KNOWLEDGE ABOUT FOOD SAFETY AND HANDLING PRACTICES – 
LESSONS FROM THE SERBIAN PUBLIC UNIVERSITIES
Nikola VUKSANOVIĆ1*, Dunja DEMIROVIĆ BAJRAMI2,3, Marko D. PETROVIĆ2,3, 
Saša JOTANOVIĆ RALETIĆ4, Goran RADIVOJEVIĆ5
1Institute of Managemant & Sciences, Hospitality, Njegoševa 1a, 21205 Sremski Karlovci, Serbia
2Geographical Institute “Jovan Cvijić”, Serbian Academy of Sciences and Arts, Belgrade, Serbia
3South Ural State University, Institute of Sports, Tourism and Service, Department 
of Tourism and Socio-Cultural Service, Chelyabinsk, Russia 
4School of Business, Vladimira Perića Valtera 4, Novi Sad, Serbia
5University of Novi Sad, Faculty of Sciences, Department of Geography, Tourism and Hotel Management, Novi Sad, Serbia
Received: Jun 21, 2021
Accepted: Apr 29, 2022
Original scientific article
*Corresponding author: Tel. + 381 63 1968 770; E-mail: vuksanovicnikola85@gmail.com
10.2478/sjph-2022-0020 Zdr Varst. 2022;61(3):145-154
145
POZNAVANJE VARNE HRANE IN RAVNANJE Z NJO –  
IZKUŠNJE SRBSKIH JAVNIH UNIVERZ
© National Institute of Public Health, Slovenia. 
Vuksanović N, Demirović Bajrami D, Petrović MD, Jotanović Raletić S, Radivojević G. Knowledge about food safety and handling practices –  
lessons from the Serbian public universities. Zdr Varst. 2022;61(3):145-154.  doi: 10.2478/sjph-2022-0020.
ABSTRACT
Keywords: 
food safety, self-
reported food handling 
practices, Serbia, 
university students
IZVLEČEK
Ključne besede: 
varna hrana, prakse 
ravnanja s hrano, 
Srbija, študenti 
univerzitetnega študija
Introduction: Education about food safety is important for public health, and the best place to provide it is a 
university environment. The aim of the research was to assess food safety knowledge and self-reported food 
handling practices among students in Serbia.
Methods: The research was performed from October to December 2020, using an electronic survey among 
students at the University of Belgrade, University of Niš, and University of Novi Sad.
Results: The average students’ age was 21 (SD=1.7), and genderwise the proportion was 54% women and 46% 
men. The average score for self-reported food handling practices was 45.7% (SD=15.7), and for food safety 
knowledge 57.9% (SD=15.7). The results showed that students whose field of study is health-related (e.g. 
nutrition, chemistry, biology, medicine and pharmacy) had the highest score for self-reported food handling 
practices (48.8%) and for food safety knowledge (57.7%). As for age, the senior students showed the highest 
score for food safety (57.2%), followed by third-year students (53.8%), second-year (51.9%), and first-year 
students (49.9%).
Conclusions: The first-year students and those whose field of the study was not health-related showed the 
lowest score in the answers to the questions about food handling practices and food safety knowledge. However, 
the longer students study, the more knowledge they have, which is not the case for those whose studies are 
non-health-related.
Uvod: Poznavanje pomena varne hrane je pomembno za javno zdravje, najboljše mesto za to pa je univerzitetno 
okolje, ki lahko v prihodnosti veliko prispeva k širjenju teh znanj. Namen raziskave je oceniti poznavanje 
varnosti hrane in praks ravnanja z njo med študenti v Srbiji.
Metode: Raziskava je potekala od oktobra do decembra 2020 z elektronsko anketo med študenti Univerze v 
Beogradu, Univerze v Nišu in Univerze v Novem Sadu.
