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INTRODUCTION
Dining in restaurants is an important part of the American lifestyle, as evidenced by the more than 70 billion meals or snacks served by restaurants annually, generating $566 billion in sales (20). A major trend in the restaurant industry is the growing number of ethnic restaurants. This growth is a result of changing demographics and increased interest in ethnic cuisine. According to the U.S. Census Bureau, 34.4% of the U.S. population in 2008 was expected to be in a racial/ethnic minority group (32). As the minority population increases, so does demand for ethnic foods. Of the racial/ethnic minorities in the U.S., the Hispanic and Asian populations are the two largest groups likely to be involved in the restaurant business. Economic census data of 2002 show that minority-owned businesses account for 10.2% of accommodation and foodservice businesses, representing 11.0% of total sales in this sector (29). Specifically, Asian and Hispanic business owners, the two largest minority ethnic groups, comprise 85.3% of total minority business owners and create 88.0% of total sales generated by minority businesses in this sector (30, 31). The Centers for Disease Control and Prevention (CDC) estimated that foodborne illnesses cause approximately 76 million illnesses, 325,000 hospitalizations, and approximately 5,000 deaths each year in the U.S. (19). The actual number of foodborne illnesses may be even higher, as many foodborne illnesses are not reported. Food safety in restaurants is especially important because the results of poor food handling behaviors can affect more than one individual. Of the reported cases of foodborne outbreaks, 60% were traced to a restaurant (10). By definition, foodborne outbreaks affect two or more people, but when outbreaks are linked to restaurants, many more people may be affected. For example, the Jack in the Box E. coli outbreak in 1993 resulted in approximately 700 illnesses and four deaths from a single cause — infected meat (9). Over 600 people were infected with Hepatitis A in one restaurant in 2003 after eating mild salsa that contained contaminated green onions grown in Mexico (35). In addition to these examples, restaurants

were responsible for numerous cases of outbreaks in the U.S. (10, 22). Ethnic restaurants are not exempt from foodborne illness cases associated with operations. Consumers are often aware of poor food handling techniques and environmental cleanliness at ethnic restaurants and rate ethnic restaurants lower on these attributes than on other attributes (14). In addition, researchers have found increased concerns about food handling at ethnic restaurants (1, 2, 17, 26, 27). Foodborne illness data from CDC showed that total outbreaks associated with ethnic foods rose from 3% to 11% of total cases between 1990 to 2000 (26). Bacillus cereus outbreaks were frequently associated with unsafe cooling practices for fried rice (4, 18), which is commonly served in ethnic restaurants. According to the CDC database, 1,662 individuals were affected by Bacillus cereus in 73 outbreaks in the U.S. from 1990 to 2006. Of those, 25 outbreaks were traced back to the restaurant setting, with rice or fried rice dishes being the most common source (13 of 25 restaurant outbreaks and 31 of 73 total outbreaks) (4). A review of 29.5 million laboratory-diagnosed foodborne illnesses confirmed unique associations between frequency of certain foodborne illnesses and racial/ethnic groups (13). Researchers speculated that there might be different high-risk consumption behaviors for different racial/ethnic groups and recommended targeting different groups with pertinent food safety education information (13). These racially/ethnically specific high-risk consumption behaviors may be because the family is a major source of information on how to handle food (12). The restaurant industry, especially the ethnic restaurant segment, provides a familiar working environment for many first-generation immigrants who may have language barriers (15, 34). The associations between racial/ethnic groups, common foodborne illnesses (13), and certain food handling behaviors (12) indicate a necessity for additional food safety training for members of ethnic minority populations, who typically own and operate ethnic restaurants. The most recent (2008) data published by the CDC indicated that foodborne illness incidences have not changed

from the 2005–2007 data (5). The CDC recommends continued education of restaurant employees and consumers about foodborne illness risks and prevention measures (5). Along with this recommendation, the associations among racial/ethnic groups, undesirable food handling practices (12, 13), and the increased prevalence of outbreaks in ethnic restaurants (26) may justify emphasis in food safety training for personnel working in ethnic restaurants. Furthermore, Simonne et al. contended that current general food safety training may not be adequate to reduce the number of foodborne outbreaks associated with ethnic foods because of the lack of specificity of this training to ethnic food handling practices (26). Researchers have demonstrated that food safety training improves food handling practices in restaurants. The inspection scores of pre- and post-sanitation class interventions were significantly different, showing that improvement had occurred following the food sanitation classes (6). Managers who were mandated to take the class because of either a documented foodborne illness from their operation or a serious sanitation breach on their most recent inspection improved their facility’s inspection score by an average of 14.7 points. Even those who voluntarily attended the class without problematic inspection scores improved by an average of 7.5 points, compared to no improvement for control group participants (6). Despite consumer perceptions about food safety in ethnic restaurants (14) and reports by food safety researchers of increased needs for food safety training for ethnic restaurants (1–3, 6, 17, 26, 27), little research has been conducted to describe and analyze food handling behaviors in independent ethnic restaurants. One of the barriers to identifying food handling practices in ethnic restaurants is the unwillingness of ethnic restaurant personnel to participate in research (24, 25). Nonetheless, research and extension activities specifically targeting food handling behaviors at these restaurants may be needed to ensure food safety. In Kansas, there are 4,671 licensed eating-and-drinking places, employing nearly 130,000 workers and generating over $3 billion in sales (21). At the time

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Food Protection Trends - July 2010

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