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Where is The Greatest Risk of Contracting a Food Borne Illness?
Inside or Outside Your Home (i.e. Restaurant, Deli, Cafeteria, Hotel Kitchen, Public or Private Event)?
There have been a number of studies over the years regarding sources of foodborne illness. The studies have focused mainly on either a foodborne illness outbreak or sporadic foodborne illness cases. Here is the difference:
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Foodborne Disease Outbreaks - The U.S. Centers for Disease Control and Prevention defines a food poisoning outbreak as two or more people who become ill or die after eating the same food. Outbreaks are less than 1% of all cases of foodborne illnesses. To read more on outbreaks click on Food Poisoning Outbreaks.
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Sporadic Foodborne Disease - Those cases not clearly linked to an outbreak. They are far more common but are much less likely to be investigated than are cases associated with recognized outbreaks. These make up the other 99% of cases. [1] [2]
The study results for the sources of outbreaks are pretty overwhelming or obvious.
Here they are in a pie chart:
Sources of foodborne disease outbreaks reported to the Centers for Disease Control and Prevention during the period 1998–2004. Data are from Centers for Disease Control and Prevention. United States foodborne disease outbreaks. Centers for Disease Control and Prevention (Atlanta), 2006. “Restaurants” includes delicatessens, cafeterias, and hotels. (2)
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Restaurants are the clear majority when it comes to outbreaks but what about for sporadic cases? There have been a number of studies over the years regarding the sources of sporadic illnesses. Most of these studies have been performed using different methods and have many limitations. But the conclusions from the CDC and others state “Despite these important limitations, the consistent findings demonstrating an association between increased frequency of eating in restaurants and increased risk of foodborne disease bear further examination……consumption specifically of foods prepared outside of the home was associated with a greater risk of foodborne disease than was home-cooked foods.” [1] |
So clearly restaurants are more likely the primary source and the greatest risk of foodborne illness!
Why is this the case when commercial restaurants are regularly inspected by local or state inspectors and have to meet standards that are far beyond anything in the home kitchen?
Here are some of the major reasons:
Time & Temperature Abuse
It is generally recognized that the most common cause of food poisoning or food borne illness in the developed world is from potentially hazardous foods (meats, poultry, seafood and any processed foods, or processed fruits and vegetables) being left out for too long in the food temperature danger zone (between 41° and 135° Fahrenheit) during its processing or storage. Bacteria can double every 15 minutes in this prime temperature range. This can occur from:
Inadequate Reheating - When leftovers are not reheated to above 165°F for at least 15 seconds. Inadequate Hot Holding - Cooked foods not held at or above 140° F until served. |
The chances of this happening in a busy restaurant are much greater than at your home. At home, you or the person doing the cooking is most likely preparing only one meal at a time and it is served immediately after it is ready. Preparation and processing at a restaurant are very different. Please read on.
Preparing Too Far Ahead of Serving Time
Many restaurants have no choice but to do much of their preparation long before the food is to be served if they are going to meet their customer demand of timely service. Their kitchen facilities and the number of staff are just not adequate to produce large numbers of meals on demand. This delay increases the risk of a food poisoning microorganism taking hold and giving it more time to reproduce to large enough numbers resulting in an illness.
Preparing in Bulk
Restaurants prepare much of their meals in bulk. Larger containers, pots etc. take longer to heat up and cool down again exposing the food to longer periods of dangerous temperatures. Also, larger mass or batch production has the unfortunate affect of a larger potential spread of the pathogenic source for the illness. See Amplification below.
Equipment Overuse and Breakdown
The constant opening and closing and high use of both the cooling units and warming units in a busy restaurant stresses the equipment. Even though the equipment is specially designed for commercial use, it does eventually breakdown. I have seen countless cooling and warming units that where not adequately maintaining safe temperatures.
Poor Personal Hygiene
This can include everything from poor handwashing practices, to a cut or sore on the hands, to a food handler or kitchen worker who is ill. For anyone that has worked full time in a restaurant kitchen, these bad habits, or just plain mistakes or absentmindedness can easily occur throughout the day. Practices that most people at home are less likely to do and have less an affect beyond themselves and those few that they are preparing for. To read more on how to identify these habits as a customer in a restaurant click on Poor Personal Hygiene Habits in a Restaurant.
Amplification of a Pathogen
What might otherwise only affect one or two people at your home or just your family, can literally affect hundreds at a busy restaurant. For example, many restaurants break open dozens of eggs at once and “pool” them together in a large mixing bowl for anything from omelets to some type of dessert. Although legal if temperature and time are monitored, the potential problem with this practice is if just one egg is contaminated with say Salmonella, the entire batch now becomes contaminated. The restaurant has amplified the effects of that one egg, which otherwise might have made just one person ill. Cross contamination is another example of this where, for example, the same cutting board used to process raw chicken is used to process vegetable or fruits or other ready-to-eat foods again potentially spreading a pathogenic microorganism to other foods that were not originally the source for the organism, thereby amplifying its affect.
Conclusion
Both studies and just plain common sense points to the fact that restaurants (including delis, cafeterias, hotel kitchens, public or private events etc.) are a greater risk for contracting a foodborne illness than a private home. The nature and practices of a restaurant provide an environment that is higher risk by definition.
So what can you do as a customer to minimize this risk?
Do what I advocate throughout this web site and that is to educate yourself on how to identify the risky practices, foods, and the restaurants themselves.
Start at FoodPoisoningPrevention.com to avail yourself of the many articles available on how to identify and avoid food poisoning hazards.
REFERENCES
1. “Eating in Restaurants: A Risk Factor for Foodborne Disease?” Author: Timothy F. Jones1, and Frederick J. Angulo http://www.cdc.gov/enterics/publications/390_jones_2006.pdf/
2. “Surveillance for Sporadic Foodborne Disease in the 21st Century: The
FoodNet Perspective” Author: Ban Mishu Allos, Matthew R. Moore, Patricia M.
Griffin, and Robert V. Tauxe
http://www.cdc.gov/enterics/publications/8_allosb.pdf
Michael Doom worked as a Registered
Environmental Health Specialist (REHS) for Los Angeles
County for more than 21 years. For most of these years he worked as a
field inspector and Supervising Senior REHS in the retail
food inspection programs. His experience within Los Angeles
County has taken him to some of the smallest “mom and pop”
restaurants and markets in the poorest areas of south Los
Angeles, as well as to the largest facilities and affluent
areas on the west side. He has literally conducted thousands
of inspections of numerous types of restaurants, food
markets, warehouses, events, and more; educated hundreds, if
not more than a thousand, food facility owners, managers and
employees on food sanitation and
food safety,
and how to
prevent food poisoning hazards;
has supervised more than 50 field inspectors that were
responsible for an inventory of food facilities larger than
many U.S. states.
Mr. Doom has a B.S. in Biology from
Loyola Marymount University, an REHS with the state of
California, holds a Project Management Professional (PMP®)
credential from the Project Management Institute, and a
Masters Certificate in Project Management from George
Washington University. Mr. Doom continuously works to expand his knowledge
and experience in the subject of food safety, sanitation and
food poisoning prevention.
He can be reached at
Mike@foodpoisoningprevention.com
About the Author