Rezultati: Povprečna starost študentov je bila 21 let (SD = 1,7), po spolu pa je bilo razmerje 54 % žensk in 46 % 
moških. Povprečni rezultat pri praksi ravnanja z živili je bil 45,7-odstotni (SD = 15,7), pri znanju o varnosti živil 
pa 57,9-odstotni (SD = 15,7). Rezultati kažejo, da so študenti, katerih študijska smer je povezana z zdravjem 
(npr. prehrana, kemija, biologija, medicina in farmacija), dosegli najvišjo oceno za prakse ravnanja s hrano 
(48,8 %) in poznavanje varne hrane (57,7 %). Kar zadeva starost, so študenti zaključnih letnikov dosegli najvišjo 
oceno za znanje o varnosti živil (57,2 %), sledijo jim študenti tretjih letnikov (53,8 %), študenti drugih (51,9 %) 
in študenti prvih letnikov (49,9 %).
Zaključki: Študenti prvih letnikov in študenti, katerih študijska smer ni povezana z zdravstvom, so dosegli 
najnižje število točk pri odgovorih na vprašanja o praksah ravnanja s hrano in znanju o varnosti hrane. Vendar 
dlje kot študenti študirajo, več znanja imajo, kar pa ne velja za tiste, katerih študij ni povezan z zdravstvom.
1 INTRODUCTION 
Up until 2018, the Serbian system of food control was at 
an unenviable level, and thus there was a lot of space for 
numerous failures, often with very serious consequences 
for people’s health (1). However, as of 1 January 2018, 
the use of a new integrated system of management and 
control of food safety, developed with EU support, was 
implemented. 
In Serbia, as well as in other countries round the world, 
foodborne illnesses or food poisoning are becoming a 
major health problem of primary importance (2). The 
diseases caused by food poisoning, both in developing 
countries such as Serbia and in the developed countries of 
Europe and the USA, can cause significant morbidity and 
mortality from foodborne illnesses (3). 
Meta analysis (4) highlights the heterogeneity between 
food groups, and the fact that many factors influence 
consumers’ product preferences and purchasing decisions, 
and this can also be considered a health problem. There 
are numerous studies emphasizing that food handlers of all 
ages consider that they know how to handle food safely, 
but their self-reported food handling behaviors do not 
support this supposition (5–8). Food mishandling is more 
common in some consumer groups than in others (9, 10). 
Young male adults (18-29 years old), men, and individuals 
with education higher than high school are more likely 
to have risky food handling than others (11–13). This age 
group (18-29 years old) is not considered to be “at risk” 
for foodborne illness. However, the consequences of their 
unhygienic food practices become serious when they start 
providing care for other household members who are at 
risk, such as pregnant women, young children, and ageing 
adults (14, 15).
Accordingly, relevant research has been done to date 
in Greece (16), Slovenia (17), Bulgaria (18), Spain (19), 
Sweden (20), Turkey (10, 21, 22), Jordan (23), Lebanon 
(24), Saudi Arabia (25,  26), Malaysia (27–29), Canada (30), 
Australia, and the UK (31). The reports from the listed 
countries indicated a significant level of awareness of food 
safety knowledge among a similar profile of respondents 
but with a constant need for new educational initiatives. 
This should involve the promotion of more optimal 
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146
behaviors, improvement in food safety practices, and 
interventions on food safety. The majority of the research 
showed that a university environment is an ideal place for 
implementing the strategy of prevention of the diseases 
caused by improper food handling, since they will be the 
ones who will cook, train, and be parents in the future. 
It is interesting to point out that a related study had already 
been done among the cadets of the Military Academy in 
Serbia (32). The evaluation of the level of food safety 
knowledge among them showed relatively good knowledge 
of some food safety issues, including prevention of cross 
contamination in the kitchen, hand and personal hygiene. 
Another similar research (33) evaluated self-reported 
food handling practices and food safety knowledge 
among undergraduate students in Serbia, with the aim of 
determining whether the university curriculum influences 
the food safety outcome among participating students.
Considering previous studies, this research will focus 
on the assessment of knowledge about food safety and 
self-reported food handling practices among students 
of the three public universities in Serbia – University of 
Belgrade, University of Niš, and University of Novi Sad. 
