Occupational factors and mental health outcomes among professional food handlers: A scoping review protocol

Harshit Singh; Senthilkumaran Piramanayagam; K Thirugnanasambantham

doi:10.12688/f1000research.150054.2

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Study Protocol

Revised

Occupational factors and mental health outcomes among professional food handlers: A scoping review protocol

[version 2; peer review: 1 approved, 3 approved with reservations]

Previously titled: Occupation-related antecedents, job-related outcomes, and intervening factors of mental health disorders among food handlers: A scoping review protocol

Harshit Singh¹, Senthilkumaran Piramanayagam ¹, K Thirugnanasambantham¹

PUBLISHED 06 May 2025

Author details Author details

¹ Welcomgroup Graduate School of Hotel Administration, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India

Harshit Singh
Roles: Conceptualization, Investigation, Methodology, Writing – Original Draft Preparation, Writing – Review & Editing

Senthilkumaran Piramanayagam
Roles: Conceptualization, Investigation, Methodology, Writing – Original Draft Preparation, Writing – Review & Editing

K Thirugnanasambantham
Roles: Conceptualization, Supervision, Validation

OPEN PEER REVIEW

REVIEWER STATUS

This article is included in the Manipal Academy of Higher Education gateway.

Abstract

Background

Occupational mental health is a growing global concern, particularly in high-demand service industries. Food handlers —such as chefs, kitchen staff, and waiters—often work under physically and emotionally demanding conditions, including long hours, low autonomy, verbal aggression, and customer-facing stress. Studies suggest they face an elevated risk of mental health disorders such as stress, anxiety, depression, and burnout. Despite their vulnerability, evidence on the occupational factors influencing mental health among food handlers remains fragmented and sparse.

Objective

This scoping review aims to systematically map existing global literature on the occupational antecedents, mental health outcomes, and intervening factors affecting professional food handlers. The review will identify key determinants, consequences, and contextual influences to inform future research, workplace interventions, and policy development.

Inclusion criteria

We will include empirical studies—quantitative, qualitative, or mixed-methods—that explore occupational mental health among professional food handlers in structured food service settings (e.g., restaurants, catering, institutional kitchens). Grey literature, including dissertations, policy documents, and industry reports, will be included if publicly available and methodologically transparent. Only English-language sources published between 2000 and 2024 will be considered.

Methods

This scoping review will follow the JBI methodology and Arksey and O’Malley’s (2005) five-stage framework: (1) identifying the research question; (2) identifying relevant studies; (3) study selection; (4) data charting; and (5) collating and reporting results. Systematic searches will be conducted across databases including PubMed, PsycINFO, CINAHL, Scopus, Web of Science, and ProQuest Dissertations & Theses Global. Grey literature will be retrieved from institutional repositories, professional bodies, and relevant websites. Data will be extracted using a standardized form and analyzed thematically to describe the scope, trends, and research gaps.

Keywords

Food handlers, Mental health disorders, Pathogenesis, Intervening variables, Occupational outcomes

Corresponding author: Senthilkumaran Piramanayagam

Competing interests: No competing interests were disclosed.

Grant information: The author(s) declared that no grants were involved in supporting this work.

Copyright: © 2025 Singh H et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

How to cite: Singh H, Piramanayagam S and Thirugnanasambantham K. Occupational factors and mental health outcomes among professional food handlers: A scoping review protocol [version 2; peer review: 1 approved, 3 approved with reservations]. F1000Research 2025, 13:600 (https://doi.org/10.12688/f1000research.150054.2) First published: 07 Jun 2024, 13:600 (https://doi.org/10.12688/f1000research.150054.1) Latest published: 06 May 2025, 13:600 (https://doi.org/10.12688/f1000research.150054.2)

Revised Amendments from Version 1

Summary of Major Revisions (Version 2 vs. Version 1)

In response to the reviewers' valuable feedback, we have substantially revised the manuscript to improve its focus, clarity, and methodological vigour. The key changes in this version include:

1. Refinement of Title: The title has been revised to explicitly emphasize the focus on professional food handlers in occupational settings, addressing concerns about the broad and ambiguous use of the term "food handlers."

2. Strengthened Background and Rationale: The introduction now includes updated global data on the prevalence and burden of occupational mental health disorders, including sector-specific findings that justify the public health significance of the review.

3. Clarity in Scope and Feasibility: We have included the clarification that this review is exploratory in nature, aiming to map existing evidence rather than conduct comparative analysis, and explained how contextual variation across countries will be managed during synthesis.

4. Providing more detail on Inclusion Criteria: We elaborated on the types of studies to be included (quantitative, qualitative, and mixed methods) and specified our approach to incorporating grey literature, including sources, retrieval methods, and criteria for inclusion.

5. Justification of Time Frame: We defended the 2000–2024 search window by explaining the sparse nature of research on this topic and the need to capture longitudinal trends.

6. Methodological Rigour and Transparency: Additional detail was provided on data extraction, thematic synthesis, and categorization strategies to manage the breadth of the review and improve analytical clarity.

We, authors of this research protocol, believe these changes significantly strengthen the protocol and ensure alignment with scoping review standards and the expectation of the journal.

To read any peer review reports and author responses for this article, follow the "read" links in the Open Peer Review table.

Introduction

Mental health is a critical component of overall well-being and a growing concern worldwide. According to the World Health Organization (WHO), one in eight individuals globally lives with a mental disorder, highlighting the urgency of addressing this issue from multiple dimensions, including occupational contexts (World Health Organisation, 2022). The WHO defines mental health as “A state of mental well-being that enables people to cope with the stresses of life, to realize their abilities, to learn well and work well, and to contribute to their communities. Mental health is an integral component of health and well-being and is more than the absence of mental disorder.” The WHO emphasizes that mental health is a basic human right and an integral element of our general health and well-being (World Health Organisation, 2022). The prevalence of mental health conditions and their socioeconomic consequences is enormous. A health condition is a broad term that generally covers mental and psychological disorders.

