Figure 1: Threat
evaluation matrix (7)
Risk
assessment for universities and hospitals restaurants in Gaza, Palestine, in
2012
Darwiesh MK, MSc1,
Al-Hindi AI, PhD2*
1. MSc Student, Faculty of Science, Islamic
University of Gaza, Gaza, Palestine. 2- Professor, Dept. of Medical laboratory Sciences, Faculty of Health Sciences,
Islamic University of Gaza, Gaza, Palestine.
Abstract
Received: February 2014, Accepted: January 2015
|
Background: A cross-sectional analytic method was used to
assess health and safety risks that really matter in restaurants of
universities and hospitals in the Gaza strip, Palestine. Materials and methods: A 40-item questionnaire was completed by workers in
all university and governmental hospital restaurants in the Gaza strip.
Another 30-item questionnaire was completed by university students, in
addition to 40 checklists and 40 personal meetings were conducted by the
researcher. The collected data were analyzed by the risk score matrix to
detect the risk level (low, medium, high, and very high) for each risk
factor. Results: In general, university and hospital restaurants
were similar in terms of risk, but the details differed. The results showed that
22.7% of physical and electrical risk factors in universities were at a very
high risk level. It was found that 50.0% of cleanliness of the location and
equipment risk factors were at a high risk level, and 60.0% of machinery and
equipment risk factors were at a moderate risk level. In addition, the most
frequently observed risk factor was employees’ and customers’ safety and
health. The results on hospital restaurants showed 75% of physical and
electrical risk factor and machinery and equipment risk factor were at a moderate
level and high level, respectively. Conclusions: It can be concluded that hospital and university
restaurants are similar in terms of risks and levels of risks. Moreover,
restaurant employees, cleaners, organization employees, visitors, university students,
and patients in hospitals may be at risk if exposure to hazards. Therefore, the
development and implementation of a plan with specific measures to address
the identified risks is recommended. |
Keywords: Risk, Assessment, Restaurants, Universities,
Hospitals.
Introduction
Risk
is defined as the uncertainty of outcome, whether positive opportunity or
negative threat, of actions and events. Risk has to be assessed in respect of
the combination of the likelihood of something happening and the impact of its
occurrence. Risk management includes identifying and assessing risks (the
“inherent risks”), and then, responding to them (1). The restaurant industry could have significant
risks, so it must be carefully analyzed to ensure that hazards associated with
this occupation are identified and the risks of those hazards are assessed.
Once the level of risk is known, control measures can be put in place to reduce
it. The lower the level of risk an occupation presents, the less chance of an
accident occurring in that occupation (2). According to the author’s knowledge,
there is no available data on the different risk factors in university*and
hospital restaurants in Gaza, Palestine. The majority of studies carried out in
Gaza were related to health risks or food contaminations.
Recently, in Gaza, interest toward restaurants and the quality of food provided
has been growing; however, still little attention is
paid to the numerous risks in restaurants. The central Public Health
Laboratory (PHL) in Palestine in 2005 collected a total of 9, 435 food samples
(3.022 in the Gaza strip and 6,413 in the West Bank) for bacteriological
examinations (3).
According to their reports, 20.5% of
the food samples collected was contaminated (16.7% in the West Bank and 28.5%
in the Gaza strip). Among the food contaminations found in microbiological
examination, coliform and yeast had the highest rates (3). The present study
will address the following aims: (a) to assess risks that are of importance in
restaurants of universities and hospitals in the Gaza strip; (b) to consider health
and safety risks with the potential to cause harm for workers, guests, and
properties at these restaurants; (c) to detect the level of risks
(low, medium, high, and very high) using the risk score matrix; (d) to
determine which types of restaurants (universities, hospitals) are more at
risk; and (e) to detect the most frequent risk factors in restaurants.
This study was performed in order to recommend interventions to treat potential
work place risks of the study areas.
Materials and Methods
This was a cross-sectional analytical study carried out on all university
and hospital restaurants in the Gaza strip from November 2011 to May 2012.
An approval was obtained from the Ministry of Health and all
Universities participated in the study in 7/5/2012. Informed consents were
obtained from every participant.
The target population of this study consisted of restaurants in two
sectors:
1-
The high education sector represented by universities.
2-
The health sector represented by governmental
hospitals.
