Restaurants Can Manage Sick Workers to Help Prevent Outbreaks

Key Takeaways from Our Research

Waitress carrying multiple plates on her arms.

We found gaps in restaurant practices for managing sick workers. Taking the following steps can help manage sick workers:

  • Create or strengthen written policies that require food workers to tell managers when they are sick, including which symptoms should keep workers from working. We found sick worker policies are common, but many could be stronger.
  • Address the reasons why managers and workers work when sick. We found 1 in 5 food workers had worked while sick with vomiting or diarrhea for at least one shift in the previous year. Workers worked while sick for many reasons, including personal, financial, and social reasons.
  • Take a proactive role in deciding whether sick workers should work, for example asking sick workers if they had foodborne illness symptoms. We found managers often left the decision to work to their sick staff members.
  • Create schedules that ease the pressure for workers to work when they are sick. One example is having on-call workers for every shift.

Food workers can spread illness if they work while sick.

Germs from sick food workers can get onto food, and customers who eat it can get sick, too. Food workers can spread illnesses like norovirus and E. coli if they work while sick. Lowering the number of workers who work when they are sick can reduce the number of foodborne illness outbreaks.

We wanted to learn more about how restaurants manage sick workers.

EHS-Net interviewed food workers and managers to find out how restaurants handle sick workers. We wrote reports on our findings about

  • Common traits of food workers who worked when they were sick.
  • Reasons food workers worked when they were sick.
  • Restaurant policies about sick workers.
  • How restaurant managers supervised food workers when they were sick.

Sick worker policies are common, but many could be stronger.

Most restaurants have a sick worker policy, as recommended by the FDA Food Code. Most policies included provisions to tell managers when they are sick and mentioned vomiting and diarrhea as symptoms that keep a worker from working, in alignment with the Food Code. But

  • One in three policies did not list symptoms that should keep sick workers from working.
  • Most policies did not mention jaundice or sore throat accompanied by fever, which are symptoms that the Food Code states should keep a worker from working.

Food workers said they worked while sick for many reasons.

More than half could remember a time that they worked when sick with vomiting or diarrhea. One in five workers said that they had worked when sick with vomiting or diarrhea for at least one shift in the previous year. Some workers said the restaurant did not have paid sick leave or a sick leave policy.

African Man Sitting On Bed Suffering From Stomach Pain

Food workers also said they worked while sick because they

  • Did not feel very sick or thought they would not pass their illness to anyone else.
  • Did not want to leave the restaurant shorthanded or coworkers short staffed.
  • Had a strong sense of duty or work ethic or feared losing their job.

Workers were more likely to say they had worked when sick if they worked in a restaurant that

  • Served more than 300 meals a day.
  • Had a manager with less than 4 years of experience.
  • Did not have a policy that required workers to tell a manager when they are sick.
  • Did not have an on-call worker.

Workers were also more likely to say they had worked while sick when they had

  • Concerns about leaving coworkers short staffed, and
  • Concerns about job loss.

Managers did not take a proactive role in deciding whether sick workers should work.

About half of food workers said their manager knew what their symptoms were.

  • Very few managers said they asked sick workers if they had vomiting or diarrhea.
  • Almost all food workers said it was their decision (not the manager’s) to work when sick.
What Is EHS-Net?

This study was conducted by the Environmental Health Specialists Network (EHS-Net). EHS-Net is a federally funded collaboration of federal, state, and local environmental health specialists and epidemiologists working to better understand the environmental causes of foodborne illness.