Y HOC VJET NAIM THANG 4 - <jv .
KIEN THU'C, THirC HANH VE VE SINH AN TOAN THITC PHAM CIIA NGircri PHUC v y TAI CAC BEP AN TRU'O'NG MAM NON, TIEU HOC BAN TRU QUAN LE CHAN - HAI PHONG NAM 2013
T O M TAT
Bang ghien cu'u md ta cat ngang ve kien thirc, thuc hanh ve sinh an toan thu'c pham ciia ngu'di vien phyc vu tai cac bep an tap the tru'dng mam non va tieu hoc ban trii tren dia ban quan Le Chan - Hai Phdng, Ket qua cho thay: Ty le ngudi phuc vu co kien thirc dat kha cao tren nhieu tieu chi du'de danh gia nhu ve thUc pham tiTOi an toan dat (>85%); Cac nguyen nhan gay ngg dpc thUe pham ty le dat thap Phat la 80%; Nhan biet cac dau hieu ciia ngo dpc thUc pham dat 100%; ThUc hanh ciia NPV cho thay c6
>95% sir dung bao hp lao dong khi lam viec va thu'c hien cac yeu cau ve smh khi che bien thye pham.
SUMMARY
KNOWLEDGE, PRACTICE ON FOOD SAFETY AND HYGIENE OF W A I T E R S I N KINDERGARTEN A N D P R I M A R Y SCHOOL
KITCHENS I N LE CHAN D I S T R I C T - H A I PHONG I N 2 0 1 3 A cross-sectional study on knowledge and practice toward food hygiene and safety m kindergarten and primary school kitchens in Le Chan district - Haiphong Oty. Results: The proportion of waiters attaining the good level of knowledge is relatively high on several criteria such as safe fresh food (>85%) ; the lowest proportion of attaining good knowledge was the one on causes of food poisoning (80%); however, the proportion of good knowledge on symptoms of food poisoning was very high at 100%; About practice, more than 95% of waiters used working protection and respected hygiene requirements in food processing.
I. OAT VAN OE
Theo To chire Y Te The Gidi (WHO) "Thye pham ludn la nguon gay nhiem doe cap va man tinh" [ 6 ] . Theo cae sd lieu thong ke cho thay, hien ed hdn 400 eae benh lay truyen qua thye pham khdng an toan. Moi thang Lien hiep qudc nhan du'de khoang 200 bao eao tir 193 quoe gia ve eae trudng hdp thu'c pham bi nhiem dde.
Thong ke ve benh tat gay bdi d nhiem thye pham
* Tn/dng Dat hgc Y Ddac Hat Phong '* Trddng Cao dSng Y teHai Phong
Phan bign khoa hgc: GS.TSKH Nguyen Van Hieu
Pham Minh Khue*, Vii Diic Long**
cho biet: 6 0 % cac tru'dng hdp la do vi sinh vat gay d nhiem thirc an d eac cd sd dieh vu an udng. Cung theo WHO cho rang cac nu'dc cd quy dinh bat budc ve bao cao ngo dde thu'c pham chi dat 1 % so vdi sd mac thye te [ 7 ] . 6 Viet Nam, hang nam cd khoang 3 trieu ca ngd ddc thi/c pham, gay td'n hai tren 200 trieu USD [ 4 ] . Nhieu nghien cyu cho thay kien thirc, thye hanh ciia nhu'ng ngu'di che bien thye an ddng vai tro het syc quan trong trong viec eai thien ve smh an toan thu'c pham. Tai Hai Phdng, trong 2 nam gan day: nam 2010 xay ra 94 vy vdi 250 ngiTcJi mae, nam 2011 xay ra 98 vu va con sd mac len tdi 350 ngu'di [ 2 ] . Le Chan la mdt quan npi thanh, mat do dan sd cao nhat thanh pho (16.519 nga'di/km2) tinh tang ATVSTP du'de cho la dia ban kha phyc tap. Do vay, ehiing toi nghien cyu de tai nay nham mue tieu; Wd ta kien th&c, thai do, thWc hanh ve ATVSTP ciia ngWdi phuc vu tai cac bep an trWdng mam non va tieu hpc tren dia ban quan Le Chan thanh phd Hai Phong nam 2013.
M. DOI TirOTJG VA PHLTffNG PHAP NGHIEN CUU 2 . 1 . Doi tu'dng, dja d i e m va thdi gian nghien cii'u
- Ooi tu'dng va dja diem nghien cyu la: Ngufli phyc vu (NPV) bao gom ngi/dl quan ly, ngu'di che bien, ngu'di phan phdi thye pham tai bep an tap the cac tru'dng mam non va tieu hpc quan Le Chan thanh phd Hai Phong.
