| Description |
The purpose of this study was to examine the effectiveness of health department interventions and procedures in reducing the occurrence of specific critical violations identified during routine restaurant inspections. Interventions included in the analysis were internet posting of restaurant inspection results, announced routine inspections and follow-up inspections. This study uses a longitudinal analysis of inspection results from restaurant inspections conducted by the Salt Lake Valley Health Department between January 1, 2008 and April 30, 2011. Bivariate methods were used to assess the changes in the proportion of inspections during which the restaurant was cited for the target critical violations. The occurrence of five specific, FDA defined, critical violations were included as outcome measures: poor hygiene practices, improper holding temperatures, inadequate equipment cleanliness, lack of protection from cross-contamination, and improper sanitizer concentration. The probability of having a violation decreased in routine inspections conducted after the website launch when adjusted for inspector experience, risk level and seasonality. The adjusted odds ratios, ranging from 0.64 to 0.80, were statistically significant for all critical violations, with the exception of cross-contamination which was borderline significant (p=0.053). The largest effect was found in equipment cleanliness violations (aOR=0.64). Announced inspections were associated with significant reduction in the odds of personal hygiene (aOR=0.11, p=0.00) and equipment cleanliness (aOR=0.19, p=0.00) violations after adjusting for food type, visible kitchen, outside quality assurance, season and standardized inspector. An assessment of follow-up inspections revealed the proportion of inspections with a violation was greater among those restaurants which had a previous follow-up inspection as compared to those inspections that did not have a previous follow-up inspection (range of difference = 6.98% - 22.46%) for each of the five critical violations. The risk of having a violation increased for all targeted critical violations during inspections conducted after a follow-up inspection compared to restaurant inspections without a prior follow-up, when adjusting for restaurant type, inspector experience and season. The adjusted odds ratios were significant for all target violations (aOR range = 1.67 - 1.96) with the largest odd ratios associated with personal hygiene violations (aOR = 1.96, p<0.001). |
