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Article

Main Barriers in Reducing Microbial Load in Raw Vegetables Served on Brazilian School Menus

by
Sueny Andrade Batista
1,
Emanuele Batistela dos Santos
2,
Gabriel Teles Câmara
1,
Ester Cardoso Paes Rose
1,
Pedro Tourinho Dantas
1,
Raquel Braz Assunção Botelho
1 and
Verônica Cortez Ginani
1,*
1
Department of Nutrition, College of Health Sciences, University of Brasilia, Brasilia 70910-900, Brazil
2
Department of Food and Nutrition, Faculty of Nutrition, Federal University of Mato Grosso, Cuiabá 78060-900, Brazil
*
Author to whom correspondence should be addressed.
Hygiene 2024, 4(4), 527-539; https://doi.org/10.3390/hygiene4040040
Submission received: 15 November 2024 / Revised: 6 December 2024 / Accepted: 13 December 2024 / Published: 18 December 2024
(This article belongs to the Section Food Hygiene and Safety)
Browse Figure
Review Reports Versions Notes

Abstract

This study assessed raw vegetable sanitizing in Brazilian schools and identified barriers to standards. This experimental and quantitative study was conducted in 12 school food services in the Federal District (Brazil) public primary education institutions. Microbiological analyses were conducted with vegetable samples (before and after sanitizing) and water used in the sanitization process, collected before the process. The Petrifilm® E. coli/Coliform Count Plates and COLIlert methods were used to evaluate vegetables and water samples, and a checklist of good practices was applied in each school food service to identify barriers to proper sanitization. Thirty-five samples of raw vegetables were offered to students, 32 samples of water, and 17 hygiene processes were evaluated. The results indicate that 76.5% (n = 13) of hygiene processes were considered unsatisfactory, with an average increase of 5.8 log CFU g−1 (DV = 7.4) in the initial microbial load in 47.1% (n = 8) of the evaluated processes; moreover, 33.3% (n = 6) of the samples exceeded the tolerable limit, with an average value above 1.5 × 103 CFU/g. Attention to food handler training and necessary organizational changes is essential to ensure safe food and promote healthy student eating habits, highlighting the importance of strengthening basic hygiene practices and following the parameters for sanitizing vegetables.

