What We Know and What We Do: The Gap in Food Safety. (Learning from Experience)

Article excerpt

In February 4th, 2002, Dr. David Satcher, the Surgeon General, delivered a remarkable speech on public health issues at the Press Club in Washington, D.C. He addressed the health disparities among ethnic populations. Satcher argued that while many gains have been made in closing the gap between whites and minority groups, there is still much work to do. After I enjoyed listening to him, my mind was engaged with environmental health issues, especially food safety in our restaurants. We have gained so much knowledge about food protection and safety, yet we have not closed the gap between what we know and what we do. To illustrate this long journey, I have been exploring experiences from the past and present to share with my fellow environmental health professionals concerning the issue of food safety in restaurants today.

Times of Yore

We should be very grateful to pioneers like C.E.A. Winslow, one of the leading figures in the history of public health, for the wisdom and knowledge that laid the ground for further improvement and achievement. Winslow asserted that public-health practice should be based on the science of preventing disease, prolonging life, and promoting health and well-being. He felt that community organizations should work toward sanitation of the environment, the control of communicable diseases, and the education of individuals for personal health.

In the old days, with the assumption that "no normal person wants to consume dirty or decomposed food," health inspectors began a crusade in New York, which was followed by efforts in other major cities around the country, as a way to protect the health of the public who were dining in restaurants.

When we search through the past literature on public and environmental health, we realize that pioneers paved the ground for us and that we have resurfaced the ground step by step. Also, we learn that they managed to perform impressively with minimal knowledge. With limited information, tools, and technology, pioneers in public health established local health departments in many states around the country. They devised food safety regulations for eating establishments and gave priority to control measures and inspections. Their concerns were centered around Salmonella infection, viral hepatitis, amebic dysentery, and typhoid fever that could result from eating in restaurants. In this respect, old-timers devoted themselves to the perception that the public is entitled to sanitary conditions and safe food when eating in a public dining establishment.

The Current Scenario

Through the years, we have achieved a great deal in terms of improved sanitation, eradication of many viral and bacterial diseases, and behavior change in food-handling procedures; however, the gap between what we know and what we do is still wide.

Local health departments, drawing on the experiences of their environmental health divisions and sanitarians, are fully aware of what is going on in restaurants nationwide. A person who walks into a public food establishment--either a fast-food restaurant or a fine dining establishment--may have no qualification or any interest in judging how sanitary the place is. He or she trusts public-health officials and environmental health specialists to exercise care and expertise.

In one of my routine inspections a few years ago, I had to deal with an arrogant restaurant owner who did not care about the health and safety of his customers. The restaurant was not an immediate threat to the public, but the practices were far from acceptable according to environmental health standards. After I'd spent weeks educating this elderly owner and patiently trying to change his food-handling behavior, he finally confessed that he was absolutely off track and that he was lucky none of his dear customers had gotten sick. Pest control, acceptable cleanliness, the sanitary levels of kitchen and equipment, and the personal hygiene of his personnel were among the situations we had to correct to bring this restaurant up to minimum environmental health standards. …