A new report from the CDC underscores the need for improved policies and enforcement to prevent food contamination by ill or infectious food workers. The implementation of paid leave for sick workers is a primary concern.

The research suggests that implementing comprehensive ill-worker policies, such as requiring employees to report illnesses to managers, can effectively reduce the occurrence of employees working while they are sick in restaurants. Furthermore, the study suggests that paid sick leave and supportive regulations are linked to improved food safety outcomes, resulting in lower rates of foodborne illnesses.

In the past few weeks, the U.S. has seen a California restaurant sicken nearly 100 with norovirus, 45 confirmed patients in a Salmonella outbreak from two Mexican restaurants in Boston, and a case of Hepatitis A linked to a Taco Bell in Washington state, showing that foodborne illness outbreaks in retail food establishments are a significant public health concern.

Hundreds of outbreaks of foodborne illness outbreaks in retail food are reported to the Centers for Disease Control and Prevention (CDC) each year. While epidemiological and laboratory data are typically reported, minimal environmental health data from outbreak investigations are shared. A report published May 30 in the CDC’s Morbidity and Mortality Weekly Report (MMWR) Surveillance Summaries highlights the importance of collecting and analyzing environmental health data to enhance prevention efforts.

The report, titled “Foodborne Illness Outbreaks at Retail Food Establishments — National Environmental Assessment Reporting System, 25 State and Local Health Departments, 2017–2019,” summarizes the findings from the National Environmental Assessment Reporting System (NEARS) during the specified period. NEARS was launched by the CDC in 2014 to complement the existing National Outbreak Reporting System (NORS) and provide additional insights into foodborne illness outbreaks.

Between 2017 and 2019, a total of 800 foodborne illness outbreaks associated with 875 retail food establishments were reported to NEARS by 25 state and local health departments. Among these outbreaks, 69.4 percent had a confirmed or suspected agent identified, with norovirus and Salmonella being the most common pathogens, accounting for 47.0 percent and 18.6 percent of outbreaks, respectively. Contributing factors were identified in 62.5 percent of outbreaks, with approximately 40 percent of these outbreaks having at least one reported factor associated with food contamination by an ill or infectious food worker.

“It’s important for restaurants to develop and enforce policies that require workers with certain symptoms to 1) notify their manager, and 2) stay home or not work with food,” says the report.

The report emphasizes the role of ill workers in foodborne illness outbreaks and highlights the importance of proper food safety policies and practices in retail food establishments. Interviews conducted with establishment managers revealed that while most establishments had a policy requiring workers to notify their manager when they were ill (91.7 percent), only 23 percent of policies listed all five illness symptoms that workers needed to report. Additionally, 85.5 percent of establishments had a policy restricting or excluding ill workers from working, but only 17.8 percent of policies listed all five symptoms requiring restriction or exclusion.

The findings point to a need for improved policies and enforcement to prevent food contamination by ill or infectious food workers. Norovirus was identified as the most commonly reported cause of outbreaks, consistent with previous national outbreak data. The report also suggests that existing policies should be re-evaluated and refined to better address the risk of foodborne illness.

When asked about the updat on the risks of dining out at restaurants or caterers, food safety expert, and lawyer Bill Marler gave some advice to those in the industry, “My take away – hand washing, sick leave policies and vaccinate your employees against hepatitis A.”

The data collected through NEARS provide valuable insights for health departments responsible for ensuring food safety in retail food establishments. By identifying gaps in food safety policies and practices, these departments can prioritize their outbreak prevention and control efforts. The report calls for future analyses to explore specific outbreak agents, foods, and contributing factors, which can further inform the development of effective prevention approaches.

Specifically, data were presented on whether establishments provided paid sick leave to workers and whether establishments with outbreaks had policies addressing four components of the Food Code relating to ill or infectious workers.

“. . . data demonstrate that fewer than half of establishments with outbreaks provided paid sick leave to at least one food worker. Research suggests that paid sick leave might improve food safety outcomes. Expanded paid sick leave in a restaurant chain reduced the incidence of working while ill among front-line food service workers, and supportive paid sick leave regulations were found to be associated with decreased foodborne illness rates.”

For the report, NEARS data were submitted by Alaska; California; Connecticut; Delaware; Fairfax County, Virginia; Georgia; Harris County, Texas; Indiana; Iowa; Jefferson County, Colorado; Kansas City, Missouri; Maricopa County, Arizona; Massachusetts; Michigan; Minnesota; New York; New York City, New York; North Carolina; Oregon; Rhode Island; South Carolina; Southern Nevada Health District; Tennessee; Washington; and Wisconsin. These health departments reported environmental assessment data from at least one foodborne illness outbreak occurring in a retail food establishment.

The full study can be viewed here.