By: Heather Williams

We put a lot of trust in the people who prepare and serve our food.  We expect that our food is safe to eat and handled appropriately.  In the United States, we have standards for food safety and many regulations in place.  Why wouldn’t we trust those who prepare and serve our food?  Unfortunately, a significant number of food workers have admitted to working while knowingly being sick.  There are many reasons someone might do this.  Some do it for financial reasons, others for sense of duty, and then there are some who fear they may lose their job if they do not cover their shift.  Could foodborne illness cases dramatically decrease if food workers could have sick leave, which would allow them monetary compensation for identifying their illness and not passing it on to other unsuspecting patrons? Let”s explore this.

Restaurants Are a Primary Source of Foodborne Outbreaks

According to the Center for Disease Control and Prevention (CDC), an estimated 48 million people become ill in the United States each year from foodborne infection.  Approximately 128,000 are hospitalized and foodborne illness claims about 3,000 lives each year.  Over half of all foodborne outbreaks reported to the CDC can be linked back to eating in restaurants or delicatessens.

In one study, a group of investigators gathered data from FoodNet.  This resource is also known as the Foodborne Diseases Active Surveillance Network, a central databases where participating sites report information regarding foodborne illness.  In a study analyzing 457 foodborne disease outbreaks, 300 were restaurant related.  98% of the 300 had only one contributing factor causing the outbreak.  The most common contributing factor resulting in 137 outbreaks was “handling by an infected person or carrier of pathogen.”  This is a significant number considering one lapse can have such high statistical repercussions.

The purpose of the study was to identify the contributing factors in restaurant-linked foodborne disease outbreaks. 75% of the outbreaks investigated were linked to Norovirus and Salmonella. These infections were predominately linked back to transmission by food workers.  Significant resources are devoted to preventing contamination of food products before they make it to the point of service.  Restaurants must ensure that staff have adequate training and understanding for how to handle the food once it becomes in their custody.  Food worker health and hygiene were primary factors in contributing to foodborne illness.

Why Do Food Workers Work While Sick?

Another CDC study was designed to poll food workers about their experiences of working while sick.  Study participants were asked what happened the last time they worked while they were sick, why they worked while they were sick, and what affected their decision to work while sick.

More than half (60%) of those who were polled admitted to having worked while being sick.  Luckily a large portion took additional steps to not pass on their foodborne illness while at work.  In fact, one in five reported that they did not handle food at all while sick.  One in three discussed washing hands more frequently.  According to the study, almost all of those who worked while sick admitted that it was their own decision and not the managers to work while sick.  Four in ten even admitted their manager did not know what their symptoms were.

When asked why the food worker decided to work while being sick, a variety of answers were given.  Some said that the restaurant did not offer paid sick leave or have a sick leave policy available to the staff.  Others claimed that the restaurant was shorthanded and there was no one else that could take their shift.  Some admitted that they did not feel they were very sick and thought that they would not pass their illness on to anyone.

The study asked questions to identify factors that affected the food worker’s decision to work while sick.  Seven in ten employees cited the severity of symptoms and the possibility of making other people sick affected their decision.  Six in ten noted that their dedication to their jobs and not wanting to leave their co-workers short-staffed played into their decision.  Half of the food workers considered not getting paid in their decision and one in four explained that fear of losing their job contributed to their decision.

Sick Employee Policies

All restaurants should have a sick employee policy.  Local and state health departments have requirements in place preventing a manager from allowing an employee to work with food while contagious and sick.  According to the FDA there are five illnesses that pose the biggest threats to restaurants due to their higher risk to pass onto others.  This list includes E. coli, hepatitis A, shigella, Salmonella, and norovirus. In 2009 the FDA published a Food Code that specifically states that any employee diagnosed with any of these “Big 5” illnesses must be reported to the local health department immediately.  This food code also provides guidelines and restrictions for sick employees with these specific illnesses that should be included in the restaurants sick employee policy.

Could Sick Leave Reduce Foodborne Illness?

If you are connecting the dots, studies have shown that foodborne illness is primarily linked to restaurant exposure.  The majority of restaurant foodborne illness results from sick employees.  A primary reason sick employees report to work at a restaurant is for financial reasons, citing fear of losing their income and in many cases fear of losing their job all together.  A Sick Employee policy that covers all of these variables could considerably reduce the number of foodborne illness.

Of course there is always one driving factor.  The factor that governs most business decisions.  Money.  There is a corresponding cost of course that goes along with paying an employee who is not working.  It goes without saying that anyone on the outside of payroll could argue that bad press and negative reviews certainly costs more than paying for an employee to stay at home until no longer contagious.  But sometimes businesses gamble with even higher stakes at play.

Another factor comes into consideration.  Many states do not use a typical wage when it comes to food workers.  For example, Texas has a special category for employee minimum wage for “tipped employees” at $2.13 per hour, with a minimum that brings the wage to the federal minimum wage of $7.25 after tips are included.  For a tipped employee, they are generally guaranteed the minimum wage, but often count on additional tips to bring up their income to a living wage.  If a restaurant paid an employee sick leave based on the federal minimum wage, there would still be an incentive for the employee to not self-report illness to achieve a higher rate of pay.  There really is no good way to solve this problem; however some pay is better than no pay and certainly removing the fear of self-reporting would reduce incidence of foodborne illness.

For now, we hope that both the employee and the restaurant behave responsibly when it comes to preventing illness and hopefully this means that a better effort at preventing others from become sick maintains a high priority.