Thực trạng ô nhiễm vi sinh vật, kiến thức, thực hành của người kinh doanh thức ăn đường phố tại thành phố Thanh Hóa năm 2007 - 2008

TC.DD & TP6 (2) - 2010<br /> <br /> <br /> THU'C T R A N G 6 N H I E M V I S I N H V A T , K I E N THtyC, T H I / q<br /> H A N H C U A N G i r d l K I N H D O A N H THU'C A N DU'&NG P H O<br /> TAI T H A N H PHO T H A N H H O A N A M 2 0 0 7 - 2 0 0 8<br /> <br /> Hodng Khdi Lap', Trinh Xuan Nhdf<br /> <br /> Bang phucmg phap nghien ciiu md ta tien hanh tren cac ddi tugng lam dich vu thiic an dudng phd,<br /> xet nghiem vi sinh vat mpt sd dung cu che bien thuc pham va thiic an dudng phd da cho thay: tinh<br /> trang 6 nhiem vi sinh vat thirc an dudng phd tai thanh phd Thanh Hoa trong cac nam 2007 - 2008<br /> d miic kha tram trpng. Trong do, dac biet cac thuc pham cd miic dp d nhiem cao lai la nhiing thuc<br /> pham dugc nhieu ngudi su dung nhu nem chua, gid cha. Nhieu loai thuc pham hi d nhiem tir hai<br /> loai vi khuan trd len vdi ty le kha cao va cd ca vi khuan gay benh nhu tu cau<br /> Nghien ciru ciing cho thay: Kien thiic, thuc hanh cua ngudi lam dich vu thiic an dudng phd cdn<br /> rat han che. Mirc dp 6 nhiem vi sinh vat cac dung cu che bien thiic an va ban tay cua ngudi lam<br /> dich vu thirc an dudng phd cdn cao hon mirc do d nhiem cac loai thuc pham. Dieu nay cho thay<br /> sir can thiet phai tiep tuc tang cudng cdng tac tap huan vl ve sinh an toan thuc phim (VSATTP)<br /> cho nhdm ngudi lam dich vu thuc an dudng phd va cdng tac giao due siic khoe cho ngudi tieu dung<br /> Tir khoa: O nhiem vi sinh vat, kien thite, thuc hdnh, thicc dn dudng phd.<br /> <br /> I. DAT VAN DE Ket qua nghien ciiu cua mot sd tac<br /> Ngay nay, thiic an dudng phd la mot gia trong vai nam gan day da cd tren 55<br /> loai hinh djch -vu rat thuan tien, phu hgp vu ngd ddc thuc pham do thirc an dudng<br /> vdi ngudi tieu dung vi gia ca va ngudn phd. Thdng ke cua Cue an toan ve sinh<br /> vdn dau tu de md rdng loai hinh djch -vu thuc pham tir nam 1999-2004, d nude ta<br /> nay khdng cao, ban nQa nd cdn tao ra xay ra 1386 vu ngd dgc thuc phim thi cd<br /> cdng an viec lam cho kha nhieu ngu'di lao 1056 vu do thirc an dudng pho va bIp an<br /> ddng trong xa hdi. Tuy nhien, djch vu cdng cdng. Nguyen nhan gay 6 nhiim<br /> thiic an dudng phd ciing cd nhieu nguy thiic an dudng phd rat da dang nhung chu<br /> ca gay ngd ddc thuc pham do nhieu yeu do thuc pham d nhiim vi sinh vat<br /> nguyen nhan. Cac nguyen nhan thudng (VSV) ehilm ty le khoang 50%[2].<br /> gap la tinh trang ve sinh mdi tradng Tai thanh phd Thanh Hoa, hinh thiic kinh<br /> (VSMT) chua dam bao, ve sinh ngudn doanh thuc pham thirc an dudng pho rit<br /> nude, trang thiet bi, dung cu che bien va da dang. Theo sd lieu cua Trang tam Y tl<br /> phu thudc vao kien thiic, thai do, thuc du phdng Thanh Hoa, nam 2007 tren dia<br /> hanh ve sinh an toan thuc pham ban tinh cd 80%) ca sd ve sinh nhan vien<br /> (VSATTP) ciia ngudi kinh doanh djch vu khdng dat yeu cau, 68% so ngudi lam<br /> thiic an dudng phd v.v. djch vu khdng kham sue khoe djnh ky<br /> <br /> 'PGS.TS. DH Y Dugc Thai Nguyen<br /> ^ ThS.Bs. TTYT.TPThanh Hda<br /> <br /> 53<br />  TC.DD & TP6 (2) - 2010<br /> <br /> theo quy djnh cua Bd Y te, 44%o sd mau Thay cac gia trj vao cdng thiic, tinh dugc<br /> thuc pham khdng bao dam tieu chuan vi n = 310.