According to the Ministry of education and high education, 7 universities
have a valid license: Islamic University of Gaza (IUG), Al-Azhar, Al-Aqsa,
University of Gaza, AL-Omma, Palestine, and AL-Quds Open University. The
largest university was IUG in terms of the number of students; as the number of
students in the year 2011 reached 20.000 (8.000 male, 12.000 female). The
number of governmental hospitals was 13, but not all hospital had restaurants;
Al-Shifa Hospital does not have a restaurant due to the new daily delivery
system of ready meals by a contracted company.
The restaurant of the Rantisi Pediatric Hospital in the Gaza strip
provides daily meals for 5 hospitals: Al-Naser, Eyes, Psychiatry, and Durra, in
addition to Rantisi Pediatric Hospital itself.
The restaurant of Kamal Adwan
Hospital in Northern Gaza offers its services to its hospital as well as the
Beit-Hanoun Hospital. All the remaining hospitals have restaurant inside their
buildings; Al-Aqsa Hospital in the middle zone of the Gaza strip, the Nasser Hospital
and European Hospital in Khan Younis in Southern Gaza, Abu Yousef Al Najjar
Hospital in Rafah in Southern Gaza, and United Arab Emirates Crescent Hospital
in Rafah in Southern Gaza.
The study population consisted of 70 samples divided into 2 categories.
The first category included 40 workers, in addition to kitchen managers. The
second category contained 30 students (males and females), and university
staff.
All headquarters of universities, and governmental hospitals in the Gaza
strip, Palestine, were studied. All students registered in each university, and
restaurant workers and managers were enrolled into the study.
Procedures
Data collection was performed using 4 tools:
1. A structured
self-report questionnaire: In each restaurant, 2-3 workers were asked to completed a questionnaire
including data and questions about the types of risks in restaurants and 3-4
students completed another questionnaire.
Construction
of questionnaire no. 1
A structured face-to-face
questionnaire with closed-ended questions was conducted by the researcher. To
construct the questionnaire, the researcher used different guidelines and
references which were concerned with restaurant risk assessment, such as workplace
health and safety hazard identification constructed by Workplace Health and
Safety Queensland (4), restaurant and cafe risk management guide issued by the
Wesfarmers General Insurance Limited, and example risk assessment for food
preparation, cooking, and service issued by the Health and Safety Executive
(5).
The
questionnaire included questions related to the 8 risk factors of slips, trips
and falls, workers, customer safety and health, physical and electrical risks,
machinery and equipment, food deliveries, food contamination, cleanliness of
location and equipment, employee training, the type of restaurant, and the
number of workers.
Construction
of questionnaire no. 2
A structured face-to-face questionnaire with close-ended questions was
conducted by the researcher to collect data about university cafeterias. The
questionnaire included questions related to slips and falls, and physical
conditions of the cafeteria. In the present study, the risk score matrix was
adopted for the two questionnaires to investigate severity and likelihood in
the questionnaire, and then, to determine the level of each detected risk.
Checklist: In
every restaurant, the researcher walked around the kitchen, the stockroom, and
all other areas noting things that might pose a risk, and filling a check-list used
to verify the availability of specific conditions, like ventilation and lighting in the kitchen, working of the refrigerator temperatures organizer, and safety
conditions for workers.
Personal meeting: In each group of staff, some workers were interviewed using specific
questions with multiple choice answers, like “Who is responsible for the
controlling of insects and rodents in the restaurant?”; and “What are the most
common problems you are facing at work?”. The last two questions were open
ended. Using this tool, the researcher listened to workers’ concerns and
opinions about health and safety conditions at the work place.
Processing of collected data
The collected data have been processed by two methods:
The risk score matrix was used to analyze the threat of greatest
concern, and detect the risk level (6) (Figures 1).
Figure 1: Threat
evaluation matrix (7)
Data analysis was performed using the
Statistical Package for the Social Sciences (version 15; SPSS Inc., Chicago,
IL, USA) to compare the variables. Z-test was used to examine the statistical
difference between two population proportions. Chi-square test was used to
examine the statistical difference between more than two population proportions
and the relationship between
two nominal (qualitative)
variables. If P-value is smaller than the level of significance and α is
equal to 0.05, then there exists a significant relationship between the given
proportions.
