We gratefully acknowledge the assistance of Michael F. Jacobson, Lucy Alderton, Stan Horab,
and Dana Martin. We would also like to thank Bert Bartleson, public health official; J. Glenn
Morris, M.D., University of Maryland; and Eric Juzenas, J.D., M.P.H., American Public Health
Association, for reviewing and editing drafts of this report.
The Center for Science in the Public Interest is a non-profit organization that focuses on food and
nutrition policies. It is supported largely by the more than 900,000 subscribers to the
Nutrition Action Healthletter.
We gratefully acknowledge the assistance of Michael F. Jacobson, Lucy Alderton, Stan Horab, and Dana Martin. We would also like to thank Bert Bartleson, public health official; J. Glenn Morris, M.D., University of Maryland; and Eric Juzenas, J.D., M.P.H., American Public Health Association, for reviewing and editing drafts of this report.
The Center for Science in the Public Interest is a non-profit organization that focuses on food and nutrition policies. It is supported largely by the more than 900,000 subscribers to the Nutrition Action Healthletter.
First Printing, November 1996
KEY FINDINGS AND RECOMMENDATIONS
RESTAURANT FOOD CAUSES TOO MANY CASES OF FOOD POISONING
Table I. Sources of Reported Restaurant Outbreaks with Confirmed Cause, 1988-1992
Table II. Health Department Survey Results
Figure I. Cooking Temperature Requirements for Pork, Eggs, Fish, and Poultry
Figure II. Cooking Temperature Requirement For Hamburger
Figure III. Refrigeration Temperature Requirement
Figure IV. Cooling Temperature Requirement
Figure V. Reported Frequency of Inspections Per Restaurant in 1994
Figure VI. Actual Frequency of Inspections Per Restaurant in 1994
Hidden dangers lurk in restaurant food, dangers that can cause acute illness and sudden death. Harmful bacteria, viruses and parasites in ready-to-eat restaurant food cause several thousand deaths and millions of illnesses each year. Government data show that consumers are twice as likely to report getting sick from a food poisoning outbreak caused by restaurant food than from food prepared at home. And with more consumers eating away from home than ever before, the number of illnesses and deaths is likely to rise, unless restaurants and the state, city, and county agencies that regulate them improve systems for ensuring food safety.
Most food poisoning from restaurant-prepared food is easy to prevent. Simple steps, like checking cooking and refrigeration temperatures, and assuring proper handling, could greatly reduce foodborne illness from restaurant-prepared food. But in this examination of the standards used to regulate the restaurant industry by state and local agencies, the Center for Science in the Public Interest (CSPI) has documented gaping holes in the manner that restaurants are regulated around this country.
During an era when more and more responsibility is being shifted from the federal government to state and local governments, this examination of restaurant food safety makes two important findings: (1) despite the fact that the federal Food and Drug Administration (FDA) publishes national standards to guide states and localities in how best to regulate restaurants to prevent food poisoning, states and local governments often fail to adopt those national standards; and (2) even when the standards are adopted, inspection agencies have trouble enforcing them, due to infrequent inspections and funding deficiencies.
That is the bad news. But this report also documents the good news. More and more restaurants are setting and enforcing their own standards, using new systems of preventive controls called HACCP (which stands for Hazard Analysis and Critical Control Point) systems. These restaurant leaders are providing important examples for others in the industry. Federal, state, and local regulators should examine these systems, which may ultimately pave the way for mandatory adoption of HACCP systems in the restaurant industry.
In a survey of 45 state and local government agencies that conduct inspections of restaurants, CSPI found that a large majority of agencies are not following FDA's national standards for restaurants (the "Food Code"). The worst agencies CSPI surveyed included the ones in San Francisco, California; Dallas, Texas; Detroit, Michigan; and the state of Delaware. Concord, New Hampshire, and the state of Rhode Island were the two best agencies CSPI surveyed.
The nationwide publicity that followed the outbreak of a deadly strain of E. coli bacteria traced to fast-food hamburgers in 1993 and publicity regarding the safety of certain products such as seafood has provided the incentive for many restaurants to test new systems to improve their food safety performance. Preventive HACCP controls, coupled with laboratory testing, are being used in several national restaurant chains.
Adoption of the following recommendations would greatly improve the safety of food served in restaurants:
Restaurant customers have a right to expect that the food they eat will not harm them. Yet, customers have no way to control what goes on in restaurant kitchens. They depend on restaurants to follow safe standards of food handling, and on local inspection agencies to enforce those standards. But each year, many millions of illnesses and thousands of deaths are linked to food prepared in the nation's restaurants, delicatessens, and cafeterias, a fact which shows that inspection agencies and restaurants often let customers down.
The best available national data show that, between 1983 and 1992, 42% of all reported food-poisoning outbreaks were traced to food eaten in restaurants, delicatessens, and cafeterias. In comparison, only 21% of the food-poisoning outbreaks were attributed to food eaten at home.
Although there is no official estimate of how many of the 6.5 million to 33 million food poisonings a year are caused by food eaten in restaurants, there are likely millions of such illnesses, all of which could be prevented by better food handling in restaurants and better enforcement of national food safety standards.
Both industry and government officials agree that the food safety problems linked to restaurants are substantial. In 1995, General Mills Restaurants executive, Ron Magruder, acknowledged that andards, many food poisonings from restaurants could be prevented."
According to a CSPI survey of state and county restaurant inspection agencies described in this report, many inspection agencies do not enforce nationally accepted standards to ensure food safety. Even though the FDA Food Code provides a set of food safety standards for restaurants, the majority of surveyed state and local jurisdictions either use outdated versions of the Food Code or have never adopted key parts of it. Agencies with the most outdated standards include those in Detroit, San Francisco, Dallas, and the state of Delaware. The two agencies with the most up-to-date standards were Concord, New Hampshire and the state of Rhode Island.
Many state and local governments also fail to provide inspection agencies with adequate budgets. Under funding of restaurant inspection agencies prohibits them from properly training staff and providing needed equipment, hampering the agencies' effectiveness, according to Potter of CDC.
[ Press Release]