of deficiencies linked to CDC foodborne ill- ness risk factors and reduce foodborne ill- ness on military installations. Future research could use ratings of defi- ciency severity (i.e., critical or noncritical) to determine a more detailed level of food service sanitation and safety operations. Fort Liberty could reinforce food safety training requirements by meeting with directors of all major food service facility categories to discuss deficiency findings and food safety training shortcomings. This meeting could include food safety training templates or programs the facilities could implement to reinforce food safety knowledge among PICs and FSEs. Fort Liberty could also implement standard operating procedures for facilities inspected by DPH and/or establish a policy to publish food facility inspection ratings to the military installation population. These actions could incentivize facilities to increase their food safety knowledge, poten- tially reducing identified deficiencies within their facilities. A facility with repeated defi- ciencies in missing food safety training or other deficiencies could be temporarily man- dated to cease operations until the facility rectifies the issues. Acknowledgment: We thank the Fort Liberty DPH for its cooperation in granting access to the data inspection reports used in our study. Corresponding Author: Stephanie L. Rich- ards, MSEH, PhD, Environmental Health Sci- ences Professor, Graduate Program Director, Department of Health Education and Promo- tion, College of Health and Human Perfor- mance, East Carolina University, 3403 Carol Belk Building, 300 Curry Court, Greenville, NC 27858. Email: richardss@ecu.edu
FIGURE 3
Deficiencies in Food Safety Training and Foodborne Illness Risk Factors by Facility Type at Fort Liberty, 2021
Elementary and Middle Schools (8) Mobile Food Unit and Truck Vendors (21)
Childcare Facilities (17) Military Cafeterias (14)
Fast Food and Retail Establishments (64)
0 100 200 300 400 500 600 700 800 900
Missing Training
Poor Personal Hygiene
Food From Unsafe Sources
Inadequate Cooking
Improper Holding Temperatures
Contaminated Equipment
Deficiencies
Recommendations and Conclusion
Limitations Limitations of our study include using a fixed sample from Fort Liberty. Our study was cross-sectional rather than longitudinal in that inspections in a specific year were included. Data were collected from facilities at a specific point in time versus collecting data repeatedly from the same population over an extended period. Our study also relied on secondary data from standardized inspection reports, and thus there could be variations in the interpretation of individual inspectors who collected the data. Further- more, our study observed the quantity (i.e., presence or absence) rather than severity of deficiencies. If the severity of each deficiency was rated, analyses could determine the num- ber of deficiencies with a more severe impact on food safety and sanitation and the poten- tial for foodborne illness outbreaks.
Food safety training requires reinforce- ment and hands-on application. If FSEs are not continuously observed and pro- vided hands-on training with opportuni- ties to apply what they have learned, they might not adhere to training, guidelines, and regulations for reducing deficiencies. Additional work should be done to improve behavioral-based food safety training to encourage implementing, retaining, and applying food safety training among DoD food facilities in the U.S. Moreover, existing food safety training programs across other military installations should be compared to evaluate the extent to which trends and potential mitigation could overlap. Mainte- nance of the required food safety training by FSMs and FSEs could minimize the number
References
Brown, L.G., Le, B., Wong, M.R., Reimann, D., Nicholas, D., Faw, B., Davis, E., & Selman, C.A. (2014). Restaurant manager and worker food safety certification and knowledge. Foodborne Pathogens and Disease , 11 (11), 835–843. https://doi.org/10.1089/fpd.2014.1787 Centers for Disease Control and Prevention. (2018). Estimates of foodborne illness in the United States . https://www.cdc.gov/ foodborneburden/2011-foodborne-estimates.html
Centers for Disease Control and Prevention. (2024). Restaurant food safety: Research partners . https://www.cdc.gov/restaurant-food- safety/php/practices/research-partners.html Conference for Food Protection. (2024). Food protection manager certification . https://www.foodprotect.org/food-protection-manager- certification/ Defense Health Agency, Public Health. (2018). Food safety . https:// ph.health.mil/topics/foodwater/ifs/Pages/default.aspx
continued on page 26
25
January/February 2025 • Journal of Environmental Health
Powered by FlippingBook