Editor's Note: For National Public Health Week, the Tacoma-Pierce County Health Department is sharing stories of their work with community partners invested in the health of Pierce County. Here are Kara Ziegler, Environmental Health Specialist, and Rachel Knight, Food Program Coordinator.
I (Kara) began working for the health department in early 2010 in the Food and Community Safety Program as an Environmental Health Specialist, also known as a restaurant, field, or health inspector. Our team has eleven environmental health field inspectors that are each responsible for conducting inspections within our own assigned geographic area. Every restaurant in Pierce County is inspected one to three or more times per year depending on the complexity of the menu being served and their compliance with the food safety code during previous inspections. During the inspections we look for proper cooking and maintaining foods at the right temperatures, contaminated equipment, food from unsafe sources, and employee cleanliness and hygiene … hand washing!
We arrive unannounced and introduce ourselves, although we are easily recognizable with our navy blue smocks and hats with the Health Department logo and our ID badges. After entering the kitchen, we wash our hands to set a good example for employees and to avoid spreading contamination ourselves. Most managers and employees are more than happy to work with us, however in some situations employees quickly hide things and may be confrontational. One time, I was unable to locate the manager for 45 minutes of my inspection until an employee found him hiding upstairs.
During inspections, we cite all major or critical violations found and work to correct the problems. An important part of our evaluation is checking the temperatures of foods known to grow bacteria if left in the danger zone, between 41⁰ and 140⁰ Fahrenheit. For example, if a pan of cooked rice is found in a steam table at 110⁰ F we will work with employees to determine how long the rice has been below the required hot holding temperature of 140⁰ F to help make the decision if it is safe to reheat the rice and continue to serve it, or if it needs to be discarded to protect customers from getting ill.
During an inspection last year at a national restaurant chain location in my area, I introduced myself to the new manager, washed my hands, and began my inspection. It was 11:00 a.m., so the restaurant was just about to hit the lunchtime rush. Shortly into the inspection, I obtained a cooking temperature for some hamburgers coming off the grill. Although hamburgers should always reach a final cooking temperature of 155⁰F, I was surprised to find 12 hamburgers cooked with a minimum cooking temperature of 131⁰F. That wasn’t high enough to kill off any potential E. coli, so we discarded those hamburgers.
The manager offered to cook three more hamburgers for me as per company protocol for checking cooking temperatures. When they came off the grill, the thermometer read 156⁰F, which was in the safe range. Hmmm, perhaps the first batch was an anomaly. I decided to set up my laptop by the grill station to continue making observations. Soon after, 12 more small hamburgers were cooked, and these came out with a minimum cooking temperature of 141⁰F. Houston, we have a problem! We again discarded all 12 hamburgers. There seemed to be a distinct difference in cooking three hamburgers versus cooking 12 hamburgers during a normal lunch rush.
I had the manager make adjustments to the grill to allow the hamburgers to cook longer and cooked another batch of 12 that reached 155⁰F. However, I wasn’t convinced that cooking temperatures would remain at 155⁰F after what I had seen so far. I had the manager adjust the grill one more time and cooked another batch to obtain a final cooking temperature of 158⁰F. The facility was cited for a critical cooking violation and provided a copy of the final report detailing my findings, requirements to meet code, and corrective actions taken during inspection.
Undercooked burgers, especially those served to children, were a serious red flag for me. With the history of the large Jack-in-the-Box outbreak in 1993 resulting in hundreds of illnesses and the death of four children as a direct result of undercooked hamburgers, I knew this could be a bigger issue. Returning to the Health Department, I alerted my direct supervisor to the issue and passed the information along to the entire group during our staff meeting. Rachel Knight, Food Program Coordinator was understandably concerned. I’ll let her finish the story for you.Food Safety by the numbers in Pierce County 3,922 (# of permitted food facilities in Pierce County) 11 (# of restaurant inspectors on staff at the Tacoma-Pierce County Health Department) According to the CDC, 48 million or 1 in 6 (# of Americans who get sick each year from foodborne illness ) 3,000 (# of Americans that die of foodborne diseases each year)
(Rachel) When Kara explained the situation she observed, I had flashbacks to 1993 and pictures of kids in hospitals. We needed to see if this was an isolated incident or something more widespread. Last year another county in Washington had a similar issue but no other reports around the state. The same day as Kara’s report, we had an update from the state to watch for undercooked burgers when inspecting this chain so it was already on my radar.
We produced a list of all the permitted outlets of this chain in Pierce County, and inspectors went to them to check for the problem. Six of them had some issue with undercooking. The next day inspectors recapped the reports, and we found a better trend of correlation between operator knowledge, maintenance of equipment and undercooking.
I contacted staff at Washington State Department of Health (DOH)and gave a quick review of the problems we found in Pierce County, along with the observations, recommendations, and requirements for the chain. A warning was put out across Washington for this chain. DOH also notified neighboring states of the issue and got in contact with the chain representative to start working through the problem.
I contacted the owners of the facilities in Pierce County to explain the issues and our requirements. They agreed that this must be dealt with immediately and were supportive in the actions we needed to take. This is the kind of response we always hope for; that both local and corporate management are cooperative and eager to keep the public safe. We continue to work with the company to ensure the situation is resolved for the long term.
The good news is that we have not had any reported illnesses from this chain. But I don’t think we could have been so confident if it weren’t for our team of inspectors ensuring that it is safe to eat out in Pierce County.