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Article

Food Safety Practices and Contamination Patterns in University Food Outlets: A Cross-Sectional Study

by
Vivat Keawdounglek
1,*,
Warapon Paenkhokuard
1,
Anuttara Hongthong
1,
Tantika Sinjai
2 and
Siripan Puanmoon
3
1
Program of Environmental Health, School of Health Science, Mae Fah Luang University, Chiang Rai 57100, Thailand
2
School of Health Science, Mae Fah Luang University, Chiang Rai 57100, Thailand
3
Head of Food Outlets Service, Property and Asset Management Office, Mae Fah Luang University, Chiang Rai 57100, Thailand
*
Author to whom correspondence should be addressed.
Hygiene 2026, 6(2), 35; https://doi.org/10.3390/hygiene6020035
Submission received: 24 April 2026 / Revised: 1 June 2026 / Accepted: 5 June 2026 / Published: 9 June 2026
(This article belongs to the Section Food Hygiene and Safety)

Abstract

Background: Food contamination in institutional food service settings remains a significant public health concern, particularly where large numbers of consumers are exposed daily. This study aimed to assess chemical and microbiological contamination, evaluate food handlers’ knowledge, attitudes, and practices (KAP), and identify contamination patterns in university food outlets. Methods: A cross-sectional study was conducted across all 77 food outlets within a university in northern Thailand. KAP was assessed using a structured questionnaire, while chemical and microbiological contamination were evaluated using standard screening methods. Results: Food handlers demonstrated generally high KAP scores; however, microbiological contamination was still observed, including Escherichia coli on food handlers’ hands (27.3%) and food-contact utensils (14.3%), as well as Salmonella spp. in ready-to-eat food (6.5%). In contrast, chemical contamination was rarely detected in screening tests. Moreover, cluster analysis identified four distinct contamination patterns, indicating heterogeneity in contamination risk across outlets. Conclusions: These findings suggest that reported food safety practices may not fully prevent contamination and that food safety management should incorporate both behavioral and operational controls to effectively reduce contamination risks in institutional settings.

Graphical Abstract

1. Introduction

Food contamination in food service establishments continues to be a major public health concern, particularly in institutional settings where large numbers of consumers are exposed daily [1,2]. According to the World Health Organization [3], foodborne diseases affect more than 600 million people each year and cause substantial morbidity and mortality worldwide. In Southeast Asia, the burden remains especially high, highlighting the need for effective food safety control in routine food service operations [4,5,6,7,8].
Previous studies [9,10,11,12,13,14,15,16,17] have commonly focused on either contamination prevalence or food handlers’ knowledge, attitudes, and practices (KAP) as indicators of food safety performance. Although food safety training is generally associated with improved knowledge and awareness, contamination is still frequently reported even in settings where food handlers have received training and comply with hygienic guidelines. These findings suggest that conventional approaches based solely on training and routine inspection may not fully explain how contamination occurs in practice. Moreover, one possible explanation is that contamination risk is not evenly distributed across food outlets, even when similar control measures are implemented. Food contamination can arise from multiple pathways, including chemical hazards introduced during production and distribution, as well as microbiological contamination occurring during food preparation, handling, and contact with surfaces [18]. When food outlets are treated as homogeneous systems, important differences in contamination mechanisms may be overlooked, limiting the effectiveness of uniform food safety interventions [19,20].
University food service environments provide a useful setting for examining these issues, as they operate under structured food safety systems while still reflecting real-world operational complexity [14,21]. In this study, all food outlets within a university setting in northern Thailand were included, where mandatory food safety training and routine monitoring of chemical and microbiological hazards are implemented [22,23]. Despite these measures, repeated detection of both chemical and microbiological contamination has been reported, indicating persistent challenges in controlling contamination during daily operations [24,25].
To better understand variation in contamination patterns, an exploratory analytical approach was applied to food outlets based on observed contamination characteristics. This approach allows for the identification of heterogeneous contamination patterns without assuming causal relationships, thereby supporting a more nuanced interpretation of food safety risks across different outlets. The aim of this study was to (1) assess chemical and microbiological contamination in university food outlets, (2) evaluate food handlers’ knowledge, attitudes, and practices related to food safety, and (3) identify patterns of contamination to better understand potential pathways and inform more targeted food safety control strategies.

2. Materials and Methods

2.1. Study Design and Setting

A cross-sectional study was conducted at a university in northern Thailand from January to October 2025. The study included all 77 food outlets operating on the campus, consisting of 46 ready-to-eat food vendors offering freshly prepared meals and 31 kiosks primarily selling beverages, snacks, desserts, and bakery products. All food outlets operating on campus were required to comply with food safety regulations and hygiene standards established by the university and local public health authorities. Food handlers participated in annual food safety training programs covering hygiene and safe food handling practices. In addition, routine inspections were conducted according to institutional guidelines, including assessments of personal hygiene, health examinations, food handling practices, dress code compliance, and environmental sanitation in food preparation and sales areas. In addition, food outlets included in this study operated independently and were not sub-branches of a single enterprise or franchise network.