- Thdi gian nghien c y u : T y thang 1/2013 den thang 11/2013.
2.2. Phu'dng phap n g h i e n cii'u 2.2.1. Thiet ke nghien c&u: Nghien cirtJ djch te hpc md ta cat ngang
2.2.2. Cdmau:
- Cd mau bep an tap the; chpn toan bd gom 40 bep an .
- Cd mau cho dieu tra kien thu'c, thye hanh ciia ngu'di phyc vu ap dung cdng thye tinh cd mau cho mdt ty le:
58
Y HOC VIET NAM THANG 4 - SO 1/2014
n-ZL^. PO-P) (P.ef o n: cd mau nghien cyu.
o Zl-a/2: He sd tin cay=l,96, dp tin eay 95%.
c P: Ty le ngu'di phuc vu cd kien thye dung ve VSATTP, theo nghien cyu tru'de la 0,5[3].
o £ : Op chinh xac: 0,1 Cd mau tdi thieu n = 120 ngu'di
2.2.3. Cach chgn miu:
-Tai dja ban Quan Le Chan cd 40 bep an tap the d cac tru'dng tru'dng mam non va tieu hpc ban
tru, trong so dd cd 20 bep an thuoe tuyen quan quan ly (sd tre tren 200/tru'dng) va 20 bep an thudc tuyen phu'dng quan ly (sd tre du'di 200/tru'dng).
- Tai 40 bep an tap the, mdi bep an chon phdng van 3 ngu'di; 01 ngu'di quan ly, 01 ngu'di che bien thye pham, 01 ngu'di phan phdi thye pham chin.
Td'ng so ddi tu'dng di/dc du'a vao nghien cyu la 120 ngu'di.
2.3. Xif ly so lieu: Sd lieu xy ly bang phan mem SPSS 13.0.
III. KET QUA NGHIEN cCru BangS.l.Ti le nqird
^ ^ ^ ^ KQNC**
C T N C * ^ ^ ^ ^ ^ ^ N9I dung ^^•^•^--^^
Thit Ca Rau
Phu gia thtrc pham Ca 4 loai tren
phuc vu (NPV) nhan biet dung thuc QuanQL***
n 60 60 60 59 59
(%)
100,0 100,0 100,0 98,3 98,3
•ham tu'cJi song an toan.
Phu'clng QL n 45 55 59 th 48 45
(%)
75,0 91,7 98,3 80,0 75,0
P
<0,05
>0,05
>0,05
<0,05
<0,05 Tyle Chung (%)
87,5 95,8 99,2 89,2 86,7
* = Chi tieu nghien c&u, **= Ket qua nghien cuV, ***= Quan ly Nh$n xit: Ket qua bang tren cho thay ty le NPV nhan biet diing thu'c pham lu'di song an toan ciia tuyen quan quan ly dat 100%, phy gia thye pham dat 98,3%. Ty le nay d tuyen quan eao hdn tuyen phu'dng cd sy khac biet cd y nghTa thong ke vdi p<0,05.
Bang 3.2. Ty le NPV nhan biet du'de cac nguyen nhan gay ngd doc thu'c pham.
~ ~-____^ KQNC
CTNC ______
Do thu'c 3n nhiem phai vi sinh vat gay benh
Do hoa chat I<h6ng an toan su* dung trong thirc pham
Do thirc pham co chira cac doc to tl/ nhien
Do thi/c pham bj bien chat, oi thiu
Quan QL n 60 60 59 60
%
100,0 100,0 98,3 100,0
Phu'dng QL n 60 55 48 60
»/o 100,0 91,7 80,0 100,0
P
>0,05
>0,05
<0,05
>0,05
Ty le Chung
(%)
100,0 95,8 89,2 100,0 Nh$n xit! Ket qua bang tren eho thay ty le NPV nhan biet dimg ca 4 nguyen nhan gay ngd ddc thye pham tai tuyen quan quan ly dat 100,0% eao hdn d tuyen phu'dng d mot tieu chi (80,0%), sy khae biet nay cd y nghTa thong ke vdi p <0,05.
Bang 3.3. Ty le nhan biet dung cae dau hieu pho bien ciia ngo ddc thye an.
