title: Health department inspection criteria more likely to be associated with outbreak restaurants in Minnesota.
abstract: Millions of routine restaurant inspections are performed each year in the United States, and the Centers for Disease Control and Prevention has reported that a majority of foodborne illness outbreaks occur in restaurant settings. In an attempt to relate the data collected during inspections  in Minnesota to illness likelihood, data from routine inspections conducted at outbreak restaurants were compared with data from routine inspections conducted at nonoutbreak restaurants. The goal was to identify differences in recorded violations. Significantly more violations were recorded  at restaurants that had outbreaks. The majority of these violations were related to contamination in the facility and environment and to food handling procedures. Relative risks also were calculated for violations significantly more likely to occur at locations that had outbreaks of norovirus  infection, Clostridium perfringens infection or toxin-type illness, and Salmonella infection. These three pathogens are estimated to cause the majority of foodborne illnesses in the United States. Meta-analysis of composited data for the three pathogens revealed 11 violations  significantly more likely (α < 0.05) to be identified during routine inspections at outbreak restaurants than during inspections at nonoutbreak restaurants. Application of this information permits assessment of health department inspection data in a consistent fashion. This approach  can help identify criteria more likely to be associated with outbreak locations and allow operators to focus on interventions that will have the most significant impact in higher risk establishments.
authors.affiliation: Ecolab, Eagan, MN 55121, USA. ruth.petran@ecolab.com
authors.forename: Ruth L
authors.initials: RL
authors.lastname: Petran
authors.forename: Bruce W
authors.initials: BW
authors.lastname: White
authors.forename: Craig W
authors.initials: CW
authors.lastname: Hedberg
mesh_terms: D004196:Disease Outbreaks / Q000517:prevention & control; D004777:Environment; D004866:Equipment Contamination; D005506:Food Contamination / Q000517:prevention & control; D005511:Food Handling / Q000379:methods / Q000592:standards*; D005513:Food Inspection / Q000379:methods* / Q000592:standards; D005516:Food Microbiology; D006801:Humans; D006920:Hygiene; D008910:Minnesota; D011634:Public Health / Q000592:standards; D012147:Restaurants / Q000592:standards*; D012307:Risk Factors