitarno inženirstvo / International Journal of Sanitary Engineering Research Vol. 15  1/2022
The average score achieved by participants was 78%, with no participant
achieving 100%. The highest individual mark was 93% achieved by 5
respondents and the lowest individual mark was 53% achieved by 2
respondents.
Food handlers have the ability to reduce food poisoning by either preventing the
growth or survival of bacteria or by preventing contamination of foods. The
findings from this study show that, based on the sample that took part in the
questionnaire, the overall food safety knowledge of food handlers was found to
be good. However overall knowledge of bacteria was found to be poor, with 67%
unable to correctly identify the best method of controlling bacterial growth on
food. Over half 53% of food handlers did not know that food poisoning can be
caused by food that looked, smelt, and tasted normal. This mirrors findings by
Walker et al [20] that clearly revealed “food handlers did not understand that
organoleptic assessment of food was insufficient to identify food contaminated
by pathogenic bacteria and therefore they were relying on incorrect physical
attributes for food safety control”. Thirty-five of the respondents were also
unaware of the importance of time/temperature control required when cooling
cooked foods ready for refrigeration. Previous studies support these findings,
and emphasize that a lack of knowledge from exists from food handlers around
time-temperature control of foods [21] [22]. According to the WHO, time and
temperature abuse by food handlers is one of the main reasons for causing
foodborne outbreaks [23].
It is a possibility that the lack of continuous or recent training and food safety
reinforcement may have contributed to the lack of food hygiene knowledge
concerning a number of key questions. When individual knowledge scores were
analysed, this produced an average score of 78% (calculated by looking at the
average score achieved for each participant). This can be considered satisfactory
if compared with the level 1 Basic Food Hygiene Certificate that has a twenty-
question multiply-choice test and carries a 75% pass mark. The importance of
satisfactory food knowledge is expressed by Bas et al [24] “the significant
presence of knowledge is a motivation for adequate practices and justify the
necessity of training. Knowledge allows the handler to modify its practice since
he has motivation to change his behaviour”. However, concerns expressed [13]
suggests that “it is unwise to automatically assume that improved knowledge
will lead to behavioural changes involving improved practice, and also suggested
that other factors, including staff attitudes can limit or prevent improvements in
staff practices”.
Participants Food safety attitudes
The attitudes of participants towards food safety is illustrated in figure 3, in
which participants where asked to indicate the extent to which they agreed with
each statement.
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11Sanitarno inženirstvo / International Journal of Sanitary Engineering Research Vol. 15  1/2022
Figure 3: Participants food safety attitudes.
Additional statistical analysis was undertaken to compare the level of
participant’s knowledge with their attitudes. Only the relationship between the
variables: knowledge score and attitude statement, ‘I do not come into work and
handle food when I am sick’ was proven to be statistically significant, with a p-
value of 0.041 (where p<0.05 is statistically significant)
Food handler attitude is a critical factor that can affect food safety behaviour and
practices leading to foodborne illnesses. Zanin explains that, “attitude can be
seen as the main link between knowledge and practices; food handlers
demonstrating a positive attitude are more likely to translate them into safe
practices” [24]. Therefore, it may be appropriate to say that a food handler
demonstrating a negative attitude may practice risky behaviour. The findings
from this study show that respondents demonstrated significantly positive
results for food safety attitudes. However, there was a more varied response to
the statement, ‘I do not come into work and handle food when I am sick’, with
8% disagreeing and 2% strongly disagreeing. Although this percentage is low it is
still concerning that 10% of food handlers felt it was acceptable for them to work
in food preparation areas while sick. A statistical analysis revealed that the level
of participant’s knowledge was related to this attitude, with those scoring lowest
on the knowledge scale, more likely to attend work when ill. This can be viewed
as a significant given that an infected food handler has been described as a
contributing factor in 12% of outbreaks in England and Wales [25]. FSA best
practice recommends food handlers displaying symptoms of illness should be
excluded from the business until such time as evidence to the contrary is
received, removing the potential risk of contamination of food [9]. 
