Poor food inspection results could predict foodborne illness outbreaks

Study shows significantly poorer inspection results in institutional catering, and supports link between poor food hygiene inspection results and a higher risk of foodborne outbreaks of sickness 

Poor food inspection results could help predict where foodborne illness outbreaks might occur, according to a new study by Finnish researchers investigating a link between the two. 

The study, published in the International Journal of Environmental Health Research, set out to determine if there was a link between routine inspection results and the occurrence of foodborne outbreaks in restaurants and institutional catering. The researchers hypothesised that poorer inspection results would be associated with an elevated risk of outbreaks of illness. 

The team, led by Elina Leinonen, Senior Officer at the Finnish Food Authority, considered a total of 150 restaurants and institutional catering establishments linked to outbreaks in Finland between 2015 and 2018. They compared the establishment’s most recent routine inspection prior to the outbreak with the results of a randomly selected routine inspection in a control outlet.  

Finland’s Oiva risk-based grading system works much like the UK’s Food Hygiene Rating Scheme, but rates food establishments on a four-point scale ranging from excellent to poor,  rather than five. The latter two grades, ‘To be Corrected’ and ‘Poor’, suggest that there is some non-compliance with food safety and that consumers may be considerably misled, for example, by incorrect information on food. 

Confirmed foodborne outbreaks are classified on their strength of evidence, from A – strong evidence – to D, no clear evidence, and is based on descriptive and analytical epidemiological findings, laboratory analysis and possible contributing factors.  

The researchers used the strength of evidence registered for each outbreak to evaluate the confidence in the outcome that a particular food service establishment was associated with an outbreak. 

The study revealed that no major differences were seen in restaurants, but significantly poorer inspection results were observed in outbreak establishments in institutional catering, which include central and industrial kitchens, catering, and sites that prepare precooked food products for sale. 

In institutional catering, differences were observed in criteria such as cleanliness of facilities, surfaces and equipment, but also in their adequacy and maintenance. 

“Official control is intended to identify and correct risk factors for foodborne illness,” explained Leinonen. “However, we were aware that the detection of relationships between routine inspection results and risk of foodborne outbreaks may be influenced by many factors." 

In institutional catering, differences were observed in criteria such as cleanliness of facilities, surfaces and equipment, but also in their adequacy and maintenance. The researchers say this suggests a well-kept food handling environment is essential to preventing foodborne illnesses; businesses should therefore pay attention to the cleanliness of the food handling environment and equipment. 

“Our study showed the importance of a clean and well-maintained food handling environment on food safety. Effective correction of non-compliances regarding these issues as well as constant maintenance of a favourable situation by the food business operator is essential,” concluded Leinonen. 

Kate Thompson, CIEH Director said “This is a useful report, not least because it adds to the evidence base linking poor food hygiene inspection results to a higher risk of foodborne outbreaks of illness. This is consistent with the findings of the FSA’s Chief Scientific Adviser, who reported that ‘broadly compliant’ premises have a smaller chance of a foodborne disease outbreak than those that are not broadly compliant.”

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