2.2. KAP Questionnaire

A structured questionnaire (Table S1) was developed based on the knowledge–attitude–practice (KAP) framework [9,10,11,12,13,14,15,16,17]. The instrument consisted of three domains. The knowledge domain (K) comprised four items assessing participants’ understanding of fundamental food safety and hygiene principles, including proper handwashing procedures, hygienic hand-drying practices, safe storage of cleaned utensils, and awareness of mandatory hygiene training requirements for food handlers. This domain consisted of true/false questions, and the internal consistency reliability assessed using the KR-20 coefficient was 0.704, indicating an acceptable level of reliability [26,27].
The attitude domain (A) consisted of nine items assessing perceptions and beliefs regarding food safety management, consumer protection, safe ingredient selection, compliance with food safety regulations, willingness to invest in hygiene measures, confidence in water safety, and the perceived value of food safety certification and hygienic food preparation. Responses were assessed using five-point Likert scales, and the Cronbach’s alpha coefficient was 0.722 [28,29,30].
Lastly, the practice domain (P) assessed routine food handling and hygiene practices, including safe utensil storage, reheating of ready-to-eat foods, prevention of cross-contamination through separate equipment use, cleaning of vegetables and fruits, and glove use during food handling. Responses were assessed using five-point Likert scales, and the Cronbach’s alpha coefficient was 0.718 [28,29,30].

2.3. Food Sample Collection

Data collection was conducted between September and October 2025 during the academic semester, when all food outlets were in regular operation. Food samples were collected once from each participating outlet after food preparation had been completed and the products were ready for sale to consumers. Sampling was conducted during routine operating hours to reflect typical food handling and serving conditions within the university food outlets.

2.4. Assessment of Microbiological Contamination

Each food outlet was assessed using a standardized microbiological sampling protocol, which included one hand swab from a food handler, one utensil sample, one wiping cloth sample, and one ready-to-eat (RTE) food sample [31]. Initial screening for coliform contamination was performed using SI-2 reagent [7]. Samples showing a positive reaction were further examined for presumptive E. coli using CompactDry™ EC plates (Nissui Pharmaceutical Co., Ltd., Tokyo, Japan) [32]. Presumptive positive colonies were subsequently cultured on Eosin Methylene Blue (EMB) agar (HiMedia Laboratories Pvt. Ltd., Mumbai, India) and incubated under standard conditions (35–37 °C for 24–48 h) to observe characteristic colony morphology [33]. Results were recorded as detected or not detected. In addition, the presence of Salmonella spp. in RTE food samples including rice with curry dishes, boiled pork used for noodle preparation, traditional Thai desserts, and Hainanese chicken rice were examined following the Bacteriological Analytical Manual (BAM) procedures [34]. In addition, all microbiological analyses were performed by the research team at the Medical Science Laboratory, Mae Fah Luang University (MFU), Thailand, in accordance with MFU biosafety protocols and the BAM procedures.

2.5. Assessment of Chemical Contamination

Chemical contamination was assessed using rapid screening test kits following the Thailand SAN PLUS [35] standard for routine food safety surveillance. Target analytes included borax, formalin, salicylic acid, sodium hydrosulfide, and pesticide residues. Because food outlets used different raw materials, the specific chemical tests performed varied depending on the types of food products available at each outlet [36], as presented in Table S2. Pesticide residue testing, particularly in fruit and vegetable samples, was first prioritized to evaluate the effectiveness of raw material cleaning and preparation processes [35]. In addition, all chemical tests were performed according to the manufacturers’ instructions, and the results were recorded qualitatively as either detected or not detected. These screening methods provide indicative results and are not intended for quantitative analysis. All test kits for chemical contamination were conducted and approved by the Department of Medical Sciences, Thailand, following the manufacturer’s instructions. In addition, all chemical analyses were performed by the research team at the Medical Science Laboratory, Mae Fah Luang University (MFU), Thailand, following the manufacturer’s instructions.

2.6. Statistical Analysis

Descriptive statistics were used to summarize KAP scores and contamination outcomes. KAP scores were standardized using Z-scores [37] and calculated using IBM-SPSS version 30 (IBM Corp., Armonk, NY, USA) to allow comparability across domains. Moreover, microbiological and chemical contamination outcomes were treated as binary variables (detected/not detected). An exploratory two-step cluster analysis [38] was performed to identify patterns of contamination across food outlets. This approach was used to describe heterogeneity in contamination patterns and was not intended for hypothesis testing or causal inference.

3. Results

3.1. Knowledge, Attitude, and Practice Level

Overall, food handlers demonstrated high levels of food safety knowledge, attitudes, and practices. The mean knowledge score was 0.81 (out of 1.00), while the mean attitude and behavior scores were 4.65 and 4.80 (out of 5.00), respectively (Table 1, Table 2 and Table 3). For the knowledge domain, high levels of awareness were observed for basic hygiene practices, such as proper utensil storage and avoiding the use of soiled wiping cloths for hand drying. However, knowledge related to correct handwashing procedures was comparatively lower, with only 37.7% of participants answering correctly. In addition, attitude scores were generally high across all items, indicating strong positive perceptions toward food safety. The highest score was observed for the belief that customers should be treated as members of one’s own household, while perceptions related to the safety of potable water showed comparatively lower scores. Similarly, reported food safety behaviors were consistently high. Most participants reported performing key practices regularly, including reheating ready-to-eat (RTE) food and using separate equipment for raw and cooked foods.