^ — ^ ^ ^ ^ KQNC DSu hl|u ^^~~~-~~-_
Ttidi gian xuat hien sau khi Sn < 48 qid Buon non, dau bunq
Tra 161 dung (%) CSQ*
(n=60) 60 60
Ty le (%)
100 100
CSP**
(n=60) 60 60
Ty le (%)
100
"100" ^ Tylf Chung (%)
100
^100
Y HOC VIET NAM THANG 4 - SO 1^2014
Tieu chay nhieu lan Co qiat, hon me Ca 4 dau hieu
60 60 60
100 100 100
60 j 100 60 100 60 100
100 100 100
•*"= Cdsdquan quan ly, **= Cdsdph&dng quan ly Nhan xet: Ket qua bang tren cho thay ty le NPV nhan biet dung cac dau hieu pho bien ciia ngd dpc thye an rat cao chiem 100% d ea ddi tu'dng quan quan ly va phu'dng quan ly .
Bang 3.4. Thirc hanh cua NPV sir dung bao ho lao donq khi lam viec Chl tieu nghien ci^u
€)eo tap de (hoac mac bao ho)
€)eo khau trang Deo gang tay Doi mu Ca 5 qui dinh tren
Quan QL n 20 20 20 20 20
»/o
100 100 100 100 100
Phu'dng QL n 20 19 20 19 19
o/o
100 95 100 95 95
Ty le Chung % 100 97,5 100 97,5 97,5 Nh$n xit: Ket qua bang tren eho thay sy dyng bao hp lao dpng khi lam viec ciia NPV tai bep Sn ciia
cti sd quan quan ly tuan thii dung ca 5 qui djnh (100%), ed sd phu'dng cdn cd 5% tru'dng hdp khongdeo khau trang va dpi mu khi lam viee.
Bang 3,5. Thu'c hanh ciia NPV trong viec thuc h -~~___^^^ KQNC
CTNC ^~~~---..__^
Cat ngan mong tay
Rira tay trirdc khi che bien, chia thirc an
Khong hilt thuoc, an keo khi phan phoi thu'c pham
Bo thirc an khi co dau hieu oi thiu Deo gang tay khi chia thi/c pham chin
Sir dung dung cu dirng, gap, miic thirc an song, chin rieng biet Ve sinh sach se ndi che blen, phong an hang ngay
Thu'c hanh cu CSQ
n=40 40 40 40 40 40 40 40
Ty le % 100 100 100 100 100 100 100
en cac ye a NPV {«
CSP n=40 36 40 38 40 39 40 40
u cau ve /o)
Tyle
»/o
95 100 95 100 97,5 100 100
inh.
P P>0,05
P>0,05
P>0,05
Ty le Chung
(%)
95 100 97,5 100 98,75 100 100 Nhan xet: Ket qua bang tren nghien cffu ve thirc hanh tren doi tuong ngu'di che bien, phan phoi thiJc an trong viec thirc hien cac yeu cau ve sinh cho thay tai ca sd quan quan ly tuan thii dung cac tieu chi (100%), cd sd tuyen phi/dng ty le nay thap hdn tren mpt sd tieu chl nhu" cat ngan mdng tay, deo gang tay khi che bien thdc pham, tuy nhien sd khac biet nay khong cd y nghia thdng ke vdi p>0,05.
IV. BAN LUAN
Nghien ciru ciia chiing toi da tien hanh dieu tra tren 120 ngu'di phuc vu tai 40 bep an tap the ban trii cac tru'dng mam non va tieu hpc tren dja ban quan Le Chan thanh phd Hai Phong, cho thay mpt so ket qua: Kien thirc ciia ddi tu'dng
nghien ciru ve ty le nhan biet thdc pham tudi an toan dat 100% d tuyen quan quan ly cao hdn cac cd sd bep an tuyen phu'dng quan ly, sd khac biet cd y nghTa (p<0,OS). Ket qua nay ciia chiing til phii hdp vdl ket qua nghien ciru ciia Phan Th!
Kim va cdng sd tien hanh tai Ha Tay nam 2005
60
Y HOC VlfeT NAM THANG 4 - SO 1/2014 [4] nhang eao hdn nhieu so vdi nghien ciia ciia
Oo Manh Hiing (2012- Hu-ng Yen) [3] vdi thye pham la Thit (62,5%); C a ( 6 7 , l % ) ; Rau (98,8%).
