Condições higiênico-sanitárias das unidades de alimentação e nutrição das escolas e creches de educação infantil atendidas pelo programa nacional de alimentação escolar – PNAE: um estudo da Baixada Santista
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Data
2012-04-24
Autores
Cunha, Diogo Thimoteo da [UNIFESP]
Orientadores
Rosso, Veridiana Vera de [UNIFESP]
Tipo
Dissertação de mestrado
Título da Revista
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Introdução: O Programa Nacional de Alimentação Escolar - PNAE é hoje o maior
programa de alimentação do Governo Federal. Unidades de Alimentação e Nutrição
de escolas e creches oferecem um grande risco de contaminação aos escolares
devido à falta de cuidados nos procedimentos que evitam o desenvolvimento de
microrganismos nos alimentos. Objetivo: Avaliar as condições higiênico-sanitárias
das Unidades de Alimentação e Nutrição de escolas e creches atendidas pelo PNAE
nos nove municípios da Baixada Santista – SP. Métodos: Primeiramente foi
conduzida uma revisão sistemática para verificar as características dos trabalhos
publicados na área. Posteriormente foram avaliadas 59 unidades de alimentação e
nutrição escolares dos nove municípios da Baixada Santista – SP sorteadas após
critérios de amostragem. Para avaliação das unidades utilizou-se lista de verificação
pré-testada e adaptada. As questões foram pontuadas baseadas no risco sanitário
segundo a Resolução SS-196. A partir do percentual de conformidades, as escolas e
creches foram classificadas em cinco situações de risco. Para avaliar a percepção
de risco para doença transmitida por alimentos, utilizou-se um questionário
estruturado aplicado com manipuladores de alimentos e diretores segundo as cinco
chaves para inocuidade dos alimentos da Organização Mundial da Saúde.
Resultados: Na revisão sistemática, foi possível observar que as não
conformidades mais frequentes se referiram à: higiene das mãos, uniformização, uso
de telas de proteção em janelas, portas e ralos, sanitários de uso exclusivo aos
manipuladores, uso de controle químico contra vetores e pragas urbanas e falta de
utensílios e materiais. Essas não conformidades são relacionadas à tríade das Boas
práticas na alimentação escolar: manipulador, estrutura física e gestão. Em relação
a pesquisa com as unidades de alimentação e nutrição da Baixada Santista, foi
observado que 62% das Unidades de Alimentação e Nutrição de escolas estavam
inadequadas, sendo: higiene de mãos, controle integrado de pragas e vetores
urbanos, manipuladores e higiene de alimentos os blocos temáticos com maior
inadequação. Quando comparadas escolas e creches, foi verificado que nas creches
a higiene de mãos (p<0,01) e ambiental (p<0,05) é mais adequada, mesmo os
manipuladores de escolas participando com mais frequência em formações em Boas
Práticas (p<0,05). Em relação à percepção de risco foi possível identificar que
manipuladores de alimentos, que receberam treinamento específico para essa
atividade, possuíam maior percepção de risco de insegurança alimentar em relação
aos não treinados, independente de idade e escolaridade (p<0,05). A percepção de
risco dos pesquisados foi baixa ou regular em 50% dos manipuladores de alimento e
61,5% dos diretores de escola. Também foi identificado o fenômeno conhecido como
viés otimista, no qual os manipuladores acreditam que são imunes a eventos
negativos. Conclusão: Os blocos identificados com maior inadequação são os que
oferecem grande risco de multiplicação e sobrevivência de micro-organismos,
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apontando a alta probabilidade da presença de perigo nos alimentos manipulados
nesses locais. Novas estratégias de formação de manipuladores devem ser
estudadas, pois utilizar as que priorizam o incremento do conhecimento muitas
vezes não reflete na mudança de atitudes e de práticas.
