title: Managerial practices regarding workers working while ill.
abstract: Surveillance data indicate that handling of food by an ill worker is a cause of almost half of all restaurant-related outbreaks. The U.S. Food and Drug Administration (FDA) Food Code contains recommendations for food service establishments, including restaurants, aimed at reducing the frequency with which food workers work while ill. However, few data exist on the extent to which restaurants have implemented FDA recommendations. The Centers for Disease Control and Prevention's Environmental Health Specialists Network (EHS-Net) conducted a study on the topic of ill food workers in restaurants. We interviewed restaurant managers (n = 426) in nine EHS-Net sites. We found that many restaurant policies concerning ill food workers do not follow FDA recommendations. For example, one-third of the restaurants' policies did not specifically address the circumstances under which ill food workers should be excluded from work (i.e., not be allowed to work). We also found that, in many restaurants, managers are not actively involved in decisions about whether ill food workers should work. Additionally, almost 70% of managers said they had worked while ill; 10% said they had worked while having nausea or "stomach flu," possible symptoms of foodborne illness. When asked why they had worked when ill, a third of the managers said they felt obligated to work or their strong work ethic compelled them to work. Other reasons cited were that the restaurant was understaffed or no one was available to replace them (26%), they felt that their symptoms were mild or not contagious (19%), they had special managerial responsibilities that no one else could fulfill (11%), there was non-food handling work they could do (7%), and they would not get paid if they did not work or the restaurant had no sick leave policy (5%). Data from this study can inform future research and help policy makers target interventions designed to reduce the frequency with which food workers work while ill.
authors.affiliation: California Emerging Infections Program, 360 22nd Street, Suite 750, Oakland, California 94612, Sonomaceuticals/WholeVine Products, 421 Aviation Boulevard, Santa Rosa, CA 95402, USA.
authors.forename: D M
authors.initials: DM
authors.lastname: Norton
authors.affiliation: National Center for Environmental Health, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, Georgia 30333, USA. lrg0@cdc.gov.
authors.forename: L G
authors.initials: LG
authors.lastname: Brown
authors.affiliation: California Department of Public Health, Food and Drug Branch, 850 Marina Bay Parkway, Building P, First Floor, Richmond, California 94808, USA; Alameda County Department of Environmental Health, 1131 Harbor Bay Parkway, 2nd Floor, Alameda, CA 94502, USA.
authors.forename: R
authors.initials: R
authors.lastname: Frick
authors.affiliation: Tennessee Department of Health, 425 5th Avenue N., # 3, Nashville, Tennessee 37243, USA.
authors.forename: L R
authors.initials: LR
authors.lastname: Carpenter
authors.affiliation: Tennessee Department of Health, 425 5th Avenue N., # 3, Nashville, Tennessee 37243, USA; Office of Public Health Science, Food Safety and Inspection Service, U.S. Department of Agriculture, Butler Square West, Suite 989-C, 100 North 6th Street, Minneapolis, MN 55403, USA.
authors.forename: A L
authors.initials: AL
authors.lastname: Green
authors.affiliation: Georgia Department of Public Health, 2 Peachtree Street N. W., 15th Floor, Atlanta, Georgia 30303, USA.
authors.forename: M
authors.initials: M
authors.lastname: Tobin-D'Angelo
authors.affiliation: Minnesota Department of Health, 625 Robert Street N., P.O. Box 64975, St. Paul, Minnesota 55164, USA.
authors.forename: D W
authors.initials: DW
authors.lastname: Reimann
authors.affiliation: Rhode Island Department of Health, 3 Capitol Hill, Providence, Rhode Island 02908, USA.
authors.forename: H
authors.initials: H
authors.lastname: Blade
authors.affiliation: New York State Department of Health, Corning Tower, Empire State Plaza, Albany, New York 12237, USA.
authors.forename: D C
authors.initials: DC
authors.lastname: Nicholas
authors.affiliation: New York State Department of Health, Corning Tower, Empire State Plaza, Albany, New York 12237, USA.
authors.forename: J S
authors.initials: JS
authors.lastname: Egan
authors.affiliation: Minnesota Department of Health, 625 Robert Street N., P.O. Box 64975, St. Paul, Minnesota 55164, USA; National Center for Food Protection and Defense, University of Minnesota, St. Paul, MN 55108, USA.
authors.forename: K
authors.initials: K
authors.lastname: Everstine
mesh_terms: D000328:Adult; D002487:Centers for Disease Control and Prevention, U.S.; D004196:Disease Outbreaks; D005506:Food Contamination / Q000032:analysis; D005511:Food Handling / Q000592:standards*; D005517:Foodborne Diseases / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008875:Middle Aged; D016272:Occupational Health / Q000592:standards*; D010559:Personnel Management / Q000592:standards*; D012147:Restaurants / Q000592:standards*; D018582:Sick Leave; D014481:United States; D014486:United States Food and Drug Administration; D000078329:Workforce