GENERAL ARTICLES

Look Out When You Eat Out

This article is not nice. It doesn’t apply to clean restaurants. But far too many dirty restaurants endanger your health—and your life

SIDNEY KATZ March 15 1947
GENERAL ARTICLES

Look Out When You Eat Out

This article is not nice. It doesn’t apply to clean restaurants. But far too many dirty restaurants endanger your health—and your life

SIDNEY KATZ March 15 1947

Look Out When You Eat Out

SIDNEY KATZ

This article is not nice. It doesn’t apply to clean restaurants. But far too many dirty restaurants endanger your health—and your life

ONE AFTERNOON last winter the doctors in a Saskatchewan town had an unusually busy time. Twenty people had sent out an urgent call for medical assistance. They all displayed the same symptoms: extreme nausea and violent vomiting accompanied by persistent diarrhoea.

Investigation revealed that all the patients had eaten their noonday meal at a certain restaurant. When the medical officer of health visited the restaurant’s kitchen, he seized the remains of a suspicious-looking dessert, pineapple trifle, and ordered the establishment temporarily closed.

In the provincial laboratories in Regina, where the pineapple trifle was analyzed, Dr. H. S. Doyle, director of the Division of Communicable Diseases, discovered that the food was teeming with harmful bacteria known as staphylococcus aureus.

“When some of the bacteria recovered from the food was injected into a kitten,” reported Dr. Doyle, “the animal became ill in less than two hours and died 36 hours later.”

It was later revealed that the dessert had been held for 18 hours unrefrigerated, prior to serving. As every food handler should know, moist mushy foods, if contaminated, are excellent breeding places for germs and should never be left at room temperature.

Unfortunately such incidents of neglect in food handling are all too frequent in Canadian cities and towns. Despite the existence of sanitary codes and health inspectors, poor sanitation in some restaurants, dining rooms, soda fountains and refreshment booths continues to spread disease—and sometimes death.

It has been estimated that we eat 550 million restaurant meals a year. We eat them in surroundings which range from small unpretentious hamburg joints to elegant dining rooms with linen tablecloths and English bone china.

Which of these eating places endangers your health?

We Have a Long Way to Go

FOR THE past several weeks I have been investigating restaurant conditions in Canada. I have spoken to municipal sanitary inspectors and accompanied them on their rounds. I have interviewed provincial health authorities and restaurant owners and workers. I have called on bacteriologists to discuss reports of food poisoning that have appeared recently in the public health journals.

From them I learned that we still have a long way to travel to eliminate all the dangers of eating out. I found that a minority of eating places are scrupulously clean, while the rest vary from partially clean to downright dirty.

Do not imagine for one moment that our public health authorities are not aware of this problem of filthy eating establishments. Indeed, there are many hopeful signs that we are starting a real nation-wide cleanup.

Take the two largest cities in Canada. During 1946 in Montreal, inspectors made 43,620 visits to premises where food is served, stored and sold; they condemned 357,820 pounds of foodstuffs, ordered numerous improvements and took 292 court actions against unsanitary establishments. In Toronto, last year, a corps of eight sanitary inspectors made monthly rounds of local eating places and insisted on 1,022 improvements.

The Canadian Restaurant Association is making a determined effort to safeguard public health.

Headquarters of the association in Toronto regularly bombards its 1,200 members—probably less than 10%, of the total number of eating places in Canada—with reports, booklets and other data on how to combat filth. At present the association as well as many nonassociation restaurants are cooperating with the Health League of Canada in establishing food handler’s schools in many communities.

The food handler’s school program is under the direction of Dr. Roger G. Knipe of the Health League, and aims to reach every individual in the restaurant business—from dishwasher to owner— and show them good food-handling technique by means of speakers, demonstrations and moving pictures.

All these efforts aimed at improving restaurant sanitation are commendable, but there are still too many eating establishments where you can’t have a meal without a risk.

Here are some of the things I found in the course of my investigations.

A few months ago, workmen on a construction job near Toronto were in the habit of going to a nearby cafeteria for their midday meal. One day,

14 men who consumed egg .salad sandwiches became ill. Five required hospitalization. According to a provincial health authority, the man who made the sandwiches had an open sore on his finger. The germs from the finger entered the filling, multiplied, and caused the poisoning.