1. Introduction

The supply of high-fiber foods such as vegetables meets one of the goals established in Brazil’s National School Feeding Program (NSFP). This program constitutes a relevant dietary practice in Brazilian public schools [1]. It is guided by the human right to adequate food, the universality of free school meals, equity, sustainability, continuity, respect for eating habits, and the sharing of responsibility to offer school meals [2].
NSFP recommends that public school food menus be based on fresh foods. The supply of these foods varies from 280 g to 520 g per student during the week for those studying part-time and full-time, respectively [3]. The benefits of this food group are numerous, and its importance in preventing Non-Communicable Chronic Diseases (NCDs), such as diabetes, cardiovascular diseases, hypertension, and obesity, is well documented [4].
However, these foods have been increasingly associated with foodborne outbreaks, with a high occurrence related to Salmonella [5,6,7]. Outbreaks have been linked to the consumption of vegetables worldwide, including in the European Union, China, Brazil, Korea, and the United States. Some of the vegetables involved have been melon [8], watermelon [9], apple, tomato, celery, lettuce, radish, and orange [10,11]. Another study points to the contamination of fresh and ready-to-eat leafy vegetables by pathogenic agents, with a higher prevalence of Staphylococcus aureus, Escherichia coli, and Clostridium perfringens [12]. Elias, Decol, and Tondo [13] pointed to the presence of Foodborne Disease (FBD) outbreaks associated with the consumption of contaminated vegetables in different locations, such as in Latin America between 2000 and 2010 (4.4% of the total number of outbreaks) and in the USA between 1998 and 2007 (33% of the total number of outbreaks and 50% to portions of produce including salads). In New Zealand, in 2012, 716 food poisoning outbreaks occurred, of which 13.3% were attributed to leafy vegetables, 10% to tubers, 6.7% to fruits/nuts, and 3.3% to stem vegetables. Between 2014 and 2023, 2.6% of food outbreaks in Brazil were caused by consuming vegetables and 1.8% by fruits and similar [14].
Contamination and proliferation of pathogens that cause FBD can be associated with a variety of situations, such as the use of untreated manure on agricultural land, runoff from livestock operations, wildlife intrusion, contaminated groundwater, use of animal fertilizers and pesticides, exposure to contaminated water (irrigation or flooding), ineffective pest control, fecal contamination produced by wild and domestic animals, inefficient cold chain, and worker and consumer hygiene [12,15,16].
Reiterating the link between good handling practices and the prevention of FBD, it is essential to focus on the role of handlers in the final stages of the food supply chain. In the case of vegetable contamination, surface contamination is a concern, and adequate hygiene is paramount, given the possibility of disinfecting food inputs. When these practices are not followed, it becomes a critical point, as it is the last barrier to avoiding FBD related to the biological risks of raw vegetables. Brazilian public schools include the final stages of the food supply chain and act as health-promoting environments, which aim to offer these foods through the NSFP. When considering the characteristics (e.g., social vulnerability) and number of students served in school food services (SFSs), Brazilian public schools become a priority environment for public health policies.
In that regard, daycare centers and schools are potential locations for outbreaks of water or food origin. Studies in China, Colombia, Finland, and Southeast/Central Asia [17,18,19,20] corroborate this by pointing out the school environment as the location of relevance, due to the vulnerability of the public (children, individuals in greater social vulnerability) and the proportion that an outbreak can reach, due to the large number of students who attend this environment. In China, between 2003 and 2017, school canteens were responsible for 6.9% of reported outbreaks (n = 1353), 20,077 hospitalizations, and eight deaths [21]. Lim et al. [22], when carrying out an epidemic investigation in elementary schools, identified an outbreak of diarrheal infection by enteropathogenic E. coli in South Korea. In the Brazilian context, the school environment ranked fifth concerning establishments with the highest incidence of outbreaks, responsible for 8.6% (n = 1075) of notifications from 2000 to 2017 [23]. A new analysis that considered the period from 2014 to 2023 ranked third, representing 12.5% (n = 856) of reported outbreaks [14].
As for other aspects in the context of school feeding, the study by Da Cunha et al. [24] evaluated the risk perception of FBD of handlers and directors in SFSs in public schools. The participants perceived a medium risk; there was a negative correlation between age and risk perception, an optimistic bias, non-recognition of the risk associated with the binomial time versus temperature for cooking food, and a lower perceived risk of FBD after eating raw vegetables.
A worrying reality is observed regarding the context presented, with urgent changes needed to guarantee safe food for students. Failure to guarantee food safety (FS) in the school environment violates the Human Right to Adequate and Healthy Food and prevents the guarantee of Food and Nutrition Security. As a result, students will not be able to achieve the school’s primary objective, which consists of human development in its fullness, in conditions of freedom and dignity, and respecting and valuing differences, just as what is recommended by the NSFP [1,2,25,26]. Given the above, this study evaluated the effectiveness of raw vegetable sanitizing offered in Brazilian public schools and identified the main barriers when the established sanitizing parameters were not achieved.

2. Materials and Methods

This experimental and quantitative study was conducted between November 2021 and June 2023 in 12 SFSs in the Federal District (Brazilian Federal Capital) public institutions serving primary education. The school sample was selected by convenience. The participation of schools was conditional on adherence to the “Grow Healthy” and “School Health Program” programs as part of the “Healthy Food and School Food Supply Chain” project.
Microbiological analyses were carried out with vegetable samples (before and after sanitization) and water samples before being used in the sanitization process. The proposal was to evaluate the effectiveness of the vegetable hygiene processes. For this evaluation, the Petrifilm total coliform and COLIlert methods were used for vegetable and water samples, respectively. Samples were collected to carry out microbiological tests, according to recommendations from the American Public Health Association (APHA) [27]. In addition to microbiological analyses and data comparison, a good practices checklist for SFSs was applied to identify barriers to possible failures associated with the hygiene process [28]. Each SFS was visited for three days, and the good practices checklist was applied.

