June, 2008

Research Perspective and Comments & Analysis

Something About Mary

During her career as a household cook in the early 19th century, Mary Mallon infected 47 known people with typhoid, three of whom died. Typhoid Mary denied having the disease and refused to stop working until she was forcibly quarantined. While our understanding of foodborne illness has come a long way, the dire impact of food-safety lapses remains. Mary’s story underscores the intimate connection between those who prepare and serve food and the food itself.

This piece of history explains why I feel it is essential for the produce industry to educate consumers (and food handlers) on the do’s and don’ts of handling fruits and vegetables. Last year I took on the role of chairman of the Partnership for Food Safety Education, whose vision is to change consumer behavior to prevent foodborne illness (www.befoodsafe.org and www.fightbac.org). If we as an industry do little to proactively teach, then consumer ignorance of what causes foodborne illness has little value as our defense.

Fresh produce is a powerful solution for foodservice operators: Produce fills the plate inexpensively, adds color and texture, and satisfies consumers’ demands for fresh, nutritious food. Collaboration can be a win-win-win relationship for supplier, operator and diner alike, especially when the supplier and operator partner to improve meal quality and safety. Both know firsthand that the consequences of a food-safety violation spread like fever — and can kill a business just as fast.

Because of Produce Marketing Association’s (PMA) ongoing work to elevate the food-safety dialog and generate solutions, we’ve been tracking consumer attitudes about produce safety for over two years. In March, Opinion Dynamics Corporation asked 1,000 consumers a range of produce safety-related questions on PMA’s behalf. Their findings will interest supermarket and restaurant foodservice operators — and their produce suppliers.

We learned a majority of Americans buying prepared foods place the burden for produce safety on dining establishments, much more than suppliers or growers. Fifty-one percent of consumers assign that responsibility to operators, 21 percent to produce suppliers and 16 percent to farmers. Surveyed consumers also perceive foodservice segments differently; they are most confident in produce safety at fine-dining establishments, followed by supermarkets, then casual dining; quick-service restaurants (QSR) ranked last. As we’d expect, those same consumers report they patronize QSRs most often; as many as 13 percent eat at them five to 10 times a month.

That juxtaposition is important. Our customers are dining at QSRs out of necessity for convenience and value, while at the same time feeling the lowest level of confidence in the safety of our fresh products. That’s a precarious balance between their needs and their fears. And that’s not a recipe for our long-term foodservice success.

Our latest survey indicates the 2006 leafy greens crisis is still hanging over us. While 80 percent of people surveyed say they don’t avoid ordering specific produce because of safety concerns, 17 percent say they do. Twenty-four percent of those say they won’t order spinach, and 22 percent avoid lettuces. PMA’s survey hit shortly after reports of contaminated restaurant lemons broke in the media; no surprise that 6 percent won’t order lemons.

While consumers may place the onus on foodservice operators, food safety is a responsibility shared by operators, suppliers and growers. This is one reason why PMA hosts the only conference dedicated to produce in foodservice, the PMA Foodservice Conference & Exposition, providing the produce foodservice supply chain with the knowledge and business relationships needed to position produce as the smart, safe solution to operators’ needs.

Food safety is a key focus of this year’s conference, which will be held July 25-27 in Monterey, CA. Attendees will find out the status of food-safety legislation and regulations and hear updates on industry initiatives, including the Leafy Greens Marketing Agreement and the Produce Traceability Initiative. Speakers will include PMA’s new chief science officer, Dr. Bob Whitaker. We look forward to seeing you at the conference in Monterey.

Supermarkets shouldn’t take comfort from the public’s concern about dining establishments; surveyed consumers gave us an earful about food safety at supermarket foodservice operations. On one hand, only fine-dining restaurants rated higher than supermarkets on consumers’ food-safety confidence scale. On the other, significantly more consumers report having seen a food-safety violation in a supermarket than any restaurant type; 20 percent claim to have seen a supermarket violation versus 16 percent for QSRs and 7 percent for casual dining. (I’m not surprised — supermarket food preparation areas are typically built with far more transparency to the shopper than most dining establishments.)