The cost of mental condition to the world economy, which stood at approximately US$ 2.5 trillion in 2010, is expected to reach US$ 6 trillion by 2030, alongside an increase in social cost. Low- and middle-income countries (LMIC) alone need to bear 35 per cent of the total cost of healthcare for mental health conditions. In addition to the direct costs involved in the treatment of mental health conditions, countries also face indirect costs, such as reduced economic productivity, unemployment, societal inequality, suicides, and substance use. In most societies, mental health is neglected and fails to provide care and support to people (World Health Organisation, 2022). Although mental health conditions are common across the globe, millions of individuals suffer from silence, which has a significant negative impact on their daily lives. The World Mental Health Report published by the WHO in 2022 indicates that even after publishing its landmark health report in 2001, the recommendations remain valid today (World Health Organisation, 2022).

Mental health and individual’s occupation are highly interlinked. Employees’ mental health is a ubiquitous concern in the workplace. While most employees report at least one symptom of poor mental health, approximately 20 per cent of employees have mental illness (Rosado-Solomon et al., 2023). Occupational mental health—the study of psychological well-being in work environments, has become increasingly significant due to the growing evidence linking work conditions to a wide range of mental health outcomes. Poor occupational mental health is associated with reduced job performance, absenteeism, presenteeism, workplace accidents, and turnover. Employees’ mental health has a huge impact on organizations and, subsequently, on global society. A joint policy brief on mental health by the WHO and the International Labour Organization (ILO) indicates that 12 billion working days are lost every year due to anxiety and depression (World Health Organisation & International Labour Organisation, 2022). The burden is particularly acute in low- and middle-income countries (LMICs), where resources to support workers’ mental health are often limited (World Health Organisation & International Labour Organisation, 2022).

Numerous studies have shown that food handlers, particularly those working in professional food service environments, experience disproportionately high levels of mental distress. For instance, Ishaque et al. (2021) found that over 60% of waiters in upscale restaurants in urban India reported symptoms of depression, anxiety, and stress. Cristina et al. (2021) also reported significant associations between workplace mobbing and mental health conditions such as depression and anxiety among gastronomes. Globally, food handlers are exposed to several psychosocial risks, including verbal aggression, physical workload, low job control, and irregular work hours, all of which contribute cumulatively to occupational burnout and mental exhaustion (Bi et al., 2021; Cristina et al., 2021; Wilkesmann & Wilkesmann, 2021; Zewude & Habtegiorgis, 2021).

In the United States, chefs and cooks have been found to exhibit high levels of job-related stress and dissatisfaction, which are strongly linked to mental health conditions (Cerasa et al., 2020). Similarly, European studies have indicated that kitchen and hospitality workers report among the highest rates of occupational stress in the service industry. During the COVID-19 pandemic, mental health challenges in this workforce were further exacerbated by job insecurity, reduced working hours, and increased occupational exposure (Wilkesmann & Wilkesmann, 2021).

Research studies that attempt to identify the factors that are critical for mental health among food handlers are multifactor: job-related factors (Eburne & Eburne, 2010; Ishaque et al., 2021) person- or employee-related factors (Chuang et al., 2011; Harris & Giuffre, 2010; Hinterstoisser, 2011), organization-related factors (Chen & Wang, 2019; Chuang et al., 2011; Ishaque et al., 2021), contextual factors (Cerasa et al., 2020; Cristina et al., 2021; Harris & Giuffre, 2010; Hinterstoisser, 2011; Kohli & Mehta, 2022) and external environment-related factors (Chen & Wang, 2019; Wilkesmann & Wilkesmann, 2021). However, there is no synthesized evidence on the antecedents of mental health conditions among foodservice employees. Similarly, outcomes of mental health conditions also described in the literature. It is also multidimensional, as the mental health of food handlers has significant effects on individuals, organizations, family members, and society at a large (Cerasa et al., 2020; Chen & Wang, 2019; Chuang et al., 2011; Cristina et al., 2021; Harris & Giuffre, 2010; Hinterstoisser, 2011; Ishaque et al., 2021; Kohli & Mehta, 2022; Pidd et al., 2015). The most common outcome frequently highlighted in literature is employee turnover. The most common antecedents, outcomes, and contextual factors are presented in Figure 1.

Figure 1. Food Handler’s mental health conditions.

While employee mental health and well-being are crucial, there remains a dearth of research in this area, particularly among foodservice handlers (Cristina et al., 2021; Ishaque et al., 2021; Kohli & Mehta, 2022). The existing literature demonstrate that food handlers constitute a high-risk occupational group whose mental well-being directly affects not only their own health but also food safety, workplace productivity, and public health. Yet, the evidence remains fragmented, and no comprehensive synthesis currently exists to map the breadth and depth of this issue globally. This scoping review aims to address this gap by consolidating existing evidence and identifying key risk factors, outcomes, and intervening variables affecting mental health in this vulnerable population.

2. Methods

The researchers in the proposed scoping review will adopt the updated methodological guidelines of the JBI for the scoping review protocol (Peters et al., 2020). A preliminary search of PROSPERO, MEDLINE, JBI Evidence Synthesis, and Cochrane Database of Systematic Reviews was conducted to confirm that no current or scoping reviews or systematic reviews were underway.

This review aims to examine the factors that contribute to mental health conditions among food handlers employed in professional food service settings worldwide. We will identify the factors associated with mental health conditions, including stress, depression, anxiety, and burnout, among food handlers. These factors are classified as individual- or person-related, occupation- or work-related, organizational-, and environment-related. We will also explore the outcomes of mental health conditions among food handlers in individuals, organizations, and society. We will look at potential mediators and moderators that may influence the complex relationship between the factors that influence foodservice employees’ mental well-being. Through a comprehensive review of the literature, we hope to highlight gaps, synthesize insights, and inform future research, practices, and policies to effectively address mental health concerns among food handlers, who are an overlooked occupational group. The research questions of the proposed scoping review were developed based on Population, Concept and Context (PCC framework). The framework is presented in Table 1.

