ABSTRACT: The aim of this study was to evaluate habits and practices of cheese consumers toward their level of knowledge of food safety. A total of 1000 people were interviewed in several cities of the state of Rio de Janeiro, Brazil. Five hundred thirty-eight (53.8%) people consume cheese daily, while 318 (31.8%) and 144 (14.4%) consume cheese weekly and monthly, respectively. Five hundred twenty-two (52%) people reported its usage as an ingredient used in the preparation of other dishes, while 320 (32%) of the interviewed people consume cheese directly as a part of the diet. Typical Brazilian cheeses such as “Minas Frescal” and “Prato” cheese are preferred by 528 (52.8%) of the consumers. Of the total consumers, 764 (76.4%) purchase cheese from supermarkets, while 236 (23.6%) from open-air markets. Inspected cheese is purchased by 350 (35%) consumers, while 650 (65%) buy it without knowing if they were submitted to previous fiscalization. Four hundred thirty (43%) consumers do not know any disease transmitted by cheese that has not been inspected. Overall, educational campaigns must be developed by the Sanitary Surveillance and the Health Agencies to improve the knowledge of the consumer about food safety of cheeses.
Cheese is defined as the fresh or matured product obtained by draining the whey (the moisture or serum of the original milk) after coagulation of casein. Casein is coagulated by acid produced by selected microorganisms, by coagulating enzymes, or by adding food-grade acidulants, resulting in curd formation (Natl. Dairy Council 2000). The great diversity of technological processes used in its manufacture results in different physical, chemical, and microbiological qualities for the processed product and someone may create environmental conditions favorable for the development of pathogens (Carvalho and others 2007).
The consumption of cheese around the world increases continually due to its versatility and adaptability to recipes, greater availability of various types of cheese, and the increased interest in cheese-containing dishes. Brazil is the 3rd largest producer of cheese in the world, following the European Union and the United States (Geisler 2007). The “Minas Frescal” cheese, a Brazilian soft cheese, contributes nearly 40% to cheese production and consumption, and its production is concentrated mainly in small and medium industries (Oliveira and others 1998).
The increase in the consumption and production of cheese around the world is directly proportional to the concern food safety's aspects related to this product. Several studies have reported the incidence of pathogens like enteropathogenic Escherichia coli (EPEC), Aeromonas hydrofilla, Staphylococcus aureus (Araujo and others 2002), and Salmonella Enteritidis (Nunes and others 2003) from retail cheese samples. Listeria monocytogenes has been isolated not only from retail samples of cheese (Silva and others 1998), but also from in-process samples and the production environment (Silva and others 2003). Cheese-associated outbreaks of foodborne disease also are well documented, including outbreaks due to S. Enteritidis (PHAC 1999) and Staphylococcus aureus (Carmo and others 2002). Alterkruse and others (1998) identified several types of cheese as the food vehicle for 32 outbreaks in the United States between 1973 and 1992, resulting in 11 hospitalizations and 58 deaths; the primary determinants for contamination of processed product were identified as postpasteurization recontamination and the use of raw milk. Cardoso and Araújo (2004) reported failure of 42.3% samples of cheese by the Sanitary Surveillance in the Federal District, Brazil between 1997 and 2001 for microbiological nonconformities. Buyser and others (2001) in their review of foodborne disease associated with dairy products, documented the great role of cheese as a vehicle for disease and demonstrated the ability of pathogens to survive processing conditions, with registered survival of S. Enteritidis and E. coli 0157:H7 in brine used in the manufacturing of cheese. It is also necessary to consider that some cheeses allow multiplication or survival of pathogens, due to its favorable environment, as higher pH and water activity (Little and Knochel 1994; Piccinin and Shelef 1995; Glass and others 1998; Ramsaran and others 1998; Ingham and others 2000; Rogga and others 2005; Stephan and others 2007).