Shortly before last Christmas several people in a western city interrupted their shopping to have a snack in a restaurant. More than 50 diners became violently sick a few hours later. Doctors blamed the epidemic on the chef who made the salad dressing: he had failed to wash his hands

after visiting the bathroom.

In a city in the Maritimes, two women were stricken with a high temperature which doctors quickly diagnosed as typhoid fever. When nine more cases were reported during the next month, alarmed health officials, inaugurated an intensive search to find the source of infection. A public health nurse entered the kitchen of a local restaurant and saw something that horrified her.

There, handling food, was a known typhoid carrier. Her history as a carrier went back 23 years. She had given typhoid fever to relatives and neighbors. Yet this woman, Continued on page 66

Continued on page 66

Look Out When You Eat Out

Continued from page 9

capable of starting an epidemic singlehandedly, was touching the food that reached the mouths of hundreds of people each day.

In one restaurant, in a large Canadian city, employees coming to work at 6 o’clock in the morning would often surprise the rats who scurried to cover across rows of pies. In a department store eating place in the same city, one of the girls quit after a rat bit her.

The rat carries some of man’s worst diseases. As host to these diseases, the rat and his parasites introduce them to the human body with dangerous results. His repertoire includes typhus fever, ratbite fever, infectious jaundice and trichinosis.

A short time ago, a public health expert, while eating on one western lunch counter, watched a waitress remove a glass, empty a few inches of water that had not been drunk, refill it, and hand it to a patron who had just sat down. The girl was surprised when the health official reprimanded her.

An apparently shining but unsterilized glass can transmit common cold, influenza, septic sore throat — and worse. To quote Dr. Thomas Parran, Surgeon General of the United States Public Health Service, “The spirochete (which causes syphilis) has been found on a glass half an hour after inadequate rinsing.”

In another community, George A. DeVuyst, an executive member of the Canadian Restaurant Association, visited a number of establishments that provided lunch-counter service.

' “Restaurants require washrooms and other food facilities,” he Sported, in the Hotel and Restaurant Magazine, March, 1946, “poolrooms and lunch counters don’t provide these facilities. A shoe shiner is cleaning «boots at one time. Next you’ll see him behind**

bar handing someone a hot dog. ‘ In poolrooms, no waiters or waitresses are required. The boy who racks the balls also serves hot dogs and hamburgs. Even at that he has no place to wash his hands.”

An unwashed hand can be contaminated with the organisms of respiratory and intestinal diseases. Any of these diseases may be yours—without the asking — when an unwashed hand touches your food.

What We Feed Tourists

Canada is rightly taking a lot of trouble to attract tourists; we spend thousands of dollars abroad, singing the praises of our mountains, lakes and forests. But how about our eating facilities? The following cases are taken from the files of the Department of Health of Ontario—a province whose record in health matters is as good as any in Canada:

In one summer hotel, 30 people fell ill after eating the remnants of a pie that had been standing at room temperature for 24 hours. The man who chopped the filling had a cut on his finger that contaminated it. In the same district, at a summer camp, 25 youngsters became ill after eating jellied tongue. The cook’s infected arm was the cause of the epidemic.

A traveller who visited two roadside refreshment booths on a 20-mile stretch of highway reported that at one place the meat was sliced with a knife thick with filth; at the other, hundreds of flies hopped around pies and pastries which lay around unprotected.

“Few roadside booths are adequately equipped with refrigeration,” Dr. J. T. Phair, Deputy Minister of Health for Ontario, told a 1946 convention of Canadians interested in tourists. “Many are operated by people whose standard of cleanliness and sanitation is negligible . . . they are not the slightest bit interested in either the quality of the food they sell or the health hazards associated with the selling of it.”

Many people choose a restaurant by “eye appeal.” But, as one chief sanitary officer recently observed, “The 24-carat exterior of many restaurants does not always extend to the core of any restaurant—the kitchen.”

Tricky plastic fronts and chrome fittings are often desirable because they are easily kept clean. But the cautious restaurant patron should also concern himself with such questions as: Is the food stored in a clean place? Are cooking utensils kept spotless? Have employees a sanitary bathroom with washing facilities nearby? Is the garbage kept out of the way in sturdy ratproof containers?