Table 1. PCC Framework of the proposed scoping review.

P	Population	Chefs/cook/gastronomes/Kitchen workers/waiters
C	Concept	Mental Health/Stress/Anxiety/Burnout/Occupational stress
C	Context	Restaurants/food service industries/street food vending/institutional catering

With the above PCC framework, we aimed to address the following research questions: (1) What are the occupation-related factors that cause mental health conditions in food handlers working in profession food service settings? (2) What are the outcomes of food handlers’ mental health conditions for individuals, organizations, and society? (3) Do any intervening factors moderate or mediate the relationship between antecedents and outcomes of food handlers’ mental health? (4) What strategies have been adopted to address mental health conditions among food handlers working in profession food service settings?

2.1 Eligibility criteria

Population: Studies focusing on professional food handlers, including chefs, cooks, gastronomes, kitchen workers, waiters, and other staff engaged in food preparation or service in occupational settings (e.g., restaurants, catering, street food vending, institutional kitchens).

Concept: Studies that explore mental health conditions (e.g., stress, anxiety, depression, burnout) and their antecedents, outcomes, or intervening factors in food handlers.

Context: Any professional or occupational food service setting, including but not limited to restaurants, food courts, canteens, catering services, and street food vending.

Types of studies: We will include quantitative, qualitative, and mixed-methods studies that are empirical in nature.

Grey literature: Reports, dissertations, conference proceedings, theses, government or NGO publications, and industry reports will be considered if they provide sufficient methodological detail and full-text access. We will contact authors where necessary to retrieve complete documents. The weight of evidence from grey literature will be considered narratively and distinguished from peer-reviewed sources in the synthesis. Limitations regarding peer review, replicability, and completeness will be clearly acknowledged during interpretation.

Publication period: Studies published between 2000 and 2024.

Language: Only studies published in English will be included due to resource constraints.

The time frame for inclusion was set from January 2000 to April 2024. This broader time span was intentionally selected to ensure a comprehensive mapping of the existing evidence base on mental health conditions among food handlers. Given the limited number of focused studies on this topic, particularly in the early years, restricting the review to only the past 10 years may exclude foundational or seminal works that provide important context regarding occupational stressors and mental health risks in the food service sector. Including studies from the year 2000 allows us to capture longitudinal trends, identify shifts in workplace dynamics, and observe the impact of global events (e.g., economic downturns, pandemics) on the mental well-being of food handlers. During data synthesis, we will ensure that findings are reported with consideration of study publication date, so readers can distinguish between emerging and longstanding themes. This approach aligns with the objectives of a scoping review, which is to map the breadth and scope of literature rather than limit inclusion based on recency alone.

This scoping review will include Peer-reviewed journal articles with empirical data, Government reports, policy briefs, and industry white papers that examine mental health issues within food service occupations, academic theses and dissertations that have investigated relevant topics and conference proceedings and poster presentations where sufficient methodological details are available. All sources will be screened for relevance, and only those that contribute directly to addressing the research questions will be retained. Grey literature will be included using a structured approach guided by the JBI Manual for Evidence Synthesis to ensure rigour and relevance.

2.2 Types of sources

This scoping review will include:

Peer-reviewed journal articles with empirical data.

Government reports, policy briefs, and industry white papers that examine mental health issues within food service occupations.

Academic theses and dissertations that have investigated relevant topics.

Conference proceedings and poster presentations where sufficient methodological details are available.

All sources will be screened for relevance, and only those that contribute directly to addressing the research questions will be retained. Grey literature will be included using a structured approach guided by the JBI Manual for Evidence Synthesis to ensure rigour and relevance.

2.3 Search strategy

The search approach aims to locate both published and unpublished studies. An initial limited search across Web of Science, Scopus, Google Scholar, PubMed, EMBACE, and CINAHL was conducted to identify key articles, extract relevant keywords, and index terms describing the topic. With guidance from a library specialist, a comprehensive search string was developed by combining these terms using Boolean operators (See Appendix I).

The search terms and string used in preliminary search strategy for PubMed is presented in Table 2.

Table 2. Preliminary search strategy for PubMed.

Food Service establishments	((((((restaurants) OR (“food service establishment”)) OR (“food processing units”)) OR (canteens)) OR (Street food vendors)) OR (“food courts”)) OR (“food establishments”))
AND
Mental health	((((((Psychological wellness), (Cognitive health)) OR (Mindful health)) OR (Behavioural health)) OR (Psychological well-being)) OR (Mental wellness)) OR (Mental health)) OR (Emotional stability)) OR (Psychosocial health)) OR (Inner balance)) OR (Stress)) OR (Burnout)) OR (Anxiety)) OR (Occupational stress)) OR (Cognitive functioning)) OR (Mental resilience))
Food Handlers	(((((Chefs) OR (Cooks)) or (Street Vendors)) OR (Food Hawkers)) OR (Food Helpers)) OR (Gastronomes) OR (Waiters) OR (Kitchen Workers) OR (Restaurant Operators)) OR (Servers)) OR (Stewards))
Filters	From 2000-2024

This search will be adapted for each database/information source included: PubMed, EMBASE, CINAHL, Web of Science Core Collection, PsycINFO, and ProQuest Dissertation and Theses Global for unpublished literature. The reference lists of all the included evidence sources will also be handsearched to identify additional eligible studies. The search strategy utilized a combination of controlled vocabulary (e.g., MeSH, CINAHL Headings) and natural language terms related to the population (food handlers), concept (mental health), and context (workplace). Proximity and truncation operators were applied to capture the relevant variations in terminology.