3.2. Chemical and Microbiological Contamination

The prevalence of chemical and microbiological contamination is presented in Table 4. This table shows that chemical contamination was rarely detected in the screening tests, with formalin and pesticide residues identified in 2.6% and 1.3% of the samples, respectively. No borax, salicylic acid, or sodium hydrosulfide contamination was detected. In contrast, microbiological contamination was more frequently observed. In this study, E. coli contamination was detected on food handlers’ hands in 27.3% of outlets and on food-contact utensils in 14.3% of outlets. Meanwhile, no contamination was detected on wiping cloth samples. In addition, Salmonella spp. was identified in 6.5% of RTE samples. Despite generally high KAP scores, microbiological contamination was still observed across several outlets.

3.3. Cluster-Based Patterns of Food Contamination

From the cluster analysis, four clusters of food establishments were identified, each showing distinct contamination patterns in relation to KAP scores (Table 5). Firstly, cluster 1 (n = 15) was characterized by relatively high KAP scores but consistent E. coli contamination on food handlers’ hands (100.0%), with no detectable chemical contamination. Next, cluster 2 (n = 11) showed lower knowledge and attitude scores but relatively higher behavior scores. This cluster was characterized by E. coli contamination on food-contact utensils (100.0%) and on food handlers’ hands (36.4%), along with occasional detection of Salmonella spp. in RTE food (9.1%). Cluster 3 (n = 18) exhibited both chemical and microbiological contamination, including formalin detection (11.1%) and a higher prevalence of Salmonella spp. in RTE food (22.2%). This cluster also showed lower KAP scores compared with the overall mean. Finally, cluster 4 (n = 33) demonstrated minimal contamination, with no detectable E. coli or Salmonella spp., and generally higher KAP scores. However, low levels of pesticide contamination (3.1%) were observed in this group. Overall, these findings indicate heterogeneity in contamination patterns across food outlets, even in the presence of generally good food safety practices.

4. Discussion

This study examined chemical and microbiological contamination in university food outlets and identified distinct contamination patterns using an exploratory clustering approach. Overall, chemical contamination was rarely detected in screening tests, whereas microbiological contamination was observed in several outlets. Four clusters were identified, each reflecting different contamination characteristics and KAP profiles.
The low detection rate of chemical hazards may reflect effective control at earlier stages of the food supply chain. However, the use of rapid screening methods may also limit sensitivity in detecting low-level contamination, as reported in previous studies by Hollender et al. [39] and Lebelo et al. [40]. Similar concerns have also been highlighted in previous studies [36,41]: the absence of detectable chemical hazards should be interpreted with caution.
Microbiological contamination was observed across multiple clusters, particularly on food handlers’ hands and food-contact utensils. Similar findings were reported by Hossain et al. [5], Saifullah et al. [17], and Ay & Doğan [42], suggesting a possible association between KAP levels and contamination patterns. However, contamination was also detected in clusters with relatively high KAP scores, indicating that reported knowledge and practices alone may not fully explain contamination occurrence [15,43]. As can be seen in the previous studies of Ibrahim et al. [44], Sheehama et al. [45], and Sandu et al. [46], this discrepancy highlights the importance of operational and environmental factors, such as hand hygiene practices, utensil sanitation, and water quality, in influencing contamination risk.
From a food safety perspective, these findings suggest that training-based approaches alone may be insufficient to control contamination. Greater emphasis should be placed on process-level controls and routine verification activities, including monitoring of hand hygiene, food-contact surfaces, and environmental sanitation. Consistent with previous studies [20,47,48,49,50], the identification of distinct contamination patterns across clusters also indicates that targeted, context-specific interventions may be more effective than uniform control strategies.
However, this study has several limitations. First, it was conducted in a single university setting, which may limit the generalizability of the findings to other contexts. Second, chemical contamination was assessed using rapid screening methods, which may have limited sensitivity for detecting low-level residues. Third, the knowledge domain included a limited number of items following refinement during instrument validation to ensure acceptable internal consistency. Although this improved reliability, it may have reduced the comprehensiveness of knowledge assessment. Fourth, the study did not specifically compare contamination patterns between different types of food outlets, such as ready-to-eat vendors and kiosks. Finally, the cross-sectional design limits the ability to infer causal relationships between KAP and contamination patterns. Future studies should further investigate outlet-specific contamination risks and operational factors. In addition, the use of more advanced analytical techniques, including high-performance liquid chromatography (HPLC) for confirmatory analysis and the comparison of food contamination between the several types of university food outlets should be addressed in a further study.

5. Conclusions

This study demonstrates that microbiological contamination remains present in university food outlets despite generally high levels of food safety knowledge, attitudes, and practices among food handlers. The identification of distinct contamination patterns highlights that contamination risk is not uniformly distributed across outlets and may be influenced by both behavioral and operational factors. These findings suggest that food safety management should move beyond training-based approaches and incorporate process-level controls, including improved hand hygiene practices, utensil sanitation, and environmental monitoring. In addition, the use of cluster-based analysis may provide a useful framework for identifying context-specific contamination patterns and guiding targeted interventions. Overall, an integrated approach that combines behavioral, operational, and environmental strategies is essential for improving food safety in institutional food service settings. Future studies should further evaluate the effectiveness of targeted, cluster-informed interventions in reducing contamination risks.

