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Foodborne Diseases

Foodborne diseases are illnesses contracted from eating or drinking contaminated food and beverages. Illnesses include foodborne intoxications and infections, which are often incorrectly referred to as food poisoning. There are many different foodborne diseases that are caused by viruses, bacteria, parasites, toxins, metals, and prions. Symptoms of foodborne illness range from mild stomach pain to life-threatening illnesses.

The quality of food, and controls used to prevent foodborne diseases, are primarily regulated by the US Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC), and local public health authorities. These diseases may be occupationally related if they affect the food processors, food preparers and servers (cooks, waiters), or workers who are provided food at the worksite.

Top Contributing Factors to Foodborne Disease Outbreaks

The CDC’s Environmental Health Services found that the top four contributing factors in outbreaks are:

  • Sick food workers contaminating ready-to-eat foods through bare-hand contact.
  • Sick food workers contaminating food through some other method, such as with a utensil they contaminated.
  • Sick food workers contaminating ready-to-eat food through glove-hand contact.
  • Food handling practices, such as not keeping food cold enough, lead to growth of pathogens.

Food Handler Permit

Many states require those who work with unpackaged food to receive a food handler permit or a food manager certification. See your local health department for guidance.

Sick Employees

Food service establishments can play an important role in limiting the spread of foodborne diseases. Consider taking the following steps to help reduce the spread of virus and bacteria from employees:

  • Ensure employees who are sick with either diarrhea or vomiting do not come to work. Do not allow these employees to return to work for at least 24 hours after their symptoms have disappeared.
  • Notify your local health department if any of your employees are diagnosed with E-coli, salmonella, shigella, or hepatitis A.
  • Consider vaccinating your employees against hepatitis A. Hepatitis A is one of the few foodborne illnesses that can be prevented by vaccination. Contact your local health department for more information.
  • Maintain a clean food preparation area.

Food Handling and Storage  

All employee food service facilities and operations should be carried out in accordance with sound hygienic principles. In all places of employment where all or part of the food service is provided, the food dispensed should be wholesome, free from spoilage, and processed, prepared, handled, and stored in such a manner as to be protected against contamination. Employees should not consume or store food and beverages in toilet rooms or in an area exposed to a toxic material.

Avoid cross contamination by using separate cutting boards and plates for raw meat, poultry, and seafood. Raw meat, poultry, seafood, and eggs should be kept separate from all other foods in the fridge. Food should be cooked to an internal temperature that is high enough to kill germs that can make someone sick. Use a food thermometer to ensure foods are cooked to a safe internal temperature:

  • Cook whole cuts of beef, pork, veal, and lamb to 145°F (then allow the meat to rest for three minutes before carving or eating)
  • Cook ground meats (beef, pork, etc.) to 160°F
  • Cook all poultry, including ground chicken and turkey, to 165°F
  • Cook fin fish to 145°F or until flesh is opaque

Unused foods should be chilled/refrigerated promptly and be kept at a temperature below 41°F. Food temperatures should be checked throughout the day using a temperature log. Never leave perishable food out for more than two hours (or one hour if it is hotter than 90°F outside).

Food Traceability

Food traceability is the ability to follow the movement of a food product and its ingredients through all steps in the supply chain, both backward and forward. Traceability involves documenting and linking the production, processing, and distribution chain of food products and ingredients. In the case of a foodborne illness outbreak or contamination event, efficient product tracing helps government agencies and those who produce and sell food to rapidly find the source of the product and where contamination may have occurred. This enables faster removal of the affected product from the marketplace, reducing foodborne illness incidents.

Existing FDA regulations require much of the food industry to establish and maintain records that document one step forward to where food has gone and one step back to its immediate previous source.

Cleaning and Sanitizing

Cleaning and sanitizing food-contact surfaces is one of the most important steps to prevent foodborne illnesses. Here are a few reminders to protect guests:

  • Double handwashing. Wash hands for 20 seconds with soap and water before, during, and after food preparation. In addition, employees should always wash their hands in the restroom sink and then wash them again at a handwashing sink before continuing their duties. This practice is called double handwashing.
  • Vigilant cleaning and sanitizing practices. Pathogens can spread to food from equipment that hasn't been properly cleaned and sanitized between uses. Cleaning removes food and other dirt from surfaces. Sanitizing reduces surface pathogens to safe levels.
  • Review your cleaning and sanitizing products. Cleaners must be stable, noncorrosive, and safe to use. Be sure to follow manufacturer instructions. Utensils and equipment can be sanitized using heat or chemicals. If you use heat to sanitize, use a high-temperature dishwasher or soak items in water at least 171˚F for at least 30 seconds. If you use chemical sanitizers, rinse, swab or spray items with a sanitizing solution. Follow manufacturer instructions as well as local regulatory requirements.
  • Train staff when to clean and sanitize food-contact surfaces. Clean and sanitize items after each use and before food handlers start working with a different type of food. Also, clean and sanitize utensils and equipment after food handlers are interrupted during a task and the items may have been contaminated. If items are in constant use, clean and sanitize every four hours.

Active Managerial Control Plan

An active managerial control (AMC) plan is a type of food safety management system that focuses on proactive steps and training to reduce food safety risks. An AMC plan should include:

  1. Written policies. Policy statements set expectations for employees. For example, the policy for cold holding might be that all temperature controlled for safety (TCS) food will be kept refrigerated below 41°F.
  2. Training. All staff should be trained on the policies. As part of a cold-holding policy, all food preparation staff should be trained that TCS food should be 41°F or less. The person in charge should not be the only person who is aware of and responsible for following the policies.
  3. Monitoring. A temperature log for checking temperatures of TCS foods throughout the day is one way to monitor a cold-holding policy, for example.
  4. Corrective action (what to do if the monitoring shows that a policy is not met). The corrective action should be part of the policy statement. For example, does the cold-holding policy tell staff what to do if the TCS food is out of temperature on the temperature log?

Additional Resources
https://www.usda.gov/
https://www.fsis.usda.gov/wps/portal/fsis/home
https://www.foodsafety.gov/
https://www.cdc.gov/foodsafety/prevention.html
https://www.osha.gov/SLTC/foodbornedisease/
https://www.foodonline.com/
https://www.restaurant.org/Home
https://www.osha.gov/SLTC/foodbornedisease/
https://www.cdc.gov/nceh/ehs/publications/cf-infographic.html
https://health.utah.gov/hepatitisa/food-safety
https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.141
https://www.fda.gov/food/new-era-smarter-food-safety/tracking-and-tracing-food#:~:text=Food%20traceability%20is%20the%20ability,of%20food%20products%20and%20ingredients
https://www.restaurant.org/Articles/Operations/3-tips-sanitary-food-contact-surfaces
https://www.restaurant.org/Articles/News/Take-active-control-of-food-safety

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