A Baseline Assessment of U.S. Naval Food Facilities Using the Food Code's New Risk-Based Inspection Program
Boyd, Derek, Journal of Environmental Health
When you can measure what you are talking about and express it in numbers, you know something about it. --Lord William Thomson Kelvin (1824-1907)
Quantifiable Void in Assessing the Effectiveness of Food Safety Initiatives
Food safety has been a major concern over the last century. The United States is considered to have the safest food in the world, but it is also home to some of the largest foodborne outbreaks and recalls in history (Bryan, 2002). For the past two decades, there has been concern over emerging diseases, changes in pathogens, increased population, and globalization of the food supply (Altekruse, Cohen, & Swerdlow, 1997).
The food industry is a big business, comprising 12.2 million employees and a projected revenue of $476 billion in 2005 (National Restaurant Association [NRA], 2005). Nearly half of the adults in the United States dine in food service facilities every day (NRA, 2005). These facilities account for more than 40 percent of the foodborne-disease outbreaks (two or more cases) reported to the Centers for Disease Control (CDC) from 1993 to 1997 (Olsen, Mackinon, Goulding, Bean, & Slutsker, 2000).
CDC has identified specific risk factors that contribute to these outbreaks (Bean, Goulding, Lao, & Angulo, 1996). Restaurant inspections that focus on these factors are intended to prevent outbreaks of foodborne illness (U.S. Department of Health and Human Services [DHHS], 2001). There is debate, however, as to the effectiveness of these inspections (Bryan, 2002).
Today there are 35 food safety laws and a dozen federal agencies responsible for regulating them (Nestle, 2003). Until recently, however, there has been no way for these agencies to accurately measure the effectiveness of this system. The military is no exception. Currently there is no standard practice by which Navy food safety personnel can determine the success of their prevention efforts.
In the late 1990s, the FDA developed a national study to confront this issue in retail facilities. The immediate goal was to identify urgent priorities in food safety procedures and practices that have the potential to cause foodborne illness. The long-term aim was to evaluate trends and document the measurement of changes over time. FDA has charged other regulatory agencies to do the same and compare their results with those of the FDA.
Report of the FDA Retail Food Program Database of Foodborne Illness Risk Factors
In 1993, the government tasked federal agencies with developing a way to express the goal of food safety in measurable form (Office of Management and Budget, 1993). Foodborne-illness morbidity and mortality data were not an ideal performance indicator because of the inherent limit of underreporting. As an alternative methodology, the FDA Retail Food Program Database of Foodborne Illness Risk Factors initiative, began in 1997. For the first time, a national baseline on the occurrence of foodborne-illness risk factors had been designed (FDA Retail Food Program Steering Committee, 2000).
The overall goal of the project was to meet the Food Safety Objective of a 25 percent reduction in the occurrence of these risk factors as set forth in Healthy People 2010 (DHHS, 2000). For an accurate appraisal, the data were to be collected at five-year intervals, with the final collection period in 2008 (FDA Retail Food Program Steering Committee, 2000). The second FDA data collection report was published in 2004.
On the basis of the 1988-1992 surveillance summaries, FDA's National Retail Steering Committee (Steering Committee) specifically chose the following five foodborne-illness risk factors as their performance indicators:
* unsafe sources,
* inadequate cooking,
* improper holding temperatures,
* contaminated equipment, and
* poor personal hygiene.
The FDA regional retail food specialists collected data during site visits at over 900 establishments representing nine distinct facility types, focusing both on general and on highly susceptible populations:
* in institutional food service:
-- nursing homes, and
-- elementary schools;
* in restaurants:
-- fast-food restaurants and
-- full-service restaurants;
* in retail food stores:
-- deli operations,
-- meat and poultry departments,
-- seafood departments, and
-- produce departments. …