2.1. Microbiological Analysis

For collecting vegetables, the use of SFSs utensils was prioritized. Each analyzed vegetable had a sample collection of 100 g. However, only 25 g were used for analysis. The samples were stored in sterile bags and transported at refrigeration temperature until arriving in the laboratory. After collecting each food, serial dilution was prepared to perform the analyses (10−1, 10−2, and 10−3).
Petrifilm® E. coli/Coliform Count Plates (No. 6404) were inoculated with 1.0 mL aliquots of three dilutions of each food sample collected and prepared according to the manufacturer’s instructions. After incubation at 35 ± 1 °C for 48 ± 2 h, the blue colonies with bubbles were considered E. coli, and the red colonies with bubbles were considered total coliforms. The result was obtained by counting colonies and expressing in CFU/g. According to the microbiological criteria recommended by the International Commission on Microbiological Specification for Food [29], the acceptable standards for food samples are counts below 102 per g/mL for coliforms at 35 °C.
The water samples were analyzed using the COLIlert® method, a qualitative analysis method that allows the simultaneous detection of total coliforms and Escherichia coli. On each visit to the SFS, a 500 mL sample of water used in food production was collected. Sodium thiosulfate was used to inactivate chlorine. All samples were transported at refrigerated temperature to the laboratory. From the collected sample, 100 mL was removed to carry out microbiological analyses, and the remaining amount was for further procedures.
The water samples (100 mL each) received the COLIlert® culture medium and were incubated for 24 h at 35 ± 1 °C. The color change of the sample detects the presence of microorganisms. The yellow color indicates a positive result for total coliforms, and positive fluorescence—with the aid of an ultraviolet lamp—indicates E. coli [30]. The standards established by the Brazilian National Health Surveillance Agency for water samples establish the absence of E. coli or thermotolerant coliforms and the absence of total coliforms in 100 mL of the analyzed product.

Assessment of Hygiene Process

To evaluate the hygiene process for fresh raw food, it was considered that washing followed by disinfection should eliminate ~1 log CFU g−1 [31,32].

2.2. Assessment of Food Safety Practices

This research stage consisted of applying a risk-based checklist approved by the current Brazilian food safety legislation [33]. The National Education Development Fund developed this tool to verify good practices in school food services [28]. Each school was visited three times during the same week, and the results were organized as follows: if non-compliance was detected only on one day, the item was considered non-conforming.

2.3. Statistical Analyses

Descriptive statistical analyses were conducted on the effectiveness of the vegetable’s hygiene, water potability processes (percentage distribution), and the non-compliance presented with the application of the checklist of good handling practices (mean, standard deviation, and percentage distribution).

3. Results

Twelve schools were visited within 142 schools that met the project criteria. The SFSs are in seven of the 35 administrative regions of the Federal District and represent around 8% of the SFSs for primary education in the FD. Thirty-five food samples were collected, and 17 hygiene processes for raw fruits and vegetables were evaluated. In one of the schools (School 9), the sample could not be collected before cleaning, as the inputs had already been handled at the time of collection. However, the hygiene process was recorded according to the handlers’ reports. Regarding water analysis, 32 samples were evaluated.
The results indicate that of the 17 hygiene processes, 76.5% (n = 13) were considered unsatisfactory. There was an average increase of 5.8 log CFU g−1 (SD = 7.4) in the initial microbial load in 47.1% (n = 8) of the food samples. It should be noted that, in School 9, the food was offered only with the cleaning process, with no disinfection. However, among the 18 hygiene processes (considering 17 samples post-sanitization and the only sample collected in the school 9), 66.7% (n = 12) presented counts below 102 per CFU/g for coliforms at 35 °C, which is within the appropriate parameters for consumption. Of these, 8.3% (n = 1) are close to the tolerable limit. The samples that exceeded the tolerable limit, 33.3% (n = 6), presented an average value above the limit of 1.5 × 103 CFU/g (Table 1).
As for the water samples, 81.3% (n = 26) were considered unsatisfactory, with total coliforms. Only one school (8.3%) presented all negative water samples for total coliforms—the only one with total effectiveness in the hygiene process. As for the product dilution parameters and action time, no process was followed correctly (Table 1).
The relevant results to the study regarding the application of the checklist of good practices are presented in Table 2, and critical failures can be observed mainly in personal hygiene, water tanks, vegetables consumed raw, utensils, and environmental hygiene, as well as the presence of documents at operational and managerial levels.
Figure 1 demonstrates some situations in SFSs, where microbiological analysis samples were taken.