The types of violations consumers perceive and report most often include spoiled or rotten food, employees not wearing gloves and poor hygiene in food handling. This suggests the confidence they hold in supermarkets also is fragile. It behooves us to double-check where we can further tighten our food-safety practices in our supermarket foodservice operations. On many days, we are today’s household cooks — and there is no room for more Typhoid Marys.

The Rest Of The Story

Although it is easy for us all to agree that everyone should do the right thing, the longer version of Typhoid Mary’s story points to why it is hard to adopt procedures that will actually make that happen.

What most people don’t know about Typhoid Mary is that she was ultimately released from quarantine with one simple condition: She agreed never to work as a cook again.

Not working as a cook, however, put Mary Mallon in the category of an unskilled worker. She was a laundress for a while and had other domestic employment but, ultimately, she went back to being a cook — which was a better paying job.

It is hard to know if Mary Mallon ever really understood or emotionally accepted the risk she posed to others. Mary was what is known as a “healthy carrier” and was seemingly unaware she had ever had typhoid fever — not unusual as a mild case could seem like the flu.

Almost five years after Mary Mallon was released from quarantine, she used an alias and got a job cooking at, of all places, the Sloane Maternity Hospital in Manhattan. Soon there was a typhoid fever outbreak. Twenty-five people became ill and two died.

Although Typhoid Mary was famous, she was not alone. Every year, New York City generated around 100 healthy carriers and only a fraction of them were ever caught. Among those whose livelihood was in the food business, others were also known to have violated their pledge not to work in the food industry.

Making rules is easy. What is difficult is having the policies in place to make sure the rules really are implemented. Let us say a supermarket produce department wants to make sure that whenever an employee is on the floor, his apron is clean. Making the rule may help some, but people will forget. So if a supermarket produce department is serious about wanting clean aprons, the policy will be that the company will launder aprons, it will have aprons pre-positioned by the door and employees will be required to put on new aprons every time they begin a shift or even every time they come on the floor.

Equally, making rules requiring employees to practice food safety is easy; developing the policies and procedures to make it happen is a challenge.

For example, the very first rule of food safety is that if an employee is sick, you don’t want him working. Most organizations, from picking crews to restaurant operators, have a rule such as that. Very few, though, have the kind of sick-leave policies that would make such a decision easy for a worker, especially a lower paid worker such as one at a quick-serve restaurant.

Another example is foodservice workers who wear gloves. In some localities, this is required by code; in other cases, it is a restaurant policy. Yet it is not uncommon to see a worker turn around, while still wearing those gloves, and accept payment or ring someone up.

Once again, making a policy about when to wear and when not to wear gloves is fine. But really, if one is serious, it is a matter of staffing and operational design. In this example, the problem is that one person has responsibility for both food handling and accepting cash. It is eliminating that organizational design flaw that will enhance food safety more than any rule about gloves.

Proper hand washing is perhaps the single most important rule to enhance food safety. Even in the case of typhoid fever, the typical route of transmission is through people who were infected with the typhoid bacillus passing the disease from their infected stool onto food that they were preparing with unwashed or inadequately washed hands. Yes, Typhoid Mary probably transmitted typhoid fever because she didn’t wash her hands adequately or at all.

Now, in most places, it’s the law that employees handling food have to wash their hands. Yet few establishments have taken any practical steps to make sure it happens and is effective. If a bathroom requires someone to touch a door or handle to exit, even a conscientious hand washer may re-infect himself just by leaving the bathroom. Same thing if he has to turn a crank or push a button to get paper towels to dry his hands.

For obvious reasons, monitoring employee behavior in restrooms is problematic, so those organizations serious about hand washing will redesign bathrooms to place the sinks outside the restrooms. This way cameras and other devices can monitor hand washing.

It also turns social pressure on employees and customers alike to wash their hands. For those working in kitchens or food-processing facilities, another effective procedure is requiring everyone to wash their hands when they come into the kitchen and have them do it publicly in plain view of everyone.

What unites all these ideas and more is this: If the industry wants to deliver safe food, the habits of our employees are crucial. Moving those habits in the direction of safety is more than a matter of issuing proclamations; it is a matter of engineering work flow, work place design and compensation schemes all designed to move food safety forward.