Consider one popular restaurant which serves over 1,000 meals a day in one of our large Canadian cities. It was proud of the lush pastries and cakes from its own bakeshop.

The local sanitary inspector was startled by what he saw when he visited “our own bakeshop” one day. Mucky grease and dirt, one quarter of an inch in thickness, covered the mixing machine which smelled as if it hadn’t been cleaned in years. Raw materials were stored in makeshift bins; sticky masses of raisins and bags of flour were in.filthy condition.

In another restaurant I asked the waitress who served me why the food was so often dirty. She told me that when the regular kitchen became too small, the boss moved some of the worktables where food was prepared to the cellar beside the furnace. It was not unusual to have the food sprinkled with sprays of furnace ashes and dust.

In an eastern city, one large restaurant stored potatoes in a corner of

the basement. The rats visited regularly every night. “It’s no problem,” explained the dishwasher. “We just cut away the part that’s been gnawed at and use the rest.”

Failure to maintain the walls, floors, and ceilings of an eating establishment in good condition can endanger the health of the people who eat in it. In one prairie restaurant, the waitress blithely swept the cracked linoleum flooring, sending up clouds of dust which settled on the food of the 20 or 30 customers. In another town the sanitary inspector received a complaint about odors which came from a lunch counter next door. Investigating he found the kitchen so poorly ventilated that heat and moisture caused the paint on the ceiling to loosen and fall into the food as it was being prepared.

Washrooms have always been a sore spot in restaurant sanitation. It is essential that clean, well-equipped washrooms be provided for both patrons and employees. But are they?

I walked into a large restaurant on one of the main streets in Montreal early one morning and visited the washroom. The sight and smells that met me turned my stomach, and I’m not squeamish. Toilets were blocked, the floors were littered and the washbasins littered with grime. It had evidently been in that condition since the previous evening.

The chief sanitary inspector of an Ontario city recommended that one restaurant be closed up. Here’s the way he described the washroom: “It was

downstairs and in very poor condition. Whißky and beer bottles and all kinds of different articles were always found in it. There was no hot water, there was no soap, the washbasin was always dirty, but he always had paper towels. That was the joke about it.”

Medical men are, quick to point out that the washroom can be the starting point of a half-dozen life-endangering diseases. The restaurant operator who does not provide clean toilets, hot and cold running water, clothes hooks, toilet paper, soap and individual towels is waging deadly bacteriological warfare on the public.

How Germs Multiply

“Food poisoning,” or “ptomaine poisoning” as we incorrectly call it, is rarely caused by eating food that has been poisoned. Most cases of food poisoning are really food infections caused by germs. Someone handling the food or working in the kitchen manages to transfer the disease germs to the food.

Two men were admitted to hospital in Hamilton suffering with severe cramps and vomiting. They had both eaten pie at a downtown restaurant a few hours previously. Hospital bacteriologists discovered staphylococci aureus in the patients’ vomitus.

Everyone in the restaurant was carefully examined. Swabs showed the presence of similar organisms in the nose of the pastry cook; literally millions of the bacteria were found swimming in the pastry bag used to decorate the pies and cakes.

In an industrial plant 20 people had to be hospitalized after eating sandwiches supplied by the company cafeteria. The arch criminal was a tiny germ that came from the infected finger of a girl who made the sandwiches.

Sometimes contamination is due to flies. Two boys complained of being sick after eating custard tarts. A visit to the soda fountain where they had their snack showed that pies and pastries were left exposed on the shelves to hordes of flies.

Every time you see a fly in a restaurant remember that he can carry as many as 700,000 germs with him wher-

ever he goes. The fly has no teeth to chew solid foods, so he puts out a drop of saliva through his sucking tube and sucks it back and forth until he’s dissolved part of the food. Then he laps it up and departs happily, leaving a whole menagerie of germs behind him.

Next time you’re dining out and there are flies buzzing around your food, don’t dismiss the matter with a quip. Squawk to the manager instead.

Our health laws require—and rightly so—that restaurant employees should be regularly examined for communicable diseases. But how thoroughly and how often is the examination carried out?

A cook in a Montreal restaurant told me that he worked in the same place for two years and only had one medical checkup. In another province a doctor diagnosed his patient as suffering from an advanced case of t.b. He winced when he learned what thé man did for a living: he had been a dish-

washer for the past eight years.