<br /> sinh vat. Thuc trang neu tren gay nhieu b. Cff mlu dilu tra chit luffng ve sinh<br /> nguy CO dan den cac vu ngd ddc thue thiic an ducmg ph6.<br /> phim do thiic an dudng phd. De cd each - Lay 310 mau thiic an dudng phd va<br /> nhin toan dien han ve d nhiem vi sinh vat dung cu khac nhau cua 10 phudng gdm:<br /> thirc an dudng phd tren dja ban thanh phd Bun, banh phd: 30 mlu ;Thit, va cac san<br /> Thanh Hoa, tir do dua ra cac khuyen cao pham tir thjt: 60 mau; Ca va cac san<br /> trong chi dao, quan ly phu hgp cd hieu pham tir ca: 60 mau; Rau sdng cac loai:<br /> qua, chiing tdi tien hanh nghien cii'u van 30 mau; Gid cha: 30 mau; Nem chua: 30<br /> de nay vdi hai muc tieu sau: mau; Ban tay ngudi true tiep che bien: 40<br /> 1. Xae djnh thuc trang d nhiem vi sinh vat mau; Dung cu che bien, chiia dung thuc<br /> thuc an dudng phd tai thanh phd Thanh pham an ngay: 30 mau.<br /> Hda. 3. Cac chi tieu nghien ciiu.<br /> 2. Danh gia thuc trang kien thiic, thuc - Miic do d nhiem vi sinh vat thiic an<br /> hanh ciia ngudi tham gia djch vu thirc an dudng phd: (VK hieu khi; Coliform; -<br /> dudng phd. E.coh.,- S. aureus.; CL.perfiingens.; Sal-<br /> II. DOI TlTOTVG VA PHl/ONG PHAP monella.)<br /> NGHIEN ClTU - Kien thiic, thuc hanh ve sinh thuc pham<br /> 1. Doi tugng nghien ciiu cua ngudi kinh doanh thiic an dudng phd<br /> - Nhii'ng ngudi kinh doanh djch vu thiic 4. Phuong phap thu thap va xii ly so lieu.<br /> an dudng phd. - Kien thiic, thuc hanh cua ngudi tham<br /> - Cac san pham la thii'c an dudng phd , gia djch vu thiic an dudng phd theo mau<br /> dung cu che bien, bao quan thiic an phieu hdi cd san<br /> Thdi gian nghien ciiu: Tir 2007-2008. - Danh gia tinh trang d nhiem vi sinh vat<br /> Dja diem nghien ciiu: Cac phudng cua thite an bang xet nghiem vi sinh vat tai<br /> TP Thanh Hoa: Ba Dinh, Nggc Trao, laobo cua Trang tam Y te dir phdng<br /> Ddng Ve, Tan San, Phu San, Tradng Thi, Thanh Hoa.<br /> Dien Bien, Ddng Thg, Lam San, Ddng San,. - Sd lieu dugc xii ly tren phan mem Epi-<br /> 2. Phuong phap nghien cii'u: Cat ngang info 6.04<br /> md ta cd phan tich. III. KET QUA NGHIEN ClTU<br /> a. Cff mau dieu tra kien thiic, thu'c l.Thuc trang 6 nhiem vi sinh vat thiic<br /> hanh: an dircmg pho<br /> pxq<br /> n= Z^(l-oc/2) x.