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Should Weights and Risk Categories Be Used for Inspection Scores To Evaluate Food Safety in Restaurants?
03/01/2016
Diogo Thimoteo da Cunha, Veridiana Vera de Rosso, Elke Stedefeldt
The objective of this study was to verify the characteristics of food safety inspections, considering risk categories and binary scores. A cross-sectional study was performed with 439 restaurants in 43 Brazilian cities. A food safety checklist with 177 items was applied to the food service establishments. These items were classified into four groups (R1 to R4) according to the main factors that can cause outbreaks involving food: R1, time and temperature aspects; R2, direct contamination; R3, water conditions and raw material; and R4, indirect contamination (i.e., structures and buildings). A score adjusted for 100 was calculated for the overall violation score and the violation score for each risk category. The average violation score (standard deviation) was 18.9% (16.0), with an amplitude of 0.0 to 76.7%. Restaurants with a low overall violation score (approximately 20%) presented a high number of violations from the R1 and R2 groups, representing the most risky violations. Practical solutions to minimize this evaluation bias were discussed. Food safety evaluation should use weighted scores and be risk-based. However, some precautions must be taken by researchers, health inspectors, and health surveillance departments to develop an adequate and reliable instrument.
Proposal of a new method for the risk scoring and categorization of Brazilian food services
06/01/2022
Fernanda Dineia Viera, Elke Stedefeldt, Patricia Arruda Scheffer, Lidiane Viera Machado, Raísa Moreira Dardaque Mucinhato, Angela Karinne Fagundes De Castro, Thalita Antony de Souza Lima, Diogo Thimoteo Da Cunha
Risk scores are used worldwide to predict foodborne disease (FBD) outbreaks in the food service industry. This study aims to develop and validate a new method for the calculation of the FBD risk score for the checklist used to categorize food service outlets. The proposed novel method is based on a risk score for each item using a risk matrix (consequence × probability), overcoming the limitations of the previous scoring process used during the World Cup in Brazil, which was based on a factorial analysis. The classification of consequences was based on critical points identified by experts prior to the World Cup in Brazil. Probability was defined based on the violation percentage of each item evaluated during inspections from 1536 food service outlets. Validation was performed using a secondary database of 3072 food service assessments in two inspection cycles. The risk scores of the new method were compared with those used during the World Cup. Each food service was classified based on their risk score into four categories: A, B, C, and pending. Good concordance (Lin's correlation coefficient = 0.8711 and 0.9205) was observed between the new and previous scores in the two inspection cycles, respectively. Comparison of the classifications showed substantial agreement (Kappa = 0.749, p < 0.001) to the first inspection cycle and near-perfect agreement (Kappa = 0.821; p < 0.001) to the second inspection cycle. This new method allows the inclusion and exclusion of assessment elements depending on local reality. Simpler methods can be used throughout Brazil and serve as a model for other countries’ food safety assessments.
Food safety of food services within the destinations of the 2014 FIFA World Cup in Brazil: Development and reliability assessment of the official evaluation instrument
03/01/2014
Diogo Thimoteo da Cunha, Ana Beatriz Almeida de Oliveira, Ana Lucia de Freitas Saccol, Eduardo Cesar Tondo, Eneo Alves Silva Junior, Veronica Cortez Ginani, Fabio Tadeu Montesano, Angela Karinne Fagundes de Castro, Elke Stedefeldt
This study aimed to explain the elaboration process of a risk-based instrument to evaluate the hygienic and sanitary conditions and grading of food services in the host cities of the 2014 FIFA World Cup. Twenty-four Brazilian experts were invited for this elaboration. They were asked to determine the likelihood of different food handling situations that could lead to an outbreak. The nominal group technique was used for this purpose. A draft of the evaluation instrument was then created, based on Brazilian good manufacturing practices regulation and the opinion of the food safety experts. The draft evaluation instrument was used to evaluate 354 food services located in 10 cities that will host games as part of the 2014 FIFA World Cup and 141 food services in seven state capitals that will not host the games. In 25 establishments, the application of the evaluation instrument was conducted by two health surveillance auditors at the same time to measure the inter-rater reliability using the kappa statistic. For each item a raw score was determined by the experts and adjusted based on the results of a factor analysis. Approximately 55% of the items exhibited almost perfect agreement, with values between 0.81 and 1.00, and another 26% agreed substantially. The lowest raw score assigned was 10, and the highest was 240. Factor loadings ranging from 0.0001 to 0.6274 were determined for each of the items. Based on the assigned scores, the overall scores of the establishments could range from 0 (all items in compliance with the law) to 2565.95 (all items inadequate) resulting in five classification categories when using the evaluation instrument. In summary, an evaluation instrument to be applied to food services to permit the evaluation and grading of food service establishments regarding the sanitary aspects of food handling has been developed. The release of the results of the evaluation and grading of the food services has the potential to improve the food services in the areas covered by the Brazilian sanitary legislation.
Inspection Score and Grading System for Food Services in Brazil: The Results of a Food Safety Strategy to Reduce the Risk of Foodborne Diseases during the 2014 FIFA World Cup
04/07/2016
Diogo Thimoteo da Cunha, Ana Lúcia de Freitas Saccol, Eduardo Cesar Tondo, Ana Beatriz Almeida de Oliveira
In 2014, Brazil hosted one of the most popular sport competitions in the world, the FIFA World Cup. Concerned about the intense migration of tourists, the Brazilian government decided to deploy a food safety strategy based on inspection scores and a grading system applied to food services. The present study aimed to evaluate the results of the food safety strategy deployed during the 2014 FIFA World Cup in Brazil. To assess food safety, an evaluation instrument was applied twice in 1927 food service establishments from 26 cities before the start of the competition. This instrument generated a food safety score for each establishment that ranged from 0.0 (no flaws observed) to 2565.95, with four possible grades: A (0.0–13.2); B (13.3–502.6); C (502.7–1152.2); and pending (more than 1152.3). Each food service received a stamp with the grade of the second evaluation. After the end of the World Cup, a study was conducted with different groups of the public to evaluate the acceptance of the strategy. To this end, 221 consumers, 998 food service owners or managers, 150 health surveillance auditors, and 27 health surveillance coordinators were enrolled. These participants completed a survey with positive and negative responses about the inspection score system through a 5-point Likert scale. A reduction in violation scores from 393.1 to 224.4 (p < 0.001) was observed between the first and second evaluation cycles. Of the food services evaluated, 38.7% received the A stamp, 41.4% the B stamp, and 13.9% the C stamp. All positive responses on “system reliability” presented a mean of 4.0 or more, indicating that the public believed this strategy is reliable for communicating risks and promoting food safety. The strategy showed positive results regarding food safety and public acceptance. The deployed strategy promoted improvements in the food safety of food services. The implementation of a permanent policy may be well accepted by the public and may greatly contribute to a reduction in foodborne diseases (FBDs).