Food Safety Magazine, October/November 2010

By Aqualia L. Nelson, MS, REHS/RS, Aiko Allen, MS, Suzanne R. Hawley, Ph.D., MPH, Theresa St. Romain, MA and Shirley A. Orr, MHS, ARNP, NEA-BC

Creating a Positive
Partnership Between
Foodservice Establish-
ments and Inspectors
The restaurant industry has a significant impact on environmental health, and the magnitude of that impact has been in-
creasing in recent years. Americans’ de-
pendence on restaurants is noteworthy;

on average, 48% of money spent by
Americans on food goes toward restaurant meals.1 As a result, in

2009, projected restaurant food sales grossed $565.9 billion, and
9% of the national workforce was employed at approximately
945,000 restaurant locations across the United States.1

ditional local interventions, such as increased inspection frequency and food safety certifications, are necessary to improve sanitation in restaurants. 6-8

Traditionally, the relationship between EHS and restaurateurs has been adversarial, often due to assumed differences between the two groups. Foodservice workers frequently fear the inspection process, believing that the mission of EHS is to find violations and reprimand, rather than to work collaboratively toward a common goal of food safety. As a result of this sometimes tense relationship between EHS and foodservice employees, traditional regulatory approaches do not necessarily ensure the adoption of desired food safety behaviors. 9 Non-traditional approaches, such as announced inspections, emphasize the importance of food safety, rather than focusing on compliance with regulations, and have proven to be more successful than traditional approaches to restaurant regulation. 10

To date, an understudied area remains the knowledge, attitudes and intentions of EHS and restaurateurs that may influence their willingness to collaborate on food safety at the local level. This study, conducted in Johnson County, KS, utilized a survey and focus groups to assess the attitudes of EHS and restaurateurs toward one another, and examined barriers to and methods for creating partnerships between the two groups.

The combination of these factors has led to a greater potential for foodborne illness (FBI) due to improper food handling; that is, contamination by other foods or by food handlers themselves. 2 With this heightened risk comes the need for increased food safety sanitation efforts. In recent years, the Centers for Disease Control and Prevention has formed numerous national-level partnerships between key restaurant industry stakeholders. 3 However, much of the responsibility for ensuring the safety of restaurant food still rests on the shoulders of one party: the local-level environmental health specialist (EHS), commonly known as a food inspector.

EHS are responsible for local inspection-related activities to promote safety and prevent outbreaks. They generally employ a combination of educational and enforcement techniques, as well as legislative and regulatory approaches, to correct violations. Previous research has shown that the education of food workers is far more effective in promoting safe behavior—including proper food preparation— than is enforcement. 4 However, education alone does not guarantee that food workers will employ safe food-handling practices. 5, 6 Studies have indicated that ad-

Methods

Study Setting

Johnson County is an urban county in northeast Kansas that includes several suburbs of the Kansas City metro area. Johnson County contains 1,467 foodservice establishments: restaurants, schools, mobile units and 231 retail foodservice establishments, which include grocery and convenience stores.