Results
Comparisons for each factor between restaurants (hospitals
and universities)
Slips and falls
The low risk level (LRL) for slips and falls was
higher in hospital restaurants than university restaurants; the proportions for
hospitals and universities equaled 86.1% and 77.3%, respectively. The moderate
risk level (MRL) of university restaurants was higher than hospital restaurants;
the proportions for hospitals and universities equaled 8.3% and 13.6%,
respectively. The high risk level (HRL) of university restaurants was higher
than hospital restaurants; the proportions for hospitals and universities equaled
5.6% and 9.1%, respectively. The LRL of workers’ and customers’ safety and
health, physical and electrical risks, and machinery and equipment risks, was
higher in university restaurants than hospital restaurants. The LRL of food
deliveries was similar for both university and hospital restaurants. The
proportions of LRL for food contamination of hospitals and universities equaled
77.8%. The LRL of cleanliness of location and equipment varied between hospital
and university restaurants. Employee training LRL seems to be similar in both groups
(Figures 2 and 3).
Figure 2: Comparison
of all factors between university restaurants
Figure
3: Comparison of all factors between hospital restaurants
Comparison of all risk factors and their levels in general
The LRL (94.1%) of the employee
training factor is
significantly higher than other factors (P = 0.001). The MRL (42.3%) of the
physical and electrical risks factor is significantly higher than other factors (P = 0.001). The HRL
(58.8%) of the machinery and equipment factor is significantly higher than other factors (P = 0.001).
Only the physical and electrical risks factor has a very high risk level (VHRL)
(19.2%) (Table 1).
Table 1: Comparisons of risk factors
|
Risk level |
Slips and falls (%) |
Workers’ and customers’ safety and health (%) |
Physical
and electrical risks (%) |
Machinery and equipment (%) |
Food deliveries (%) |
Food contamination (%) |
Cleanliness of location and equipment (%) |
Employee
training (%) |
c2 |
P-value |
|
Low |
82.8 |
83.1 |
30.8 |
17.6 |
77.8 |
77.8 |
20.0 |
94.1 |
216.9 |
0.001* |
|
Moderate |
10.3 |
10.2 |
42.3 |
23.5 |
18.5 |
7.4 |
40.0 |
2.9 |
80.3 |
0.001* |
|
High |
6.9 |
6.8 |
7.7 |
58.8 |
3.7 |
14.8 |
40.0 |
2.9 |
164.3 |
0.001* |
|
Very High |
- |
- |
19.2 |
- |
- |
- |
- |
- |
NA |
|
* The proportion difference is significant at the 0.05
level.
NA: There are not enough valid cases for the chi-square test
Results of workers’ interviews
Table 2
presents restaurant workers’ ages; the highest age at hospital and university restaurants were 55
years and 35 years, respectively. Half
of university workers perform regular medical examination for infectious
diseases, while 95% of workers at hospitals perform regular examination. Similar results were
obtained on using oil for frying two times in university and hospital
restaurants. In universities restaurants, oil used for frying was used more
than three times.