The analyzed universities are the largest academic and 
scientific institutions in Serbia in terms of the number of 
students, departments, faculties, and staff. 
2 METHODS 
2.1 Study population
The study was conducted from October to December 
2020. An email requesting students’ participation and 
containing the link to the survey was sent to 1,000 
students in Novi Sad, Belgrade, and Niš by the University’s 
Registrar’s Office. The population was from different 
fields of study (health-related and non-health-related) 
and years of study (second, third and fourth years). Out 
of 1,000 filled questionnaire forms, 930 (79.5%) were filled 
correctly (respondents answered all questions) and were 
used for further statistical analysis.
Table 1 presents a sample design which includes 
information about the sample and population, sampling 
error, and confidence level. 
Collection method
Sampling unit
Sampling unit
City
Sampling error
Confidence level
Novi Sad
3.8%
95%
Belgrade
5%
99%
Niš
3.2%
95%
Table 1. Sample design research data.
Self-administrated questionnaire
Students over 18 years of age
140,500 per year
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147
2.2 Questionnaire
The questionnaire was developed by incorporating 
questions selected from an updated, reliable, and valid 
instrument produced by Byrd-Bredbenner et al. (9), and 
used in similar studies done in Serbia (32, 33). Appropriate 
modifications were made to some of the selected 
questions, as regards adjustments to specific eating 
habits in Serbia. The questionnaire was subjected to a 
preliminary validation (81 students, 27 per city) to assess 
its clarity, the suitability of wording, and the average 
time needed for its completion. Based on this pilot study, 
necessary modifications were identified and resolved, but 
its results were not included in the final survey. 
The final questionnaire consisted of four parts: 
introduction, demographic characteristics, self-reported 
food handling practices, and food safety knowledge 
questions. The demographic characteristics included 
gender, age, field of study and year of study, campus, 
residential area and status, involvement in cooking, and 
parental employment. The self-reported food handling 
practices section included 16 questions, while the food 
safety knowledge section included 14 questions. Most of 
the items were multiple-choice questions.
2.3 Statistical analysis
IBM SPSS Statistics v18 software was used for all the 
statistical analyses. The demographic characteristics 
represented the independent variables. Food-safety and 
handling knowledge and practices outcomes represented 
the dependent variables. Each multiple-choice item had 
one correct answer that was assigned a score of 1 point, 
while 0 points were assigned to all the wrong answers. A 
T-test and Analysis of Variance (ANOVA) were conducted 
to compare the mean sum of the correct responses of 
every section of the questionnaire. 
3 RESULTS 
A total of 930 undergraduate students participated in 
the study: 54% females and 46% males. The study sample 
was composed 30% of students from health-related fields 
of study (nutrition, biology, chemistry, medicine, and 
pharmacy) and 69% from non-health-related fields of study 
(arts, engineering, law, and business) (Table 2). The mean 
student age was 21 (SD=1.7). Four percent of them were 
first years, 41% were second years, 29% were third years, 
and 25% were fourth years. Around 68% of the students 
lived with their parents. Only 6% of the students reported 
that they cook their own meals daily. Of all the students, 
30% of them had a working mother.
The overall food handling practices score was the sum of 
the correct responses in the self-reported food handling 
practices section for each student, and its mean value 
was 45.7% (SD=15.7). The mean score and the significance 
levels for each variable are presented in Table 3. In terms 
of food handling, female students scored significantly 
(p<0.001) better than male students. Also, students in 
health-related fields scored significantly (p<0.001) better 
than non-health-related ones. In addition, the residence 
area had a significant (p=0.006) effect with City scoring 
the highest, and Rural area the lowest. Moreover, students 
having working mothers scored better than those whose 
mothers are housewives, and the significance was border-
line significant (p=0.05). On the other hand, age, year of 
study, campus, residential status, and cooking habits were 
not significantly associated with practice and knowledge 
scores (p>0.05).
