Nov 28, 2006 (CIDRAP News) – Restaurants that have a certified kitchen manager (CKM) seem to have a lower risk of serving food that triggers infectious illnesses, according to a study comparing restaurants that were involved in disease outbreaks with those that were not.”We were much less likely to find a certified kitchen manager in a restaurant that experienced an outbreak,” said Craig W. Hedberg, PhD, lead author of the research report in the November issue of the Journal of Food Protection. He is an associate professor of environmental and occupational health in the University of Minnesota School of Public Health in Minneapolis.Certified kitchen managers—those who have completed a food safety training course—are required in some states but not all, the researchers say.Hedberg, along with researchers from the Centers for Disease Control and Prevention (CDC) and the University of Tennessee, examined 22 restaurants involved in disease outbreaks between June 2002 and June 2003 and 347 restaurants with no recent outbreaks. The study was a project of the CDC’s Environmental Health Specialists Network (EHS-Net), which covers all or parts of nine states.”This was the first systematic attempt to look at the environmental evaluations in restaurants with outbreaks and compare that to a large body of similar data from restaurants with no indication of any outbreak going on,” Hedberg told CIDRAP News.The researchers used a combination of interviews and direct observation to assess restaurant operations and policies related to food safety. Observers followed the preparation of certain food items, Hedberg said.The EHS-Net specialists identified 107 restaurant-linked outbreaks in their areas (out of 179 outbreaks overall), but staff size limited the number investigated to 22. Nonoutbreak restaurants were defined as those with no history of outbreaks for the preceding 3 years and no complaints of food-related illness within the past year.Outbreak and nonoutbreak restaurants were similar in many respects, but 71% of the nonoutbreak restaurants (243 of 347) had a CKM, versus 32% (7 of 22) of outbreak restaurants, the researchers found.The findings “suggest that the presence of a CKM reduces the risk for an outbreak and was the major distinguishing factor between the outbreak and nonoutbreak restaurants,” the report says. In particular, CKMs seemed to be associated with a lower risk of outbreaks linked to norovirus and Clostridium perfringens, two of the three most common outbreak pathogens. Also, bare-hand contact with food was less likely to be a factor in outbreaks in restaurants that had CKMs.Most restaurants, regardless of outbreak history, relied on on-the-job food safety training for workers, the authors found. They surmised that CKMs probably improved the quality of this training, leading to less bare-hand contact with ready-to-eat foods and better control of food temperatures.However, in restaurants with outbreaks, the presence of a CKM didn’t seem to reduce the role of infected food handlers as contamination sources leading to the outbreaks, according to the report.In addition, the researchers found that most restaurants had policies requiring food workers to report illnesses and barring staff members from working while sick, but those policies appeared to make little or no difference in the rate of outbreaks or in the role of infected food handlers as contamination sources. Most restaurants, both outbreak and nonoutbreak, did not offer sick leave for food workers.The findings suggest that food safety training programs need to put more emphasis on managing food worker illnesses, the authors say. On the basis of previous studies on gastrointestinal illness, they estimate that 50,000 US food workers are likely to work while infected with norovirus.Carol Selman of the CDC, senior author of the study, said the Food and Drug Administration (FDA) and the Conference for Food Protection, which advises the FDA, have recommended that all states require restaurants to have CKMs. She said the findings may help sway those who have been “on the fence” as to whether to adopt that requirement.”It basically lent credence to what had been recommended by the FDA and the Conference for Food Protection,” Selman told CIDRAP News. She is a senior public health advisor in the division of emergency and environmental health services of the CDC’s National Center for Environmental Health in Atlanta.However, while the findings suggest that CKMs may help prevent norovirus outbreaks, “the key determinant appears to be the presence of an infected food worker,” the researchers write. “This conclusion must be confirmed by further studies involving a larger series of outbreaks.”Selman said EHS-Net is an offshoot of the CDC’s Foodborne Diseases Active Surveillance Network, or FoodNet, which collects data on all laboratory-diagnosed cases of common foodborne diseases in all or parts of 10 states. EHS-Net includes at least one environmental health specialist and one epidemiologist in each participating state or area, she said.Hedberg said EHS-Net was set up to help explain some of FoodNet’s findings about exposure to foodborne pathogens, especially “a number of suggestions coming out of FoodNet that restaurants were playing an important role in the epidemiology of foodborne diseases.”Previous studies have failed to find consistent links between restaurant inspection results and disease outbreaks, the authors say. Their study was designed to identify both system failures that led to outbreaks and underlying reasons for the failures.Hedberg CW, Smith SJ, Kirkland E, et al. Systematic environmental evaluations to identify food safety differences between outbreak and nonoutbreak restaurants. J Food Protection 2006 Nov;69(11):2697-702 [Abstract]
For the next 10 days, more than 200 USC students will drink only tap water as they participate in the Wells Project.The money saved from not drinking other beverages will be donated to Rwandan communities to provide clean, safe water through Living Water International.Water · Funds raised by the Wells Project finance the construction of wells throughout Africa. This well was built in a Ghana village. – Photo courtesy of Living Water InternationalThe Wells Project, founded at Texas A&M University in 2007, was created to give college students an opportunity to improve the water crisis in Africa. The Wells Project has since partnered with Living Water International, an organization founded in 1990 devoted to providing potable water sources to African villages; the organization has established 30 chapters at universities throughout the nation.Lindsey Caldwell, co-founder of USC’s Well Project, said USC’s chapter’s goal is to involve the entire campus in the 10-day event.“We all agreed we wanted the Wells Project to unite the campus, not segregate or become an exclusive organization,” Caldwell said in an email. “As we are starting out, we have everyone from engineering students to Greek students to athletes.”Different chapters each made a video to promote the project this year, and junior quarterback Matt Barkley represented USC.USC Wells Project has set a goal of raising $10,000 this year, and 100 percent of funds will go toward the construction of wells in Rwanda.Living Water International will drill wells in Rwanda with the funds raised and participants will receive a Wells Report that includes pictures and statistical information about the wells. The report will include coordinates so that participants can view the well through Google Earth.Caldwell said she founded the USC chapter of Wells Project after hearing about the program’s successes elsewhere and decided to bring the project to USC to raise awareness of the international water shortage and provide a platform for students to help solve the problem.“I heard about the camaraderie it brought to the campus and the sheer joy the members had when they reached their fundraising goals,” Caldwell said. “I wanted that for USC. I wanted students to feel like they were making a difference, [and could] unite campus and help change the world.”Lainey Barkley, a sophomore majoring in human performance and a participant in the project, said she chose to take part in the Wells Project because it helps solve a severe global issue.“By giving up something that is not a necessity in my life, I am being a part of bringing a necessity to someone else,” Barkley said. “It is also a good reminder, each time I deny myself a drink I want, that I have been given all I need and have everything to be grateful for.”Heidi Ippolito, a senior majoring in cinema television and critical studies and a project participant, said it will be difficult to give up other beverages, but she is confident the project will have a positive impact on her life.“Missing my daily coffee and tea will certainly be a challenge, but it is a challenge that I hope will remind me of my own blessings,” Ippolito said.The Wells Project will set up information tables on Trousdale Parkway today and Wednesday. Participants will be selling shirts and food items and giving away wristbands and fliers. Participants also plan to raise awareness by carrying five-gallon jugs in a water walk from the Finger Fountain to the statue of Traveler.