Supplementary Materials

The following supporting information can be downloaded at: https://www.mdpi.com/article/10.3390/hygiene6020035/s1; Table S1: Questionnaire; Table S2: Type of raw materials sampling for chemical analysis with the test-kits.

Author Contributions

Conceptualization, V.K.; methodology, V.K., W.P., and T.S.; software, V.K. and A.H.; validation, S.P. formal analysis, W.P. and T.S..; investigation, V.K.; resources, V.K., T.S., and S.P.; data curation, V.K. and A.H.; writing—original draft preparation, V.K.; writing—review and editing, W.P., T.S., and A.H.; visualization, V.K.; supervision, V.K.; project administration, V.K.; funding acquisition, V.K. All authors have read and agreed to the published version of the manuscript.

Funding

This study was financially supported by the fundamental fund (FF) from the Thailand Science Research and Innovation (TSRI) in the financial year 2025 (research grant NO.: 682A05018). Moreover, the article processing charge (APC) was supported by Mae Fah Luang University.

Institutional Review Board Statement

The study was conducted in accordance with the Declaration of Helsinki and approved by the Mae Fah Luang University Ethics Committee in Human Research (experimental protocol no. EC 24197-18, COE 207/2024, and the date of approval was 6 November 2024), which reviewed the protocol in compliance with the international guidelines, including the Declaration of Helsinki, the Belmont Report, CIOMS Guidelines, and the International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use-Good Clinical Practice (ICH GCP). In addition, the protocol of microbiological analysis was approved by the Sub-Institutional Biosafety Committee 2, Mae Fah Luang University (Submission No. MFU-IBC2-BR2-25-0005, and the date of approval was 30 May 2025).

Informed Consent Statement

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

Data Availability Statement

The original contributions presented in this study are included in the article/Supplementary Material. Further inquiries can be directed to the corresponding author.

Acknowledgments

The authors would like to thank the food handlers at the University of Northern Thailand, who volunteered their time to participate in this study. The authors also acknowledge the Property and Asset Management Office, Mae Fah Luang University, for facilitating several kinds of resources, including a laboratory and a vehicle for sample collection.

Conflicts of Interest

The authors declare that there were no conflicts of interest.

Abbreviations

The following abbreviations are used in this manuscript:
RTEReady-to-eat food
KAPKnowledge, attitude, and practice
EMBEosin methylene blue agar