The mean food-safety knowledge score was 57.9% 
(SD=15.1). The mean score and the significance levels 
for each variable are presented in Table 3. There was 
no statistically significant difference (p=0.106) between 
female and male students. Students in health-related 
fields scored significantly (p=0.001) better than non-
health-related ones. The higher the year of study, the 
higher the knowledge score was. Senior students scored 
the highest, followed by third years, second years and 
first years, and the difference was border-line significant 
(p=0.07). Students living with parents scored significantly 
(p=0.09) higher than those living alone or with friends. 
Students who cook daily scored significantly (p=0.001) 
lower than those who cook less frequently or never. 
Gender 
Age group 
Field of study 
Year of study 
  
 
Campus 
 
Residential area 
 
Cooking habits  
 
Maternal employment
Demographic variables %a
Male 
Female
18-20 
21-23
Health-related  
Non-health-related
First  
Second  
Third  
Fourth 
Novi Sad 
Belgrade 
Niš
City  
Suburb  
Rural area 
Cook daily  
Sometimes  
Rarely 
Never  
Works  
Housewife
45.1 
54.9
67.9 
33.1
30.8 
69.2
4 
41.1 
29.8 
25.1
32.4 
43.5 
24.1
51.2 
38.5 
10.3
9.6 
33.4 
30.7
26.0 
30.7 
69.3
Table 2. Demographic characteristics of the study population 
(N=930).
a relative percentage based on valid values
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Students from health-related fields of study reported the 
highest average self-reported food handling practices 
(48.8%) and food safety knowledge (57.7%) scores (Table 
3). The difference between these students and their 
counterparts from non-health-related fields of study was 
significant (p<0.05) for both self-reported food handling 
practices and food safety knowledge parts. This could be 
due to the presence of modules and courses relevant to 
food safety, hygiene and microbiology in the curricula of 
health-related fields of study. 
Fourth-year students reported higher food safety 
knowledge scores (57.2%), followed by third-year (53.8%), 
second-year (51.9%) and first-year (49.9%) students, and 
the difference was border-line significant (p=0.07) (Table 
2). This can be attributed to the fact that as the students, 
especially in health-related fields of study, stay longer in 
the field of study, they cover more aspects of food safety 
(16, 24). Male and female students were equally (~54%) 
knowledgeable in terms of food safety (Table 3); however, 
female participants responded significantly (p<0.001) 
better (46%) than males (42%) in terms of self-reported 
food handling practices. This conforms to the findings 
from previous studies, in which females outperformed 
male university students (9, 16, 24).
Students from the campus of Novi Sad had the highest 
score (45.8%) for the questions regarding self-reported 
food handling practices, followed by those from Belgrade 
(44.5%), and Niš (44.1%), whereas for the food safety 
questions, the highest score was reported for the students 
from the campus in Belgrade (54.5%), followed by Novi 
Sad (53.3%), and Niš (52.9%). No statistical significance has 
been found (Table 3).
Students living with their parents scored better (Table 
3) than those living alone or with friends or roommates; 
however, the difference was only significant (p=0.009) 
for the food safety knowledge questions. This can be 
Age
Gender
Field of study
Year of study
Campus
Residence area
Residential status
Cooking habits
Maternal employment
Demographic variables Self-reported food handling practices
Sig.* Sig.*Mean±SDa Mean±SDa
Food safety knowledge
18 
19 
20 
21 
22 
23 
Male 
Female 
Health-related 
Non-health-related
First 
Second 
Third 
Fourth 
Novi Sad 
Belgrade
Niš
City/Town 
Suburban area
Rural area 
Parents 
Friends/roommates
Alone 
Daily
Sometimes 
Rarely 
Never 
Works 
Housewife 
0.370
0.001
0.001
0.635
0.251
0.006
0.909
0.605
0.05
44.7±13.2
44.8±14.4 
43.2±14.4 
42.8±13.6 
43.5±15.1 
44.4±15.0
43.4±13.8 
47.4±14.3 
48.8±13.3 
42.9±13.8 
42.3±13.7 
44.3±13.9 
45.8±14.7 
48.4±14.1 
45.8±15.1 
44.5±13.8 
44.1±12.9
55.8±15.1
51.3±14.3
32.5±19.1
48.6±12.7 
44.9±15.1 
46.1±14.3 
48.1±15.7
45.3±15.1
43.9±13.8
43.1±14.1
48.1±15.1
45.1±14.8
0.127
0.113
0.001
0.07
0.316
0.112
0.009
0.001
0.09
Table 3. Mean scores for self-reported food handling practices and food safety knowledge sections per demographic characteristics.
