Foodborne illness is a significant public health problem in the U.S. Annually, more than 800 foodborne illness outbreaks are reported to the Centers for Disease Control and Prevention (CDC) and most of these occur in retail food service establishments (e.g., restaurants) (Gould et al., 2013). State and local health department investigations of outbreaks collect information valuable in preventing future outbreaks. Of particular value are the data collected during environmental assessments.
Environmental assessments are focused on identifying the environmental causes of outbreaks (also known as contributing factors and environmental antecedents). In other words, the goal is to describe how and why the environment contributed to the introduction or transmission of agents that cause illness (Selman & Guzewich, 2014). For example, an environmental assessment could determine that the contributing factor to an outbreak was an ill worker who transmitted illness to customers (i.e., how the outbreak occurred). The assessment could further determine that the ill worker was working because neither they nor their manager understood that the worker could spread illness through food (i.e., why the outbreak occurred). Findings from environmental assessments can be used to recommend effective interventions that stop ongoing foodborne illness outbreaks and prevent future outbreaks.
Environmental assessments are typically conducted by food safety program officials. They visit the outbreak establishment and conduct a thorough review of the processes and practices used with the suspected outbreak food items. This review could include interviewing staff about food safety policies and practices, observing food preparation practices, and reviewing records. These assessments can be viewed as forensic-type investigations in which investigators reconstruct past events in the outbreak establishment along with other members of an investigation team.
From a local food safety program perspective, foodborne illness outbreaks might not happen very often. So, opportunities to conduct outbreak environmental assessments are limited and food safety program officials might not have much experience conducting them. Thus, their outbreak investigation activities can more closely resemble routine inspections, which are less likely to identify environmental causes of outbreaks than environmental assessments. Additionally, there are few training opportunities focused on outbreak...