Restaurant workers not washing hands is a big health risk. See the Phoenix-area places with the most violations

This spring, a Maricopa County health inspector reported that a worker in a restaurant moved a trash can with gloved hands and then worked with ready-to-eat food without washing their hands or changing their gloves.

It was a routine weekly inspection visit to Taco Papi in Scottsdale, a restaurant that serves authentic Mexican food.

And it's a common problem.

At a Sbarro in Tempe, inspectors visiting in June saw a worker touch their face while eating and then handle food without washing their hands.

This month, an inspector saw an employee at The Oink Cafe in Phoenix handle dirty dishes and then touch clean dishes without first their washing hands.

Restaurant workers not washing their hands properly, not washing them at all or using bare and unwashed hands to touch customers’ ready-to-eat meals are some of the most common health violations across restaurants and other food serving establishments in Maricopa County.

Look 'em up: Check your favorite dining spots in The Republic's new restaurant inspection database

A review of inspection records from the past year shows that one in five priority violations relate to these. Priority violations are major violations that directly contribute to an increased risk of foodborne illness or injury for restaurant customers.

There are dozens reasons a restaurant can receive a priority violation — the most common involves food temperatures, but handwashing is the next most frequent.

As pedestrian as it may seem, lack of hand hygiene is the greatest risk to the public for spreading pathogens from one person to a large number of people. Two of every five foodborne illnesses originate from restaurant workers, according to the CDC.

In May, a multi-state outbreak of salmonella sickened 109 people in 29 states, including Arizona. Another outbreak in June spread to 28 states and put 64 people in the hospital. Salmonella is the No. 1 foodborne pathogen that puts people in the hospital, according to the CDC. It's unclear whether anyone was sickened in a restaurant.

Still, a single salmonella case does not give the whole picture. For every one case, there are about 30 not reported, according to the CDC. Many people recover without medical care and are not tested for salmonella.

The CDC says such outbreaks are easily controlled with proper hand washing. But many Maricopa County restaurants repeatedly fall short.

In the past year, about 90 restaurants and other food-serving establishments in the county have had at least two violations related to unsanitary handling of food. Five of those with more than two violations are in Scottsdale. Some restaurants have as many as four violations.

None of the restaurants mentioned in this article responded to requests for comment.

What the FDA food code mandates

Maricopa County inspectors follow the FDA's Food Code, which requires restaurant workers to wash their hands and put on fresh gloves before touching ready-to-eat food. They are never supposed to touch such food bare handed. Food handlers also are supposed to wash their hands after handling raw meat, cleaning up spills or carrying garbage, even if they were wearing disposable gloves for those tasks.

For instance, a restaurant worker who goes from touching cash to touching raw meat to serving sandwiches to picking up a clean plate is expected to wash their hands with soap three times during the course of these tasks, with each hand wash lasting at least 20 seconds.

But how realistic is it for restaurant workers to keep track of rigorous handwashing rules in a busy restaurant when an inspector is not in sight?

Andy Linton, a deputy director for Maricopa County Environmental Services, said this is why the department focuses on teaching restaurants to put in place a functional food-safety system to keep the public safe even when inspectors are not around.

One solution is having multiple workers for the different tasks, he said.

“If one person is dedicated to making salads or cutting vegetables or handling ready-to-eat foods and not going in between tasks, then they won’t have to be washing their hands a lot,” he said.

Maricopa County inspectors have seen this method used across many restaurants and believe it works. Linton said the county is in support of whatever any restaurant does to ensure public safety.

The association representing restaurants in the state said having one worker for each task isn't a burden on the establishments.

"Preventing foodborne illness is good business," said Dan Bogart, chief operating officer of the Arizona Restaurant Association.

A risk management plan that ensures separation of duties is the standard in a majority of restaurants in state and does not necessarily mean employing more workers than usual, he said."There's going to be instances where a policy or procedure is not followed or something is overlooked, and that's just where having a good, active managerial control in place will catch those and help correct them," Bogart said.

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Shutting down repeat violators an unlikely outcome

Even though the county can shut down a restaurant with repeat violations, it's unlikely to happen.

“We are not out to shut down businesses,” said Johnny Diloné, a spokesperson for the Maricopa County Environmental Services. “Our job is to protect the public; we try to work with restaurants as partners in achieving this.”

He said when inspectors find a violation, they work with restaurant managers and employees to fix the problem and avoid repeating it. A restaurant only risks a shutdown if it repeats the same violation multiple weeks in a row.

While the shutdown of restaurants with multiple handwashing violations isn't common, the Arizona Department of Health Services says it has a robust surveillance program to track suspected foodborne infections.

A spokesperson for the Arizona Department of Health Services said salmonellosis, the infection caused by the salmonella bacteria, usually resolves itself without treatment.Salmonella "can be more serious in individuals who are immunocompromised, as well as newborns, infants and older adults," she said.

When salmonellosis is suspected, an establishment must report it to the health department. That's the same for campylobacteriosis, shigellosis, and e coli.

'There is risk outside restaurants'

While hand hygiene is critical in restaurants because they are points of contact for many people, those who cook at home are possibly at higher risk than restaurant patrons, said Traci Grgich, an associate teaching professor at Arizona State University.

“Someone preparing food at home without any food safety knowledge is taking more risks with their own health than going to a restaurant that at least has managers and staff educated on food safety procedures and methods,” said Grgich, who directs ASU’s Didactive Program in Nutrition.

Grgich said immunocompromised people should be careful when choosing what to eat when they eat out or at home.

Symptoms of salmonella to watch out for

The CDC advises anyone with the following symptoms to call their healthcare provider right away:

• Diarrhea and a fever higher than 102F
• Diarrhea lasting more than three days that is not improving
• Bloody diarrhea
• So much vomiting that you cannot keep liquids down
• Signs of dehydration, such as:
  • Not peeing much
  • Dry mouth and throat
  • Feeling dizzy when standing up

To report any foodborne illness in Maricopa County, go to https://www.maricopa.gov/5114/Food-Restaurants .

Reach reporter Kunle Falayi at olakunle.falayi@gannett.com or 480-268-1504 .

This article originally appeared on Arizona Republic: Restaurant workers not washing hands is a big health risk. See the Phoenix-area places with the most violations