Note: a knowledge score, relative percentage based on valid values; *statistical significance p<0.05
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attributed to the fact that when students live with their 
parents, someone else who is more experienced (most 
often, the mother) will handle the food preparation, 
resulting in better food handling and an opportunity for 
students to observe and learn more about food safety.
Detailed scores on the self-reported food handling 
practices and food safety knowledge questions are 
presented in Tables 4 and 5. In the self-reported food 
handling practices section, the highest score was for 
hand washing; 89% of the participants reported that they 
wash their hands with soap and water before eating or 
preparing food. On the other hand, the lowest score was 
for how to check that a burger is cooked enough; only 8.7% 
of the participants reported that they use a thermometer 
to check the temperature at the center. 
From the detailed insight into the scores for responses to 
the 16 questions related to self-reported food handling 
practices, it can be concluded that the students from Novi 
Sad had the highest score, for as many as 10 questions, 
followed by the students from Belgrade, and then Niš. 
At the same time, the students from Novi Sad showed 
the best knowledge about the use of a thermometer for 
checking the temperature at the center of the item.
(1) At home, what is most practiced after 
using a cutting board to slice raw meat 
and need to cut tomatoes afterwards?
(2) On campus, how do you dry 
your hands after washing them?
(3) In the fridge (not freezer) of your 
house, where is the raw meat stored? 
 
 
(4) If you have a sore on the back of 
your hand, do you prepare food?
 
(5) When you cut raw meat and need to 
use the knife again, what do you do?
(6) Do you take off jewelry 
when preparing food? 
(7) At home, how do you check 
that a burger is cooked enough?
(8) At home, you fry eggs until the:
 
Questions Multiple-choice responses
Belgrade NišNovi Sad
Correct responses
Use the board as it is 
Wipe the board with a paper towel 
Wash the board with soap and water 
Use a different cutting board 
Paper towel 
Hot air electrical dryer 
Leave them to dry on their own 
Your clothes 
Top shelf 
Medium shelf 
Lowest shelf 
Yes, but after putting a bandage on it 
Yes, but after putting on a glove 
Yes, but after bandaging the sore and putting on a glove 
No, I do not prepare food until the sore heals
Reuse the knife as it is 
Rinse the knife with cold water 
Wash the knife with soap and water 
Wipe the knife with a cloth 
Yes 
No 
Not applicable 
By checking the color 
By checking the firmness 
By measuring the temperature at the center 
By checking the cooking time 
Egg white is solid and the yolk is semi-solid 
Egg white and yolk are semi-solid 
Egg white and yolk are solid 
1.8%
1.9%
36.1%
60.9%
87.1%
5.9%
2.9%
2.1%
57.4%
8.4%
30.2%
33.6%
12.1%
29.4%
23.1%
1.4%
17.5%
76.1%
3.2%
79.3%
19.1%
1.4%
40.1%
36.1%
8.7%
12.1%
24.2%
7.3%
56.2%
3.3%
3.4%
45.9%
54.1%
87.8%
5.2%
2.3%
2.7%
56.1%
5.8%
34.2%
34.9%
15.6%
28.1%
19.4%
2.2%
15.0%
78.1%
2.9%
76.8%
21.5%
1.3%
35.9%
40.0%
8.1%
11.5%
22.8%
6.7%
58.3%
3.4%
3.6%
40.4%
50.5%
85.6%
6.9%
3.4%
2.1%
56.9%
6.7%
31.7%
35.1%
15.6%
27.9%
17.6%
3.2%
16.1%
77.3%
1.9%
75%
23.4%
1.1%
39.3%
38.4%
8%
11.1%
23.9%
8.8%
57.7%
Table 4. Score distribution for questions related to self-reported food handling practices.