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These findings are lower than those published by Al-Kandari et al [23] who
evaluated the knowledge, attitudes and practices of 402 food handlers in Kuwait
restaurants and had 24.4% of respondents who did not strongly agree that food
handlers should not come to work when sick. This concept is sometimes termed
as presenteeism, which is used to describe the phenomenon of working through
illness and injury. This was not a surprising result to uncover for the researcher
as social and financial pressures in the workplace can influence people’s
behaviours Hospitality employees not in senior roles are often paid on an hourly
basis and the impact that being sick can have on an individual’s income often
drives them to work even when sick, regardless of the consequences. Dewe,
Keefe and Small [26] propose there may be a number of issues that can prevent
staff absence, including attitudes of managers and work colleagues, sickness
presenteeism may be more likely where staff replacements are hard to find. The
Sainsbury Centre for Mental Health come this with research that suggests “the
larger effect and mental ill-health is particularly likely to be manifest in the form
of presenteeism rather than absenteeism” [27]
Further results gathered suggested that 77%, 75%, and 82% of the respondents
strongly agreed with the following statements respectively: their decisions
impact the safety of food in the workplace, that employers should provide regular
training on food safety/hygiene and one of their main responsibilities is handling
food safety. All of which demonstrate positive attitudes towards food safety
practices but it would be wise to inject a note of caution at this point. Research
[28] indicates that food handlers believe that they are less likely to cause food
borne illness compared to their peers, perhaps giving a false level of their
perceived skills and knowledge. So even with a positive attitude it is critical that
effective training, strong knowledge foundation, awareness and implementation
of good food handling practices is applied. According to Ko [29] “Positive
attitudes are a necessary factor for the transformation of knowledge into
appropriate practices by food handlers, being a mediator between knowledge
and practices”. 
Participant’s behaviours towards food safety practices
The Participant’s behaviours towards food safety practices is illustrated in figure
4, in which participants were asked to indicate the extent to which they agreed
with each statement.
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13Sanitarno inženirstvo / International Journal of Sanitary Engineering Research Vol. 15  1/2022
Figure 4: Participant’s behaviours towards food safety practices
TThe responses to the food safety practices questions were then divided into 2
groups – a group which indicated behaviour that posed a risk to food safety (risky
behaviour) and group which indicated behaviour that would maintain food safety
(safe behaviour). 
The safe behaviour group was comprised of those responses to questions 1-4,
which were never and rarely and forquestions 5-10, which were always and most
of the time. 
The risky behaviour group was comprised of those responses to questions 1-4,
which were sometimes, most of the time and always and for questions 5-10,
which were never, rarely and sometimes. For each question these responses
were added together provide an overall indication of each behaviour.
Table 2 shows the results of the food safety practices questions divided into safe
and risky behaviour, with overall 78% of the answers given displayed safe
behaviour towards food safety practices. While 22% of respondents’ answers
demonstrates risky behaviour towards food safety practices
B. Kingston and G. Mitchell 
14
Food Safety Practices Risky (%) Safe (%)
Do you come into work when sick? 34% 66%
Do you use your phone in food handling
areas? 58% 42%
Do you leave hot food at room temperature
for more than 2 hours? 16% 84%
Do you use your bare hands to handle ready
to eat food? 59% 46%
Do you use separate utensils and cutting
boards when preparing food? 6% 94%
Do you clean work surfaces before and after
handling food? 4% 96%
Do you wash your hands before and after
handling food? 2% 98%
Do you wear protective clothing (hat, gloves,
apron) while handling food? 14% 86%
Do you use colour coded chopping boards
when preparing food? 0% 100%
Do you check the temperature of chillers and
freezers you are using? 18% 82%
Food Safety Practices Significance
Do you come into work when sick? 0.727
Do you use your phone in food handling areas? 0.491
Do you leave hot food at room temperature for more than 2 hours? 0.401
Do you use your bare hands to handle ready to eat food? 0.615
Do you use separate utensils and cutting boards when preparing
food? 0.03
Do you clean work surfaces before and after handling food? 0.067
Do you wash your hands before and after handling food? 0.357
Do you wear protective clothing (hat, gloves, apron) while handling
food? 0.665
Do you use colour coded chopping boards when preparing food? n/a
Do you check the temperature of chillers and freezers you are using? 0.222
Sanitarno inženirstvo / International Journal of Sanitary Engineering Research Vol. 15  1/2022
Table 2 – Food safety behaviours divided into Safe and Risky behaviour. 