Table 2: Results of workers’ interviews in the restaurants
|
|
Total N (%) |
Hospitals N (%) |
Universities N (%) |
||||
|
Ages
of workers in the restaurant |
|
|
|
|
|
||
|
18-25 |
5
(12.5) |
0 (0) |
5
(25.0) |
||||
|
26-35 |
7
(17.5) |
0 (0) |
7
(35.0) |
||||
|
36-45 |
7
(17.5) |
5
(25.0) |
2
(10.0) |
||||
|
46-55 |
21
(52.5) |
15
(75.0) |
6
(30.0) |
||||
|
Regular
medical examination |
|
|
|
||||
|
Yes |
29
(72.5) |
19
(95.0) |
10
(50.0) |
||||
|
No |
11
(27.5) |
1
(5.0) |
10 (50.0) |
||||
|
Number
of times of using the same oil for frying |
|
|
|
||||
|
1.00 |
16
(50.0) |
15
(75.0) |
1
(8.3) |
|
|||
|
2.00 |
8
(25.0) |
5
(25.0) |
3
(25.0) |
|
|||
|
3.00 |
3
(9.4) |
0 (0) |
3
(25.0) |
|
|||
|
6.00 |
3
(9.4) |
0 (0) |
3
(25.0) |
|
|||
|
7.00 |
1
(3.1) |
0 (0) |
1
(8.3) |
|
|||
|
10.00 |
1
(3.1) |
0 (0) |
1
(8.3) |
|
|||
|
Who is
responsible for controlling insects and rodents? |
|
|
|
|
|||
|
Restaurant
workers |
18
(46.2) |
0 (0) |
18
(90.0) |
|
|||
|
Department
of health in the organization |
4
(10.3) |
3
(15.0) |
1
(5.0) |
|
|||
|
Specialized
companies |
17
(43.6) |
17
(85.0) |
1
(5.0) |
|
|||
Workers
reported the common problems they faced in their work place as shown in table
3. The first problem is lack of staff.
Results
of the checklist for workers
All
hospital workers wore uniforms during work hours, while only 25.0% of university
workers wore uniforms. The rate of bathroom cleanness was 75.0% and 42.86% for
hospital and university restaurants, respectively. Nearly 43% of hospital
kitchens and 87.5% of university kitchens had sufficient ventilation. All
laundries and sinks in university restaurants were in good conditions, while
42.9% of laundries and sinks in hospital restaurants had a water leakage or
rash (Table4.)
Table
3: The most common problems presented in restaurants as reported by the
workers
|
Problems |
Hospitals (%) |
Universities (%) |
|
Lack of staff |
85 |
30 |
|
Inadequate equipment |
50 |
30 |
|
Delayed maintenance of damaged
equipment |
60 |
5 |
|
Limited space |
30 |
25 |
|
Need for training courses |
40 |
15 |
Table
4: Results of the checklist for workers
|
Universities N (%) |
Hospitals N (%) |
Total N (%) |
Answers |
Variable |
|
2 (25.0) |
7 (100.0) |
9 (60.0) |
Yes |
Number of workers wearing uniform |
|
6 (75.0) |
|
6 (40.0) |
No |
|
|
6 (75.0) |
6 (85.71) |
12 (80.0) |
Yes |
Working of temperatures organizer of the
refrigerator |
|
2 (25.0) |
1 (14.29) |
3 (20) |
No |
|
|
3 (42.86) |
6 (75.0) |
9 (60.0) |
Yes |
Cleanness of workers’ bathrooms |
|
4 (57.14) |
2 (25.0) |
6 (40.0) |
No |
|
|
7 (87.5) |
3 (42.9) |
10 (66.7) |
Yes |
Ventilation of the kitchen |
|
1 (12.5) |
4 (27.1) |
5 (33.3) |
No |
|
|
7 (87.5) |
7 (100.0) |
14 (93.3) |
Yes |
lighting of the kitchen |
|
1 (12.5) |
|
1 (6.7) |
No |
|
|
|
3 (42.9) |
3 (20.0) |
Yes |
Presence of water leakage in sinks or
laundries |
|
8 (100.0) |
4 (57.1) |
12 (80.0) |
No |
Results of the questionnaire for students
The different risks mentioned by the university students are summarized
in table 5.
The difference in the risk levels of
the material of floors factor is statistically insignificant. However, the difference
in the risk levels of the factors of absence of wet floor signs and narrow paths
between the tables were
statistically significant (P = 0.001). The HRL (68.8%) was significantly higher
than other risk levels (Table 5).
Table 5: Levels of different risks according to university
students
|
P-value |
c2 |
No.(%) |
Risk level |
Variable |
|
0.881 |
0.667 |
1 (16.7) |
Low |
Material of floors |
|
1 (16.7) |
Moderate |
|||
|
2 (33.3) |
High |
|||
|
2 (33.3) |
Very high |
|||
|
0.001* |
17.080 |
3 (12.0) |
Low |
Absence of wet floor signs |
|
2 (8.0) |
Moderate |
|||
|
15 (60.0) |
High |
|||
|
5 (20.0) |
Very high |
|||
|
0.529 |
1.273 |
2 (18.2) |
Moderate |
Shortage of workers in the restaurant |
|
4 (36.4) |
High |
|||
|
5 (45.5) |
Very high |
|||
|
0.307 |
2.364 |
3 (27.3) |
Low |
Bad state of the tables and chairs |
|
2 (18.2) |
Moderate |
|||
|
6 (54.5) |
High |
|||
|
0.001* |
16.500 |
2 (12.5) |
Low |
Narrow paths between the tables |
|
1 (6.3) |
Moderate |
|||
|
11 (68.8) |
High |
|||
|
2 (12.5) |
Very high |
|||
|
0.247 |
2.800 |
2 (13.3) |
Moderate |
Size of the restaurant |
|
6 (40.0) |
High |
|||
|
7 (46.7) |
Very high |
|||
|
0.273 |
2.600 |
1 (10.0) |
Moderate |
Ventilation of the restaurant |
|
4 (40.0) |
High |
|||
|
5 (50.0) |
Very high |
|||
|
0.414 |
0.667 |
2 (33.3) |
High |
Discomfort of the students in the location of
receiving meals |
|
4 (66.7) |
Very high |
|||
|
0.368 |
2.000 |
1 (14.3) |
Low |
Self-service bars |
|
4 (57.1) |
High |
|||
|
2 (28.6) |
Very high |
* P-Value
Discussion
The present
research is the first to identify, collect, and compare risk factors, and their
description, likelihood, and risk levels in restaurants of two important
sectors in Gaza strip (universities and hospitals).