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10.2478/sjph-2022-0020 Zdr Varst. 2022;61(3):145-154
The distribution of the results, for the questions regarding 
food safety knowledge, is shown in Table 5. In the field of 
food safety, the students had the highest scores (82.7%) 
for the best way of cleaning the kitchen counter. However, 
only 10.1% knew that a person with diarrhea should not 
prepare food for others.
(9) During your supermarket 
shopping, when do you place 
refrigerated meat in your cart?
(10) At home, how do you defrost 
frozen meat/chicken?
(11) Do you have a thermometer 
in your fridge? 
(12) If your roommate or family member 
is going to be several hours late for a hot 
meal, where do you leave the meal?
(13) When preparing food, you wash your 
hands after touching which of these?
(14) At home, how do you treat 
fresh fruit and vegetables? 
(15) How often is the kitchen sink 
drain in your home sanitized?
(16) How do you wash your hands 
before cooking or eating?
Questions Multiple-choice responses
Belgrade NišNovi Sad
Correct responses
At the beginning of shopping 
About halfway through the shopping 
At the end of the shopping 
It does not matter 
Heat it in a microwave 
Put it under running water for 1 h 
Leave it on the kitchen counter for 1h 
Leave it in the fridge for a few hours 
Yes 
No 
In the fridge
In a cool oven 
In a warm oven 
On the counter 
Your face 
Clean pots and counter 
Utensils being used in food preparation 
I do not wash my hands after touching any of the above 
Dip them in water and salt
Wash them with soap 
Wash them under running water 
Boil them 
Daily 
Weekly 
Never 
Only when I wash food in the sink
Soap and water 
Water only 
Hand sanitizer 
I do not wash my hands 
7.2%
8.4%
59.7%
22.8%
17.2%
14.3%
38.5%
28.8%
55.2%
43.7%
30.1%
24.2%
32.3%
13.0%
36.9%
9.1%
33.7%
15.7%
5.8%
16.7%
71.4%
3.5%
52.1%
23.9%
2.9%
10.1%
97.1%
1.5%
0.9%
0.3%
9.6%
10.2%
57.5%
20.6%
12.7%
19.7%
31.2%
26.5%
53.7%
44.2%
27.3%
22.5%
37.8%
12.5%
33.4%
8.6%
31.2%
15.2%
5.9%
16.9%
70.9%
3.7%
48.6%
24.4%
2.4%
12.6%
97%
1.4%
1.1%
0.2%
10.2%
11.9%
54.2%
22.8%
18.9%
18.1%
33.1%
27.1%
54.6%
44.3%
38.5%
23.1%
39.7%
9.6%
32%
7.1%
31.7%
14.8%
5.7%
16.6%
71.1%
3.8%
46.7%
22.1%
3.9%
13.8%
96.9%
1.3%
1.2%
0.2%
Note: The best practices are highlighted in bold.
151
10.2478/sjph-2022-0020 Zdr Varst. 2022;61(3):145-154
(17) Which of the following scenarios for 
cleaning kitchen counters is the BEST?
(18) While washing your hands, it 
is enough to rub them for…? 
(19) Freezing kills harmful germs in food.
(20) Which food is the LEAST 
likely to cause food poisoning?
(21) What is the recommended 
temperature for freezers?
(22) What is the recommended 
temperature for fridges?
(23) Which food does NOT 
need to be refrigerated? 
(24) How can food be made safe if 
it has salmonella bacteria in it? 