2.4 Selection of studies

Our search will cover all relevant databases to generate a list of citations that will be organized and uploaded onto a systematic review platform. To ensure accuracy, duplicate records will be removed during the uploading process. After training with a pilot sample, two independent reviewers screen the titles and abstracts of the remaining citations to assess their eligibility. Citations that meet these criteria will be subjected to a full-text review. Both reviewers will evaluate the full text of these citations against the inclusion criteria, and any reasons for exclusion will be recorded in detail. In cases of disagreement between the reviewers, a third reviewer will be consulted to resolve the issue.

2.5 Data extraction

Two independent reviewers will extract data from all the studies included in the scoping review using a standardized electronic data extraction form. The form will be developed specifically for this review to capture relevant details about the participants, concepts, contexts, study methods, and key findings related to the research questions. The data to be extracted from the existing literature is presented in Table 3.

Table 3. Data extraction tool.

Item	Description (including examples of categories, which will be extended based on included studies)
Name of reviewer
Citation information
Study title
Study ID (Authors, Publication year)
Journal name
Author affiliation
Contact information
Funding(s)
Unit of Analysis
Inclusion criteria (all must be present)
Study characteristics
Aim/Objectives of the study
Study period
Study settings [Regions, Countries and Context]
Nature of Food Service Establishment [Restaurants/Food courts /Street Food vending/Canteen/Mess/Hotel]
Study design
Target Population
Years of data collection
Sample size
Sampling method
Characteristics of Participants (e.g. Age, Sex and Socio-economic status)
Measurement Tool or Instrument used [Likert Scale]
Scale of Measurement [Categorical/Scale]
Study Perspective
Independent Variable(s)
Interventions
Mediating Variables
Moderating Variables
Control Variables
Statistical Tool used
Outcomes (Individual, interpersonal, organizational, etc)
Key Findings
Limitations of the study

Prior to commencing full data extraction, the two reviewers will independently pilot test the form of the three included studies to ensure clarity, comprehensiveness, and functionality. Based on their experiences during this pilot phase, the form will be revised and finalized as needed, with any modifications documented transparently. Throughout the data extraction process, the two reviewers will work independently and meet periodically to discuss and resolve any disagreements through a consensus. If disagreements persisted after discussion, a third reviewer will be consulted to achieve resolution. For any studies published within the last 24 years where critical data are missing or unclear, attempts will be made to contact the original study authors to request additional information. Online systematic review software (https://www.cadima.info/) will be utilized to manage and streamline the data-extraction process. This systematic approach to extracting and documenting relevant data elements aims to capture key evidence from the literature in a consistent and comprehensive manner.

2.6 Data analysis and presentation

The extracted data will be synthesized and presented using both narrative and visual formats. If sufficient studies are available, findings related to mental health factors among food handlers will be organized into relevant thematic categories. These may include individual-level factors (e.g., socio-demographics and coping strategies), job/task characteristics (e.g., workload and emotional demands), organizational aspects (e.g., workplace policies and support systems), and broader contextual influences (e.g., cultural norms and regulatory environment). The analysis aims to systematically map the range of determinants and consequences associated with mental health conditions, such as stress, burnout, depression, and anxiety, specifically among this workforce. Potential moderating and mediating variables that impact the complex interplay between antecedents and outcomes will also be examined where the data permits. Diagnostic approaches and assessment methods used to evaluate mental health in food handler populations across studies will be summarized, highlighting potential strengths, limitations, and research gaps. Impacts on quality of life and workplace aspects like absenteeism, productivity and turnover will be narratively synthesized. Wherever feasible, the findings will be visually depicted using tables, figures, and conceptual models to provide an integrated understanding. Differences in mental health factors across relevant subgroups (e.g., occupational roles, geographical regions, workplace settings) will also be analyzed and presented.

3. Discussion

We plan to conduct the first scoping review that focuses on consolidating evidence across the intersecting issues of mental health conditions among food handlers, a vulnerable occupational population. This review aimed to provide a broad map of the available research landscape related to mental health status, associated factors, and relevant interventions among food handlers across diverse contexts. We will analyze the coverage, insights, and remaining knowledge gaps to guide future studies and organizational efforts to address this topic. We will use a systematic strategy to capture published and grey literature across several databases and search for citations. However, there are some limitations regarding the language (only English) and databases screened due to logistical constraints. We should note that scoping reviews do not assess the methodological quality or risk of bias in the included studies, and we will not do so either. Our intention on conducting this systematic review is not to generalise findings across diverse national contexts but rather to identify common occupational factors associated with mental health conditions among professional food handlers and highlight contextual differences where data permits (e.g., by region, workplace setting, or employment type). This study also aims to identify gaps in the literature related to under-researched populations or regions and lay the groundwork for future comparative or country-specific studies.

Despite its limitations, this scoping review represents a crucial step in consolidating the current fragmented evidence on mental health among food handlers. By synthesizing available research across diverse contexts, this review will provide a comprehensive overview of the current state of knowledge, facilitating the identification of gaps and priorities for future investigations. These findings can inform the development of targeted interventions, workplace policies, and training programs tailored to the unique needs and challenges faced by food handlers, ultimately promoting their mental well-being and overall occupational health.

Reporting guidelines

Followed PRISMA-ScR guidelines.

Data availability

No data are associated with this article.

Extended data

Mendeley: Occupation-related antecedents, job-related outcomes, and intervening factors of mental health disorders among food handlers: A scoping review protocol; https://doi.org/10.17632/9972jsjsrw.1 (Piramanayagam et al., 2024)

Data are available under the terms of the CC0 1.0 UNIVERSAL license (CC0).

Statement on the Use of Artificial Intelligence (AI):

During the preparation of version 2 of this manuscript, we used ChatGPT-3 (developed by OpenAI) to assist with the generation of keywords for search engine optimization (SEO). Additionally, we used Paperpal Prime, an AI-based language editing tool, to enhance the grammar, clarity, and readability of the manuscript.

