A progressive approach to the problem of foodborne infections

Results of routine restaurant inspections can predict outbreaks of foodborne illness: the Seattle-King County experience

To analyze the association between the results of routine inspections and foodborne outbreaks in restaurants, we conducted a matched case-control study using available data from Seattle-King County, Washington. Case restaurants were facilities with a reported foodborne outbreak between January 1, 1986 and March 31, 1987 (N = 28). Two control restaurants with no reported outbreaks during this period were matched to each case restaurant on county health district and date of routine inspection (N = 56). Data from the routine inspection that preceded the outbreak (for case restaurants) or the date-matched routine inspection (for control restaurants) were abstracted from computerized inspection records. Case restaurants had a significantly lower mean inspection score (83.8 on a 0 to 100 point scale) than control restaurants (90.9). Restaurants with poor inspection scores and violations of proper temperature controls of potentially hazardous foods were, respectively, five and ten times more likely to have outbreaks than restaurants with better results. Although this study demonstrates that Seattle-King County's routine inspection form can successfully identify restaurants at increased risk of foodborne outbreaks, it also illustrates that more emphasis on regulation and education is needed to prevent outbreaks in restaurants with poor inspection results.

A priority system model for sanitation management in food service establishments

We set out to develop a sanitation management scheme that will enable health regulatory authorities to utilize available personnel more efficiently in the regulation of the food service industry given the current budgetary and manpower constraints. Previous analyses of the Annual Food Service Establishment Sanitation Inspection Summary records from a large County Department of Health for fiscal years 1979, 1980, and 1981 indicated a cut-off point at about two to four visits for a productive follow-up sanitation inspection of food service establishments. Revisits after this point seemed counter-productive. Revisits of up to 13 times in some establishments and a high uninspection rate of others were noted. The above data, the population at risk for each establishment (generated by a prescribed method), and various control criteria were integrated into the model. Application of the model to a sample of 82 food service establishments was successful in ensuring that those operations that pose high risk to patrons are given priority in a sanitation management program while also facilitating the inspection of all food service establishments within a jurisdiction at some point.