<br /> <br /> <br /> <br /> <br /> 54<br />  TC.DD & TP6 (2) - 2010<br /> <br /> Bang 1. Nhiim vi sinh vat a cac nhom thuc pham, dung cu, ban tay ngu'ffi che bien<br /> <br /> TT Ten mau So nnau(n) So mau khong dat Ty le (%)<br /> 1 Thjt va cac san pham ti> thjt 60 31 51,7<br /> 2 Biin v^'birih phd 30 -17 56,"7<br /> 3' C^'V^s^'nph'arntii'c'^ 60 26 43,3'<br /> 4 Rau "sdng '30 20 66,'7<br /> '5 'Nerri"chua '30 23 7'6','7<br /> '6 Gidch^ 30 Ts 60<br /> "i B^n'tay '40 25 62,'5<br /> 8 Dung cu che biln thu-c pham 30 '19 63,3<br /> Tong 310 179 57,74<br /> <br /> Bang 1 cho thay: Ty le mau d nhiem vi khuan chung la 57,1A%; nem chua cd ty le<br /> sd mau d nhiem cao nhat (76,7%)), tiep den la mlu rau sdng (66,7%)), thap nhat la mlu ca<br /> va san pham tir ca (43,3%). Cac mau dung cu va ban tay ngudi che bien d nhiem vi khuan<br /> ciing chiem ty le kha cao: 63,3%) d dung cu che bien, 62,5%) d ban tay ngudi chi biln.<br /> Bang 2. Thu'c trang 6 nhiem vi khuan<br /> <br /> Thuc trang TSVKHK Coliforms E.coli S. ureus Cl.perfringens Salmonella<br /> <br /> Mau thit chin va san pham tu- thjt (n = 60)<br /> 6nhiem(%) 100 95,0 58,3 10 6,7 0<br /> Vugt TCCP (%) 51,7 45 40 8,3 6,7 0<br /> Muc nhiim cao nhat 6.7X107 4600 390 200 30 0<br /> QB 867/BYT-QB 3J05 50 3 10 Jo 0<br /> Mau ca va san pham tii- ca ( n = 60)<br /> 6nhiem(%) 100 74,7 50 2,5 8,3 0<br /> ViigtTCCP(%) 20 43,3 26,7 3,3 5 " "o<br /> Mirc nhiim cao nhat 7.4 X 105 2400 430 150 16 0<br /> QB 867/BYT-QB 105 10 3 10 10 Q<br /> Mau bun va banh phff (n = 30)<br /> 6nhiim(%) 100 76,6 56,7 6,7 0 0<br /> _VugtTCCP(%) 23,3 56,7 46,7 6,7 0 0<br /> Miic nhiim cao nhat 2.9X106 750 43 20 0 0<br /> QB 867/BYT-QB 104 10 3 10 lo" 0<br /> Mau nem chua (n= 30)<br /> 6nhilm(%) 100 91.0 75,3 10 10,0 0<br /> yugtTCCP(%) 53,3 76,7 75,3 10 6,7 0<br /> Miic nhiem cao nhlt 3.4X108 24000 3900 160 140 'o<br /> QB 867/BYT-QB 3.105 50 3 10 10 0<br /> Miu gio, cha (n= 30)<br /> O nhiim (%) 100 87 61,7 13,3 23,3 0<br /> yugtTCCP(%) 23,3 50,0 60 13,3 133 0<br /> Mirc nhiim cao nhat 5.2X107 1100 210 250 100 0<br /> QD 867/BYT-QB 3T05 50 3 10 I'o 0<br /> <br /> <br /> 55<br />  TC.DD & TP6 (2) - 2010<br /> <br /> Bang 2 cho thay: ciia viec sir dung thuc phim cd ngudn gdc<br /> - 100% mau thjt va san pham tir thjt bj d rd rang, 50,6%) hilu bilt vl quy trinh che<br /> nhiem vi khuan hieu khi, 95%) mau nhiem bien I chilu, dac biet ty le hieu biet ve<br /> Coliforms, 58,3% nhiem E. coh va 10%o tac dung chinh cua tu lanh trong phdng<br /> nhiem tu cau. Mirc do d nhiem deu vugt chdng ngd ddc thuc phim mdi chi dat<br /> tieu chuan theo quy djnh cua Bd Y te. 31,3%). Chi cd 54,5%) so ca sd cd tu lanh<br /> de bao quan thuc phim va 37,7%o sd ca<br /> - 100%) mau ca cd mat ciia vi khuan hieu sd dich -vu cd thiet bi phdng chdng cdn<br /> khi, 74,7% phat hien cd Cohforms, 50% tning. Cd 20,3%) sd ngudi tham gia dich<br /> phat hien cd E.coli. Thap nhat la Cl.per- vu thuc an dudng phd cd sir dung trang<br /> fringens (8,3%)) va S. aureus (2,5%)). bj bao hg lao ddng va cd 73,9%) sd ngudi<br /> Mirc do d nhiem vi sinh vat deu vu'gt tieu phuc •vu cd thdi quen rira tay khi che bien<br /> chuan cho phep thuc pham va cat mdng tay.