An estimated 76 million illnesses, 325,000 hospitalizations, and 5,000 deaths are attributable to foodborne illness in the United States each year. Ensuring safe food remains an important public health priority for our nation. A critical link in the farm-to-fork food chain is the food service industry. It is a diverse industry encompassing hospitals, schools, retail stores, and restaurants that range from fast food to full service and from family run to multinational chain.
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The U.S. Food and Drug Administration (FDA) has actively provided food safety guidance to food safety organizations for over 60 years. In 1934, the U.S. Public Health Service published the Restaurant Sanitation Regulations. The work of safeguarding the public’s health continued with the publication of the first edition of the Food Code in 1993.
The Food Code, which is periodically revised, was published most recently in 2005. It is used by local and state regulatory agencies to develop science-based regulations to manage foodborne illnesses in food service establishments. Presently, 49 of the 56 U.S. states and territories have incorporated the Food Code into local and state regulations that protect 88% of the population in those states and territories. The Food Codes published between 1997 and 2005 are available on the FDA Web site.
Some minor but significant differences exist among the various editions of the Food Code. For example, the temperature danger zone is defined as the temperature range that favors the growth of microorganisms. In the 1997 and previous editions of the Food Code, this range was defined as 41ºF to 140ºF. In the Food Codes published after 2001, the range was changed to 41ºF to 135ºF. The change was made because scientific evidence showed that 135ºF was well above the growth range for foodborne pathogens. It is worth noting, however, that the difference between the two ranges affects state and local food service regulations, because the actual regulations are based on specific editions of the Food Code. Therefore, this report will use the more conservative range (41ºF to 140ºF).
The Food Code uses the hazard analysis and critical control points (HACCP) approach, coupled with prerequisite programs, as a strategy to prevent food safety problems in food service operations. In addition, the 2005 edition describes the use of risk-based audits to ensure that food service establishments comply with the regulations.
In 2004, the FDA reported on the occurrence of foodborne illness risk factors in selected food service establishments. As a result of this study, five potential factors for serving unsafe food were identified: poor personal hygiene, food from unsafe sources, improper holding times and/or temperatures, inadequate cooking, and contaminated equipment and/or the prevention of contamination of food. The percentage of out-of-compliance observation for each risk factor that could contribute to foodborne illnesses in restaurants and retail operations was measured (see Table 1 below).
This research allowed state and local regulatory agencies to develop a risk-based approach for auditing food service establishments and to focus the audits on areas with specific weaknesses. In addition, food service establishments now have a priority list to use to develop an improvement plan for reducing the risk of foodborne illness. The risk factors fall into the following major groups: management and employee practices, suppliers, cooking and holding procedures for food (time/temperature), and equipment and facilities.
Managerial and Employee Practices
The Food Code requires that the owner or a manager be on the premises at all times during the hours of operation. These individuals have the responsibility of ensuring that critical activities are performed. In addition, they are responsible for assuring the production of safe food. An organization’s food safety system needs to take into account a number of challenges managers face. These include operating in a multicultural environment, high personnel turnover, low pay potential, and literacy issues.