Comparison of Listeriosis Risk Factors among Three ‘At-risk’ Consumer Groups: Pregnant Women, Older Adults and Chemotherapy Patients

Introduction: Due to weakened immune function, listeriosis is particularly associated with ‘at-risk’ consumers, predominantly affecting pregnant-women, older-adults(aged≥60years)and people receiving chemotherapy. Sporadic incidence of listeriosis is frequently related to refrigerated ready-to-eat(RTE)food products stored/consumed in the domestic kitchen. Consequently, ‘at-risk’ consumers should implement safe food handling/storage practices, including time and temperature control of RTE-foods to reduce the risks associated with L.monocytogenes. Changes in UK epidemiology data indicate reduced pregnancy associated-cases and increased older-adult and chemotherapy associated-cases.

Purpose: Determination and comparison of these ‘at-risk’ consumers’ food-safety reported behaviours and related cognitions may identify listeriosis risk factors and inform the development of targeted food-safety information. Such data is currently lacking in the UK.

Methods: Quantitative survey methods(online/paper-based)ascertained food-safety knowledge, self-reported practices and attitudes towards domestic food handling/storage. The study involved pregnant/post-partum(≤12 months)women(n=40), older-adults(≥60 years)(n=100)and chemotherapy-patients/family-caregivers(n=172).

Results: Awareness of recommended refrigeration temperatures were significantly more widespread(p<0.01)among chemotherapy-patients/family-caregivers(57%) than pregnant-women(25%) and older-adults(13%); attitudes towards recommended refrigeration temperatures were significantly more negative among older-adults(p<0.001). However, self-reported refrigeration practices were not significantly different (p>0.05), with the majority (58-65%) reporting temperatures would ‘never’ be checked. Older-adults were significantly less knowledgeable of ‘use-by’ dates, had more negative attitudes(p<0.001) towards ‘use-by’ dates and were more likely to report consumption of foods beyond the ‘use-by’ date(p<0.005). Although older-adults’ attitudes were significantly more negative towards consuming RTE foods within two days of opening, no significant differences in knowledge and self-reported practices were determined, with majority of all ‘at-risk’ consumers(82-89%) reporting consumption beyond recommendations. Failing to adhere to recommended food storage practices may increase the risks associated with listeriosis among these ‘at-risk’ consumers.

Significance: Significant differences in knowledge, attitudes and self-reported practices between ‘at-risk’ consumers may indicate why reduced pregnancy associated-cases and increased older-adult and chemotherapy associated-cases are reported in the UK. Study findings may be utilised for the development of targeted food-safety education to reduce risks of listeriosis.