Table 3 summarises the relationship between the knowledge scores and all ten
variable behaviour questions. The table shows no significant relationships
between knowledge and the majority of the behaviour variables, generating no
statistical significance except for the question, ‘Do you use separate utensils and
cutting boards when preparing food?’ with a p-value of 0.03 (where p<0.05 is
statistically significant).
Table 3: Statistical analysis for the relationship between participant knowledge
scores and behaviour
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When assessing the overall behaviour of participants their overall scores were
categorized into protective and risky behaviours.  Up to 58% of respondents
demonstrated risky behaviour by using their phones in food preparation areas. In
addition, 59% of them handle ready to eat foods with their bare hands while
working. Only one relationship provided a statistically significant result, which
was between knowledge score and behaviour question, ‘do you use separate
utensils and cutting boards when preparing food?’ which generated a value of
p=0.03This shows that participants’ knowledge translates into safety
behavioural practices regarding cross contamination. For the majority of food
safety behaviours, the results were not statistically significant as the p-value was
greater than p>0.05. In this study it translates to there being no significant
relationship between respondents’ knowledge and their protective behaviours
towards food safety. This mirrors findings by Bas et al [30] who found that good
food safety knowledge does not necessarily result in good handling practices.
Although a study conducted by Abdul-Mutalib et al [31] which evaluated the
knowledge, attitudes and practices of 64 food handlers working in restaurants in
Malaysia found evidence to suggest good knowledge led to good practice. 
It has been suggested that knowledge is the main precursor to behavioural
change and over the years much of the existing training, particularly formal
training is designed using the knowledge, attitudes and practices (KAP) model
[25]. Rennie [32] argues that this model is flawed, and that, “too little emphasis
is placed on changing individuals’ beliefs and attitudes and that the model fails
to take into account cultural, social and environmental issues”. Although training
may bring about an increase in food safety knowledge this does not always
translate in a positive change in food handling behaviour
CONCLUSION
In conclusion, the results of this study show participating food handlers’
knowledge, attitudes and behaviour levels to be satisfactory. This appears to be
in line with the findings of Ahmed et al [33], who similarly established that food
handlers had a good attitude to food safety and practices Therefore, if we applied
these results to the wider population of food handlers across Liverpool,
consumers should be fairly safe when eating out. Even though this is the case
certain aspects of participants’ food safety knowledge are limited and require
improvement, particularly relating to foodborne pathogens. The consequences of
poor food safety knowledge in areas such as these could increase the risk
associated with food borne illnesses. 
The knowledge, attitude and behaviours of food handlers cannot be viewed as
separate entities that can be tackled or addressed in specific ways but are
interconnected. Each variable is interlinked, each affecting the other. What is
clear is that no one method or tactic can be used to drive all three towards
perfect food safety practices. 
These findings support previous research that suggests whilst food safety and
hygiene training should always be encouraged it does not always translate into
improved food handling attitudes or behaviours. There is also the argument put
forth by Clayton et al [25] that food safety and hygiene training will only be
effective if the systems and resources are in place to encourage food handlers to
implement good practice. 
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Individuals learn and adapt in different ways and so any effective training must
be tailored towards the needs to the individual. It is also the case that many
people enter the hospitality and food industry without formal training, so the
value of in-house training cannot be underestimated. The effectiveness of such
training is very much dependent on the attitudes of managers and senior staff
members and the culture of an organisation. Indeed Griffith et al [34] see the
development of a food safety culture, where employees see the responsibility for
ensuring food safety is shared equally is key to ensuring food safety. A
continuous and varied training approach can prove to be most beneficial in these
circumstances. Positivity is key to driving food safety forward, but food handlers
must also be made fully aware of the consequences of risky behaviour. 
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