In 2009, according to an Associated Press calculation that used a formula created by the Centers for Disease Control and Prevention (CDC), 87 million people become ill due to foodborne contamination annually.  Of those, 371,000 are hospitalized and 5,700 die!  

Further to this metric, the CDC estimates that 70 percent of the “illnesses” occur due to failures in food service operations.  Probably, the two most memorable events were the 1993 Washington state Jack-in-the-Box contamination event that killed four children and sickened at least 700 due to E. coli-tainted meat coupled with improper burger cooking to kill the bacteria and then in 2006, when 71 people became ill with E. coli after eating at Taco Bell restaurants in four states that had served contaminated lettuce.

These two events were major, but CDC figures suggest that there are thousands or millions on a much smaller scale that do not hit our radar screen.  Most recently, a new report from the Hollin’s University (Roanoke, Virginia) found 48 percent of machine beverages tested contained coliform bacteria … begging the question as to how and how often are these machines cleaned?

The FDA has issued several guidelines for food service personnel that are aimed at reducing consumer bacterial contamination.  While a variety of publications have occurred since 1934, the FDA began publishing a “Food Code” in 1993 that was recommended by the U.S. Public Health Services for regulatory operations providing food directly to the consumer.  One can view this 698 page document on the internet or purchase it from the FDA for $69.  The 2009 full version (the seventh since 1993) was recently published. There have been numerous supplemental updates between the full versions.

The “Code” covers the following areas:  Food handling and preparation–sources, receiving, storage, display, service, and transportation; personnel–health, personal cleanliness, clothing, hygiene practices; equipment and utensils–facilities and equipment; utilities and services–water, sewage, plumbing, restrooms, waste disposal, integrated pest management; construction and maintenance–floors, walls, ceilings, lighting, ventilation, dressing rooms, locker areas, storage areas; foodservice units–mobile and temporarily units, and compliances procedures–foodservice inspections and enforcement actions.

As of April 2009, the Association of Food and Drug Officials reports that 48 of the 50 States (96 percent) have adopted codes patterned after the 1993, 1995, 1997, 1999, 2001 or 2005 versions of the Food Code and represent 95.7 percent of the U.S. population. Of the remaining two States, North Carolina and Kentucky are actively pursuing Food Code adoption Rulemaking.   

While almost all of the 50 States have adopted at least one version of the Food Code, only 43 states (84 percent of the U.S. population) have adopted a Code more recent than 1999.

Fourteen have adopted the 1999 Food Code, representing 15.2 percent of the U.S. population. Twenty have adopted the 2001 Food Code, representing 57.7 percent of the U.S. population. Nine have adopted the 2005 Food Code, representing 11.0 percent of the U.S. population. Five have adopted an earlier version of the Food Code.

Since the Code is intended to help state health departments develop regulations for their food service inspection program, there is a variance in the enforcement, penalties and infraction severity from state-to-state.  Many states and communities, as well as independent companies, offer training that can include individual “certification” for best food handling services, but what is the incentive to become certified?

Local and state communities conduct near annual inspections of restaurants in most cities.  I am sure that most of you have seen in some restaurant windows a prominent A, B, or C card in the window where the “Grade” reflects how well a restaurant complies with the local health and state sanitary code.  I always thought these “grades” were made on a consistent set of criteria, but this is not the case, so a grade of an “A” in a restaurant in New York City may not mean the same as an “A” grade in Los Angeles.   Specifically, to maintain an “A” Grade in Manhattan, the restaurant may not receive more than 14 demerits. A severe violation has a score of 7, a critical violation a score of five and a general violation a score of two.   In LA, an “A” rating is achieved with a score of 90 to 100 points. Major violations receive a six point reduction, minor violations a four point reduction and general violations a one point reduction.  The definitions for each category vary, but in both cases, a restaurant can attain an “A” rating with one infraction in their highest category and one in their next highest category.  Does this sound like an “A” to you?

In NYC, if the restaurant does not attain an “A”, it has 30 days to correct the infractions and in the interim does not have to put the “B” or “C” card on display.

Summarizing, foodservice contamination accounts for about 70 percent of food-related illnesses.  The FDA has published a massive Food Code document since 1993 to help states improve food safety, yet less than 20 percent of the states have adopted the latest code and 2 states, after 17 years are still “in process.” I wonder how many people have actually read the entire 698 page document?

States or local statues, regulations, and ordinances vary from state-to-state, and the restaurant rating system is not consistent between states or localities–and an “A” rating allows at least one severe infraction without penalty–either financially or in immediate loss of the rating.

In today’s economy every business is trying to reduce costs to remain profitable and in some cases, just to stay in business.  This is no different in the foodservice industry.  The restaurant owner desires to provide the consumer with a pleasant food experience and make money.  Given the foodservice inspection process, one can easily see that the restaurant owner may not be giving food safety his/her number one priority, but if there was a direct monetary incentive to pay more attention to food safety, would this change the food service owner’s priorities?  

Some tempting incentives might be a 10 to 20 percent federal and/or state tax credit for a 100 percent report card–no infractions during an inspection; a five to 10 percent federal and/or state tax credit for having all personnel “certified” food servers; or a guarantee to serve local and state functions for a year … these could be all levels of foodservice for a variety of events.

While incentives may not be the silver bullet to significantly improve food safety, maybe a new method is in order to raise the priority of food safety on every food server’s menu.