The Rest Of The Story

By Jim Prevor, Editor-in-Chief, Produce Business

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 the 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 workflow, workplace design, and compensation schemes all designed to move food safety forward.