A waitress who works for a chain restaurant described the medical examination that she and her fellow workers received. Sixty of them lined up for a hasty going-over by a visiting doctor. Within an hour, he had okayed the entire staff, signed the medical certificates and was on his way out.

“Clean” Dishes That Aren’t

How many have not had the experience of finding lipstick traces on the rim of their cup? Or noticed food particles clinging to silverware, left over from the last diner? Or seen hairs on a plate, and speculated whether she was a blonde or a brunette?

Usually we’ve dismissed the incident with a joke. But it can be a serious matter for no matter how clean food is, it can be contaminated by a dirty utensil. And you can contract a variety of unpleasant diseases from an unclean dish.

A dish isn’t clean just because it looks clean. It must be sterilized by immersion in boiling water for a few minutes or washed in a chemical solution. In the language of the scientist, to be safe for human use a utensil should have a bacteria count of under 100; dishwater and rinse water should be under 1,000.

How do restaurant and lunch counter dishes measure up to this standard?

Three Canadian bacteriologists, Andrew MacNabb, F. White, and O. Owen of the Division of Laboratories, Ontario Department of Health, conducted a dishwashing test just before the war. Armed with sterile glass vials and droppers, they visited a large number of eating places in four communities which we will call W, X, Y and Z. Here is what they found:

In community X, the average spoon had a bacteria count of 254,024, tumblers averaged 200,830, while forks registered 113,347.

In community W, knives averaged 666,667 and cups 525,050.

Compare these figures with the 100 —the accepted safety limit.

Let’s have a look at the water used to wash these dishes. The bacteria count should be below 1,000. None of the four communities came near meeting the safety requirement. Community X’s restaurants averaged 800,000 while community Z hit the million mark.

The bacteriologists carefully analysed the rinse water used in community Z and identified staphylococcus aureus, streptococcus, B coli, and spore bearers, all dangerous or potentially dangerous.

Many eating places think they are washing dishes when in reality they are only giving the bacteria a pleasant shower. When an inspector complained to one dishwasher, he received: the

reply, “Why, the water’s so hot I can hardly put my hand in it.”

If you put your hand in water at 145 degrees F., you get a bad scald. To sterilize dishes the water should be 180 degrees or more and should work on the dishes for at least two minutes. If the dishwasher can pub his hands in the water, the bacteria will survive without even a narrow escape from death, unless he is using a chemical disinfectant. One health authority told me that he doubted very much if more than 25% of the dishes in the smaller communities of his province were properly sterilized. Fortunately, dishwashing machines now used in most large restaurants are becoming increasingly popular. When supplied with hot water they do a satisfactory job.

But a constant menace to the dinerout is the cracked cup or plate. It is virtually impossible by any system of dishwashing to reach down in the cracks and kill dangerous bacteria colonies that live there. Yet every sanitary inspector from Halifax to Victoria will tell you that hardly a day goes by that he doesn’t have to order the destruction of cracked and chipped dishes. One inspector told me that he recently came upon a restaurant where 40% of the dishes were chipped and cracked !

It is encouraging to note that a determined battle against dirty dishes is being waged in many parts of the country. In Saskatchewan a mobile kitchen toms the province and demonstrates the proper way to sterilize utensils. Manitoba uses a dramatic technique called the “Seeing Is Believing” method, devised by a University of Manitoba bacteriologist, Dr. M. C. Jamieson. Germs collected from restaurant dishes are left to grow in glass bottles in the kitchens where the help can see them.

The Employees’ Side

Sterile dishes and clean food won’t stay that way if they are handled by people with dirty hands. When I asked one restaurant owner why so many waiters and waitresses knew so little about proper serving, he pleaded that restaurant staffs are inadequately trained. The turnover of restaurant personnel, he told me, is normally among the highest in any industry. “How can we train them,” he asked, “when they don’t Stày long enough?”

“How can you expect them to stay on the job?” an official of the Cafeteria and Restaurant Union retorted. He claimed that restaurants suffer because of poor working conditions. Wages are ôften very low: waitresses averaged

from $12 to $20 a week. “Many people think,” he said, “that the girls make a fortune in tips. In some of the larger establishments they may make an extra few dollars, but that is not true of thousands of others. Canadians have not adopted the usual American practice of tipping.”

