The FDA has released findings from the first phase of a 10 year study that is looking at restaurant foodborne illness factors in fast food restaurants and full service restaurants. The report looked at risk factors from 2013 to 2014. The first 10-year study was conducted between 1998 and 2008.
In the 2008 study, the FDA found that the restaurant foodborne illness factors that needed the most improvement were poor personal hygiene, improper food holding/time and temperature, and contaminated equipment and protection from contamination.
More than half of all food poisoning outbreaks in the U.S. every year are associated with restaurant food. In 2014, when looking at outbreaks linked to a single location, restaurants accounted for 485 outbreaks, or 65% of the total, and 4780 illnesses, or 44%. Many of these outbreaks led to lawsuits. The FDA at that time stated it needed more research to identify the root causes for these poor retail food safety practices, and to determine effective intervention strategies.
The restaurant foodborne illness risk factors that were listed for this study include employee handwashing, proper temperature control of perishable foods, improper food holding time, hand-to-hand contact with ready-to-eat foods, cooking raw animal foods to safe final and required internal temperatures, contaminated equipment, and food obtained from unsafe sources.
Restaurants were randomly selected using a Geographic Information System database within a 150-mild radius of the locations of twenty-two specialists who conducted the data collection. The sample size was 384 data collection points to provide sufficient observations with a 95% confidence rate.
The specialist arrived unannounced at the restaurants, then explained the purpose of the visit to the person in charge of the facility. If entry was denied, another restaurant was selected. The 2013 FDA Food Code was used as the standard of measurement. Restaurants were marked as being in compliance, out of compliance, or not applicable.
Then, for each of the key elements, the person in charge was interviewed to see if criteria for risk factors were addressed in a food safety management system (FSMS). The answers were rated 1 through 4. One was defined as no system in place, 2 as underdeveloped, 3 as well-developed, and 4 as well-developed and documented.
The results are startling. In Table 9 in the report, in fast food restaurants, 68% were out of compliance for holding refrigerated foods at the proper temperature, 66% were out of compliance for personal hygiene, 49% for cooling foods properly, 41% for sanitizing food contact surfaces, and 37% for foods protected from cross-contamination. For full service restaurants, 86% were out of compliance for keeping perishable foods refrigerated, 82% for employee handwashing, 72% for cooling foods properly, 71% for ready-to-eat foods marked with the date and discarded within a week, and 66% for protecting food from cross-contamination. All of those factors could lead to restaurant foodborne illness outbreaks.
Food safety management systems played a major role in whether or not these restaurants were compliant. In fast food restaurants, if there was no FSMS, an average of 4.5 items were out of compliance. With a well-developed FSMS, only 1.7 items were out of compliance,. Ian full service restaurants, the numbers were similar. Restaurants without an FSMS had 5.8 items out of compliance, and with a well-developed FSMS, there were only 2. 1 items out of compliance.
In the same vein, restaurants with a Certified Food Protection Manager (CFPM) had fewer primary data items out of compliance. And restaurants were the CFPM was the person in charge at the time of data collecting had significantly better food safety management scores.
The two risk factors that needed most improvement to prevent foodborne illness, according to the FDA, were cold holding of foods requiring refrigeration, since bacteria will grow in foods out of refrigeration after two hours, and employee handwashing, since ill persons can transfer bacteria to foods through the fecal-to-oral route.
The best control in fast food and full service restaurants was in ensuring no bare hand contact with ready-to-eat foods, and cooking raw animal foods, such as meat, poultry, and eggs, to the required safe final internal temperature.