(25) For a burger to be safe to 
eat, it needs to be cooked until its 
internal temperature reaches:
(26) The microorganisms that cause 
most foodborne illnesses are: 
Questions Multiple-choice responses
Belgrade NišNovi Sad
Correct responses
Soap, then water, then sanitizer 
Sanitizer, then water 
Brush, then sanitizer 
Water, then drying 
10 seconds 
20 seconds 
30 seconds 
40 seconds 
True 
False 
Baked potato left on the kitchen counter overnight 
Leftover chicken eaten cold 
Chocolate cake left on the kitchen counter overnight 
Slices of pizza left on the counter overnight
-18°C 
18°C 
8°C 
0°C 
-4°C 
4°C 
12°C 
16°C 
Fruit salad 
Open can of peas 
Raisins 
Chocolate pudding 
Cook it well 
Freeze it for 3 days 
Such food cannot be made safe 
Don’t know 
52°C 
71°C 
121°C 
130°C 
Bacteria 
Viruses 
Parasites 
Fungi
82.7%
8.2%
4.9%
2.5%
24.1%
32.7%
27.4%
5.2%
31.0%
67.8%
27.8%
16.3%
37.1%
17.1%
72.5%
4.2%
5.9%
14.2%
11.3%
68.2%
10.1%
6.6%
4.8%
6.9%
82.2%
6.1%
65.9%
7.3%
5.2%
19.3%
12.4%
33.1%
27.3%
10.4%
62.8%
9.9%
8.4%
14%
81.3%
8.2%
5.9%
2.9%
23%
33.4%
28.7%
4.3%
29.3%
69.1%
27.3%
15.8%
38.6%
16.6%
73.4%
3.9%
5.6%
13.9%
10.3%
67.9%
11.1%
6.3%
4.5%
6.4%
80.2%
5.5%
66%
7%
4.9%
19.6%
11.4%
33.6%
28.7%
9.4%
63.5%
10.9%
8.9%
13.8%
80.1%
8.7%
5.7%
1.8%
23.1%
30.7%
25.9%
4.7%
30.2%
67.2%
26.1%
16.1%
36.9%
18.8%
72.1%
4.1%
5.7%
14%
9.9%
67.8%
10.7%
6%
4.3%
6.1%
79.9%
5.7%
65.7%
7.1%
5%
19.9%
12.9%
32.9%
29.3%
8.4%
62.1%
9.1%
8%
15.1%
Table 5. Score distribution for questions related to food safety knowledge.
4 DISCUSSION
In the last 15 years, a range of research (10, 16–18, 20–33) 
has been conducted in order to assess the knowledge, 
attitudes, and practices related to food safety among 
students, and at universities, and they have all had a 
similar contribution, which can be seen in the continuity 
of the conducted studies and the results of this research. 
The study proved that students from the University of 
Novi Sad had better knowledge related to self-reported 
food handling practices, whereas students from Belgrade 
had better knowledge regarding food safety basics. In the 
previous study (33), students from both universities had 
the same score for self-reported food handling practices, 
but students from the University of Novi Sad had a better 
knowledge than students from Belgrade regarding food 
safety basics. In our study, the overall food handling 
practice score was the sum of the correct responses in 
the self-reported food handling practices section for each 
student and its mean value was 45.7% (SD=15.7), while 
the mean score for the food-safety knowledge was 57.9% 
(SD=15.1). A similar finding was reported in Lebanon (24), 
Greece (16), and Serbia (32, 33). Lazou et al. (16) reported 
that the mean scores of food safety knowledge and self-
reported food handling practices among Greek university 
students were 60% and 44% (16), in Lebanon they were 53% 
and 44% (24), and in Serbia they were 56% and 46% (32, 33).
In terms of self-reported food handling, female students 
scored significantly (p<0.001) better than male students. 
On the other hand, there was no statistically significant 
difference between female and male students regarding 
food-safety knowledge. Similar results have been 
determined for female students in Lebanon (24) and Serbia 
(33), and the opposite was seen for students of Veterinary 
Medicine in Bulgaria (18).