“By improving working conditions,” said the union official, “we hope to convince our members that restaurant work can provide respectable and permanent employment; that it’s not a temporary job of hash-slinging.”

When I presented these views to a group of Canadian restaurant owners, they heartily agreed that there were altogether too many operators in the business who were undesirable employers. They emphasized, however, that working conditions in many of the larger restaurants compared favorably with those in any other industry. “Besides receiving a weekly wage,” they told me, “the girls are given two meals per day, their uniforms are supplied and laundered free of charge, and the public tips them. It all mounts up.”

In our larger centres restaurant

supervision is the responsibility of the municipal government. All health bylaws, however, have to receive the approval of the provincial government, which also stands by to advise and assist local councils on difficult problems. In the rural areas of some provinces — like Saskatchewan — restaurants are controlled directly by the province.

Sanitary codes are always being rewritten and amended to meet changing conditions. But laws alone will not provide the solution to unsanitary restaurants.

“You can’t legislate public health,” says Dr. Roger G. Knipe, director of the industrial health division of the Health League of Canada. “The urgent need is education.”

Dr. Knipe told me that there is a shortage of trained sanitary inspectors in practically all sections of Canada. It is important to increase their numbers because the sanitary inspector is more teacher than policeman, he said.

Be Your Own Inspector

But probably the most powerful force in ridding a community of unsanitary restaurants is an alert public opinion. You and I have responsibilities in this respect; when eating out, we must keep our eyes open and be quick to recognize an unsanitary eating place when we come upon one. It’s not difficult if you know the few common-sense rules of good food handling.

To start with, notice the man or woman who is serving you. Is she dressed in a clean uniform? Are her hands clean? If they touch your food or the eating part of your dishes, raise merry heck and find out if there’s a food handler’s school in your community. If not, why not? Remember —they are not deliberately breaking good health practices—they just don’t know any better.

Does the waitress hand you a glass, clutching it by the rim? It’s a bad, unsanitary practice. Does she hand you the silverware with the eating end clutched in her hand? Refuse to take it. Does she carry her towel, like many do, under her arm pit? It’s an unaesthetic and unsanitary habit.

Are there flies buzzing around while you eat? Is the rim of your glass marked with lipstick? Does your food contain some foreign particle? If so, speak to the manager and tell him you want to see the kitchen. Here are some of the things you can look for backstage:

The surfaces of the walls, floors and ceilings should be absolutely smooth and painted; vermin breed readily in cracks. Adequate ventilation and light are a “must.” Plumbing and drainage should be in perfect working order. Have a special look at the washrooms —they should * be fully equipped to ensure personal cleanliness.

Are the doors and windows leading to the outside in good repair and properly screened? Powerful exhaust fans are desirable for expelling insects, smoke and odors. See if the food is stored properly. Fruits, vegetables and other food products—whether in sacks or boxes—must not be left standing on the floor but stored high and dry wheré rats, dirt and moisture cannot get at them. Perishable goods like meat, milk and cream-filled pastries should be refrigerated in clean surroundings until ready for actual use.

Pay close attention to the dishwashing procedure. If a machine is being used, the water in the sterilizing section should be at least 170 degrees. If a hand system is employed, three-compartment basins are desirable—two are an absolute minimum. The first should contain water at 130 degrees to remove food particles and grease, while the second should be full of water at 170 degrees for rinsing. At least two minutes are required for proper rinsing, but if the water is boiling, 30 seconds are enough. If there is no mechanical device for maintaining the water at a high temperature constantly, a chemical disinfectant should be employed.

Make it your business to find out how the garbage is disposed of. It should be kept covered in ratproof tins, far away from food.

Is the equipment cleaned regularly? This applies to everything—garbage cans, refrigerators, meat-cutting blocks, bread slicers and utensils of all descriptions. A restaurant may have the most up - to - date equipment in town, but unless it is kept in spotless condition it can be a source of infection.

No doubt many readers will find much in this article that is distasteful, perhaps even nauseating. Food contamination is not a pleasant thing to write about. Nevertheless, the existence of unsanitary eating places must be recognized as a potential danger to the health of the millions of Canadians who eat out.

If we fail to embark on a vigorous nation-wide cleanup, we are inviting the repetition of hundreds of cases of food-borne disease, -fc,