Each year, approximately 800 foodborne illness outbreaks are reported in the United States, and about 60% of these outbreaks occur in restaurants. While restaurant inspections performed by local health officials routinely identify food safety risks and violations, the information collected is typically used to address compliance issues at individual establishments, rather than being used as a broader public health surveillance tool.

A new University of Minnesota School of Public Health (SPH) study suggests that restaurant inspection data could be put to a new use—and play a larger role in preventing foodborne illness. By linking restaurant inspection reports with foodborne illness surveillance and outbreak investigations, public health officials may be able to better identify risks, understand how illnesses spread, and develop more effective prevention strategies.

To explore this potential, SPH researchers reviewed studies examining the relationship between restaurant inspection reports and foodborne illness outbreaks. They reviewed research comparing outbreak and non-outbreak restaurants, investigations of individual foodborne illness cases, evaluations of restaurant grading and public disclosure programs, and studies exploring opportunities and challenges associated with linking inspection and illness surveillance data.

Published in the Journal of Food Protection, the study found:

• Restaurant inspections could serve as a valuable form of hazard surveillance. By linking routine restaurant inspection data with foodborne illness surveillance systems, public health agencies may be able to better identify risks, understand transmission pathways, and prevent future outbreaks.
• Restaurants linked to outbreaks often show warning signs before illnesses occur. Across multiple studies, restaurants associated with outbreaks were more likely to have histories of violations related to sanitation, hygiene, handwashing, and cross-contamination, suggesting that inspection findings may help identify conditions that increase the risk of foodborne illness transmission.
• Public disclosure of inspection results appears to improve food safety outcomes. Research from New York City and other jurisdictions found that posting inspection grades in restaurants was associated with improved compliance with food safety standards and reductions in illnesses.

“Foodborne illness surveillance and restaurant inspections share the same ultimate goal of preventing people from getting sick, but these systems are often operating separately,” said Melanie Firestone, SPH assistant professor and lead author. “Bringing them together would allow us to better understand the relationship between food safety violations and illness outcomes, identify emerging risks more quickly, and provide public health agencies with another tool to prevent foodborne illness transmission in restaurants.”

The researchers note that differences in how restaurant inspection data is collected and stored can make broader public health analysis difficult. The study also points out that more standardized and accessible inspection data, along with strong collaboration between food safety regulators and public health researchers and practitioners, could improve efforts to identify risks and prevent foodborne illness outbreaks.