References

  1. Subedi, D.; Gautam, A.; Kandel, M.; Thakur, S.; Jyoti, S. Food safety knowledge, attitudes, practices, and associated factors: A cross-sectional survey of Nepalese consumers. Food Humanit. 2025, 5, 100793. [Google Scholar] [CrossRef] [Scilit]
  2. Ajekiigbe, V.O.; Ogieuhi, I.J.; Anthony, C.S.; Bakare, I.S.; Anyacho, S.; Ogunleke, P.O.; Agbo, C.E. Consumer behavior and its role in E. coli outbreaks: The impact of fast-food preparation practices and hygiene awareness. Trop. Med. Health 2025, 53, 27. [Google Scholar] [CrossRef] [Scilit]
  3. World Health Organization. Food Safety. 2025. Available online: https://www.who.int/news-room/fact-sheets/detail/food-safety (accessed on 10 December 2025).
  4. World Health Organization. Burden of Foodborne Diseases in WHO South-East Asia Region. 2025. Available online: https://www.who.int/southeastasia/activities/burden-of-foodborne-diseases-in-who-south-east-asia-region (accessed on 10 December 2025).
  5. Hossain, N.M.I.; Jony, M.E.; Bakshi, P.; Rana, J.; Ferdoush, Z.; Shomrat, M.G.M.; Islam, M.R. Food safety knowledge, attitude, and hygiene practices (KAP) and microbial quality of meat in slaughterhouses: A study in Gopalganj, Bangladesh. J. Agric. Food Res. 2025, 21, 101914. [Google Scholar] [CrossRef] [Scilit]
  6. The ASEAN Secretariat. Enhancing and Integrating Regional Food Safety to Face the Changing Landscape of Food System and Health Threats. 2023. Available online: https://asean.org/wp-content/uploads/2024/09/ASCC-RD_Flagship-Report_Health4-2024.pdf (accessed on 10 December 2025).
  7. Keawdounglek, V.; Paenkhokuard, W.; Hongthong, A. Food Safety Management in Primary Schools for Ethnic Groups in Northern Thailand: A PDCA-Based Evaluation. Int. J. Environ. Res. Public Health 2025, 22, 1438. [Google Scholar] [CrossRef] [Scilit]
  8. Johnson, O.; Wan-Hafiz, W.-Z.-S.; Mahyudin, N.A.; Jaafar, S.N. Food safety training influence on food service workers’ knowledge and compliance to Malaysia food hygiene regulations 2009. Food Res. 2017, 7, 240–254. [Google Scholar] [CrossRef] [Scilit]
  9. Begum, M.; Alam, M.J.; Parikh, P.; De Steur, H. Understanding food safety knowledge, attitude, and practices of consumers and vendors: An umbrella review. Food Control 2024, 171, 111094. [Google Scholar] [CrossRef] [Scilit]
  10. Osman, A.M.; Hassan-Kadle, A.A.; Osman, M.M.; Moallim, Q.A.; Oliveira, C.J.; Vieira, R.F. Food safety knowledge, attitudes, and practices among Somali women: A one health approach addressing household food handling challenges. Food Res. Int. 2025, 223, 117910. [Google Scholar] [CrossRef] [Scilit]
  11. Ertas, M.; Bulut-Solak, B. Food safety knowledge among food handlers in Safranbolu, Turkey. Euro-Mediterr. J. Environ. Integr. 2025, 10, 3543–3553. [Google Scholar] [CrossRef] [Scilit]
  12. Adebayo, K.A.; Fagade, O.E.; Oloruntoba, E.O.; Lawal, R.R.; Oyedele, L.O. Assessing environmental hygiene and food safety knowledge, attitudes and practices in boarding schools’ food service establishments in Ibadan, Nigeria. Food Humanit. 2026, 6, 100992. [Google Scholar] [CrossRef] [Scilit]
  13. Hiko, A.; Shelfa, G.; Girma, S.; Yusuf, Y.; Tadesse, D.; Dedefo, A. Effects of training on butcheries meat sanitation practices in Eastern Ethiopia: Food safety indicator cases of Staphylococcus aureus. J. Food Prot. 2025, 88, 100468. [Google Scholar] [CrossRef] [Scilit]
  14. Sultana, T.; Paul, M.; Murshed, H.M.; Akter, S.; Adan, I.A.; Yeon, S.J.; Oh, D.H. Assessment of food safety knowledge, attitude, and practices (KAP) among university students: A cross-sectional study at Bangladesh Agricultural University. Food Humanit. 2025, 5, 100671. [Google Scholar] [CrossRef] [Scilit]
  15. Ciano, E.M.N. Hygiene knowledge, attitudes, and practices (KAP) of retailers and their association to E. coli contamination in pork sold in La Trinidad, Benguet. Mt. J. Sci. Interdiscip. Res. 2025, 85, 59–75. [Google Scholar] [CrossRef] [Scilit]
  16. Kaddouri, M.; El Alia, O.A.; Zine-Eddine, Y.; Alqahtani, A.S.; Bouhrim, M.; Galman, A.; Boutoial, K. Evaluation of food safety practices and microbiological quality of street foods in Marrakech, Morocco. Food Sci. Nutr. 2025, 13, e70322. [Google Scholar] [CrossRef] [Scilit]
  17. Saifullah; Rahman, A.; Roy, C.K.; Akter, S.; Chowdhury, S.R.; Dash, B.K. Assessment of food safety knowledge, practices, and microbial hazards in street-vended foods: A case study from Jashore Town, Bangladesh. Food Saf. Health 2025, 4, 207–219. [Google Scholar] [CrossRef] [Scilit]
  18. Aljasir, S.F. Food safety knowledge and practices among food handlers and consumers in Gulf countries: An integrative review. Glob. Public Health 2023, 18, 2287584. [Google Scholar] [CrossRef] [Scilit]
  19. Rosales, A.P.; Linnemann, A.R.; Luning, P.A. Food safety knowledge, self-reported hygiene practices, and street food vendors’ perceptions of current hygiene facilities and services: An Ecuadorian case. Food Control 2023, 144, 109377. [Google Scholar] [CrossRef] [Scilit]
  20. Teffo, L.A.; Tabit, F.T. An assessment of the food safety knowledge and attitudes of food handlers in hospitals. BMC Public Health 2020, 20, 311. [Google Scholar] [CrossRef] [Scilit]
  21. Konstantinou, G.N.; Pampoukidou, O.; Sergelidis, D.; Fotoulaki, M. Managing food allergies in dining establishments: Challenges and innovative solutions. Nutrients 2025, 17, 1737. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  22. Keawdounglek, V.; Siriratruengsuk, W.; Fakkaew, K.; Sudsandee, S.; Laor, P. The effectiveness of GMPs for control of food hazard in Mae Fah Luang University, Thailand. SUT J. Sci. Technol. 2021, 28, 070027-1–070027-7. Available online: https://www.thaiscience.info/Journals/Article/SJST/10994346.pdf (accessed on 10 December 2025).
  23. Department of Disease Control. Annual Epidemiological Surveillance Report 2023. 2023. Available online: https://apps-doe.moph.go.th/boeeng/annual/Annual/Annual%20Report%202023.pdf (accessed on 10 December 2025).