Rio de Janeiro is an important Brazilian city, being the 2nd largest economic center, losing only to São Paulo, and presenting a potential consumer market for dairy products, as cheeses. Recent research investigated the habits and practices of consumers regarding probiotic food in this city, demonstrating its importance as representative sampling of the Brazilian market (Vianna and others 2008). Considering that consumer food safety education represents a potential strategy for the prevention of foodborne illnesses, the purpose of this study was to identify habits and practices related to the food safety of cheeses supporting Sanitary Surveillance's actions, to better protect the health of the people who consume this food.
Materials and Methods
The size of the study population was determined through statistical techniques (Triola 2005), being assigned level of confidence of 95% with a maximum error of 3.5%. As on these conditions the number of people to be interviewed would be 860, it was decided that target population be set at 1000 (100%) comprising 500 (50%) from the city of Rio de Janeiro and 500 from the cities of Santo Antônio de Pádua, Miracema, São Gonçalo, Niterói, and Saquarema located in the Rio de Janeiro State (100 people each city). The interviews were conducted in places of high concentration of people, such as squares and avenues, through a structured questionnaire of multiple choices composed of 5 questions regarding the frequency, the preference for the consuming cheese, and the form of consuming it, as well as the places they bought it and the knowledge of diseases transmitted by the cheese.
The results were tabulated and graphs were constructed using the Microsoft Excel 7.0, version 2000 computer program (Microsoft Corp., Redmond, Wash., U.S.A.). The chi-square analysis was used to investigate the influence of the educational level of population sample and place about food safety of cheeses. Significance level of 95% was adopted.
Results and Discussion
The sample used in this study consisted of 1000 (100%) people aged between 18 and 78 y, comprising 513 (51.3%) male and 487 (48.7%) female. With respect to the educational level, 298 (29.8%) had only completed their basic education, 542 (54.2%) had completed their high school education, and 160 (16%) had completed their university education. Overall, the education level and city did not present relation with the practices involved at the consumption of cheese (P > 0.05).
The findings of this study are shown in Table 1. Of the total consumers, 538 (53.8%), consume cheese daily, while 318 (31.8%) and 144 (14.4%) consume cheese weekly and monthly, respectively. As majority of the interviewees consume cheese every day, the risk of outbreaks due to unsuitable storage and manipulation in the residences decreases as cheese is consumed so quickly that even abusive handling and storage will not allow the growth of pathogens in high numbers. However, if the product is consumed outside home (restaurants, snack bars, and so on), where each consumer cannot take into account the criteria for the choice of the product, such as brand, price, storage conditions, and product presentation, there are major risks of occurrence of cheese-associated diseases.
Table 1—. Habits and practices of cheese consumers.
|Frequency of consumption||%|
|Forms of consumption|| |
| Ingredient in other culinary dishes||52.0|
| Regular diets||32.0|
|Main cheeses consumed|| |
| Minas Frescal||39.2|
| Open-air markets||23.6|
Regarding the manner in which cheese is consumed, 520 (52%) reported its use as an ingredient in the preparation of other dishes, while 320 (32%) consume cheese as a part of a regular diet. This low consumption of the product “in natura” could be increased with measures of advertisement and marketing by the producers, which should be followed by an educational campaign on proper methods for selecting, holding, and preparing cheeses for safe consumption. As cheese generally is used in the preparation of other dishes, it may be most important to focus food safety education on proper refrigeration. Unhygienic handling during the preparation of the cheese dishes was responsible for the occurrence of an outbreak of staphylococcal food poisoning that affected 180 people in Bordowski, São Paulo, Brazil (Colombari and others 2007). Considering that the contamination of the cheese occurs mainly after milk pasteurization (Johnson and others 1990), the handling at the consumer's home has great importance. Washing of knives and hands prior to handling cheese, control of the storage temperature, protection from other food ingredients, mainly meats juices and raw vegetables, are simple some measures that may aid the reduction of cheese contamination by pathogens (Teng and others 2004).
