Purpose: A knowledge synthesis was conducted, using systematic and transparent methods, to identify, characterize, and summarize published research on the microbial food safety issues and implications associated with farmers’ markets.
Methods: A scoping review was conducted consisting of a comprehensive search strategy (implemented in eight bibliographic databases and verified), relevance screening, article characterization, and data charting. Two subsets of data were prioritized for more detailed systematic review (data extraction and risk-of-bias assessment) and meta-analysis: 1) studies comparing the microbial safety of foods from farmers’ markets vs. other sources; and 2) studies evaluating the use of food safety practices at farmers' markets. Two independent reviewers conducted each step.
Results: The majority of the 82 relevant studies identified used a cross-sectional design (81%) and were conducted in the United States (78%). Most studies (38%; n=32) investigated stakeholder attitudes toward food safety at farmers’ markets. Studies evaluating the use of food safety practices at farmers’ markets (n=13) identified some gaps; for example, the average prevalence of vendor handwashing was 4% (95% CI: 0 to 11%; I2=27%; n=5 studies). Twelve foodborne outbreaks and case reports were identified, resulting in a total of 411 illnesses, 38 hospitalizations, and two deaths from 1994 to 2016. Only five intervention studies were identified.
Significance: This review highlighted the current state of evidence on food safety at farmers’ markets. Key research gaps included studies evaluating food safety practices, barriers, and needs among market vendors and managers, as well as interventions to improve food safety at farmers’ markets.