  24. McSwane, D.; Rue, N.R.; Linton, R. Essentials of Food Safety and Sanitation, 4th ed.; Pearson Education: New Jersey, NJ, USA, 2005. [Google Scholar]
  25. Gupta, R.K.; Dudeja, P.; Minhas, A.S. Food Safety in the 21st Century: Public Health Perspective; Academic Press: London, UK, 2016. [Google Scholar]
  26. Appolloni, L.; Valeri, D.; D’Alessandro, D. Knowledge on indoor air quality (K-IAQ): Development and evaluation of a questionnaire through the application of item response theory. Atmosphere 2025, 16, 1163. [Google Scholar] [CrossRef] [Scilit]
  27. Lin, C.-H.; Liu, M.-Y. Development and validation of the eating support for healthcare aides (ESHA) questionnaire in long-term care. Nutrients 2025, 17, 3235. [Google Scholar] [CrossRef] [Scilit]
  28. Liu, M.; Lin, Q.; Zhang, S.; Feng, M.; Wu, G. Reliability test of the oral nutritional supplement adherence assessment scale for colorectal cancer patients. Eur. J. Cancer Care 2025, 2025, 8572726. [Google Scholar] [CrossRef] [Scilit]
  29. Xin, B.; Zhao, Q.; Chen, D.; Ma, D.; Su, H.; Jiang, W. Development and validation of an information–motivation–behavioral skills questionnaire for colorectal cancer prevention in a high-risk population. BMC Psychol. 2025, 13, 375. [Google Scholar] [CrossRef] [Scilit]
  30. Udoh, E.E.; Musa, A.Z.; Olowolafe, T.A.; Jaiyeola, T.M. Psychometric performance of the WHOQOL-HIV BREF among people living with HIV on antiretroviral therapy in Bauchi State, Nigeria. PLoS ONE 2025, 20, e0338095. [Google Scholar] [CrossRef] [Scilit]
  31. U.S. Food and Drug Administration. Bacteriological Analytical Manual, Chapter 1: Food Sampling/Preparation of Sample Homogenate. 2022. Available online: https://www.fda.gov/food/laboratory-methods-food/bam-chapter-1-food-samplingpreparation-sample-homogenate (accessed on 10 December 2025).
  32. Mizuochi, S.; Nelson, M.; Baylis, C.; Green, B.; Jewell, K.; Monadjemi, F.; Chen, Y.; Salfinger, Y.; Fernandez, M.C. Matrix Extension Study: Validation of the Compact Dry EC Method for Enumeration of Escherichia coli and Non-E. coli Coliform Bacteria in Selected Foods. J. AOAC Int. 2016, 99, 451–460. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  33. American Society for Microbiology. Eosin-Methylene Blue Agar Plates Protocol. 2007. Available online: https://asm.org/asm/media/protocol-images/eosin-methylene-blue-agar-plates-protocol.pdf (accessed on 1 June 2026).
  34. U.S. Food and Drug Administration. Bacteriological Analytical Manual, Chapter 5: Salmonella. 2024. Available online: https://www.fda.gov/food/laboratory-methods-food/bam-chapter-5-salmonella (accessed on 10 December 2025).
  35. Department of Health. The SAN PLUS Standard. 2008. Available online: https://foodsan.anamai.moph.go.th/th/san/download?id=114841&mid=38922&mkey=m_document&lang=th&did=34264 (accessed on 10 December 2025). (In Thai)
  36. Keawdounglek, V.; Chaiyakul, S.; Aunkham, A. The development of the “Laab Nuer Model” for food safety management in handling traditional Lanna cuisine in Thailand. PLoS ONE 2025, 20, e0331933. [Google Scholar] [CrossRef] [Scilit]
  37. Wahi, M.; Pezzullo, J. Biostatistics; John Wiley & Sons: New Jersey, NJ, USA, 2024. [Google Scholar]
  38. Wayne, W.D.; Cross, C.L. Biostatistics: Basic Concepts and Methodology for the Health Sciences; John Wiley & Sons: New Jersey, NJ, USA, 2014. [Google Scholar]
  39. Hollender, J.; Schymanski, E.L.; Ahrens, L.; Alygizakis, N.; Béen, F.; Bijlsma, L.; Brunner, A.M.; Celma, A.; Fildier, A.; Fu, Q.; et al. NORMAN guidance on suspect and non-target screening in environmental monitoring. Environ. Sci. Eur. 2023, 35, 75. [Google Scholar] [CrossRef] [Scilit]
  40. Lebelo, K.; Malebo, N.; Mochane, M.J.; Masinde, M. Chemical contamination pathways and the food safety implications along the various stages of food production: A review. Int. J. Environ. Res. Public Health 2021, 18, 5795. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  41. Hassan, M.H.; Khan, R.; Andreescu, S. Electrochemical science advances. Electrochem. Sci. Adv. 2022, 2, e2100184. [Google Scholar] [CrossRef] [Scilit]
  42. Ay, M.; Doğan, M. Effect of street food vendors’ food safety knowledge, attitudes, and practices on the microbiological quality of street foods. Int. J. Gastron. Food Sci. 2025, 39, 101114. [Google Scholar] [CrossRef] [Scilit]
  43. Choudhury, S.; Medina-Lara, A.; Bi, A.Z.; Ricarte, P.; Morrish, N.; Veettil, P.C. Food safety knowledge, attitude, and practices (KAP) of urban consumers in low-income and lower-middle-income countries: A scoping review. Foods 2026, 15, 1381. [Google Scholar] [CrossRef] [Scilit]
  44. Ibrahim, M.S.I.; Hafez, A.E.E.; El Bayomi, R.M.; Mahmoud, A.F.A. Review on camel meat: Health benefits, chemical contaminants, health risks, and mitigation strategies. Egypt. J. Vet. Sci. 2025, 56, 515–526. [Google Scholar] [CrossRef] [Scilit]
  45. Sheehama, W.L.N.; Singh, T. Food safety in informal markets: How knowledge and attitudes influence vendor practices in Namibia. Int. J. Environ. Res. Public Health 2025, 22, 631. [Google Scholar] [CrossRef] [Scilit]
  46. Sandu, A.M.; Chifiriuc, M.C.; Vrâncianu, C.O.; Cristian, R.E.; Alistar, C.F.; Constantin, M.; Paun, M.; Alistar, A.; Popa, L.G.; Popa, M.I.; et al. Healthcare-associated infections: The role of microbial and environmental factors in infection control—A narrative review. Infect. Dis. Ther. 2025, 14, 933–971. [Google Scholar] [CrossRef] [Scilit]
  47. Labrović, J.A.; Petrović, N.; Anđelković, J.; Meršnik, M. Patterns of behavioral engagement in an online English language course: Cluster analysis. J. Comput. High. Educ. 2025, 37, 1–26. [Google Scholar] [CrossRef] [Scilit]
  48. Tesso, M.W.; Deti, M.; Jemal, T.; Dadi, D.; Gure, A.; Nasir, D.; Roba, H. Food hygiene practices and associated factors among food handlers in food establishments of Jimma City, Southwest Ethiopia. PLoS ONE 2025, 20, e0321222. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  49. Xu, Q.; Amonsin, A.; Jeamsripong, S. Knowledge, attitudes, and practices (KAP) of animal health staff and farmers towards brucellosis control in sheep and goat in China: A cross-sectional study. PLoS ONE 2025, 20, e0318270. [Google Scholar] [CrossRef] [Scilit]
