October 2, 2023

Sick Restaurant Employees Cause 40% of Outbreaks

Sick restaurant employees cause 40% of foodborne illness outbreaks, according to an article in the Center for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report for the week of June 2, 2023. Hundreds of foodborne illness outbreaks associated with retail food establishments are reported every year to the CDC.

Sick Restaurant Employees Cause 40% of Outbreaks

The period of time included in this study was 2017 to 2019. In 2014, CDC launched the National Environmental Assessment Reporting System (NEARS) to compliment the surveillance conducted by the National Outbreak Reporting System (NORS). State and local health departments enter data from their outbreak investigations of retail food establishments.

The data entered include characteristics of outbreaks, including factors contributing to the illnesses, how many meals are served in each establishment, and food safety policies in the restaurants, including ill worker policy requirements.

During that time period, 800 foodborne illness outbreaks associated with 875 retail food establishments were reported to NEARS by 25 state and local health departments. The most common pathogens were norovirus and Salmonella. Contributing factors were identified in 52.5% of the outbreaks. About 40% of the outbreaks had at least one reported factor associated with food contamination by a sick restaurant employee.

Of the 725 managers interviewed, most said their establishment had a policy requiring food workers to notify their manager when they were sick. But only 23% said the policy listed all five symptoms workers needed to notify managers, such as vomiting, diarrhea, jaundice, sore throat with fever, and lesion with pus.

The most common contributing factor was “other” contamination by a food worker who was suspected to have an infectious ¬†illness. Non-cross-contamination sources included aerosolized vomitus and outbreaks where investigators couldn’t determine whether or not the employee was wearing gloves during food preparation.

The article states that, “Although a majority of managers reported their establishment had an ill worker policy, often these policies were missing components intended to reduce foodborne illness risk. Contamination of food by ill or infectious food workers is an important cause of outbreaks; therefore, the content and enforcement of existing policies might need to be re-examined and refined.”

Comprehensive ill worker policies will likely be necessary to mitigate this problem if ill workers continue to play a substantial role in these outbreaks. Restaurants with policies requiring workers to report illness were less likely to have employees who worked while ill.

Food workers say they work while they are sick because of loss of pay and perceived social pressure. Less than half of establishments with  outbreaks have paid sick leave. Expanded paid sick leave in a restaurant chain reduced the incidence of working while sick among front-line food service workers.

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