4. Discussion

Most schools presented results indicating failures in the vegetable hygiene processes (fruits and vegetables), with a small portion of the hygiene processes being fully effective and meeting the microbiological standard of ready-to-eat food—the presence and levels of total coliforms were highlighted. Total coliforms do not necessarily indicate the presence of pathogenic microorganisms. Their presence, especially at increased levels, indicates the need to change the practices adopted and the hygienic and sanitary quality of water and food [34]. Therefore, the results demonstrate how the hygiene process is conducted, which is the present study’s focus. The results could have generated outbreaks of foodborne illness, as even though they were isolated inadequacies, they could have compromised food safety and consequently affected student performance (school attendance, absence from classes).
Relevant aspects were found when verifying the main nonconformities between the SFSs that obtained effective sanitation processes and the SFSs that obtained a greater increase in microbial load (School 1). It was observed in the mentioned school that the handlers do not undergo periodic medical examinations and that not all of them received food safety training. Therefore, the SFSs must regularly monitor both their health and their practices. Documentary evidence on health status is essential for managers to monitor the conditions of food handlers and prevent FBD outbreaks. In addition, managers must provide continuous training and motivate adequate food handling practices [28,35], directly involving the main link in FBD mitigation—the food handler. In the general context of schools, it is observed that there were no adequate hand hygiene practices in all SFSs—considered the simplest and most basic practice [36]. Even after the critical period of the COVID-19 pandemic, when the importance of hygiene was well discussed, the practice did not become an observed reality [37,38,39]. Notably, this practice is the most important for preventing this group of diseases, and its relevance is supported by studies that show that food handlers are involved in most reported cases of FBD [40,41]. The results of studies by Hardstaff et al. [42], Lubis et al. [43], and Schumann et al. [44] reinforce the importance of hand hygiene and the link between food handlers and foodborne outbreaks. These results indicate poor hand hygiene, as sanitizers quickly inactivate total coliforms [27]. Given the aspects mentioned, the importance of the handler in ensuring food safety (FS) is reinforced; therefore, training in personal hygiene is essential.
Another inappropriate practice observed among food handlers included using ornaments (e.g., earrings)—a practice that potentially causes physical or biological contamination of food. [45]. In this sense, Sultana and Nur [46] identified microorganisms in food handlers’ ornaments and recommended prioritizing personal hygiene care to prevent food contamination and cross-contamination [46]. Although microbiological analyses of ornaments have not been carried out, their use is a potential cause of contamination.
The steps required to sanitize vegetables are another aspect. According to the current Brazilian legislation, the procedures include cleaning, disinfection, and rinsing with drinking water [33]. A study by Santillo and Mourad [47] points out that the appropriate concentration of the sanitizer, the duration of action, and the exposure of the food to the solution are often not used. Inadequate procedures combined with the possible presence of microorganisms can threaten consumer health. Therefore, adapting procedures and ensuring the quality of the water used is essential [48,49]. It should be noted that in all the schools evaluated, no hygiene parameters were respected during the procedure.
Other items identified as non-compliant according to the Codex Alimentarius [50] corroborate the microbiological analyses, such as (i) the defrosting of chicken close to vegetables; (ii) inadequate storage of raw materials and sanitized foods; (iii) excessive exposure of handled foods to room temperature; (iv) cuts on fruit surfaces to accelerate its ripening—which can facilitate contamination; (v) and food not wholly submerged during the hygiene process. Regarding exposure to room temperature, the handling process until distribution did not exceed two hours, except in “School 1”. In this SFS, an increase in microbial load was much higher than that of the other samples evaluated. This reinforces the importance of not extrapolating binomial time versus temperature, which is the primary causal factor of FBD [51].
