Study assesses link between inspection results and outbreaks

Study assesses link between inspection results and outbreaks

Researchers have tried to find out if inspection findings can be used to predict where foodborne outbreaks may happen.

The study investigated whether routine inspection results were associated with the occurrence of foodborne outbreaks in restaurants and institutional catering. The hypothesis was that poorer inspection results would be associated with an elevated risk of outbreaks.

Institutional catering includes central and industrial kitchens, catering and sites that prepare precooked food products for sale.

No major differences were seen in restaurants but in institutional catering, significantly poorer inspection results were detected in outbreak establishments, according to the study published in the International Journal of Environmental Health Research.

Inspection findings and outlet type


A total of 143 outbreaks were associated with restaurants and institutional catering establishments from 2015 to 2018 and 150 outlets linked to outbreaks were part of the study. Reports of 121 sites inspected from May 2013 to December 2018 were included. Food service sites other than outbreak establishments were selected as controls.

Median time between inspections and following outbreaks was over seven and a half months and the main causative agent in outbreaks was either unknown or norovirus.

Results of the last routine inspection before the incident in outbreak establishments were compared with results of one randomly selected routine inspection in each control outlet.

Finland’s food safety grading system uses a four point scale: excellent, good, to be corrected and poor.

Confirmed foodborne outbreaks are classed into “strong evidence” (A), “probable evidence” (B), “possible evidence” (C) or “not clear evidence” (D) based on descriptive and analytical epidemiological findings, results of laboratory analyses and possible contributing factors.

Scientists identified outbreak establishments in the data and selected their most recent routine inspection prior to the outbreak. However, they noted correction of non-compliances may mean that violations detected during the last inspection are no longer present at the time of the outbreak.

Restaurant inspection results on “work clothes” and “hand hygiene” were more favorable in outbreak establishments compared to those of controls.

Main institutional catering results


In institutional catering, differences were seen in cleanliness of facilities, surfaces and equipment. Differences were also observed in adequacy and maintenance of facilities and equipment. This suggests that a well maintained and clean food handling environment is essential to prevent foodborne illness, said researchers.

Inspection results concerning work practices of personnel or food temperature management in the kitchen did not differ between outbreak and control establishments in institutional catering.

However, for “Management of shelf life and sale period of products in serving of foods” the proportion of the grades “Good” and “To be corrected” was higher in outbreak establishments associated with epidemics with at least moderate evidence than in control sites.

This area covers time for displaying food for serving, temperatures during sale or displaying for serving, and temperature records and possible corrective actions by the food business. Time and temperature abuse in storage of food has been identified as a common contributory factor in registered foodborne outbreaks, according to the study.

Researchers said businesses need to pay attention to the cleanliness of the food handling environment and equipment.

“Effective correction of non-compliances in cleanliness of the food handling environment and equipment and constant maintenance of a favorable situation is essential in ensuring a high level of consumer safety in food service,” according to the researchers.

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