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To combat outbreaks at restaurants and other dining establishments, policies that support sick workers, including paid leave, may be needed, the agency said in a report this week.
People who showed up to their restaurant jobs while sick were linked to 40 percent of food poisoning outbreaks with a known cause from 2017 to 2019, the Centers for Disease Control and Prevention said in a report released on Tuesday.
Paid sick leave and other policies that support sick workers could improve food safety outcomes, according to the report, which was based on a review of 800 food poisoning outbreaks, using data provided by 25 state and local health departments.
Of the 500 outbreaks where investigators identified at least one cause, 205 involved workers showing up sick, the report said. Other common causes included contaminated raw food items, in 88 cases, and cross-contamination of ingredients, in 68 cases.
In 555 of the outbreaks, investigators were able to determine what virus, bacterium, toxin, chemical or parasite was to blame. Most outbreaks were caused by salmonella or norovirus, the report said.
To combat these outbreaks, “comprehensive ill worker policies will likely be necessary,” the report said. It highlighted research that showed that expanded paid sick leave reduced how often food service workers showed up at work sick, and noted that paid sick leave regulations were associated with decreased rates of food-borne illness.
Daniel Schneider, a professor of social policy at the Harvard Kennedy School, said the report was “sobering,” and highlighted that the United States is the only wealthy country with no federal paid sick leave.
“Reports like this show the real urgency of it, not just because it’s in workers’ interests, although it is, but because it is in the public interest,” Professor Schneider said.
Of the 725 managers who were interviewed by state and local health departments, 665 said that their business required food workers to tell a supervisor if they were sick, and 620 said that sick employees were either restricted or blocked from working. Fewer than half of the managers — 316 — said their business provided paid sick leave to workers.
Professor Schneider is a director of the Shift Project, which collects data about people in the retail and food service industries. He said that workers said they showed up sick because there was nobody able to cover for them, they would feel guilty leaving their co-workers short-handed, they couldn’t afford to miss work or they feared retaliation from management.
“Food service workers face really impossible trade-offs around issues like working sick because food service jobs are so low-paid in our economy,” he said.
To discourage workers from showing up sick to their jobs at restaurants, catering businesses and food trucks and carts, businesses may need to better enforce existing policies, such as those that prohibit workers from coming in sick; come up with plans to staff a restaurant when someone calls out sick; and adopt “a food safety culture where absenteeism due to illness is not penalized.”
While the health departments providing information on outbreaks represented “geographically diverse areas,” the report cautioned that its findings might not be representative of all U.S. outbreaks. It also said that it was based on information that was collected before the coronavirus pandemic and acknowledged evidence that many retail food establishments had since changed at least some of their policies.
Each year, 48 million people become sick from a food-borne illness, according to C.D.C. estimates. Of those, 128,000 are hospitalized and 3,000 die.