Given the context of the SFSs, other factors are relevant, such as the lack of potability of the water used in food production. All SFSs are supplied by water from the public service, guaranteeing its potability up to the water meter or delivery point. After that point, the responsibility becomes the customer’s [52]. Although all SFSs have a water reservoir, no documents prove the buildings’ suitability. In only 41.7% (n = 5), the reservoir is cleaned every six months by a specialized company, and only in 8.3% (n = 1) was there a document proving the potability of the water. The results mentioned above are associated with the presence of total coliforms in 88.6% (n = 39) of the water samples, and that only 8.3% (n = 1) of the SFSs presented 100% samples free of the microorganisms investigated highlight the urgency of changes to guarantee water potability and safe food production.
Studies have demonstrated the presence of the coliform group in school water systems [53,54,55]. In similar studies, authors concluded that water contamination by coliforms may be associated with a lack of sanitary routine, disinfection of water reservoirs, and a lack of maintenance on facilities, such as changing filters with adequate frequency, the possible presence of contamination in the pipes, and the poor state of hygiene of the pipes [53,55]. The microbiological quality of water influences the hygienic-sanitary conditions of utensils, equipment, and facilities and, consequently, the quality of prepared food [56]. The studies above and the results found in the present study highlight the importance of sanitary routines, inspection, and monitoring of the quality of water distributed in SFSs.
The failures in good practices observed in this study highlight the need for food handlers training, as Brazilian legislation requires the assurance of FS in SFSs. It is essential to clearly define the sanitation process, including the method, product, concentration, and contact time of the chemical, and/or physical agents used. This information should be included in standardized operating procedures and be easily accessible to handlers. In addition, the good practices manual is essential for managing and operating food services [33,35], and its use must be accompanied by adequate training. In this sense, training and increasing the knowledge of food handlers does not necessarily result in safe food handling procedures [57], highlighting a gap between discourse and adequate hygiene practices [41,58]. This study shows that although 75% (n = 9) of SFSs offer training, failures still occur, such as inadequate washing of hands, vegetables, and utensils (100%, n = 12); inadequate use of non-disposable cloths (83.3%, n = 10); and utensils stored without protection against dust, insects, and rodents (75%, n = 9). Zanin et al. [59] observed that 50% of the reviewed articles indicated that knowledge does not translate into appropriate attitudes or practices. This reinforces the need to rethink training models to overcome this gap.
Possible paths to be followed are suggested by the scientific literature in the area, such as identifying factors of employee commitment, since food handlers with strong commitment are more likely to implement safe food procedures; involve employees not only in the work context but also in decision-making, encouraging them to present suggestions for improvement during the training and learning processes [60]; and structure the knowledge to be transmitted to the food handler to support the formation of risk perception [41,61].
Stedefeldt et al. [62] highlight the collaborative nature of the requirements for effective training, including training leaders in people management and food safety (FS), establishing adequate workload, using language aligned with the handlers’ culture, offering appropriate infrastructure, developing common values between handlers and the company, and providing an adequate environment with the necessary resources. This approach ensures that all stakeholders share responsibility for FS.
In addition, some points, independent of the handlers, must also be addressed, such as the frequency and cleaning of the water tank, the preparation of documents such as good practice manuals, and standardized operating procedures, ensuring the potability of the water, the presence of an exclusive sink for hand hygiene, periodic examinations, ongoing training, and the supervision of food handling [33,63]. The present study identified that many SFSs do not adequately meet these requirements.
The flaws in good handling practices observed through microbiological analyses, the checklist, and photographic records indicate the need for significant changes, even more so when associated with the sociocultural context of public school students and their possible vulnerability. Considering the extent of harmlessness, changes are necessary to prevent FBD and contribute to a healthy diet. Thus, offering vegetables promotes health through high-fiber foods [64]. These contribute to healthy growth and development, the formation of adequate eating habits, and the prevention of another critical group of diseases, NCDs [65,66].

