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Improved Food Safety Information Provision May Reduce Risk of Foodborne Infection Among Chemotherapy Patients, According to Cardiff Met Academics

​1st December 2017

Research undertaken by the ZERO2FIVE Food Industry Centre research group at Cardiff Metropolitan University's School of Health Science into the availability and adequacy of food safety information available to UK cancer patients, will be published in Public Health this week.

Authors Drs Ellen Evans and Elizabeth Redmond are both research fellows at the prestigious ZERO2FIVE Food Industry Centre at Cardiff Metropolitan University and their findings indicate that chemotherapy patients may be aware of the increased risk of infection due to immunosuppression (or a depleted immune system) during treatment but may underestimate foodborne infection risk and fail to implement adequate food safety practices in the home due to the lack of appropriate food safety information available to chemotherapy patients.

Foodborne infection is largely a preventable disease if safe food handling and storage practices are followed. Consequently, safe food handling and storage practices during food preparation at home are required to reduce the risk of foodborne infection for these 'at risk' consumers.

The project focussed on evaluating the availability of food safety information for immunocompromised chemotherapy patients and their associated caregivers. The multi-phased study received a Tenovus Cancer Care Innovation grant and analysed in-depth interviews and content-analysis of online patient information resources.

Interviews with patients determined they may take precautions to avoid crowded spaces or public transport, to reduce the risk of communicable diseases, but food safety isn't considered a priority, despite the risk of food poisoning reportedly greater among cancer patients than the general population. Indeed, cancer patients are reported to be five times more likely to develop listeriosis, the symptoms of which can be severe or fatal.

Online food-related information resources for chemotherapy patients were obtained from only 35 of 154 National Health Service (NHS) chemotherapy providers in England, Scotland and Wales, the Department of Health (DoH) and only three of 184 identified UK cancer charities.

From reviewing the identified resources, it was determined that advice relating to hand decontamination was most frequently included, practices to reduce the risk of listeriosis or safer alternatives to risk associated food products were lacking. Although some information detailing food safety recommendations are available, access to this information for patients is limited, considerable gaps exist and information provided varies greatly between sources.

Concernedly, in some cases the information that is provided promotes potentially unsafe practices. The most comprehensive sources of food safety information were tailored for neutropenic patients (where the body has a low level of neutrophils / a type of white blood cell) and these are unlikely to be provided to/accessed by all people undergoing chemotherapy.

The research has identified the clear need for an effective, standardised food safety resource specifically targeting chemotherapy patients and family caregivers. Such intervention is essential to assist efforts in reducing the risks associated with foodborne infection among chemotherapy patients.

Dr Ellen Evans said: "The research team and I feel very privileged to have received crucial funding from Tenovus Cancer Care to complete this research project, which was very interesting to work on.

"While it was reassuring to determine that patients are well informed regarding immunosuppression and the risk of infection, it is very worrying that they underestimate the risk of foodborne infection.

"The findings highlighted our concerns that information resources on the importance of food safety practices in the home to reduce the risks associated with foodborne infection are lacking.

"We are very grateful to the patients and family caregivers who participated in the study and to Professor Louise Fielding (1968-2013), who shared her personal chemotherapy experiences and recognised the need for food safety information for patients during her own chemotherapy treatment and started the research in this area before her untimely death.

"Since completing the research, we are now exploring methods to deliver targeted food safety information."

For more information, see: Evans, E. W., & Redmond, E. C. (2017). An assessment of food safety information provision for UK chemotherapy patients to reduce the risk of foodborne infection. Public Health, 153(12), 25-35.