Protecting child health by preventing school-related foodborne illnesses: Microbiological risk assessment of hygiene practices, drinking water and ready-to-eat foods in Italian kindergartens and schools

The purpose of this study was to evaluate hygiene and microbial safety in 26 Italian school catering establishments. This involved monitoring the microbiological quality and safety of ready-to-eat foods (n = 395), drinking water (n = 43), food contact surfaces (n = 139), and food handlers (n = 249). Food samples analyses revealed an adequate level of microbiological quality and safety. Of particular concern was the isolation of Salmonella spp. and Listeria monocytogenes in 5.8% and 1.9% of raw vegetable samples, respectively. Escherichia coli counts exceeded the microbial reference standards in 8.6% of soft cheeses samples and in 27.3% of multi-ingredients preparations. Staphylococcus aureus counts exceeded the reference limits only in 5.7% of soft cheeses samples. The hygienic level of food contact surfaces was very high, since only 1.4% of samples showed unacceptable contamination. Concerning the food workers' hands, the results showed that the total bacterial count, coagulase positive staphylococci and Enterobacteriaceae levels exceeded the reference standards in 18.1%, 10.4%, and 11.2% of cases, respectively. The results of the water analyses indicated that 47.8% of the tap water and 10.0% of drinking water samples examined were found to be non-conforming to law limits. In conclusion, since children have a relatively lower immunity than adults, additional safety measures are needed to protect them from foodborne pathogens and high microbial contamination in school lunches. Consequently, our results suggest that various changes in the timing of food preparation and holding temperatures are needed, and good manufacturing practices and HACCP principles need to be applied more rigorously. (C) 2013 Elsevier Ltd. All rights reserved.