171057 Predicting foodborne outbreaks at restaurants: Results of a risk assessment model

Tuesday, October 28, 2008: 9:05 AM

Heidi D. Sato, PhD, MPH , College of Health Sciences, TUI University, Cypress, CA
This study examined relationships between risk factors and foodborne outbreaks at restaurants. Two approaches were used: 1) historical cohort and 2)case control. The historical cohort design was used to test relationships between outbreaks and prior violations among 19,753 restaurants during a one-year period. A case control design was used to test relationships between outbreaks and the organizational culture, foods served, and number of customers. A case was defined as a restaurant with a foodborne outbreak during a one-year study period. In the case control study, five inspectors surveyed managers from 186 “case” restaurants and 277 “control” restaurants, randomly selected and stratified by number of seats and risk rating. Using multivariate analysis, outbreaks were significantly associated with buffets (OR=3.14, 95%CI=1.54-6.64), higher price entrées (OR=1.64, 95% CI=1.29-1.83), larger number of customers (OR=1.24, 95% CI=1.14-1.36), larger number of seats (OR=2.32, 95% CI=2.05-2.63), and sanitizing violations (OR=1.98, 95% CI=1.03-3.50). Other factors associated with outbreaks included cooking/reheating violations, contamination violations, full wait service, off-site catering, food prepared for multi-day use, larger number of foodhandlers, menu size, ownership type, receiving imported seafood, receiving/pooling eggs, and serving raw meats or produce. A structural model based on number of customers, foodhandling violations, and raw food served was developed for estimating the risk of foodborne outbreaks at restaurants. The results suggest that structural equation modeling is an effective tool for predicting foodborne outbreaks at restaurants. Utilizing a risk-based model would allow health departments to focus more inspections towards restaurants that pose the greatest risk to public health.

Learning Objectives:
1. Describe the relationships of foodhandling violations, foods served, organizational culture, and number of customers on foodborne outbreaks at restaurants. 2. Describe the predictors of foodborne outbreaks at restaurants that were identified using structural equation modeling. 3. Describe how this risk assessment model can be used for determining the probability of foodborne outbreaks at specific restaurants and for targeting high risk restaurants for more routine inspections.

Keywords: Outbreaks, Risk Assessment

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I designed the study and was the primary researcher
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Environmental Epidemiology
See more of: Epidemiology