Factors associated with safe food handling practices in the food service sector.

Purpose: This review assessed the methodological quality of relevant food safety studies, investigated the available evidences for factors associated with safe food handling practices (SFHPs) and suggested required improvements.

Methods: A systematic literature search was carried out in five databases. A pre-designed criteria was used for data extraction and quality assessment. Evidence synthesis was performed, based on specified criteria.

Results: Out of a total of 1768 published research articles, 28 met the inclusion criteria. Strong evidence suggests that food handlers' knowledge and attitudes on food safety contribute to SFHPs. Moderate evidence exists about the association between a food handler's food safety training and SFHPs. Limited evidence is available about the influence of the educational level and work experience of a food handler, to SFHPs. Insufficient evidence exists about the association between socio-demographic characteristics and SFHPs. A conceptual framework is presented to illustrate the associations.

Conclusions: Available evidence supports that in order to promote SFHPs, responsible authorities should focus on improving on the food safety knowledge and attitudes of food handlers. Future food safety studies may richly benefit from overcoming the methodological shortcomings presented in this review.