Comparison
of risk factors between university and hospital restaurants
University
and hospital restaurants were similar in terms of the slips and trips risk
factor and its levels. The highest proportion of risk level for this factor was
LRL. Despite the agreement between universities and hospitals in terms of the
slips and trips factor, there was variation in its level between the two. For
example, in the health and safety executive report, it was declared that slips
and trips are responsible for 33% of all major injuries of employees, in 90% of
cases the floor was wet, and 95% of major slips resulted in broken bones (8).
In this study, hospital restaurant workers mentioned slips and trips as the
most frequent risk factor at their work place, university restaurant workers
mentioned it as the second most frequent risk factor. This is
due to the fact that none of the restaurants in the study put up warning signs for
wet floor where required. In restaurants of Gaza, this risk is lower because of precautions taken to
prevent dangerous injuries such as closing the restaurant doors when cleaning
the floor with water, immediate removal of damaged chairs or tables. Moreover,
during the present study, entrances, stairs, and ramps of the restaurants were
in good conditions and safe. Most university restaurant workers noted the workers’
safety and health factor as the most frequent risk factor,
whereas most hospital restaurant workers considered it to be the second most
frequent. A number of important points were seen as related to this risk factor,
like acute shortage in rest places for workers in most study restaurants. Many
workers refused to wear gloves, especially in university restaurants, due to it not being comfortable during work. Although the
rate of injuries resulting from this risk factor is low, it can be serious
in other cases; sprains and
strains of muscles and lenders are common among food service workers and
improper fitting and repetitive motions are often associated with sprains, strains,
and tear injuries in restaurants (9). Electrical equipments are widely used in
the restaurant industry. Frequent use and cleaning may cause equipment to
become electrically unsafe, electricity can kill and even non-fatal shocks can
lead to severe and permanent injuries (10). This is compatible with the present
study results, where the physical and electrical risk factor is the only one
recorded as very high level in university restaurants. Even in hospital
restaurants, this factor came first in the MRL. This is due to the lack of regular
testing of electrical systems by a competent electrician. The help of competent
electricians is only requested when there is a problem which restaurant workers
cannot fix. Moreover, an insufficient number of, and low quality fire
extinguishers were observed in restaurants. In general, the highest HRL was
that of the machinery and equipment risk factor, and caused by incorrect
reassembly of machines and poor maintenance and lack of use of guards. A
significant number of accidents are due to inadequate isolation of machines
(11). The machinery and equipment risk factor had the highest rate in hospitals
with a significant difference to the rate of universities. This is because of the
use of different large machines in hospitals to prepare complete meals
(breakfast, lunch, and dinner) daily for patients and hospital employees, while
university restaurants mainly prepare and serve sandwiches and fast food, which
do not need large machines.
The food
deliveries factor is considered as one of the ten most important contributory
factors in the outbreak of food-borne diseases (12). Although the steps
followed in food delivery in the studied restaurants were satisfactory, the
shortage of workers in hospitals significantly affected this factor. The delivery
of ready meals to patients is a new trial in hospitals of Gaza. In the past
meals were prepared in hospital kitchens and offered to the patients. University
and hospital restaurants are similar in terms of the food contamination risk
factor. The level of risk is mainly the result of the lack of reviewing manager
information about food contamination by workers and no clear labeling for
containers in the kitchens. All hospital restaurant workers were
using the same oil once or twice for frying and they followed the instructions
of the Ministry of Health since the meals are provided to patients. Much attention is paid to the quality of food to be healthy. While repeated use of oil for frying in private companies in
university restaurants has increased due to their prioritization of economic
aspects and the absence of monitoring procedures.
The results
showed that few workers considered the cleanliness of location and equipment
factor as hazardous. This is not compatible with the researcher’s direct
observation of a low level of cleanliness especially in university restaurants.
