title: First time compliance inspections to evaluate an artificial trans fat ban in Nassau County.
abstract: BACKGROUND
  In 2007, Nassau County, New York, restricted the use of artificial trans fats in food establishments licensed by the Nassau County Department of Health (NCDH). The regulation took effect April 1, 2008.
  
  
  OBJECTIVE
  This study assesses first-time inspection compliance rates with the trans fat ban and examines barriers to enforcement.
  
  
  METHODS
  A sample of food service establishments was inspected by an NCDH employee for labels documenting trans fat. Surveys that examined operator awareness and attitudes toward the ban were administered. A separate survey was conducted among the NCDH Office of Food Protection public health sanitarians to determine organizational barriers to enforcement. All inspections and surveys were conducted in Nassau County from June to September 2010.
  
  
  RESULTS
  A total of 360 food service establishments were randomly selected for inspection; 328 completed the operator surveys. Compliance was 81%, even though 52% of operators were not aware of the ban. Of those who were aware, 57% heard about the regulation from the media, and almost all (92%) reported that compliance with the ban was easy. Of noncompliant respondents, 59% cited lack of knowledge regarding the ban as the primary reason for noncompliance. Of those who indicated they had received any customer feedback (9%), almost all reported the feedback to be positive. Knowledge of trans fats was not associated with compliance, but owners who were aware of the ban were more likely to be in compliance. Among the 23 participating sanitarians, 96% believed the ban was effective; language barriers were cited as the primary obstacle to enforcement.
  
  
  CONCLUSIONS
  As assessed through surveys and inspections, the trans fat ban in Nassau County yielded relatively high compliance rates within 2 years and was accepted by sanitarians, establishment operators, and consumers.
authors.affiliation: New York City Department of Health and Mental Hygiene, Queens, New York; Nassau County Department of Health, Uniondale, New York; Case Western Reserve University, Cleveland, Ohio. Electronic address: rsood@health.nyc.gov.
authors.forename: Rishi K
authors.initials: RK
authors.lastname: Sood
authors.affiliation: Nassau County Department of Health, Uniondale, New York.
authors.forename: Maria
authors.initials: M
authors.lastname: Torroella Carney
authors.affiliation: Nassau County Department of Health, Uniondale, New York.
authors.forename: Tavora
authors.initials: T
authors.lastname: Buchman
authors.affiliation: Nassau County Department of Health, Uniondale, New York.
authors.forename: Celina S
authors.initials: CS
authors.lastname: Cabello
authors.affiliation: Nassau County Department of Health, Uniondale, New York.
authors.forename: John F
authors.initials: JF
authors.lastname: Lynch
authors.affiliation: Case Western Reserve University, Cleveland, Ohio.
authors.forename: Scott H
authors.initials: SH
authors.lastname: Frank
authors.affiliation: Case Western Reserve University, Cleveland, Ohio.
authors.forename: Erika S
authors.initials: ES
authors.lastname: Trapl
mesh_terms: D004041:Dietary Fats / Q000008:administration & dosage; D019358:Fat Substitutes / Q000008:administration & dosage*; D005513:Food Inspection / Q000331:legislation & jurisprudence*; D005515:Food Labeling / Q000592:standards; D006801:Humans; D007881:Legislation, Food; D009518:New York; D012147:Restaurants / Q000592:standards*; D011795:Surveys and Questionnaires; D044242:Trans Fatty Acids / Q000008:administration & dosage*
chemical_list: D004041:Dietary Fats; D019358:Fat Substitutes; D044242:Trans Fatty Acids
keywords: food policy; nutrition policy; partially hydrogenated oils policy compliance; trans fatty acids