<br /> -100 % cac mau xet nghiem bun va banh rv. BAN LUAN<br /> phd deu bj d nhiem vi khuan hieu khi va<br /> LTinh hinh 6 nhiem VSV thii'c an<br /> miic do d nhiem deu vu'gt qua tieu chuan<br /> du'ffng pho nam 2007 tai TP Thanh<br /> cho phep. Dieu can chu y la cac mau biin<br /> Hoa<br /> va banh phd dugc xet nghiem cd tdi<br /> 46,7% sd mau bi d nhiem E.coli. Qua nghien ciiu 310 mau thuc pham,<br /> ban tay ngudi che bien thuc pham, dung<br /> - 100%) cac mau nem chua deu phat hien cu che bien thuc pham cho thay: ty le<br /> cd d nhiem cac vi khuan vugt qua quy mau khdng dat TCVS chung trong cac<br /> dinh cho phep cua Bd Y te. Cd den 75,3% mau thuc pham la 57,74%. trong dd muc<br /> sd mau bj d nhiem vi khuan E.coli. 10% do d nhiem cao nhat la nem chua<br /> d nhiem S.. aureus (76,7%); Trong mau thjt va cac san pham<br /> -100% cac mau gid, cha dugc xet nghiem ve thjt ty le d nhiem vi sinh vat vugt qua<br /> deu cho thay cd d nhiem vi khuan hieu TCCP ciia Bg Y tl la 51,7%; 60% trong<br /> khi. Dac biet d nhiem vi khuan E.coli gid, cha; 56,7%) trong biin va banh phd.<br /> vugt qua TCCP cua Bg Y tl ty le d nhiem vi sinh vat tren dung cu va<br /> ban tay ngudi che bien thuc pham kha<br /> - Ket qua xet nghiem d nhiem vi sinh vat cao: Ty le d nhiem d mau dung cu che<br /> d dung cu che bien thuc pham cho thay: bien thuc pham la 63,3%o, d mau ban tay<br /> 61,4% mau xet nghiem cd d nhiem vi ngudi che bien la 62,5%o. Dieu nay cho<br /> khuan hieu khi, 63,3% d nhiem Col- thay nguy ca gay d nhiem vi sinh vat thuc<br /> iforms, 60%) d nhiem E. coh, 6.6% 6 pham mdt phan cd the tir dung cu che<br /> nhiem S. aureus. bien khdng dam bao ve sinh va cd the do<br /> 2. Kien thiic , thuc hanh cua ngu'oi d nhiem tii' ban tay ban cua ngudi che<br /> phuc vu thiic an duong pho bien, phuc vu. Dac biet nguy hilm ban<br /> khi mau thuc pham bj d nhiem vi sinh vat<br /> Ket qua dieu tra cho thay chi cd nhit la tu cau vang Trong nghien ciiii cua<br /> 40,6%) sd ngu'di tham gia djch vu thuc an ehiing tdi, cac mau thuc pham bj d nhiim<br /> dudng phd hieu biet rat han che ve 10 tu ciu cao nhit ttong gid cha (13,3%)), sau<br /> nguyen tac vang trong lua chgn, che bien dd din nem ehua (10%)). Day la nhung<br /> thuc pham, 50,6% hieu biet ve tac dung<br /> <br /> 56<br />  TC.DD & TP6 (2) - 2010<br /> <br /> <br /> thuc pham dugc khach hang sir dung vdi 50,6%), vl quy trinh che bien mdt chieu:<br /> tan sd cao. 50,6%), ve tam quan trgng cua viec hge<br /> tap kiln thiic ve sinh an toan thuc pham<br /> Miic do d nhiem vi sinh vat d dung<br /> va kham siic khoe dinh ky: 97,4%, dac<br /> cu che bien thirc an va tir ban tay ban cd<br /> biet hilu bilt vl tac dung chinh cua tu<br /> phin cao ban miic do d nhiem cac thuc<br /> lanh trong viec de phdng ngd dgc thirc<br /> pham, dieu nay cho thay can dac biet<br /> pham dat d miic qua thap: 31,3%. Chinh<br /> quan tam tdi hanh vi ve sinh cua ngudi<br /> lam djch 'vu thirc an dudng phd va su can dieu nay da dat ra cho ngudi quan ly va<br /> thiet phai tang cudng kiem tra chat lugng cac ban nganh hiiu quan can quan tam<br /> ve sinh cac dung cu che bien thiic an nhieu ban ve cdng tac trayen thdng giao<br /> dudng phd. due siic khoe d cdng ddng ma true tiep la<br /> nhiing ngudi san xuat, che bien, kinh<br /> Y nghia djch te hge ve nguy ca d doanh thuc pham de bao ve siic khoe<br /> nhiem vi sinh vat ngoai miic do tieu thu ngudi tieu dung.