Sd d? cd s y khac nhau nhu' vay chung tdi cho rang cd the doi tu'dng nghien cyu cua ehung tdi du'de tap huan tot hdn. Ket qua nghien cyu ve kien thye nhan biet nhulig dau hieu cua ngd dde thye pham va nguyen nhan gay ngd thye pham ciia NPV cung cho ty le dat rat cao gan 100% cd sd d tuyen quan quan ly va tren 8 0 % cd sd tuyen phu'dng quan ly, ket qua nay ciia chung tdi cung cao hdn han so vdi ciia Oo Manh Hiing .Nghien ciru ve thye hanh mang bao hp lao ddng khi che bien thye pham ket qua cho thay > 9 5 % sy dyng bao hd lao ddng khi che bien thye an , ket qua eiia Chung tdi eao hdn han so vdi nghien eyu cua Nguyen Thj Van (2012-Hai Phdng) [5] tren dpi tu'dng \h ngu'di phyc vu tai cac nha hanh an uong, Chimg toi cho rang doi tu'dng nghien cyu ciia chung tdi la cae bep an phue vu eho nhu'ng lira tuoi tre em nen ngu'di phyc vy cd y thye ve v? sinh tdt hdn. Ket qua nghien cyu ve thye hanh trong viee thye hien eac yeu cau ve sinh cho thay cd tir 95% t r d len NPV thye hien tot cae ti&u chi, ket qua nay eiia chiing tdi eung eao hdn hSn so vdi nghien cirtJ ciia Do Manh Hiing va eiia Nguyen Thj Van [ 3 ] , [ 5 ] . Chiing tdi cho rang sy khac nhau dd la do doi tu'dng phue vu ciia cac bep Sn khac nhau nen nhan thye ciia NPV khae nhau va thye hanh khac nhau.
V. K f r LUi^N
Qua dieu tra tong sd 120 ngu'di phyc vy tai 40 bep 5n mam non va tieu hoe ban trii quan Le Chan-Hal Phdng, trong dd cd 20 bep an thudc quSn quan ly va 20 thupc phu'dng quan ly, ket qua cho thay:
• Kien thye ciia ngu'di phuc vu la kha tot tren nhlHu tieu chi danh gia nhu" vie thye pham tu'di an toan dat > 8 5 % ; Kien thye ve nguyen nhan gay
ngd ddc thu'c pham tieu chi' dat thap nhat la 8 0 % ; Kien thye ve nhan biet dau hieu cua ngd dpc thye pham dat 100%.
Thye hanh cua ngu'di phyc vu: Thap nhat ed 95% sy dyng bao hd khi lam viee va > 9 5 % NPV thye hien cac yeu cau ve ve sinh khi che bien thiic an.
- Tren hau het cac tieu chf du'de danh gia eho thay ddi tu'png nghien cyu d tuyen quan quan ly ed ty le dat cao hdn tuyen phu'dng.
TAI LIEU T H A M KHAO
1. Bo Y te (2012), Chien Iddc qua: gia ve an toan ve smh thut pham giai doan 2011-2020 va tam nhin 2030, Ha Hq\.
2. Chi cue An toan v^ sinh thu'c pham Hal Phong (2012) , Bao cao tong ket cong tac An toan ve smh thuc pham thanh phd Hal Phong nam 2009-2012, Hai Phong.
3. Do Manh Hiing (2013) '"Thdc trang ve sinh an toan thdc pham va cong tac quan ly bep Sn tap the cac trddng mam non tai Hung Yen nSm 2012
",Luan van tot nghiep bac si chuyen khoa I I , tru'dng dai hpc Y khoa Hai Phing, Hai Phong.
t\. Phan Thj Kim, Nguyen Thanh Phong, Le Van Bao (2005): "'Danh gia kien thdc, thdc hanh vi VSA TTP cua ngwdi trdc tiep san xuat tai mgt sd lang nghe san xuat thdc pham truyen thong cua Cinh Ha Tay", TTKH, Cue VSATTP, Ha Noi.
5. Nguyen Thj Van (2012), thdc trang an toan ve sinh thpc pham, kien thdc, thai do cua ngddt phuc vu tai nha hang an udng quan Le Chan, Hat Phdng nam 2012, luan van thac si y te Cong dong, tru'dng dai hoc Y khoa Hai Phdng, Hai Phong.
6. Turner, P. J., S. Mehr, et al. (2013). "Safety of food challenges to extensively heated egg in egg- allergic children: a prospective cohort study."
Pediatr Allergy Immunol 24(5): 450^55.
7. Verger, P. J. and A. R. Boobis (2013). "Global food supply. Reevaluate pesticides for food secunty and safety. "Sc\ence 341(6147): 717-718.
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