Changing the scope of restaurant health inspections

In Chicago’s Little Italy neighborhood, Joy Yee Noodles failed its city restaurant and food service inspection late last February. City health inspectors found multiple violations at this hot spot for students from the University of Illinois at Chicago, which include unclean food preparation stations and a minor pest problem.

The pan-Asian restaurant located on 1335 S. Halsted Street, managed to fix all of its violations and pass the next inspection in the following week. For Joy Yee and other restaurants in major, metropolitan areas, this repeated pass-fail scrutiny has become inefficient in combating the issues of foodborne illness and product contamination.

Charlie Candelas, the special projects director of Synergy Restaurant Consultants, said restaurants value taste and atmosphere very highly, but cleanliness must be the biggest factor in a successful business. “To be honest, many consumers are not aware of the violations that a restaurant receives. You’d have to do some research, and a lot of people don’t want to go through that," he said.

Candelas said most people will not find out about a restaurant’s health issues until it closes or is covered by the media.

Synergy works with restaurants around the world to save businesses from closing through reevaluating finance, marketing, and even health strategies. Candelas said health-related problems are the hardest to recover from.

“In the food industry, companies are complaining that [health legislation] is not descriptive enough,” said Robert Brackett, a researcher and professor of food microbiology at the Illinois Institute of Technology’s Institute for Food Safety and Health.

According to the IFSH’s Food Safety Preventative Controls Alliance, which Brackett is a committee member of, there are guidelines that local scientists are working to establish. These guides are accessible to the public and focus on the biggest issues in food safety at multiple levels of production: worker health and hygiene, building and equipment maintenance, sanitation, safe drinking water, proper food cleaning and packaging. The IFSH guides are meant to provide a checklist for restaurants to follow that adhere to current Chicago-wide food regulations.

The Natural Resources Defense Council also issues warnings, with the help of the Environmental Protection Agency, when the product at the manufacturing level has been compromised due to pollution or improper pest control. One of the reasons why cities really feel the impact of food-borne illness at any level of production is due to congestion.

“More than 80 percent of Americans now live in or around cities,” the NRDC reports in its Urban Solutions memo. Its goal is to clean up larger facilities and infrastructure for agriculture, water, and sanitation in order to reduce potential outbreaks that stem from the source.

If restaurants have unsafe water flowing through their faucets or contaminated meat from the farm, which is completely out of their control, customers and staff are exposed to a great deal of harm.

According to the United States Department of Labor’s Occupational Safety and Health Administration, there is a code known as the North American Industry Classification System. Here, the federal government establishes and monitors all kinds of business, from the food industry to the pharmaceutical industry, and much more. At the food manufacturing level in the past year, there were three major citations in a single inspection for blood-borne pathogens, costing $6,000 in fines. At the food service level, general requirements for worker and area protection was about $20,000 for 14 citations. In total, the food manufacturing level sustains about $805,000 in fines, and food service only had $183,000 in fines, but the improper reporting of food handling at the service level is more common than the manufacturing level.

“Some restaurants come to us once they had one too many violations, and the business slows down,” Candelas said. “We try several approaches depending on the restaurant and the situation they are in. If it has something to do with violations pertaining to cleanliness we would definitely advise them to get stricter with their staff on following the appropriate regulations.”

OSHA also has guidelines for worker and area sanitation but still needs more data at the microscopic level of what is happening when businesses deal with major outbreaks.

According to the Centers for Disease Control and Prevention’s 2014 study on identifying food-borne illness in Chicago using social media, “an estimated 55 million to 105 million persons in the U.S. experience acute gastroenteritis – stomach flu - caused by food-borne illness each year, resulting in costs of $2-$4 billion annually.”

The CDC studied Foodborne Chicago, a project of the Smart Chicago Collaborative that sends its information to the City of Chicago’s Department of Public Health by using social media to monitor food poisoning and outbreaks.

FBC inspected 133 restaurants, received 193 complaints via the Internet aside from Twitter, cited 3,701 tweets about food poisoning, and 784 tweets on reports submitted to the city in the past year. Brackett said, in confirmation with the CDC report, that current inspection regulations and standards are too vague, and are not pinpointing the real issue as to why still so many people are suffering from food-borne illness each year.

“The whole goal is to have the regulatory system, and the food safety system has to be science-based,” Brackett said. “We might find new organisms that weren’t a problem before, but may interact in different ways when exposed to other pathogens. The survival of salmonella in dry ingredients in the last 10 years are often the source of large outbreaks.”

It turns out, according to Brackett, the No. 1 pathogen from food handlers found in recent years is not salmonella but norovirus ­– viruses that cause inflammation in the stomach and intestines that lead to severe cases of stomach flu.

FBC found more cases of food poisoning occurring and spreading in Chicago, as opposed to areas surrounding the city. Norovirus is also notorious for spreading rapidly from person-to-person in closed-off spaces.

The U.S. Department of Agriculture and Food and Drug Administration have significantly cracked down on improper food handling in the production sector of factories and farming in the past five years through microbial analysis, but for food service businesses like Joy Yee, there is little to no scientific inspection.

“With national and international distribution of food, you may have people in all 50 states becoming ill and no one would recognize that as a pattern until now,” Brackett said. “We are using different types of genetic and molecular characterizations to share our results. This allows the disparate cases to form a pattern, finding the same organism making all these people sick at the same time, that allows us to trace back where and what the pathogen came from.”

Brackett and other researchers who have worked with the FDA and CDC in the past are attempting genomic sequencing of bacteria found in the first couple of customers who get ill in order to prevent a larger spread of an outbreak. “Genome sequencing has shortened response times dramatically by regulatory agencies,” Brackett said.

Now that genome sequencing has gotten cheaper and is used more frequently, Brackett said this may become the ultimate tool of efficient and accurate inspection for health inspectors everywhere.

For restaurants like Joy Yee in areas with growing populations, one failing inspection is enough to cause harm to its reputation, but according to the National Restaurant Association, “A food-borne illness outbreak can cost an operation thousands of dollars or even result in closure. More important than the monetary costs, though, are the human costs.”

Even though millions of people get sick each year due to food-borne illness, in 2011, the CDC reported about 3,000 deaths from various outbreaks in congested areas throughout the country.

Joy Yee has not been linked to any food poisoning scandals or outbreaks, but all food service businesses must hold this responsibility food safety as a part of their business protocol.

“The worst thing that can happen to you is having someone get sick because of something they ate at your restaurant,” Candelas said. “It’s very hard to recover from that. The business won’t be the same anymore.”