Foodborne Illness Risk Factors in Restaurants

ANAB Accreditor for Food Safety Management Systems Certification (ISO 22000 and FSSC 2200) checking lettuce and cabbage for bacteria.

The FDA released a report on the Occurrence of Foodborne Illness Risk Factors in Fast Food and Full-Service Restaurants. The report shows that having a well-developed Food Safety Management System (FSMS) is linked to minimizing foodborne illness risk factors in restaurants. The report further examines the presence of a Certified Food Protection Manager (CFPM) in relation to out-of-compliance food safety behaviors/practices.

What Is Foodborne Illness?

Foodborne illness (food poisoning) is caused by consuming contaminated food, beverages, or water. The contamination is caused by a variety of bacteria, parasites, viruses, toxins, or chemical substances like heavy metals; it can occur at any stage of the food production, delivery, and consumption chain. There are over 200 foodborne related diseases, ranging from a few days of the stomach bug to more serious outcomes such as kidney failure, cognitive impairment, and even death. It is important to note, however, that all foods naturally contain small amounts of bacteria. The improper handling, cooking, or storage of food is what can result in bacteria multiplying in large enough numbers to contaminate food, causing foodborne illness.

The Center for Disease Control and Prevention (CDC) estimates that each year 48 million people get sick from a foodborne illness, 128,000 are hospitalized, and 3,000 die. These diseases contribute significantly to the global burden of disease and mortality; hence, foodborne illness is a growing public health problem.

Foodborne Illness Outbreaks at Restaurants

According to the CDC, more than half of foodborne illness outbreaks that occur each year are associated with food from restaurants. When considering incidents in 2017 involving a single location of food preparation the CDC found that restaurants accounted for 489 outbreaks (64%) and 5,533 illnesses (44%). Another study conducted by the CDC during 2017-2019 found a total of 800 foodborne illness outbreaks associated with 875 retail food establishments. In 555 of the 800 cases investigators were able to narrow down the infectious substances— salmonella (19%) and norovirus (47%). Norovirus is a pathogen that manifests as a stomach bug and is easily spread from person-to-person. Further, this study found that contamination of food by ill or infectious food workers contributed to about 40% of outbreaks identified with contributing risk factors (i.e., the food preparation factors that can lead to outbreaks, such as sick workers contaminating ready-to-eat food or not cooking food at a high enough temperature).

Contributing Factors in Foodborne Illness Outbreaks

Measuring and reporting on the occurrence of foodborne illness risk factors and food safety behaviors/practices at retail food establishments provide the foundation for identifying where risk-based interventions might have the greatest impact on enhancing public health protection. The Food and Drug Administration (FDA) released a report on its findings from the 2017-2018 data collection; it is part of FDA’s 10-year (2013-2023) study on trends in foodborne illness risk factors and food safety behaviors and practices in food service facilities.  

The study examined 421 fast-food restaurants (quick-service ordering) and 430 full-service restaurants (customers order their meal at a table where staff serves them). Four foodborne illness risk factors, comprising specific food safety behaviors, were used as the key indicators for FDA’s statistical analysis for this study:

  1. Poor Personal Hygiene: Employees practice proper handwashing; employees do not contact ready-to-eat (RTE) foods with bare hands
  2. Contaminated Equipment/ Protection from Contamination: Food is protected from cross contamination during storage, preparation, and display; food contact surfaces are properly cleaned and sanitized
  3. Improper Holding Time/Temperature: Foods requiring refrigeration are held at the proper temperature; foods displayed or stored hot are held at the proper temperature; foods are cooled properly; refrigerated, RTE foods are properly date marked and discarded within 7 days of preparation or opening.
  4. Inadequate Cooking:  Raw animal foods are cooked to required temperatures; cooked foods are reheated to required temperatures.
A kitchen in a restaurant preparing a meat dish that adheres to ANAB's Conference for Food Protection Accreditation Program.

