Addressing Employee Health in Retail Food Establishments

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Addressing Employee Health in Retail Food Establishments. Donna M. Wanucha, REHS Regional Retail Food Specialist US Food and Drug Administration Southeast Region. Overview. Is the health of an employee important? What intervention strategies can prevent food borne illness from employees? - PowerPoint PPT Presentation

Text of Addressing Employee Health in Retail Food Establishments

  • Addressing Employee Health in Retail Food EstablishmentsDonna M. Wanucha, REHSRegional Retail Food SpecialistUS Food and Drug AdministrationSoutheast Region

  • OverviewIs the health of an employee important?What intervention strategies can prevent food borne illness from employees?What are the diseases and symptoms of concern?How can the message of employee health be delivered to the front line employee?

  • CDC Estimates of Foodborne Illness

    CDC estimates that each year roughly 1 out of 6 Americans (or 48 million people) gets sick, 128,000 are hospitalized, and 3,000 die from foodborne diseases.

    CDC, December 2011

  • Food borne Illnesses

    Improper behaviors with handling of food

    Infected food workers

  • Pathogens Often Transmitted by Food Contaminated by Infected WorkersNorovirusHepatitis A virusShigella spp.Enterohemorrhagic or Shiga toxin-producing E. coliSalmonella Typhi

    The Big 5 Pathogens

  • Controls to Prevent the Big 5Hand washing

    No bare hand contact of ready-to-eat foods

    Employee Health PoliciesReportingExcluding Restricting

  • Controls to Prevent the Big 5Handwashing

    2-3 log reductionTransfer rate to food

  • Controls to Prevent the Big 5No Bare Hand Contact with Ready-to-Eat FoodPhysical barrier between hands and foodUtensils

  • Controls to Prevent the Big 5Employee Health Policies

    Employees reporting symptoms and exposures to managementExcludingRestricting

    Based on 4 levels of risk

  • Reporting RequirementsActive Symptoms- vomiting, diarrhea, sore throat with fever, jaundice, infected cut

    Diagnosis with or exposure to Big 5

  • Exclusion and RestrictionRemoves infected food workers when most likely to transmit a pathogen to food itemsBalances employees needs with risk to the publicProvides guidance on safely allowing infected employees to return to dutiesSpecific to population served- HSP

  • Science versus Practice

    So why do sick employees still go to work?

  • Factors Affecting the Ability of Food Workers to Prepare Food Safely(Green and Selman, 2005)

    Time PressureStructural environments, equipment, and resourcesManagement and coworker emphasis on food safetyWorker characteristicsNegative consequences for those who do not prepare food safelyFood safety education and trainingRestaurant proceduresGlove and sanitizer use

  • Food Service Employee Research

    Food workers view their business as low risk (Clayton et al., 2002)Behavior is motivated by values and interpretations of situations and events (Burke, 1990)

  • Food Service Employee Research

    Some research has shown that workers are more likely to implement safe practices if they understand the importance of implementing those practices (Clayton et al., 2002)Research suggests that real-life examples get food workers and managers attention and help them learn (Beegle, 2004)

  • Oral Versus Print Culture Learners

    Dr. Donna Beegle, 2004

    Oregon Environmental Health Specialist Network (EHS-Net) Communication Study

  • Communication of RiskStudy conclusion:

    Food employees = oral culture learners

    Regulators = print culture learners

  • Most Food Safety Education Today

    Presented in print or verbally in unfamiliar abstract languagePresented by someone of power and/or someone who does not understand what it is like to work in a foodservice establishmentGood behavior is often not modeled or made a priority in restaurant environment (i.e. lack of food safety culture)

  • Most Food Safety Education Today

    Often describes how but not whyIf provided, the whyis often presented:In a language that is not familiar (maybe too technical)In a way that does not relate to food employees personal experiences

  • Most Food Safety Education Today

    Examples:

    Classroom style/computer-based learningWritten manuals, pamphlets, SOPsStep-by-step how topostersTraining provided by people of power Health inspectorsAgents of the health departmentIndustry QA staff

  • IAFP Food Safety Icons -2003

  • IAFP Food Safety Icons -2003

  • Recommendations for Communicating Food Safety Concepts to Oral Culture Learners (Beegle, 2004)

    Use stories and sayings with vivid examples to allow food employees to feel the impact of a behavior

    Stress importance of role models who show and model appropriate behavior in supportive ways