Acknowledgments

None to report.

References

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Version 2

VERSION 2 PUBLISHED 07 Jun 2024

Author details Author details

¹ Welcomgroup Graduate School of Hotel Administration, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India

Harshit Singh
Roles: Conceptualization, Investigation, Methodology, Writing – Original Draft Preparation, Writing – Review & Editing

Senthilkumaran Piramanayagam
Roles: Conceptualization, Investigation, Methodology, Writing – Original Draft Preparation, Writing – Review & Editing

K Thirugnanasambantham
Roles: Conceptualization, Supervision, Validation

Competing interests

No competing interests were disclosed.

Grant information

The author(s) declared that no grants were involved in supporting this work.

Article Versions (2)

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https://doi.org/10.12688/f1000research.150054.2

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Singh H, Piramanayagam S and Thirugnanasambantham K. Occupational factors and mental health outcomes among professional food handlers: A scoping review protocol [version 2; peer review: 1 approved, 3 approved with reservations]. F1000Research 2025, 13:600 (https://doi.org/10.12688/f1000research.150054.2)

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Reviewer Report 23 Aug 2025

Ajit Singh, Chandigarh University, Sahibzada Ajit Singh Nagar, Punjab, India

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https://doi.org/10.5256/f1000research.181370.r357201

1. Figure 1 is referenced but not fully described or critically discussed. Recommendation: Provide more explanation of the visual in the text and ensure it’s professionally designed and readable.

2. Inclusion and Exclusion Criteria: While types of ... Continue reading

1. Figure 1 is referenced but not fully described or critically discussed. Recommendation: Provide more explanation of the visual in the text and ensure it’s professionally designed and readable.

2. Inclusion and Exclusion Criteria: While types of studies are listed, the criteria are somewhat vague. There’s no explanation of how grey literature will be evaluated. Recommendation: Elaborate on inclusion/exclusion criteria, especially regarding grey literature (e.g., how presentations/posters will be located and assessed), clarify if only peer-reviewed studies will be included or if dissertations and government reports are also acceptable.

3. The authors has frequently used first-person pronouns such as "We plan," "We will analyze," and "We will use." ( Refer discussion section ). While this style is acceptable in some journal formats, it is generally advisable particularly in formal research protocols and scientific manuscripts to adopt a more objective and impersonal tone. The repeated use of first-person language may reduce the perceived formality and scientific neutrality of the work.
For better alignment with academic writing conventions and to enhance the scholarly tone of the manuscript, it is recommended that the authors revise these statements using passive or third-person constructions. For example:

Instead of: "We will analyze the coverage, insights, and remaining knowledge gaps..."
Use: "The study aims to analyze the coverage, insights, and remaining knowledge gaps..."
Instead of: "We will use a systematic strategy..."
Use: "A systematic strategy will be used..."

Is the rationale for, and objectives of, the study clearly described?

No
Is the study design appropriate for the research question?

Partly
Are sufficient details of the methods provided to allow replication by others?

Yes
Are the datasets clearly presented in a useable and accessible format?

Yes

Competing Interests: No competing interests were disclosed.

Reviewer Expertise: Area of Research : Hospitality , Tourism , and Management.

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.

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2

Reviewer Report 26 Jul 2025

G.K. Sreenivasan, Bundelkhand University, Jhansi, Uttar Pradesh, India

Approved

https://doi.org/10.5256/f1000research.181370.r392265

No doubt, the food handlers actually go through severe work stress due to increasing number of competitors, expectations of the guests and work performance upto the satisfaction of the co-employees and employers. Therefore, the researchers deserve a mark of appreciation. ... Continue reading

No doubt, the food handlers actually go through severe work stress due to increasing number of competitors, expectations of the guests and work performance upto the satisfaction of the co-employees and employers. Therefore, the researchers deserve a mark of appreciation. The introduction cum literature review provides a proper base to the study. Further, consequently, appropriate objectives are identified.

The objectives seem to be achievable easily with the research design provided.

From out of the summary of the major revisions given, it is apparent that the authors have seriously followed the review undertaken by the first reviewer.

No issues of competent interest are found.

The reviewer expects the full-length paper eagerly.

Is the rationale for, and objectives of, the study clearly described?

Yes
Is the study design appropriate for the research question?

Yes
Are sufficient details of the methods provided to allow replication by others?

Yes
Are the datasets clearly presented in a useable and accessible format?

Yes

Competing Interests: No competing interests were disclosed.

Reviewer Expertise: work-life balance, tourism marketing, e-marketing service marketing, customer relationship marketing

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard.

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8

Reviewer Report 03 Jun 2025

Benta Mbare, Tampere University, Tampere, Finland

Approved with Reservations

https://doi.org/10.5256/f1000research.181370.r383211

The revised version of the manuscript is clearly written and generally easy to follow. However, I have a few concerns that could be addressed to strengthen its clarity and rigor.

Introduction and focus
The first and ... Continue reading

The revised version of the manuscript is clearly written and generally easy to follow. However, I have a few concerns that could be addressed to strengthen its clarity and rigor.

Introduction and focus
The first and second paragraphs of the introduction appear somewhat scattered in their review of mental health, particularly the second paragraph. While mental health is indeed an important issue, it is a broad domain, and not all mental health challenges originate from or are influenced by the work environment. The manuscript currently lacks a clear explanation of how the general discussion on mental health, along with the cited costs, directly connects to the study’s specific focus. I think the paper would benefit from narrowing the scope to occupational mental health, with an explanation to how it relates to the population under study. Alternatively, if the intention was to consider broader mental health issues (including non-work-related factors), then I think the authors should more explicitly justify how these are relevant to the study objectives.

