Factors Associated With Knowledge, Awareness, and Hygiene Practices Among Food Handlers: A Cross-sectional Study at Tourist Attractions in the Upper Tapi River, Thailand

Introduction: Thailand has some of the world’s tastiest food. However, food safety is important for foodborne disease prevention and control and to build confidence in food safety measures among consumers, tourists, and the general population. Materials and methods: The study as a cross-sectional survey was conducted among food service at tourist attractions in the Upper Tapi basin from October 2023 to May 2024. Purposive sampling was applied, and the study questionnaire was given to the 135 food handlers. Coliform bacteria samples were collected from food handlers hands (n=135), water used in drinking (n=57), water used in cooking (n=89), ice (n=118), and kitchen utensils (n=332) for testing as part of the SI-2 indicator assessment, which SI-2 initial coliform bacteria testing solution for fieldwork. Results: The food handlers in this study were 48 males (35.56%) and 87 females (64.44%). Seventy-two (53.33%) food handlers were younger than or equal to 28 years old (SD 28.21±7.65 years). Food handlers' education level was found to be either secondary school (35 persons, 25.93%) or above secondary school (64 persons, 47.40%). Eighty-six restaurants (63.70%) were operational status initiated more than six days per week. Ninety-six restaurants (71.11%) had more than five years of experience. Forty-seven (34.81%) employees had passed the clean food good test; 88 (65.19%) had not passed the clean food good test training. The results showed that food handlers’ overall knowledge of food safety was moderate (average score 7.20, SD 0.20, max 10.00, min 5.89). It was found that food handlers had a high level of awareness of food sanitation (average score 2.52, SD 0.24, max 2.89, min 1.68). The overall level of food sanitation hygiene practices was moderate (average score 1.93, SD 0.14, max 2.09, min 1.45). The results for coliform bacterial contamination with SI-2 test kits from 731 samples across 135 sites showed contamination of 206 samples (28.18%). Conclusions: Food entrepreneurs and food handlers must promote and support food sanitation knowledge to develop their potential for knowledge and understanding of food sanitation and to comply with laws or regulations.