If you’d asked me last week, I probably would have guessed that corner-cutting chefs and contaminated produce were the main causes of food-related illnesses coming out of US restaurants. But I would have been wrong: According to a Centers for Disease Control and Prevention report published on May 29, the biggest known reason customers get sick from eating at restaurants is because workers show up to the job while they’re ill.
The study covered 800 foodborne illness outbreaks reported by 25 state and local health departments between 2017 and 2019. About 500 cases had at least one contributing factor identified, and 205 of those cases (41%) likely involved sick staff handling food. In 555 of the 800 cases, investigators were able to narrow down the infectious substances: salmonella (about 19%) and norovirus (47%) as either a confirmed or suspected factor. Salmonella, the bacteria, is most commonly caused by eating raw or undercooked meat—and salmonellosis, the illness, is contagious in humans. The norovirus, which manifests like a stomach bug, is easily spread from person-to-person via food.
Meanwhile, about 18% of outbreaks were chalked up to contaminated raw food items and 14% were the result of ingredient cross contamination. Ultimately, about 25% of the 800 cases the CDC documented involved sick staff, making this the largest known contributor to all foodborne illnesses.
As a diner, it’s easy to think the obvious solution is that restaurant workers should stop clocking in when they’re ill. But it’s not quite that simple for most. Advice from the study authors, opinions of independent experts, and current Twitter discourse is, in a rare turn of events, seemingly aligned: An expansion of paid sick leave at restaurants is essential to keep ill workers from, well, working. But fewer than half of the restaurant managers (44%) surveyed by the CDC offered paid sick leave for their employees, which means staff have to grapple with the choice between earning a paycheck that day and potentially infecting their customers or colleagues.
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“Food service workers face really impossible trade-offs around issues like working sick because food service jobs are so low-paid in our economy,” Daniel Schneider, a professor of social policy at the Harvard Kennedy School, told The New York Times. The CDC report did mention that its findings were based on information collected before the pandemic—a period when the treatment of restaurant workers came under greater scrutiny—and said that many retail food establishments have since changed at least some of their sickness-related policies.
Still, about one in six Americans contract a foodborne illness each year, and 3,000 die. Restaurants have long been considered a major source of spread, and though some states mandate paid sick leave, the US is the only wealthy country on earth with no federal policy—a sobering fact that disproportionately impacts service workers. That same lack of safety net is also making diners sick, as the CDC report indicated. Studies like this “show the real urgency of [paid sick leave],” Schneider told the Times, “not just because it’s in workers’ interests, although it is, but because it is in the public interest.”