Use of references
The introduction appears to rely heavily on a single source, WHO (2022), with limited engagement with other empirical literature. While the WHO reference is important, I think the manuscript would benefit from the inclusion of additional, more recent, and diverse scholarly sources to better situate the study within the current academic discourse. Additionally, some of the cited references seem somewhat outdated and may not reflect the latest developments or findings in this area. I suggest for the authors to incorporate more recent empirical studies that align with the study’s objectives.

Feasibility and scope of the study
In my opinion, the study’s aim to examine mental health among food handlers globally raises some feasibility concerns. Labour market characteristics, occupational conditions, and cultural perceptions of mental health vary significantly across countries, and these differences are likely to influence the outcomes. It is unclear whether the study intends to conduct a comparative analysis across different contexts, and if so, which elements will be examined to account for these variations. Clarification on the intended scope and methodological approach to address such disparities would be helpful in evaluating the feasibility and relevance of the intended study.

Competing Interests: No competing interests were disclosed.

Reviewer Expertise: Health and development; occupational health; organisational psychology, inequalities and inclusions, minorities, health science; qualitative research

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.

CITE

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Version 1

VERSION 1

PUBLISHED 07 Jun 2024

Views

4

Reviewer Report 28 Apr 2025

Hala Samir Abou-ElWafa, Industrial Medicine and Occupational Health, Public Health & Community Medicine Department, Mansoura University, Mansoura, Dakahlia Governorate, Egypt

Approved with Reservations

https://doi.org/10.5256/f1000research.164588.r299033

The magnitude of the problem of mental health disorders among food handlers was not clearly stated in order to justify carrying out this review. So, the burden of the problem should be more elucidated otherwise it will

The magnitude of the problem of mental health disorders among food handlers was not clearly stated in order to justify carrying out this review. So, the burden of the problem should be more elucidated otherwise it will not be of public health importance and not deserving further reviewing.
Searching for literature from year 2000-2024 is a very long duration. I suggest being more concise for example in the last 10 years.
Authors mentioned that grey literature will be searched too including presentations and posters also but did not clarify how you will find them and their weight of evidence.

Is the rationale for, and objectives of, the study clearly described?

Partly
Is the study design appropriate for the research question?

Yes
Are sufficient details of the methods provided to allow replication by others?

Partly
Are the datasets clearly presented in a useable and accessible format?

Partly

Competing Interests: No competing interests were disclosed.

Reviewer Expertise: Occupational health and industrial medicine

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.

CITE

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Views

13

Reviewer Report 02 Jan 2025

Benta Mbare, Tampere University, Tampere, Finland

Approved with Reservations

https://doi.org/10.5256/f1000research.164588.r348983

This protocol is written concisely and is easy to follow and understand. However, the intended study appears to be very broad in scope which is too ambitious and may challenge the analysis process. Below are my reflections

... Continue reading

This protocol is written concisely and is easy to follow and understand. However, the intended study appears to be very broad in scope which is too ambitious and may challenge the analysis process. Below are my reflections

Title: The current title of the study does not effectively convey the purpose or focus of the research. At present, it appears to be a collection of terminologies, some of which are repetitive and lack coherence. To improve clarity and impact, the title should be restructured to succinctly reflect the study's objectives and scope.

Broader context: Mental health is a broad and multifaceted subject. Thus, the background part should emphasise on occupational mental health and also mention the global prevalence and burden of occupational mental health conditions.

Focus of study: Food is handled by many professionals and consumers. It is my understanding that the authors aim to investigate food handlers specifically within professional settings. I think the title should explicitly reflect this distinction to avoid confusion as the term “food handlers” sound quite broad.

Feasibility and scope: The aim to study mental health among food handlers worldwide may not be entirely feasible, especially given the significant differences in labour market profiles and occupational conditions across countries. These disparities are likely to influence the findings on "mental health." Is there an intended comparative analysis regarding these distinctions, and what are the specific elements to be examined?

Study selection criteria: The scope of study selection is unclear. What types of studies are the authors intending to include? Will the review encompass qualitative, quantitative, or mixed-methods research? Are non-academic reports or grey literature (e.g., government publications, industry data) also considered, and if so, what criteria will be used to evaluate their inclusion? Providing more detail on the methodology and selection criteria would enhance the protocol’s transparency.

Is the rationale for, and objectives of, the study clearly described?

Yes
Is the study design appropriate for the research question?

Yes
Are sufficient details of the methods provided to allow replication by others?

Partly
Are the datasets clearly presented in a useable and accessible format?

Not applicable

Competing Interests: No competing interests were disclosed.

Reviewer Expertise: qualitative research, occupational health; organizational psychology, inequalities and inclusions, minorities, health sciences

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.

CITE

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Version 2

VERSION 2 PUBLISHED 07 Jun 2024

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Version 2 (revision) 06 May 25	read		read	read
Version 1 07 Jun 24	read	read

Benta Mbare, Tampere University, Tampere, Finland
Hala Samir Abou-ElWafa, Mansoura University, Mansoura, Egypt
G.K. Sreenivasan, Bundelkhand University, Jhansi, India
Ajit Singh, Chandigarh University, Sahibzada Ajit Singh Nagar, India

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1 Views

23 Aug 2025 | for Version 2

Ajit Singh, Chandigarh University, Sahibzada Ajit Singh Nagar, Punjab, India

1 Views Cite this report Responses(0)

Approved With Reservations

1. Figure 1 is referenced but not fully described or critically discussed. Recommendation: Provide more explanation of the visual in the text and ensure it’s professionally designed and readable.

2. Inclusion and Exclusion Criteria: While types of studies are listed, the criteria are somewhat vague. There’s no explanation of how grey literature will be evaluated. Recommendation: Elaborate on inclusion/exclusion criteria, especially regarding grey literature (e.g., how presentations/posters will be located and assessed), clarify if only peer-reviewed studies will be included or if dissertations and government reports are also acceptable.