Limitations

Given the sample size, the results should not be generalized. Instead, they serve as a point of attention for developing training programs for food handlers. It is also noted that the results may not necessarily reflect the routine conduct of the food service, as this is a cross-sectional study. Therefore, the results should be used as guidance for improving food safety conditions and not as a diagnosis.

5. Conclusions

This study showed a substantial increase in the initial microbial load of the coliform group in vegetables after the cleaning process and that a considerable portion of the samples is not within the tolerable parameter for consumption, thus highlighting critical flaws in food handling. Added to this reality is the predominant presence of total coliforms in water samples used in food production. Both findings point to the risk of FBD outbreaks, compromising FS, and, consequently, the food security of students and mitigating the benefits those high-fiber foods present. The greater vulnerability of the target audience of these SFSs heightens the risk. Organizational, managerial, and operational changes are urgent, and effective training processes must be understood and formulated so that the adoption of appropriate practices can be implemented and executed.

Author Contributions

Conceptualization, S.A.B., E.C.P.R. and V.C.G.; Data Curation, S.A.B. and G.T.C.; Formal analysis, S.A.B., G.T.C. and P.T.D.; Investigation, S.A.B. and G.T.C.; Methodology, S.A.B. and V.C.G.; Resources, S.A.B.; Visualization; S.A.B.; Writing—Original Draft, S.A.B.; Supervision, V.C.G.; Project administration, V.C.G.; Writing—Review and Editing, E.B.d.S., R.B.A.B. and V.C.G. All authors have read and agreed to the published version of the manuscript.

Funding

This research was funded by FAPDF (No. 166/2020, notice No. 03/2018 Scientific, technological research and innovation spontaneous demand) and DPG/UnB (notice No. /0010/2023).

Institutional Review Board Statement

The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Ethics Committee of the College of Health Sciences of the University of Brasilia—CEP FS/UnB (CAAE No. 02033218.0.0000.0030).

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

Data is contained within the article.

Acknowledgments

The authors would like to thank PPGNH/UnB, CAPES, the State Department of Education of the Federal District for their support, the students who participated in the study, and members of the Research Project “Alimentação saudável e a cadeia produtiva da alimentação escolar”.

Conflicts of Interest

The authors declare no conflicts of interest.

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Hygiene 04 00040 g001
Figure 1. Photos of situations found in public school food services in the Federal District: (1)—Defrosting chicken next to vegetables (papaya and cucumber) on the day’s menu. (2)—Inadequate storage of fruit with other food inputs. (3)—Inadequate storage of fruit with other food inputs. (4)—Sliced fruit exposed to room temperature for more than 1 h in a basin containing water from the production area (directly from the tap, without filtration). (5)—Papaya with cuts to force ripening. (6)—Tangerines are used in cleaning, with units not submerged in the water and product solution.
Figure 1. Photos of situations found in public school food services in the Federal District: (1)—Defrosting chicken next to vegetables (papaya and cucumber) on the day’s menu. (2)—Inadequate storage of fruit with other food inputs. (3)—Inadequate storage of fruit with other food inputs. (4)—Sliced fruit exposed to room temperature for more than 1 h in a basin containing water from the production area (directly from the tap, without filtration). (5)—Papaya with cuts to force ripening. (6)—Tangerines are used in cleaning, with units not submerged in the water and product solution.
Hygiene 04 00040 g001
Table 1. Data on the effectiveness of vegetable cleaning processes with microbial loads before and after cleaning, the process used, conclusion of findings expressed in colony-forming units, process results according to ready-to-eat food, and water quality according to total coliforms in public schools.
Table 1. Data on the effectiveness of vegetable cleaning processes with microbial loads before and after cleaning, the process used, conclusion of findings expressed in colony-forming units, process results according to ready-to-eat food, and water quality according to total coliforms in public schools.
SchoolsVegetablesHygieneSaniti-Zation ProcessConclusionIncrease or Reduction (CFU g−1)Meets the Standard (<102 CFU/g)Presence of Coliforms in Water
BeforeAfter%n
(CFU/g)(CFU/g)
S1Apple3 × 1015.6 × 1021Ineffective/
increasing 		19.6 log No1003
S2Apple<1 × 101 est1 × 1011Ineffective/
increasing 		Unable to calculateYes1003
S3Pineapple<1 × 101 est2 × 1011Ineffective/
