I met a doctor years ago who told me he didn’t like to eat in restaurants due to fears of catching foodborne pathogens. He worked in a community health setting and frequently treated food service workers with infectious diseases. He thought too many of his food service patients were fairly lackadaisical about taking their medications and too often worked when they should call-in sick. Apparently he was on to something. A new study from the U.S. Centers for Disease Control and Prevention (CDC) found one of the causes of foodborne outbreaks at restaurants are food service workers handling food while they are ill.
The study, which was published Tuesday in the CDC’s Morbidity and Mortality Weekly Report, covers 800 outbreaks of foodborne illness at US restaurants between 2017 and 2019, reported by 25 state and local health departments.
The most common pathogens identified were norovirus in almost half of the outbreaks (47%), followed by salmonella (19%).
Contributing factors were identified in about two-thirds of restaurant-related outbreaks of foodborne illnesses. Among these, 41% were related to workers handling and contaminating food while ill.
Most of the restaurants in the study had policies in place that required sick workers to stay home and notify their supervisors if they began feeling ill while at work. However, the rules were not always clearly articulated or uniformly enforced.
The study also pointed to communication gaps between restaurants and workers. While most restaurants had written policies requiring staff to tell their managers when they were ill and highlighted the need to report certain symptoms, only a minority (23%) specified all five symptoms that should keep someone home from work: vomiting, diarrhea, a wound with pus, a sore throat with a fever, or jaundice.
Only 16% of restaurants involved in outbreaks clearly communicated and followed through on four key recommendations: They had a policy that sick staff should tell a manager when they’re not feeling well, staff were urged to report illness any time they had any one of five risky symptoms, the restaurant didn’t allow workers to work while ill, and workers had been told about all five symptoms that should keep them home from work.
The news media jumped on the CDC study, which drew an unlikely conclusion: foodborne illness illustrates the need for paid sick leave among restaurant workers. This conclusion is something of a leap considering nearly half of the restaurants offered sick leave.
While most restaurants surveyed for the study had policies aimed at keeping sick staff from working, fewer than half (44%) offered paid sick leave. The study authors say that extending paid sick leave for more restaurant workers could curb food contamination by safeguarding income for restaurant workers who typically work for low hourly wages and tips.
Part of the problem may be that some workers don’t want to reduce their paycheck when they feel lethargic and possibly sick. However, a problem with blaming foodborne illness on a lack of sick leave is that workers often don’t feel sick until after they are contagious. A Seattle-based attorney who specializes in foodborne illness cases told CNN:
Although expanding access to paid sick leave is important, he said, it probably wouldn’t stop all worker-associated outbreaks, because people often become contagious before they’re aware they are ill.
“So they’re coming to work and they don’t know they’re sick at all, and they’re transmitting salmonella or norovirus, or they’re at the very beginnings of their illness” and so not sick enough to stay home, Marler said.
In addition, there is peer pressure among food service employees to not leave coworkers short-handed by calling in sick at the last minute. Paid sick leave would not alleviate the peer pressure workers feel to avoid overloading teammates. The Public Broadcasting Service (PBS) highlighted the most logical conclusion:
Investigators with the Centers for Disease Control and Prevention called for better enforcement of “comprehensive food safety policies,” which emphasize basic measures like hand washing and keep sick workers off the job.
If you read between the lines only two-thirds of foodborne outbreaks could be attributed to a cause, of which 41% of outbreaks could be contributed to sick food service workers. That suggests just over one-fourth of outbreaks (66% X 41%=27%) could be tied to sick workers. Many of those workers may have been asymptomatic when they transferred pathogens into food. Furthermore, the CDC identified lack of enforcement of food safety policies as much of the problem. It would seem mandating paid sick leave is a favored left-of-center solution forever in search of a problem. It is doubtful it would not have made much of a difference in the cases identified.