Regarding the results of fields of study, students from 
health-related fields of study reported the highest average 
self-reported food handling practices and food safety 
knowledge compared with students of non-health-related 
fields of study. A similar finding was reported in Lebanon 
(24), Greece (16), and Serbia (33).
4.1 Study limitations and recommendations  
for future research
One of the limitations of the research is the methodological 
difference relative to previous studies. Despite the 
differences, all the studies so far have concluded that the 
results are similar regarding food safety and self-reported 
food handling practices among students. Nevertheless, 
the sample size should be increased in the future. This 
would include respondents from other public and private 
universities in Serbia and neighboring countries. As a 
result, the complete picture of the study would have a 
bigger sample size and outcomes would be even more 
important, comparable, and interesting to analyze.
It is of note that this study was performed before the onset 
of the COVID-19 outbreak, which is currently ongoing at the 
time of writing this paper. Future research should analyze 
if the hand hygiene knowledge and handling practices 
152
10.2478/sjph-2022-0020 Zdr Varst. 2022;61(3):145-154
(27) Which of these individuals should 
NOT prepare food for other people?
(28) Which food do pregnant women, 
infants, and children need NOT to avoid?
(29) Which of these individuals are the 
LEAST likely to get food poisoning? 
(30) Most disease-causing bacteria can 
grow within a temperature range between:
Questions Multiple-choice responses
Belgrade NišNovi Sad
Correct responses
A person with diarrhea 
A person with severe acne 
A person with HIV 
A person with a cold 
Soft cheeses 
Raw or undercooked eggs 
Undercooked hot dogs 
Canned vegetables 
Old people 
Pregnant women 
Teenagers 
Cancer patients 
5-60°C 
20-40°C 
40-60°C 
30-70°C 
10.1%
19.7%
14.5%
51.8%
38.4%
14.1%
2.6%
41.3%
13.1%
8.3%
63.7%
14.9%
30.7%
39.1%
13.9%
8.8%
9.9%
22.1%
13.1%
49.8%
39.9%
13.7%
1.3%
42.9%
16.1%
14.9%
60.7%
8.3%
31.3%
40.3%
8.9%
10.8%
9.7%
20.1%
17.1%
46.3%
36.1%
11.3%
4.6%
44.1%
15.1%
10.6%
59.9%
12.1%
29.9%
37.9%
16.3%
7.9%
Note: The correct answers for the knowledge questions are highlighted in bold.
among students and among other groups of food handlers 
was significantly improved, due to numerous instructions, 
guidelines and videos that have been presented during 
this pandemic (34, 35). Despite the limitations of this 
study, which require further research, we can draw 
certain conclusions from the findings summarized in the 
next chapter.
5 CONCLUSION
This research was conducted in Serbia and examined 
students from the largest national public universities in 
Novi Sad, Belgrade, and Niš, regarding food safety and 
self-reported food handling practices. On the one hand, 
as currently observed, a high level of students’ awareness 
of food safety contributes to the higher consumption of 
food, but it also represents a risk that can be caused 
by food handling, and thus a greater proneness to food 
poisoning. On the other hand, if observed long-term, this 
is an advantage, since the target group will act as parents 
in the future, and they will prepare food and meals. The 
research results point to the fact that there is a strong 
correlation between the participants’ demographic 
characteristics and self-reported food handling practices, 
as well as food-safety knowledge, which is in accordance 
with the results of previous studies. The contribution of 
the research reflects a great need for education on food 
safety for young people. A university environment is an 
ideal place for this, and the students are the target group 
where it is possible to apply the strategy of preventing 
diseases caused by incorrect food handling, as well as 
education on food safety and food handling practices.
CONFLICTS OF INTEREST 
The authors declare that no conflicts of interest exist with 
regard to this study. 
FUNDING 
No external funding was received.
ETHICAL APPROVAL
Ethical approval does not apply to the current study, since 
no personal data that could identify the respondents was 
used.
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