A Cross-sectional Survey to Review Food Safety Practices Within Pediatric Oncology and Stem Cell Transplant Centers in the United Kingdom

Food Safety and Pediatric Cancer: Neutropenia is a common complication of chemotherapy, which poses a high risk of infection and mortality. Neutropenic diet has historically been recommended for those undergoing chemotherapy. The rationale is to reduce the risk of foodborne infection by avoiding foods considered to be of high microbial risk. However, evidence for this diet is limited, and there is a lack of national consensus guidelines. Aim: Ascertain food safety advice across specialist centers providing high-dose chemotherapy for malignancy or stem cell transplants in the United Kingdom. Materials and Methods: Dietitians at 22 centers were contacted to complete a questionnaire regarding food safety guidance implemented at their center for pediatric patients undergoing high-dose chemotherapy or stem cell transplants. Questions related to restricted foods, specific guidelines implemented, ward food provision, and timings of food provision. Results: Sixteen centers responded (73%). Many aspects of neutropenic diet were consistent across centers; avoidance of unpasteurized dairy products (94%), raw/undercooked meat (94%), and unpasteurized pâté (88%). There was a lack of consistency regarding water sources used on wards and unpeeled fruits and vegetables. Conclusions: Food safety guidance for neutropenic patients differs across centers, with some practices seeming outdated and nonevidence based. A national review of food safety guidance should be considered to provide a standardized approach.