Systematic environmental evaluations to identify food safety differences between outbreak and nonoutbreak restaurants

Area of Science:

• Food Safety
• Environmental Health
• Epidemiology

Background:

• Restaurants are significant venues for foodborne disease transmission.
• The Environmental Health Specialists Network (EHS-Net) aims to identify outbreak causes and improve prevention.
• Norovirus is a leading cause of foodborne illness outbreaks.

Purpose of the Study:

• To identify underlying factors contributing to foodborne disease outbreaks in restaurants.
• To evaluate the impact of Certified Kitchen Managers (CKMs) on outbreak prevention.
• To assess the effectiveness of employee health policies in mitigating foodborne illness.

Main Methods:

• Systematic environmental evaluations were conducted in 22 outbreak and 347 non-outbreak restaurants.
• Data collected included contributing factors, foodborne disease agents, and restaurant characteristics.
• Statistical analysis, including odds ratios, was used to assess associations.

Main Results:

• Food handler illness (65%) and bare-hand contact (35%) were primary contributing factors.
• Certified Kitchen Managers (CKMs) were present in 71% of non-outbreak restaurants versus 32% of outbreak restaurants (OR 0.2).
• CKMs were linked to reduced norovirus and Clostridium perfringens outbreaks but not to reduced transmission by infected handlers.

Conclusions:

• Food safety certification for kitchen managers is a crucial measure for preventing restaurant outbreaks.
• Effective management of food worker illnesses and robust employee health policies are essential.
• Further emphasis on managing ill food workers in safety training is recommended.