  50. Saw, Z.K.; Yuen, J.J.X.; Ashari, A.; Ibrahim Bahemia, F.; Low, Y.X.; Nik Mustapha, N.M. Forward–backward translation, content validity, face validity, construct validity, criterion validity, test–retest reliability, and internal consistency of a questionnaire on patient acceptance of orthodontic retainer. PLoS ONE 2025, 20, e0314853. [Google Scholar] [CrossRef] [Scilit] [PubMed]
Table 1. The knowledge level of the food handlers in university food outlets.
Table 1. The knowledge level of the food handlers in university food outlets.
Knowledge ItemsNumber of Food Outlets = 77Average
Frequency (Percentage)
IncorrectCorrect
K1. There are six steps in good handwashing.48
(62.3)
29
(37.7)
0.38
K2. A soiled wiping cloth should not be utilized for hand drying.5
(6.5)
72
(93.5)
0.94
K3. Clean utensils should be stored in a covered, enclosed area at a minimum height of 60 cm above the floor.5
(6.5)
72
(93.5)
0.94
K4. Participation in hygiene training for food workers is mandatory and vital.0 (0.0)77
(100.0)
1.00
Overall Average0.81
Table 2. The attitude level of the food handlers in university food outlets.
Table 2. The attitude level of the food handlers in university food outlets.
Attitude ItemsNumber of Food Outlets = 77Average
Frequency (Percentage)
1 (Strongly Disagree)2 (Disagree)3 (Moderate)4 (Agree)5 (Strongly Agree)
A1. You believe that consumers gain advantages from food safety inspections.0 (0.0)0 (0.0)1
(1.3)
11
(14.3)
65
(84.4)
4.83
A2. Customers are consistently regarded as integral residents of your own household.0 (0.0)0 (0.0)0 (0.0)4
(5.2)
73
(94.8)
4.95
A3. Even if they are more expensive, you choose the safest ingredients accessible. 0 (0.0)0 (0.0)2
(2.6)
25
(32.5)
50
(64.9)
4.62
A4. You consider that the existing approaches to food safety management are appropriate. 0 (0.0)0 (0.0)3
(3.9)
15
(19.5)
59
(76.6)
4.73
A5. You consistently recall and follow the food safety regulations learned during training whenever you prepare meals. 0 (0.0)0 (0.0)1
(1.3)
9
(11.7)
67
(87.0)
4.86
A6. You are willing to allocate funds for supplies or apparatus to ensure food safety and hygiene, even if it requires personal expenditure.0 (0.0)0 (0.0)3
(3.9)
14
(18.2)
60
(77.9)
4.74
A7. You are assured of the safety and purity of potable water.6
(7.8)
4
(5.2)
32
(41.6)
21
(27.3)
14
(18.2)
3.43
A8. Securing food safety certification enhances your restaurant’s credibility with patrons. 0 (0.0)0 (0.0)3
(3.9)
11
(14.3)
63
(81.8)
4.78
A9. You are committed to maintaining high standards for safe and hygienic food preparation for customers. 0 (0.0)0 (0.0)0 (0.0)6
(7.8)
71
(92.2)
4.92
Overall Average4.65
Table 3. The practice level of a food handler in university food outlets.
Table 3. The practice level of a food handler in university food outlets.
Practice ItemsNumber of Food Outlets = 77Average
Frequency (Percentage)
1 (Never)2
(1–2 Days per Week)
3
(3–4 Days per Week)
4
(5–6 Days per Week)
Everyday
P1. Store washed plates and utensils at least 60 cm above the floor.1
(1.3)
0
(0.0)
3
(3.9)
5
(6.5)
68
(88.3)
4.81
P2. Reheat your RTE food every two or three hours.0
(0.0)
0
(0.0)
1
(1.3)
1
(1.3)
75
(97.4)
4.96
P3. Use separate cutting boards and knives for raw foods and cooked foods.1
(1.3)
0
(0.0)
3
(3.9)
3
(3.9)
70
(90.9)
4.83
P4. Use baking soda to clean vegetables and fruits.4
(5.2)
1
(1.3)
2
(2.6)
9
(11.7)
61
(79.2)
4.58
P5. Wear gloves when handling food.1
(1.3)
0
(0.0)
2
(2.6)
5
(6.5)
69
(89.6)
4.83
Overall Average4.80
Table 4. Prevalence of chemical and microbiological contamination in university food outlets.
Table 4. Prevalence of chemical and microbiological contamination in university food outlets.
Contamination TypeNon-Detected, n (%)Detected,
n (%)
Chemical contamination
Borax77 (100.0)0 (0.0)
Salicylic acid77 (100.0)0 (0.0)
Sodium hydrosulfide77 (100.0)0 (0.0)
Formalin75 (97.4)2 (2.6)
Pesticide76 (98.7)1 (1.3)
Microbiological contamination
E.coli on Food handlers’ hands56 (72.7)21 (27.3)
E.coli on Food-contact utensils 66 (85.7)11 (14.3)
E.coli on Wiping cloths used for hands 77 (100.0)0 (0.0)
E.coli on wiping cloths used for utensils77 (100.0)0 (0.0)
Salmonella spp. in RTE food72 (93.5)5 (6.5)
Table 5. Contamination profiles and standardized KAP scores across clusters identified by Two Step cluster analysis (n = 77). The percentages were calculated based on the number of participants within each cluster. Z-scores represent standardized values (mean = 0, SD = 1).
Table 5. Contamination profiles and standardized KAP scores across clusters identified by Two Step cluster analysis (n = 77). The percentages were calculated based on the number of participants within each cluster. Z-scores represent standardized values (mean = 0, SD = 1).
CharacteristicCluster 1 (n = 15)Cluster 2 (n = 11)Cluster 3 (n = 18)Cluster 4 (n = 33)
Non-Detected,
n (%)
Detected, n (%)Non-Detected,
n (%)
Detected,
n (%)
Non-Detected,
n (%)
Detected, n (%)Non-Detected, n (%)Detected, n (%)
Formalin Contamination15
(100.0)
0 (0.0)11
(100.0)
0 (0.0)16
(88.9)
2
(11.1)
33
(100.0)
0 (0.0)
Pesticide contamination15
(100.0)
0 (0.0)11
(100.0)
0 (0.0)18
(100.0)
0 (0.0)32
(96.9)
1
(3.1)
E.coli on Food handlers’ hands0 (0.0)15
(100.0)
7
(63.6)
4
(36.4)
16
(88.9)
2
(11.1)
33
(100.0)
0 (0.0)
E.coli on Food-contact utensils15
(100.0)
0 (0.0)0 (0.0)11
(100.0)
18
(100.0)
0 (0.0)33
(100.0)
0 (0.0)
Salmonella spp. in RTE food *15
(100.0)
0 (0.0)10
(90.9)
1
(9.1)
14
(77.8)
4
(22.2)
33
(100.0)
0 (0.0)
Z-knowledge score0.25(−0.55)(−0.13)0.14
Z-Attitude Score0.53(−0.21)(−1.01)0.38
Z-behavior score0.220.27(−0.86)0.27
* Salmonella spp. contamination was detected primarily in partially cooked meat products, including blanched pork and blanched chicken samples. These food items were typically consumed without additional heat treatment, which may increase the potential risk of foodborne infection.
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MDPI and ACS Style

