Dirty Dining: Restaurants Need Food Safety Letter Grades, Says CSPI

Inspection Reports Hard to Find in Many Cities


WASHINGTON—In Atlanta, chicken salad stored at a balmy 50 degrees. Inadequate hand washing in Boston. Mouse droppings in a Minneapolis ice machine. A live roach scampers across a Pittsburgh cutting board. These are some of the gory details uncovered in an analysis by the Center for Science in the Public Interest of 539 restaurant inspection reports from 20 cities. Two-thirds of restaurants had these and other high-risk food safety violations.

Today CSPI, the nonprofit nutrition and food-safety watchdog group, is calling on state and local governments to require restaurants to display food safety letter grades in their front windows. Letter grades have been used in Los Angeles county restaurants for the past 10 years, and that popular measure is credited with reducing the number of hospitalizations due to foodborne illness. Las Vegas and St. Louis have adopted similar measures recently.

Over 40 percent of the outbreaks of foodborne illness were linked to restaurant foods, while only 22 percent were linked to food prepared in private homes, according to CSPI’s Outbreak Alert! database. CSPI’s new review of restaurant inspection reports—which typically covered 6- or 12-month periods—found that 26 percent of restaurants surveyed had contaminated food contact surfaces; 22 percent had improper food holding temperatures, and 16 percent had inadequate hand-washing by employees. Thirteen percent of restaurants had rodent or insect activity documented in their inspection reports.

"A letter grade in the window has proven to be one of the most powerful incentives for restaurants to perform well on inspections," said CSPI staff attorney Sarah A. Klein. "Who wants to eat at a 'C' restaurant if a restaurant next door gets an 'A'? Unfortunately, in many of the cities we looked at, not only are there are no letter grades, but the actual inspection reports are nearly impossible for citizens to obtain or understand."

In Pittsburgh and Washington, DC, restaurant inspection reports are only made available when consumers lodge written requests under those jurisdictions' Freedom of Information Acts. In some cases, CSPI researchers had to make several requests, by mail and telephone, and wait six months to receive the requested reports. In Atlanta and San Francisco, restaurateurs are at least required to keep the most recent inspection report on hand and show it to anyone who asks. Boston, Chicago, Denver, and Philadelphia are beginning to post inspection reports or scores online, but few consumers dig down into their city or county health department’s web site before going out for a sandwich.

CSPI began its review by asking 20 cities for 30 inspection reports each, distributed among equal numbers of high-end, medium-range, and fast-food restaurants. CSPI then ranked the cities by assigning a weighted score depending on the severity of the violations it found. Austin, Boston, Milwaukee, Colorado Springs, and Kansas City had the highest weighted score. St. Louis, Seattle, Philadelphia, San Francisco, and Tucson were the five with the lowest. Of course, these cities all have varying inspection protocols and complete their reports with varying degrees of detail. And some cities (Austin and Milwaukee, for instance) reported more severe violations, but those cities have a smaller number of food establishments per inspector, indicating that inspectors might be able to be more thorough.

Though rats and roaches are the most unappetizing violations, the Centers for Disease Control and Prevention counts improper holding temperatures, lack of hand washing, improper cooking, contaminated surfaces, and unsafe food sources as the top disease-related factors. Improper hand washing, which might be indicated by a lack of hot water at a sink, can spread Hepatitis A, Shigella, or norovirus to diners. Foods not held at the proper temperature can foster the growth of dangerous bacteria such as Clostridium perfringen or Staphylococus aureus. Salmonella or E. Coli O157:H7 can sicken diners when meat or poultry is undercooked, or when raw foods are placed on unclean food surfaces.

"The results of our grading system in Los Angeles have been very positive, with improved restaurant sanitary practices, reduced rates of severe food-borne illness, and high consumer confidence in this key public health regulatory system," said Dr. Jonathan Fielding, director of public health for Los Angeles County. "We appreciate the work of CSPI to encourage greater adoption of this important food safety improvement that can benefit everybody who eats out."

Besides recommending that cities and states adopt the posting of inspection grades, CSPI says the Food and Drug Administration should revise its model food code to include easy-to-understand inspection forms and grading cards. State and local governments use the model food code as the basis for their restaurant inspection practices.

"Americans are eating outside the home and entrusting their health to restaurant workers more than ever before," said Klein. "We want to work with state legislators, city councilors, and public health officials around the country to implement these consumer-friendly letter grades. They’d go a long way toward preventing unnecessary illnesses."

For more information on restaurant grading click here

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