<br /> thuc pham, tinh chat sinh hge cua vi sinh<br /> vat, can dugc quan tam den sd thanh phan V. KET LUAN<br /> vi sinh vat d nhiem tren mdt loai thuc 1. Thuc trang 6 nhiim thiix an dirong<br /> pham. Nghien ciiu cua chung tdi cho thay pho tai thanh pho Thanh Hoa<br /> 100% mau nem chua va gid, cha cd 5 loai<br /> Ket qua nghien ciiu cho thay: tinh<br /> vi khuan; Trong do 10%) mau nem va<br /> trang d nhiem vi sinh vat thirc an dudng<br /> 13,3% gid cha d nhiem tu cau. Day that<br /> phd tai thanh phd Thanh Hoa trong cac<br /> su la dieu dang bao dgng ve nguy ca va<br /> nam 2007 - 2008 d miic kha tram trgng<br /> tinh chat cua cac "vu ngd ddc thuc pham,<br /> dang la van de cd y nghia siic khoe cdng<br /> theo Phan Thj Kim, khi thuc pham che<br /> ddng: 100%) cac thuc pham che bien san:<br /> bien an ngay bj d nhiem bdi 2 loai vi<br /> Thjt chin va cac san pham tir thjt, ca va<br /> khuan trd len thi nguy ca gay nen tinh<br /> cac san pham tir ca, bun, phd, nem chua,<br /> trang ngd dgc cap tinh cao gap hang tram<br /> gid, cha deu bi nhiem bdi vi khuan hilu<br /> lan so vdi 1 loai.<br /> khi. 45%) mau thjt va cac san pham tir thjt;<br /> 2. Thuc trang kien thiic, thu'c hanh ve 43,3%) mlu ca va san phim rtr ca; 56,1%<br /> ve sinh thiic an duong pho ciia ngu'oi mlu biin va banh phd; 16,1% mlu nem<br /> tham gia che bien, kinh doanh thuc chua; 50%) mlu gid cha nhiim Coliforms<br /> pham vugt tieu chuan cho phep. Cd tdi 40%)<br /> mau thjt va cac san phim tu thjt; 26,1%<br /> Ket qua nghien ciiu cho thay nhiing<br /> mau ca va san pham tir ca; 46,7%o mlu<br /> kien thiic ca ban lien quan den cdng tac<br /> biin va banh phd; 75,3%o mlu nem chua;<br /> dam bao chat lugng ve sinh an toan thuc<br /> 60%) mau gid cha nhiim E.coli •vugt tieu<br /> pham cdn rat thap, nhu hieu biet ve 10<br /> chuan cho phep.<br /> nguyen tac trong lira chgn, che bien thuc<br /> pham vang mdi chi dat 40,6%), hieu biet 2. Thye trang kien thiic, thye hanh vl<br /> ve ngudn nude sach: 54,8%, hieu biet day ve sinh thiic an duong ph6 cua nguoi<br /> dii ve trang bi bao hg lao dgng: 78,7%), tham gia chi biln, kinh doanh thye<br /> hieu biet ve tac dung cua tu kinh, cua viec pham<br /> xir dung thuc pham cd ngudn gdc rd rang:<br /> Kien thiic, thuc hanh ca ban dl dam<br /> <br /> 57<br />  TC.DD & TP6 (2) - 2010<br /> <br /> bao chat lugng ve sinh an toan thuc pham TAI LIEU THAM KHAO<br /> cdn rit thip: chi cd 40,6%) hieu biet ve 1. Bg Y tl. Cue Quan ly chit lugng ve sinh<br /> 10 nguyen tac trong lira chgn, ehe bien an toan thuc phim: Cac benh truyen qua<br /> thuc phim vang, ban 50% hieu biet ve thuc phim. NXB Thanh nien, 2001,trang<br /> ngudn nude sach, ve tac dung ciia tu kinh, 43,61.