Understanding the relation between establishment food safety management and Salmonella risk factor violations cited during routine inspections

Restaurants are a frequent setting for outbreaks and sporadic cases of Salmonella. The relationship among food safety management characteristics, compliance with procedures to reduce Salmonella-associated risk factors (as found during routine inspections), and the likelihood that an establishment has experienced a sporadic Salmonella case was assessed. Individual risk factor violations associated with Salmonella transmission pathways were identified by a literature review. Data from 546 routine inspection reports collected from July 2016 to June 2017, including 25 from restaurants that had experienced a sporadic case of Salmonella, were evaluated. In restaurants with certified food managers, there were fewer observations of Salmonella risk factor reduction procedures that were not in compliance. For establishments that had experienced sporadic cases of Salmonella, the person in charge at the time of an inspection was less likely to have been the establishment's official certified food manager of record (rate ratio = 0.4, 95% confidence interval = 0.2 to 0.8; P = 0.01), and there was increased likelihood of being found out of compliance for prevention of contamination by hands (rate ratio = 3.7, 95% confidence interval = 1.4 to 8.1; P = 0.001). The results of this study warrant future research on the dynamics of food safety management systems, the effect they have on risk factor violations cited on routine inspection results, and the risk for transmission of Salmonella. Analyzing routine inspection data as hazard surveillance may be useful to identify food establishments at a greater risk for transmitting Salmonella infections.