increasing 		Unable to calculateYes1003
S3Tangerine2 × 1015 × 1011Ineffective/
increasing 		1.7 log Yes1003
S4Pineapple6.1 × 102>2.5 × 1031Ineffective/
increasing 		3.4 log No1003
S4Tangerine<1 × 101 est<1 × 101 est1EffectiveUnable to calculateYes1003
S5Pineapple1.8 × 102>2.5 × 1031Ineffective/
increasing 		14.3 log No1003
S6Cucumber5 × 1022 × 1021Ineffective/
reduction 		0.7 log No1003
S7Collard greens>2.5 × 103>2.5 × 1031IneffectiveUnable to calculateNo66.72
S7Papaya7.3 × 1029.8 × 1021Ineffective/
increasing 		0.4 log No66.72
S8Cabbage>2.5 × 103>2.5 × 1031IneffectiveUnable to calculateNoNo collectionNo collection
S8Pineapple8.5 × 1021.7 × 1021Ineffective/
reduction 		0.9 log NoNo collectionNo collection
S8Cabbage >2.5 × 103>2.5 × 1031IneffectiveUnable to calculateNoNo collectionNo collection
S9 *Melon-4.7 × 1022Not evaluateUnable to calculateNo1002
S10Collard greens 8.1 × 102<1 × 101 est1Effective/
reduction		1.1 log Yes03
S11Melon1.2 × 102<1 × 101 est1Effective/
reduction		1.1 log Yes1003
S11Pineapple4 × 101<1 × 101 est1Effective/
reduction		1.1 log Yes1003
S12Apple3.4 × 102>2.5 × 1031Ineffective/
increasing 		7.1 log No331
Notes = S: means school; Est: means estimated; CFU: colony-forming unit; Effective: when it eliminates at least 94.5% of the initial microbial load. * At School “nine”, only two water samples were collected. In the other schools, three water samples were collected, except in School 8, where it was not possible to collect any samples due to operational problems. In the sanitization process, 1 means “Water and hypochlorite”, and 2 means “Water”; %: relative percentage of water samples positive for total coliforms; n: number of water samples collected.
Table 2. The main items related to the effective hygiene of raw vegetables obtained from the checklist application for school food services.
Table 2. The main items related to the effective hygiene of raw vegetables obtained from the checklist application for school food services.
Checklist ItemsComplianceChecklist ItemsCompliance
%n%n
Water connected to the public network or alternative network with its potability certified by reports10012Washbasins equipped with running water41.75
Reservoir appropriately built91.711Medical exams are renewed periodically or at least once a year506
Periodic and adequate cleaning of the water reservoir8.31Food handlers work without clinical illness83.310
Adequate hand hygiene by food handlers41.75Handler’s hair is fully protected33.34
Proper hygiene of vegetables consumed raw00Admission of the handler through medical examinations10012
Presence of Good Practice Manual with access to food handlers00All food handlers have formation in FS759
Presence of a document about water potability16.72Products used to clean and disinfect utensils/equipment are registered with the Ministry of Health10012
Presence of Standard Operating Procedures with access to food handler8.31Utensils protected against dust, insects, and rodents253
Proper utensils chemical disinfection253Benches and support tables sanitized after returning to work and/or changing shifts33.34
Proper use of disposable cleaning cloths00Handlers with complete and clean shapes33.34
Presence of a water reservoir66.78Absence of adornments506
Proper use of non-disposable cleaning cloths16.72Absence of a beard91.711
Washbasins for hand hygiene with suitable products81Utensils and equipment dried naturally or without using a cloth66.78
Notes = %: relative percentage of schools that presented adequacy in the item; n: number of schools that presented adequacy in the item.
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Batista, S.A.; dos Santos, E.B.; Câmara, G.T.; Rose, E.C.P.; Dantas, P.T.; Botelho, R.B.A.; Ginani, V.C. Main Barriers in Reducing Microbial Load in Raw Vegetables Served on Brazilian School Menus. Hygiene 2024, 4, 527-539. https://doi.org/10.3390/hygiene4040040

AMA Style

Batista SA, dos Santos EB, Câmara GT, Rose ECP, Dantas PT, Botelho RBA, Ginani VC. Main Barriers in Reducing Microbial Load in Raw Vegetables Served on Brazilian School Menus. Hygiene. 2024; 4(4):527-539. https://doi.org/10.3390/hygiene4040040

Chicago/Turabian Style

Batista, Sueny Andrade, Emanuele Batistela dos Santos, Gabriel Teles Câmara, Ester Cardoso Paes Rose, Pedro Tourinho Dantas, Raquel Braz Assunção Botelho, and Verônica Cortez Ginani. 2024. "Main Barriers in Reducing Microbial Load in Raw Vegetables Served on Brazilian School Menus" Hygiene 4, no. 4: 527-539. https://doi.org/10.3390/hygiene4040040

APA Style

Batista, S. A., dos Santos, E. B., Câmara, G. T., Rose, E. C. P., Dantas, P. T., Botelho, R. B. A., & Ginani, V. C. (2024). Main Barriers in Reducing Microbial Load in Raw Vegetables Served on Brazilian School Menus. Hygiene, 4(4), 527-539. https://doi.org/10.3390/hygiene4040040

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