“Minas Frescal” cheese represents 39.2% (392) of the consumption, followed by the Mozzarella 18% (180) and “Prato” 13.6% (136) while others less consumed, such as Ricotta, Provolone, and Camembert cheese, were just 29.2% (292). The results are in accordance with Oliveira and others (1998) who showed that the production of the “Minas Frescal” cheese was responsible for 40% of the Brazilian cheese production. The large volume of product consumed underscores the importance of strictly following measures focused on the postpasteurization hygiene of the milk used for the production of cheese and controls accomplished during cheese production related to the contamination of the equipment, people, and environment. It must also be considered that the “Minas Frescal” cheese is frequently used for the preparation of several other dishes and as a fresh cheese and, in contrast to mozzarella and “Prato cheese,” does not pass through phases such as strengthening (which includes heating to nearly 70 °C) and ripening, which impose barriers to microbial multiplication. In addition, most “Minas Frescal” cheese in Brazil is produced by small and medium dairy processors that may need assistance with design and implementation of hygienic measures to ensure the safety of the process. Brigido and others (2004) reported failure of most “Minas Frescal” cheese commercialized samples in the city of São Paulo: 95.5% due to physical–chemical parameters and 54.5% due to microbiological contamination, during the Paulista Program, which is a Sanitary Surveillance program of monitoring the hygienic–sanitary quality of diverse kinds of foods.
In general, the results reinforce the preference for typical Brazilian products, because they are part of the normal food habits of the population. Mesias and others (2003) found similar results when they ranked the cheese consumers in Extremadura, Spain: majority of the consumers showed a preference for the Manchego, typical Spanish cheese.
Regarding the place of purchase, 764 (76.4%) generally acquire cheese at supermarkets, while 236 (23.6%) purchase cheese in open-air markets. This fact re-emphasizes the need for consumer food safety education, because most of the supermarkets have routine food safety inspections and the hygienic failures in open-air markets are well known, especially due to the lack of temperature control, restrooms without proper hand washing facilities, and protection against the environment contamination (Capistrano and others 2004). Teng and others (2004) observed inappropriate practices from the hygienic–sanitary point of view during retail sale of cheese in farmer's markets in Canada as: storage of the product next to meat products (24%), lack of temperature control (14 to 21 °C) (54%), and direct bare-hand contact with the product (24%), showing that cheese handling at retail is a worldwide problem, and it is not restricted to nations in development, as Brazil.
Just 350 (35%) of the interviewees buy only inspected cheese, and the remaining 650 (65%) buy cheese without knowing if it has been inspected, which may increase their risk for foodborne diseases. Consumers may believe that all of the cheeses marketed in supermarkets are inspected and safe to consume or they may be unaware of the hazards associated with consumption of uninspected cheese and choose their place of purchase on the basis of availability and convenience. Olival and others (2002) report that the informal “Minas Frescal” is the main product consumed by the population of the county of Pirassununga, São Paulo, Brazil, and it is consumed by 24% of the population, and acquired in several outlets, as supermarkets, itinerants, and directly from the producers.
Concerning the knowledge of the possibility of the transmission of diseases by the consumption of cheese, 43% of the interviewed consumers answered negatively, showing a large lack of knowledge related to the risks of consumption of food, which was not submitted to any inspection. Jayaro and others (2006) reported the presence of several pathogens, including Campylobacter jejuni, Shiga toxin-producing E. coli, L. monocytogenes, Salmonella Typhimirium, and Yersinia enterocolitica in samples of raw milk in Pennsylvania, United States, showing the risk of consumption of raw milk and dairy products. Therefore, it is evident that major educational efforts are needed from a variety of the Health Agencies to disseminate information related to cheese-associated hazards and to avoid foodborne disease having cheese as a vehicle.
Overall, the results of this study relate inadequate habits and practices toward the cheese consumption. It also suggests that the population of the cities studied is susceptible to foodborne diseases, for a large portion of people consume noninspected cheese. Educational campaigns of conscientization involving clarifying the hazards that come from noninspected cheese and periodic inspections mainly in open-air markets should be the main actions to be performed by the Health Agencies to improve the safety of marketed cheeses and to improve habits and practices of consumer's cheese.