  • Recommendations for Communicating Food Safety Concepts to Oral Culture Learners (Beegle, 2004)

    Whenever possible, information should be provided by people with whom the food employees have a relationship Use familiar words and examples that food employees can relate to

  • Recommendations for Communicating Food Safety Concepts to Oral Culture Learners (Beegle, 2004)

    Focus on the big picture

    Allow for two-way communication

    Demonstrate concepts and have food employees demonstrate the concepts back to you

  • Getting the Message Across

    Investing time with front line employees

    Management documentation of training on employee health

  • Audio

  • Oral Learner Project

    fda.gov/Food/FoodSafety/RetailFoodProtection

    Audio of victims of foodborne illnesses- 2012

  • SummaryEmployee Health is essential in foodborne illness preventionThere must be controls in place to control fecal-oral route pathogensEmployees must know the symptoms and conditions to reportRegulators and management must get the message across to front line employees

  • Questions?

    Donna M. Wanucha, REHSRegional Retail Food SpecialistFDA, State Cooperative Programs678-616-5600Donna.Wanucha@fda.hhs.gov

    Reducing foodborne illness by just 1% would keep about 500,000 Americans from getting sick each year; reducing foodborne illness by 10% would keep about 5 million from getting sickNOROVIRUS: Causes 58% of all domestically-acquiredfoodborne illness from known agents #1 cause of illness #2 cause of hospitalization #4 cause of death Costs $2 billion per year in medical careservices and lost productivityThe 5 risk factors

    Personal hygiene is a result of employees coming to work while illRequired by the ADA (Americans with Disabilities Act) for CDC to publish this list annually.Updated annually In two parts: Annex 3, PHR, pg. 245 List I - Pathogens Often Transmitted through food by infected food employees List II - Pathogens Occasionally Transmitted through food by infected food employeesList updated annually. Will be adding non-typhoidal Salmonella

    The CDC has designated the 5 organisms in the Food Code as having hi infectivity via contamination of food by infected food employees also severity of diseases from List II NOROVIRUS causes 58% of all domestically-acquiredfoodborne illness from known agents #1 cause of illness #2 cause of hospitalization #4 cause of death Costs $2 billion per year in medical careservices and lost productivityGo through the demo of log 11-12 of viral particles in 1 gram of feces, log 2-3 reduction from hw, then transfer rate and low dosageLevel I: Active Gastrointestinal Symptoms: Active Jaundice, Vomiting and/or Diarrhea, or diagnosis with an Illness caused by S. Typhi or hepatitis A within 14 days of SymptomsLevel II: Diagnosis and symptom resolutionLevel III: Diagnosis and never developed symptoms.Level IV: Exposure to Listed PathogenRequired by the American Disabilities ActUpdated annuallyTwo parts:List 1 Pathogens frequently transmitted through food from infected food workers List 2 Pathogens occasionally transmitted through food from infected food workers

    Typical sign used today, not oral culture learner basedFDA Oral Culture Learner Materials for Retail Food Employees Available:To help improve food safety practices in grocery stores, restaurants and other food service operations, such as schools, nursing homes and hospitals, the Food and Drug Administration is providing basic training materials for front line food employees in languages they are most comfortable with. These materials for oral culture learners are part of FDAs efforts to work closely with state and local governments and operators of retail food establishments to prevent illness from contaminated food. The materials, in the form of seven downloadable posters on key safe food handling issues, are available in English, Hindi, Korean, Russian, Spanish, Traditional Chinese and Simplified Chinese, and Vietnamese at: http://www.fda.gov/Food/FoodSafety/RetailFoodProtection/IndustryandRegulatoryAssistanceandTrainingResources/ucm212661.htm Directed at improving how industry and regulatory food safety professionals communicate with front line food employees on the importance of food safety, the posters use a minimum of text, relying on photographs or drawings to show food workers in real-life situations, and make their points forcefully. The storyboard-style posters, designed to print on standard 8.5 x 11paper, cover three critical basic principles in safe food handling : Using gloves or utensils to handle ready-to-eat foods Not working when ill Proper hand washing FDA has worked closely with its regulatory, industry and academic partners to develop and field test these materials. Additional materials are under development to address other important food safety practices such as proper temperature control and minimizing cross-contamination. These materials will be posted on FDA's website as they become available. Several regulatory agencies are already using the oral culture posters to help food employees understand the importance of following safe food preparation practices including, the Alaska Department of Environmental Conservation; Oregon Department of Human Services; F