Introduction: One of the most important nutrition public policies of the federal government is the NSFP (National School Feeding Program). Food and Nutrition Units (FNU) from schools and daycare centers can offer great risk of foodborne disease, due the lack of care in procedures that avoid microorganism growth in food. Objective: The aim of this study was to evaluate the hygienic and sanitary conditions from Food and Nutrition Units from public schools and day care centers supplied by National School Feeding Program. Methods: First was conducted a systematic review to verify the characteristics of published researchs about good manufacturing practices in school kitchens. It was evaluated 59 random schools FNU of nine Baixada Santista cities. A tested and adapted check-list was used to assess the units. The questions were scored based on the health risk according to Resolution SS-196. Schools and daycare centers have been classified into five risk situations based on their score. A structured questionnaire was designed to evaluate the risk perception of foodborne disease of 84 school food handlers and 24 schools principals. This questionnaire was based on the five keys of safer food of World Health Organization. Results: in the systematic review, it was possible to observe that the non-compliance referred to: hand hygiene, uniformization, use of protection screens on windows, doors and plumb drains, use of chemical control against urban pests and vectors and lack of utensils and materials. These non-conformances are related to the good manufacturing practices triad: physical structure, handler and management. It was observed that 62% of FNU was inadequate. The thematic blocks with the most inadequacy was: hand hygiene, pest control, food handlers and food hygiene. When was compared schools and daycare centers, it was verified that on the daycare centers the hand hygiene (p<0,01) and environmental hygiene (p<0,05) is more adequate than schools, even with school food handlers participating with more frequency in good practices training (p<0,05). In relation to the perception of risk, has been possible to identify which food handlers who received training for Good Manufacturing Practices had increased risk perception of foodborne disease in relation to non-trained, independent of age and scholarship (p<0,05). The risk perception of respondents was low or regular on 50% of food handlers and 61.5% school principals. It was also identified the phenomenon known as optimistic bias, in which the handlers believe they are immune to negative events. Conclusion: The thematic blocks with most inadequacy was those who offer great risk for proliferation and survival of microorganisms, pointing the high probability of the presence of hazard in food handled at these schools. New strategies of trainings for food handlers must be studied. The use of training that priorize the knowledge enhancement many times can not reflect on changes on attitudes and practices
Introduction: One of the most important nutrition public policies of the federal government is the NSFP (National School Feeding Program). Food and Nutrition Units (FNU) from schools and daycare centers can offer great risk of foodborne disease, due the lack of care in procedures that avoid microorganism growth in food. Objective: The aim of this study was to evaluate the hygienic and sanitary conditions from Food and Nutrition Units from public schools and day care centers supplied by National School Feeding Program. Methods: First was conducted a systematic review to verify the characteristics of published researchs about good manufacturing practices in school kitchens. It was evaluated 59 random schools FNU of nine Baixada Santista cities. A tested and adapted check-list was used to assess the units. The questions were scored based on the health risk according to Resolution SS-196. Schools and daycare centers have been classified into five risk situations based on their score. A structured questionnaire was designed to evaluate the risk perception of foodborne disease of 84 school food handlers and 24 schools principals. This questionnaire was based on the five keys of safer food of World Health Organization. Results: in the systematic review, it was possible to observe that the non-compliance referred to: hand hygiene, uniformization, use of protection screens on windows, doors and plumb drains, use of chemical control against urban pests and vectors and lack of utensils and materials. These non-conformances are related to the good manufacturing practices triad: physical structure, handler and management. It was observed that 62% of FNU was inadequate. The thematic blocks with the most inadequacy was: hand hygiene, pest control, food handlers and food hygiene. When was compared schools and daycare centers, it was verified that on the daycare centers the hand hygiene (p<0,01) and environmental hygiene (p<0,05) is more adequate than schools, even with school food handlers participating with more frequency in good practices training (p<0,05). In relation to the perception of risk, has been possible to identify which food handlers who received training for Good Manufacturing Practices had increased risk perception of foodborne disease in relation to non-trained, independent of age and scholarship (p<0,05). The risk perception of respondents was low or regular on 50% of food handlers and 61.5% school principals. It was also identified the phenomenon known as optimistic bias, in which the handlers believe they are immune to negative events. Conclusion: The thematic blocks with most inadequacy was those who offer great risk for proliferation and survival of microorganisms, pointing the high probability of the presence of hazard in food handled at these schools. New strategies of trainings for food handlers must be studied. The use of training that priorize the knowledge enhancement many times can not reflect on changes on attitudes and practices
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Citação
CUNHA, Diogo Thimoteo da. Condições higiênico-sanitárias das unidades de alimentação e nutrição das escolas e creches de educação infantil atendidas pelo programa nacional de alimentação escolar – PNAE: um estudo da Baixada Santista. 2012. 131f. Dissertação (Mestrado) - Instituto de Saúde e Sociedade, Universidade Federal de São Paulo, Santos, 2012.