This is supported by another study which considered this factor as the most
commonly cited violation in restaurants (13). In hospitals, the low rate of
cleanliness is not limited to restaurants; another study showed the presence of
cockroaches in the cabinets of patients in hospitals in Gaza (14).
Employee
training risk factor had the lowest rate compared to others. This is due to the
requirement of knowledge or previous experience for employees particularly in
hospital restaurants and worker training before beginning tasks in both
university and hospital restaurants. These results are more satisfactory than
those of commercial sectors in Gaza; for example, 58.9% and 42.2% of employees
of cake bakeries had previous experience and training, respectively (15).
Risks in
university restaurants as reported by students
University
restaurants are students’ favorite places to rest and eat during the day. The
most risk detected was that of the factor of absence of wet floor signs when
required; 75% of students reported it as the first risk, with a statistically
significant difference between its levels. This result is logical since the cleaning
process is performed more than once a day and students are not alerted by a
sign every time which makes them vulnerable to slipping and falling with
various expected injuries. This is in agreement with the findings of another
study which confirms that most injuries caused by slips and falls in
restaurants occur due to slipping on wet floors, and this problem arises during
the busies time period of the restaurant when the pace of work increases (9).
The narrow corridors between tables factor was detected as the highest VHRL,
with a statistical difference between its levels, which is due to the small
size of the restaurants. The small size of university restaurants is not
limited to Gaza; it is a general phenomenon. For example, about 5000 students
eat their meals in Dortmund university restaurant in Germany, while the
capacity of the restaurant is only 1500 individuals (16). The highest VHRL was
attributed to location and discomfort of students when waiting to receive their
meal. Moreover, this was the only risk factor which was divided into only 2
risk levels; HRL and VHRL. This was due to overcrowding of customers when
buying meals and waiting for a long time to receive meals the daily repetition
of this situation.
Health
and safety status of workers
The present
study showed that 60% and 72.5% of workers wore uniforms and performed medical
examinations for infectious diseases, respectively. These results are similar
to that found in a previous study in Gaza governorate (74.7%, 77.8%) (8).
Hospital employees show greater commitment to implementing health and safety
codes than university employees, because of the guidelines of the Ministry of
Health for its employees. The highest ages of hospital
restaurant employees are higher than their counterparts in universities.
Hospital employees are affiliated to the Ministry of Health. The ages of
university employees vary, but 60% of their ages range between 18 and 35,
because businesses tend to employ youths as they are capable of achieving their
responsibilities and endure occupational pressures.
Restaurant
facilities and general health conditions
Cleanliness
of employee bathrooms in hospital restaurants was more satisfactory than
university restaurants, since the cleaning in hospitals is carried out by
specialized private companies. On the other hand, the employees of private
companies that won tenders of universities restaurants are responsible for
cleaning employee bathrooms, here the financial factor take part by lowest
number of workers for largest number of tasks. However, in both cases, the
situation is much more satisfactory than other third world countries like
Bangladesh (17). The ventilation of university restaurants is more satisfactory
than hospital restaurants because of most of hospital restaurant are found in
bedrooms, contrary to most of university restaurant that found above the
ground. Despite the differences in those responsible for
controlling of insects and rodents in restaurants of universities and hospitals,
the two complained of inefficient methods of control, and thus, the presence of
health risks. In university restaurants, no water leakage was found in
the kitchen sinks, while it was observed in the kitchen sinks of half of the hospital
restaurants. This finding was confirmed by the results of problems reported by employees.
In our
study, the results indicated that restaurant employees lack knowledge. This finding
was in agreement with the results reported by a study in Nigeria (18).
Conclusions
It can be concluded that hospital and university restaurants are similar in
terms of risks and levels of risks. However, they differed in the VHRL of physical
and electrical risks factor which was higher in university restaurants than
hospital restaurants. A difference was observed in the division of these risks
and levels of different risk factors as was previously stated. Individuals or groups of people who
may be at risk of exposure to hazards in university and hospital restaurants
are restaurant employees, cleaners, organization employees, visitors, university
students, and patients in hospitals.
Acknowledgment
The authors would like to thank all the personnel who
participated in this study.
Conflict of interest:
Non declared
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Treasury HM. The Orange Book: Management of Risk - Principles and Concepts. Norwich: Crown; 2004.
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* Corresponding author: Adnan Al-Hindi, Professor,
Dept. of Medical laboratory Sciences, Faculty of
Health Sciences, Islamic University of Gaza, Gaza, Palestine.
Email Address: ahindi@iugaza.edu.ps