Keawdounglek, V.; Paenkhokuard, W.; Hongthong, A.; Sinjai, T.; Puanmoon, S. Food Safety Practices and Contamination Patterns in University Food Outlets: A Cross-Sectional Study. Hygiene 2026, 6, 35. https://doi.org/10.3390/hygiene6020035

AMA Style

Keawdounglek V, Paenkhokuard W, Hongthong A, Sinjai T, Puanmoon S. Food Safety Practices and Contamination Patterns in University Food Outlets: A Cross-Sectional Study. Hygiene. 2026; 6(2):35. https://doi.org/10.3390/hygiene6020035

Chicago/Turabian Style

Keawdounglek, Vivat, Warapon Paenkhokuard, Anuttara Hongthong, Tantika Sinjai, and Siripan Puanmoon. 2026. "Food Safety Practices and Contamination Patterns in University Food Outlets: A Cross-Sectional Study" Hygiene 6, no. 2: 35. https://doi.org/10.3390/hygiene6020035

APA Style

Keawdounglek, V., Paenkhokuard, W., Hongthong, A., Sinjai, T., & Puanmoon, S. (2026). Food Safety Practices and Contamination Patterns in University Food Outlets: A Cross-Sectional Study. Hygiene, 6(2), 35. https://doi.org/10.3390/hygiene6020035

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