Knowledge, attitudes, and practices of food handlers on endocrine-disrupting chemicals in baby formula in Malawi- A cross-sectional study

Abstract

Abstract Background This cross-sectional study examines knowledge, practice, and attitudes regarding food safety among 100 people involved in manufacturing baby formula in Malawi regarding endocrine disruptors. The study received approval from the National Committee on Research and informed consent. Methods Data collected through face-to-face interviews were checked, cleaned and analyzed using R version 4.2.2. Logistic ordinal regression analysis was used to examine the correlation between socio-demographic variables against knowledge, attitudes, and practices. The p-value < 0.05 was considered statistically significant for the tests. Results and discussion There were more males (67%) than females (33%), at least half (51%) were below 35 years of age with 64% having at least 5 years of working experience. 92% trust in the safety of their product despite being unfamiliar with EDCs. Raw materials and packaging are suspected contamination sources. Only 42% of food handlers are aware of EDCs, slightly higher than Egypt and Ethiopia due to sociodemographic differences and study designs. Food safety knowledge correlated with sex (p = 0.016), ages 18-24 (p =0.069) and 45-54 (p = 0.036), and education level (p = 0.002). Food handlers who attained at least secondary education were better knowledgeable. The study reveals a significant knowledge gap and a higher likelihood of unsafe practices among food handlers regarding endocrine disruptors as they had positive attitudes. Conclusion The study identifies knowledge gaps and a lack of national strategies to deal with EDC contamination. It suggests the need for strengthening food safety knowledge, practices, and attitudes through legal instruments, awareness, training, and collaboration.