Factors associated with food workers working while experiencing vomiting or diarrhea.

This study sought to determine the frequency with which food workers said they had worked while experiencing vomiting or diarrhea, and to identify restaurant and worker characteristics associated with this behavior. We conducted interviews with food workers (n=491) and their managers (n=387) in the nine states that participate in the Centers for Disease Control and Prevention's Environmental Health Specialists Network. Restaurant and worker characteristics associated with repeatedly working while experiencing vomiting or diarrhea were analyzed via multivariable regression. Fifty-eight (11.9%) workers said they had worked while suffering vomiting or diarrhea on two or more shifts in the previous year. Factors associated with workers having worked while experiencing vomiting or diarrhea were (i) high volume of meals served, (ii) lack of policies requiring workers to report illness to managers, (iii) lack of on-call workers, (iv) lack of manager experience, and (v) workers of the male gender. Our findings suggest that policies that encourage workers to tell managers when they are ill and that help mitigate pressures to work while ill could reduce the number of food workers who work while experiencing vomiting or diarrhea.

Tomato handling practices in restaurants.

In recent years, multiple outbreaks of Salmonella infection have been associated with fresh tomatoes. Investigations have indicated that tomato contamination likely occurred early in the farm-to-consumer chain, although tomato consumption occurred mostly in restaurants. Researchers have hypothesized that tomato handling practices in restaurants may contribute to these outbreaks. However, few empirical data exist on how restaurant workers handle tomatoes. This study was conducted to examine tomato handling practices in restaurants. Members of the Environmental Health Specialists Network (EHS-Net) observed tomato handling practices in 449 restaurants. The data indicated that handling tomatoes appropriately posed a challenge to many restaurants. Produce-only cutting boards were not used on 49% of tomato cutting observations, and gloves were not worn in 36% of tomato cutting observations. Although tomatoes were washed under running water as recommended in most (82%) of the washing observations, tomatoes were soaked in standing water, a practice not recommended by the U.S. Food and Drug Administration (FDA), in 18% of observations, and the temperature differential between the wash water and tomatoes did not meet FDA guidelines in 21% of observations. About half of all batches of cut tomatoes in holding areas were above 41 degrees F (5 degrees C), the temperature recommended by the FDA. The maximum holding time for most (73%) of the cut tomatoes held above 41 degrees F exceeded the FDA recommended holding time of 4 h for unrefrigerated tomatoes (i.e., tomatoes held above 41 degrees F). The information provided by this study can be used to inform efforts to develop interventions and thus prevent tomato-associated illness outbreaks.

Certified kitchen managers: do they improve restaurant inspection outcomes?

Restaurants are associated with a significant number of foodborne illness outbreaks in the United States. Certification of kitchen managers through an accredited training and testing program may help improve food safety practices and thus prevent foodborne illness. In this study, relationships between the results of routine restaurant inspections and the presence of a certified kitchen manager (CKM) were examined. We analyzed data for 4461 restaurants in Iowa that were inspected during 2005 and 2006 (8338 total inspections). Using logistic regression analysis, we modeled the outcome variable (0 = no critical violations [CVs]; 1 = one or more CVs) as a function of presence or absence of a CKM and other explanatory variables. We estimated separate models for seven inspection categories. Restaurants with a CKM present during inspection were less likely to have a CV for personnel (P < 0.01), food source or handling (P < 0.01), facility or equipment requirements (P < 0.05), ware-washing (P < 0.10), and other operations (P < 0.10). However, restaurants with a CKM present during inspection were equally likely to have a CV for temperature or time control and plumbing, water, or sewage as were restaurants without a CKM present. Analyses by type of violation within the temperature and time control category revealed that restaurants with a CKM present during inspection were less likely to have a CV for hot holding (P < 0.05), but the presence of a CKM did not affect other types of temperature and time control violations. Our analyses suggest that the presence of a CKM is protective for most types of CVs, and we identify areas for improving training of CKMs.