This FDA study found that the two most commonly occurring risk factors both fast food and full-services restaurants were 1) improper holding (fast food, 77%; full-service restaurants, 94%) and poor personal hygiene (fast food, 61%; full-service restaurants, 77%). The high out-of-compliance percentage of the improper holding risk factor in full-service restaurants (94%) was largely due to high out-of-compliance findings in the following: foods requiring refrigeration are held at proper temperature (80%); foods are cooled properly (69%); and refrigerated, ready-to-eat foods (64%) are properly date marked and discarded within seven days of preparation or opening.

The study also shows that having a well-developed Food Safety Management System (FSMS) is the strongest predictor that these risk factors would be minimized. There is evidence to suggest that the employment of a Certified Food Protection Manager (CFPM) is correlated with improved, well-developed, and documented FSMS.

Food Safety Management Systems (FSMS)

Recognition of an organization’s role and position within the food supply chain is essential to ensure the delivery of safe food products to the final consumer.  As stated in the Introduction of ISO 22000:

“The most effective food safety systems are established, operated and updated within the framework of a structured management system and incorporated into the overall management activities of the organization.”

ISO 22000 is an internationally recognized standard that sets out the requirements for an FSMS, and in turn, reduces an organization’s risk of food safety incidents. To prove compliance with an FSMS standard, organizations in the food industry seek certification.

Conference for Food Protection (CFP)

The Conference for Food Protection (CFP) is an independent voluntary organization that has identified the essential components of a nationally recognized Food Protection Manager Certification Program and established a mechanism to determine if certification organization meet these standards. CFP certification standards, are intended for all legal entities that provide certification for the profession of a Certified Food Protection Manager (CFPM).

To become a CFPM, you can take one of the ANAB-accredited trainings approved by the state and pass a test.

ANAB CFP Accreditation

The ANSI National Accreditation Board (ANAB) is the accrediting organization for the Conference for Food Protection (CFP) Standards for accreditation of Food Protection Manager Certification Programs. ANAB-CFP Accreditation Program indicates that the certification organization has been evaluated by a third-party and meets or exceeds all of the Conference-established standards. To earn ANAB-CFP accreditation, the certification organization must meet the nationally recognized CFP Standards for Accreditation of Food Protection Manager Certification Programs. Additionally, to earn ANAB-CFP accreditation, the certification organization agrees to abide by certification policies and procedures, established by the CFP Food Protection Manager Certification Committee (FPMCC) that is endorsed by the Conference for Food Protection and implemented by the accrediting organization (ANAB). 

ANAB verifies and monitors continuing compliance with CFP standards through the entire accreditation period of the certified organization. Hence, ANAB ensures that the certified organization maintains its certification policies that meet the needs of Food Protection Managers.

ANAB FSMS/FSSC 22000 Accreditation

ANAB Accreditation for Food Safety Management Systems Certification (ISO 22000 and FSSC 2200) is designed for accrediting organizations that want to provide globally recognized certification of food manufacturers as well as suppliers in the entire food chain. ANAB accredits certification bodies that issue certifications to ISO 22000 and FSSC 22000. FSSC 22000 includes full implementation of ISO 22000 with additional section specific PRPs and additional FSSC 22000 requirements. 

FSSC 22000 is benchmarked by the Global Food Safety Initiative (GFSI), and it is significant to note that the FDA commenced the voluntary pilot program to assess whether private third-party food safety audit standards from schemes such as FSSC, adequately cover the relevant technical components of the PC Human Food Rule. The requirements of the PC Human Food Rule are one of the foundational regulations in implementation of the FDA Food Safety Modernization Act (FSMA).  FSSC 22000 certification requirements align with those of the FDA Preventive Controls for Human Food (PC Human Food). 

Why Choose ANAB As an Accreditor for FSMS?

Achieving ANAB accreditation for any of the Food Safety Management System (FSMS) will not only provide the CB and its certified customers with the international recognition, but it will also provide a competitive advantage to food safety certificates across markets globally as ANAB is a known accreditor with integrity. Further, ANAB accredited certificates will provide certified organizations with the ability to demonstrate verified commitment to ensure that, within their defined scope, food, food-related products and/ or services they produce/deliver are safe for the consumer.

Share this blog post:

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.