Dining outside of the home can be difficult for persons with food allergies who must rely on restaurant staff to properly prepare allergen-free meals. The purpose of this study was to understand and identify factors associated with food allergy knowledge and attitudes among restaurant managers, food workers, and servers. This study was conducted by the Environmental Health Specialists Network (EHS-Net), a collaborative forum of federal, state, and local environmental health specialists working to understand the environmental factors associated with food safety issues. EHS-Net personnel collected data from 278 randomly selected restaurants through interviews with restaurant managers, food workers, and servers. Results indicated that managers, food workers, and servers were generally knowledgeable and had positive attitudes about accommodating customers’ food allergies. However, we identified important gaps, such as more than 10% of managers and staff believed that a person with a food allergy can safely consume a small amount of that allergen. Managers and staff also had lower confidence in their restaurant’s ability to properly respond to a food allergy emergency. The knowledge and attitudes of all groups were higher at restaurants that had a specific person to answer food allergy questions and requests or a plan for answering questions from food allergic customers. However, food allergy training was not associated with knowledge in any of the groups but was associated with manager and server attitudes. Based on these findings, we encourage restaurants to be proactive by training staff about food allergies and creating plans and procedures to reduce the risk of a customer having a food allergic reaction.

Over half of foodborne illness outbreaks occur in restaurants. To combat these outbreaks, many public health agencies require food safety certification for restaurant managers, and sometimes workers. Certification entails passing a food safety knowledge examination, which is typically preceded by food safety training. Current certification efforts are based on the assumption that certification leads to greater food safety knowledge. The Centers for Disease Control and Prevention conducted this study to examine the relationship between food safety knowledge and certification. We also examined the relationships between food safety knowledge and restaurant, manager, and worker characteristics. We interviewed managers (N = 387) and workers (N = 365) about their characteristics and assessed their food safety knowledge. Analyses showed that certified managers and workers had greater food safety knowledge than noncertified managers and workers. Additionally, managers and workers whose primary language was English had greater food safety knowledge than those whose primary language was not English. Other factors associated with greater food safety knowledge included working in a chain restaurant, working in a larger restaurant, having more experience, and having more duties. These findings indicate that certification improves food safety knowledge, and that complex relationships exist among restaurant, manager, and worker characteristics and food safety knowledge.

Abbreviations: CI = confidence interval; EHS-Net = Environmental Health Specialists Network; FDA = Food and Drug Administration; OR = odds ratio. * Disassembled, cleaned, and sanitized. † California, Minnesota, New York, New York City, Rhode Island, and Tennessee. § The reference level is the second category listed. Thus, the odds ratio is for the first category listed compared to the second category listed. ¶ Numbers vary because of missing data. ** P-values for the overall ORs: p = 0.001 and p<0.001 for the manager and worker models, respectively. † † Certification defined as having taken and passed a food safety test and been issued a certificate. § § Somewhat easy, neither easy nor difficult to clean, somewhat difficult, or difficult. ¶ ¶ P-values for the overall ORs: p = 0.803 and p = 0.856 for the manager and worker models, respectively. *** P-values for the overall ORs: p = 0.441 and p = 0.445 for the manager and worker models, respectively. chubs daily reported more frequent slicer cleaning than did delis with fewer slicers, serving fewer customers, or selling fewer chubs daily. These characteristics are likely indicators of deli size, and these data are consistent with other findings suggesting that both chain and larger establishments' food safety practices tend to be better than those of independent and smaller establishments (9,10). Compared with both independent and smaller delis, chain and larger delis might have more resources, more or better trained staff, or more standardized cleaning procedures.The association of required manager food safety training and certification with more frequent reported slicer-cleaning is consistent with other findings indicating that training and certification are important in retail food safety (9,10), and highlights the important role that management can play in food safety. The finding that delis with workers with more food safety knowledge and experience had more frequent reported slicer cleaning suggests that workers also play an important role in food safety.Simple logistic regression findings suggest other characteristics that might improve cleaning frequencies. Written slicercleaning policies and worker ratings of slicers as being easy to clean were both associated with more frequent reported cleaning, suggesting that workplace policies and slicer design can affect cleaning frequency. Finally, delis with a food safetycertified manager had better reported cleaning frequencies, again pointing to the importance of training and certification.Because slicer-cleaning frequency and disassembly guidance are presented separately from each other in the FDA Food Code, some deli managers might be unaware that cleaning should include disassembly, and might clean and sanitize slicers without disassembling them. It is also possible that some slicers included in this study, especially newer ones, do not need to be disassembled to be fully cleaned.The findings in this study are subject to at least three limitations. First, the interview data might be affected by social desirab...

No abstract

The Centers for Disease Control and Prevention (CDC) estimates that 3,000 people die in the United States each year from foodborne illness, and Listeria monocytogenes causes the third highest number of deaths. Risk assessment data indicate that L. monocytogenes contamination of particularly delicatessen meats sliced at retail is a significant contributor to human listeriosis. Mechanical deli slicers are a major source of L. monocytogenes cross-contamination and growth. In an attempt to prevent pathogen cross-contamination and growth, the U.S. Food and Drug Administration (FDA) created guidance to promote good slicer cleaning and inspection practices. The CDC's Environmental Health Specialists Network conducted a study to learn more about retail deli practices concerning these prevention strategies. The present article includes data from this study on the frequency with which retail delis met the FDA recommendation that slicers should be inspected each time they are properly cleaned (defined as disassembling, cleaning, and sanitizing the slicer every 4 h). Data from food worker interviews in 197 randomly selected delis indicate that only 26.9% of workers ( n = 53) cleaned and inspected their slicers at this frequency. Chain delis and delis that serve more than 300 customers on their busiest day were more likely to have properly cleaned and inspected slicers. Data also were collected on the frequency with which delis met the FDA Food Code provision that slicers should be undamaged. Data from observations of 685 slicers in 298 delis indicate that only 37.9% of delis ( n = 113) had slicers that were undamaged. Chain delis and delis that provide worker training were more likely to have slicers with no damage. To improve slicer practices, food safety programs and the retail food industry may wish to focus on worker training and to focus interventions on independent and smaller delis, given that these delis were less likely to properly inspect their slicers and to have undamaged slicers.