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CDC Offers New Environmental Health Findings to Improve Food Safety in Restaurants

Photo collage: raw chicken with a thermometer, bin of heads of lettuce, raw beef patties on plate and a food worker preparing food.

More than half of all foodborne illness outbreaks in the United States are associated with restaurants, delis, banquet facilities, schools and other institutions according to CDC's Surveillance for Foodborne Disease Outbreaks – United States, 1998-2008.

The Centers for Disease Control and Prevention’s Environmental Health Specialists Network (EHS-Net) announces four new publications on restaurant food handling practices that have been linked with foodborne illness outbreaks in restaurant settings. These publications are on the following topics:

  • Ground beef handling,
  • Handling of leafy greens,
  • Chicken cross-contamination, and
  • Sick food workers

Food safety programs and the restaurant industry can use these findings to develop effective interventions to improve food safety in restaurants.

All EHS-Net food safety publications are accompanied by plain-language summaries of the study findings and recommendations.

Ground Beef Handling and Cooking Practices

EHS-Net did the Ground Beef Handling and Cooking Practices study because of the link between E. coli O157:H7 infections and eating in restaurants. The study describes ground beef preparation practices that could lead to cross-contamination of other foods from raw ground beef and to undercooking of hamburgers made from ground beef. Cross contamination and undercooked ground beef can lead to foodborne illness.

EHS-Net found that many restaurants prepared ground beef in ways that could lead to cross contamination or undercooking. For example, in 62% of restaurants where workers used bare hands to handle raw ground beef, workers did not wash their hands after handling it. And about 80% of managers said that they did not always use a thermometer to make sure that hamburgers were cooked to the right temperature.

This study also found that chain restaurants and restaurants with kitchen managers who are certified in food safety had safer ground beef practices than other restaurants.

Handling Practices of Fresh Leafy Greens: Receiving and Training

Foodborne illness outbreaks have been associated with fresh produce like leafy greens (such as lettuce and spinach). Restaurants’ leafy greens handling practices could contribute to foodborne illness outbreaks. EHS-Net did the Handling Practices of Fresh Leafy Greens: Receiving and Training study to learn more about how restaurant workers handle leafy greens.

EHS-Net found that many restaurants safely handle leafy greens. For example, most restaurants met the U.S. Food and Drug Administration’s (FDA’s) guidelines for rejecting shipments of leafy greens and for keeping purchase records for leafy greens. However, most restaurants did not meet FDA guidelines for refrigerating cut leafy greens at 41°F or below.

Frequency of Inadequate Chicken Cross Contamination Prevention and Cooking Practices

Poultry is the most common food associated with deaths from foodborne illness in the United States. Foodborne illness linked with chicken can be caused by cross-contamination of other foods from raw chicken or by undercooked chicken. EHS-Net did the Frequency of Inadequate Chicken Cross Contamination Prevention and Cooking study to learn more about how restaurant workers prepare and cook chicken.

EHS-Net found that many restaurants did not follow FDA’s advice when preparing and cooking chicken. For example, 40% of managers said that they do not always designate specific cutting boards for use only with raw chicken. Additionally, over half of managers said that thermometers were not used to check the final cook temperature of chicken.

Food Worker Experiences with and Beliefs about Working While Ill

Sick food workers can transmit germs from themselves to the food they prepare. People who eat that food can then get sick. This is an important cause of foodborne illness outbreaks. EHS-Net did the Food Worker Experiences with and Beliefs about Working While Ill study to learn more about factors that influence restaurant workers’ decisions to work while sick.

EHS-Net found that 20% of workers said that they had worked a shift in the past year when sick with vomiting or diarrhea, which are symptoms of foodborne illness. Additionally, workers with concerns about leaving their coworkers short-staffed and losing their job if they did not come to work because they were sick were more likely to say that they had worked with vomiting or diarrhea.

Explaining the Risk of Foodborne Illness Associated with Restaurants

These four study publications are accompanied by an overview that provides perspective on EHS-Net study findings and their potential impact. It also talks about EHS-Net’s systems-based approach to evaluating food handling practices in restaurants.

Explaining the Risk of Foodborne Illness Associated with Restaurants: The Environmental Health Specialists Network (EHS-Net) [PDF - 84 KB]

About EHS-Net and EHS-Net Studies

EHS-Net was established to contribute to a better understanding of the causes of restaurant-related foodborne illness outbreaks and to translate that understanding into improved prevention practices. The four studies described here exemplify EHS-Net’s efforts. These studies provide valuable information about important restaurant food safety practices. This information is critical for the development of effective restaurant food safety interventions.

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