3. The authors has frequently used first-person pronouns such as "We plan," "We will analyze," and "We will use." ( Refer discussion section ). While this style is acceptable in some journal formats, it is generally advisable particularly in formal research protocols and scientific manuscripts to adopt a more objective and impersonal tone. The repeated use of first-person language may reduce the perceived formality and scientific neutrality of the work.
For better alignment with academic writing conventions and to enhance the scholarly tone of the manuscript, it is recommended that the authors revise these statements using passive or third-person constructions. For example:

Instead of: "We will analyze the coverage, insights, and remaining knowledge gaps..."
Use: "The study aims to analyze the coverage, insights, and remaining knowledge gaps..."
Instead of: "We will use a systematic strategy..."
Use: "A systematic strategy will be used..."

Is the rationale for, and objectives of, the study clearly described?

No
Is the study design appropriate for the research question?

Partly
Are sufficient details of the methods provided to allow replication by others?

Yes
Are the datasets clearly presented in a useable and accessible format?

Yes

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

Area of Research : Hospitality , Tourism , and Management.

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.

Respond to this report

Responses (0)

Back to all reports

Reviewer Report

2 Views

26 Jul 2025 | for Version 2

G.K. Sreenivasan, Bundelkhand University, Jhansi, Uttar Pradesh, India

2 Views Cite this report Responses(0)

Approved

No doubt, the food handlers actually go through severe work stress due to increasing number of competitors, expectations of the guests and work performance upto the satisfaction of the co-employees and employers. Therefore, the researchers deserve a mark of appreciation. The introduction cum literature review provides a proper base to the study. Further, consequently, appropriate objectives are identified.

The objectives seem to be achievable easily with the research design provided.

From out of the summary of the major revisions given, it is apparent that the authors have seriously followed the review undertaken by the first reviewer.

No issues of competent interest are found.

The reviewer expects the full-length paper eagerly.

Is the rationale for, and objectives of, the study clearly described?

Yes
Is the study design appropriate for the research question?

Yes
Are sufficient details of the methods provided to allow replication by others?

Yes
Are the datasets clearly presented in a useable and accessible format?

Yes

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

work-life balance, tourism marketing, e-marketing service marketing, customer relationship marketing

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard.

Respond to this report

Responses (0)

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Reviewer Report

8 Views

03 Jun 2025 | for Version 2

Benta Mbare, Tampere University, Tampere, Finland

8 Views Cite this report Responses(0)

Approved With Reservations

The revised version of the manuscript is clearly written and generally easy to follow. However, I have a few concerns that could be addressed to strengthen its clarity and rigor.

Introduction and focus
The first and second paragraphs of the introduction appear somewhat scattered in their review of mental health, particularly the second paragraph. While mental health is indeed an important issue, it is a broad domain, and not all mental health challenges originate from or are influenced by the work environment. The manuscript currently lacks a clear explanation of how the general discussion on mental health, along with the cited costs, directly connects to the study’s specific focus. I think the paper would benefit from narrowing the scope to occupational mental health, with an explanation to how it relates to the population under study. Alternatively, if the intention was to consider broader mental health issues (including non-work-related factors), then I think the authors should more explicitly justify how these are relevant to the study objectives.

Use of references
The introduction appears to rely heavily on a single source, WHO (2022), with limited engagement with other empirical literature. While the WHO reference is important, I think the manuscript would benefit from the inclusion of additional, more recent, and diverse scholarly sources to better situate the study within the current academic discourse. Additionally, some of the cited references seem somewhat outdated and may not reflect the latest developments or findings in this area. I suggest for the authors to incorporate more recent empirical studies that align with the study’s objectives.

Feasibility and scope of the study
In my opinion, the study’s aim to examine mental health among food handlers globally raises some feasibility concerns. Labour market characteristics, occupational conditions, and cultural perceptions of mental health vary significantly across countries, and these differences are likely to influence the outcomes. It is unclear whether the study intends to conduct a comparative analysis across different contexts, and if so, which elements will be examined to account for these variations. Clarification on the intended scope and methodological approach to address such disparities would be helpful in evaluating the feasibility and relevance of the intended study.

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

Health and development; occupational health; organisational psychology, inequalities and inclusions, minorities, health science; qualitative research

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.

Respond to this report

Responses (0)

Back to all reports

Reviewer Report

4 Views

28 Apr 2025 | for Version 1

Hala Samir Abou-ElWafa, Industrial Medicine and Occupational Health, Public Health & Community Medicine Department, Mansoura University, Mansoura, Dakahlia Governorate, Egypt

4 Views Cite this report Responses(0)

Approved With Reservations

The magnitude of the problem of mental health disorders among food handlers was not clearly stated in order to justify carrying out this review. So, the burden of the problem should be more elucidated otherwise it will not be of public health importance and not deserving further reviewing.
Searching for literature from year 2000-2024 is a very long duration. I suggest being more concise for example in the last 10 years.
Authors mentioned that grey literature will be searched too including presentations and posters also but did not clarify how you will find them and their weight of evidence.

Is the rationale for, and objectives of, the study clearly described?

Partly
Is the study design appropriate for the research question?

Yes
Are sufficient details of the methods provided to allow replication by others?

Partly
Are the datasets clearly presented in a useable and accessible format?

Partly

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

Occupational health and industrial medicine

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.

Respond to this report

Responses (0)

Back to all reports

Reviewer Report

13 Views

02 Jan 2025 | for Version 1

Benta Mbare, Tampere University, Tampere, Finland

13 Views Cite this report Responses(0)

Approved With Reservations

This protocol is written concisely and is easy to follow and understand. However, the intended study appears to be very broad in scope which is too ambitious and may challenge the analysis process. Below are my reflections

Title: The current title of the study does not effectively convey the purpose or focus of the research. At present, it appears to be a collection of terminologies, some of which are repetitive and lack coherence. To improve clarity and impact, the title should be restructured to succinctly reflect the study's objectives and scope.