<br /> su dung thuc pham cd ngudn gdc rd rang, 2. Bg Y tl - Danh muc tieu chuin ve sinh<br /> quy trinh che bien mdt chieu...., dac biet luang thuc, thuc phim. Ban hanh kem<br /> hilu bilt vl tac dung chinh cua tu lanh theo Quylt dinh sl 867/BYT-QD ngay<br /> trong viec dl phdng ngd ddc thuc pham 04/4/1998 cua Bo trudng Bg Y tl.<br /> dat d miic qua thap: 31,3%). Cac dung cu 3. Bg Y te: De an kl hoach trien khai thuc<br /> sir dung de che bien thuc pham ciing bi d hien Chien luge Quoc gia ve dinh dudng<br /> nhiem vi sinh vat kha cao. giai doan 2001-2010. Ban ban kem theo<br /> Quylt dinh sd 2012/2003/BYT-QD ngay<br /> VI. KHUYEN NGHI 16/6/2003 cua Bo trudng Bp Y tl.<br /> 1. Ca quan y te dja phuang can tang 4. Bo Y tl- To chirc Y te The gidi: Tai lieu<br /> cudng cdng tac tap huan, truyen thdng tap huan ve sinh an toan thuc pham cho<br /> giao due VSATTP cho cac ddi tugng kinh ngudi quan ly tai cac cang tin, bep an tap the<br /> doanh thuc an dudng phd 5. Chien luge Qudc gia ve dinh duong giai<br /> doan 2001-2010. Ban hanh kem theo<br /> 2. Thuc hien triet de viec kham site khde Quylt djnh so 21/2001/QD-TTg ngay<br /> djnh ky cho ngudi kinh doanh thite an 22/2/2001 Cua Thu tudng Chinh phu.<br /> dudng phd. 6. Cac van de an toan thuc pham<br /> 3. Sd y te va cac ca quan cd lien quan can WHO/FNU/96: Nhirng yeu cau ca ban<br /> tang cudng kiem tra, thanh tra ve sinh cac ve an toan ddi vdi thiic an dudng pho.<br /> ca sd thiic an dudng phd de giam tac haj NXB y hpc 2000. Ban dich cua Nguyin<br /> sire khoe ngudi tieu dung. Huy Nga.<br /> <br /> <br /> <br /> <br /> Summary »<br /> CONTAMINATED STREET FOOD WITH MICROBIOLOGY AND STREET FOOD<br /> PROVIDER'S KNOWLEDGE AND THEIR PRACTICE AT THANH HOA CITY<br /> DURING 2007-2008<br /> <br /> By conducting a cross-sectional study on street food providers, food processing materials and<br /> street foods, results revealed that the contaminated street food with microbiology at Thanh Hoa<br /> City during 2007-2008 were at serious levels, especially fermented pork roll and lean pork paste.<br /> Which were much consumed. Many kinds of contaminated street foods with more than two kinds<br /> of microbiology have been found even with Staphylococccusaureus.<br /> The study also showed that street food provider's knowledge and practice were still very limited;<br /> microbiologied contamination levels in food processing materials and food provider's hands were<br /> found higher than those in street foods. This indicated that health education about food safety and<br /> hygiene for street food providers and consumers need to be regularly reinforced.<br /> Key words: Biological contamination, knowledge, practice, street foods.<br /> <br /> <br /> 58<br />