Eat, drink, and be …?

BMJ 1995; 310 doi: (Published 22 April 1995) Cite this as: BMJ 1995;310:1075
  1. Bernard Dixon

    Should we report dodgy looking foods and food shops to the authorities? Public spiritedness surely demands that we contact the local environmental health officer whenever we spot a suspect pie, a grubby meat counter, or a chilled compartment that is nothing of the sort. Yet how many of us take no action at all on these occasions—other than to avoid suspect premises in future, perhaps? No one relishes being a telltale.

    Now, it seems, sneaking may not necessarily make any difference, in Britain at least, because the visual inspections of food shops carried out by environmental health officers are far less meaningful than might be imagined. Indeed, there seems to be no correlation whatever between the risks of particular samples of food causing infections and the “inspection ratings” that are supposed to indicate those very dangers.

    The new evidence comes from a survey carried out by Susan Powell and Richard Attwell, of Manchester Metropolitan University, in 10 retail food premises. Two of these belonged to national supermarket chains; the others were small to medium sized delicatessens. In the interests of consistency, the same officer inspected each of the premises and completed the standard risk assessment form provided under the current UK code of practice (number 9) for food hygiene inspections (CP9), established under the Food Safety Act of 1990.

    The assessment form is a detailed document, covering everything from the types of food and methods of handling and processing to the structure of the building, temperature control, ventilation, and general cleanliness. Each of six different components is assigned a numerical value; taken together, these values provide an overall rating. This is supposed to reflect the risk of infection associated with food obtained from particular premises.

    In the second part of the study, staff at the regional public health laboratory measured the total numbers of viable bacteria, and specifically those of Staphylococcus aureus, in food samples from the 10 premises. Such counts are routinely used to indicate the potential hazard of foodborne disease(s). The foods tested were cooked turkey and cooked ham sliced on the premises.

    As Powell and Attwell report in the current issue of Epidemiology and Infection (1995; 114:143), their results show that the environmental health officer's visual inspection—doubtless carried out with the utmost competence under CP9—gave no indication at all of the risks to consumers purchasing foods from the 10 premises. Not only did the bacteriological quality of the turkey and ham not correlate with the overall inspection rating, it did not correlate with any individual part of the rating.

    “These results call into question the ability of the visual inspection scheme specified in CP9 to assess the potential risk of foodborne infection,” the investigators conclude, with what many happy eaters will see as canny understatement. They argue that certain criteria, such as inadequate temperature control, and practices likely to facilitate cross contamination, should be weighted when compiling the inspection rating.

    Powell and Attwell's logic is surely impeccable. That of the British government is rather more difficult to fathom. Unsurprisingly, the government has already recognised the shortcomings of the CP9 and has made amendments which are due to become operational this year. But these affect only the guidance which is given to environmental health officers. The scoring system itself remains unchanged.—BERNARD DIXON, European contributing editor, Biotechnology

    View Abstract