Broader context: Mental health is a broad and multifaceted subject. Thus, the background part should emphasise on occupational mental health and also mention the global prevalence and burden of occupational mental health conditions.

Focus of study: Food is handled by many professionals and consumers. It is my understanding that the authors aim to investigate food handlers specifically within professional settings. I think the title should explicitly reflect this distinction to avoid confusion as the term “food handlers” sound quite broad.

Feasibility and scope: The aim to study mental health among food handlers worldwide may not be entirely feasible, especially given the significant differences in labour market profiles and occupational conditions across countries. These disparities are likely to influence the findings on "mental health." Is there an intended comparative analysis regarding these distinctions, and what are the specific elements to be examined?

Study selection criteria: The scope of study selection is unclear. What types of studies are the authors intending to include? Will the review encompass qualitative, quantitative, or mixed-methods research? Are non-academic reports or grey literature (e.g., government publications, industry data) also considered, and if so, what criteria will be used to evaluate their inclusion? Providing more detail on the methodology and selection criteria would enhance the protocol’s transparency.

Is the rationale for, and objectives of, the study clearly described?

Yes
Is the study design appropriate for the research question?

Yes
Are sufficient details of the methods provided to allow replication by others?

Partly
Are the datasets clearly presented in a useable and accessible format?

Not applicable

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

qualitative research, occupational health; organizational psychology, inequalities and inclusions, minorities, health sciences

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.

Respond to this report

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[1] Bi Y, Choi S, Yin J, et al.: Stress on frontline employees from customer aggression in the restaurant industry: The moderating effect of empowerment. Sustainability. 2021; 13(3): 1433. Publisher Full Text

[2] Cerasa A, Fabbricatore C, Ferraro G, et al.: Work-Related Stress Among Chefs: A Predictive Model of Health Complaints.2020; 8(March): 1–8. PubMed Abstract | Publisher Full Text | Free Full Text

[3] Chen H, Wang C: Incivility, satisfaction and turnover intention of tourist hotel chefs Moderating effects of emotional intelligence. Int. J. Contemp. Hosp. Manag. 2019; 31(5): 2034–2053. Publisher Full Text

[4] Chuang N, Lei SA, Lei SA: Job Stress Among Casino Hotel Chefs in a Top-Tier Tourism City. J. Hosp. Market. Manag. 2011; 20(5): 551–574. Publisher Full Text

[5] Cristina I, Machado K, Wagner J, et al.: Stress, anxiety and depression among gastronomes: association with workplace mobbing and work – family interaction. Int. Arch. Occup. Environ. Health. 2021; 94(8): 1797–1807. PubMed Abstract | Publisher Full Text

[6] Eburne JP, Eburne JP: The Chef Drive: Cooking Beyond the Pleasure Principle. Contemp. Fr. Francoph. Stud. 2010; 14(2): 169–177. Publisher Full Text

[7] Harris DA, Giuffre P: ‘“The Price You Pay”’: How Female Professional Chefs Negotiate Work and Family. Gend. Issues. 2010; 27: 27–52. Publisher Full Text

[8] Hinterstoisser TM: An Investigation into the Relationship Between Conscientiousness, Self-Awareness, and Occupational Stress Outcomes in Culinary Chefs. University of Denver; 2011. Reference Source

[9] Ishaque F, Id S, Amu H, et al.: Prevalence and predictors of work-related depression, anxiety, and stress among waiters: A cross-sectional study in upscale restaurants. PLoS ONE. 2021; 16(4): e0249597–e0249518. PubMed Abstract | Publisher Full Text | Free Full Text

[10] Kohli N, Mehta M: Occupational Stress: A Case Study among Chefs and Kitchen Workers. International Journal of Advnaces in Engineering and Management. 2022; 4(3): 970–977. Publisher Full Text

[11] Peters MDJ, Marnie C, Tricco AC, et al.: Updated methodological guidance for the conduct of scoping reviews. JBI Evidence Synthesis. 2020; 19: 3–10. PubMed Abstract | Publisher Full Text

[12] Pidd K, Roche A, Fischer J, et al.: A recipe for good mental health: A pilot randomised controlled trial of a psychological wellbeing and substance use intervention targeting young chefs A recipe for good mental health: A pilot randomised controll. Drugs: Education, Prevention and Policy. 2015; 22(4): 352–361. Publisher Full Text

[13] Piramanayagam S, Singh H, Thirugananasambantham K: PRISMA-ScR - Checklist for Study Titled: Occupation-related antecedents, job-related outcomes, and intervening factors of mental health disorders among food handlers: A scoping review protocol. Mendeley Data. 2024; V1. Publisher Full Text

[14] Rosado-Solomon EH, Koopmann J, Lee W, et al.: Mental Health and Mental Illness in Organizations: A Review, Comparison, and Extension. Acad. Manag. Ann. 2023; 17(2): 751–797. Publisher Full Text

[15] Wilkesmann U, Wilkesmann M: Which factors are associated with the chefs’ perception of stress at the beginning of COVID-19 lockdown ?. Int. J. Hosp. Manag. 2021; 96(October 2020): 102945. Publisher Full Text

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Occupational factors and mental health outcomes among professional food handlers: A scoping review protocol

Abstract

Background

Objective

Inclusion criteria

Methods

Keywords

Revised Amendments from Version 1

Introduction

Figure 1. Food Handler’s mental health conditions.

2. Methods

Table 1. PCC Framework of the proposed scoping review.

2.1 Eligibility criteria

2.2 Types of sources

2.3 Search strategy

Table 2. Preliminary search strategy for PubMed.

2.4 Selection of studies

2.5 Data extraction

Table 3. Data extraction tool.

2.6 Data analysis and presentation

3. Discussion

Reporting guidelines

Data availability

Extended data

Acknowledgments

References

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