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Seventy-five million cases of foodborne illness occur each year in the United States according to a 1999 study by the Centers for Disease Control and Prevention (1). Of these cases, 325,000 hospitalizations and 5,000 deaths result. From 1985-1990, Salmonella ente?itis alone was responsible for 10,253 cases of poisoning, including 46 deaths (2).
Despite the high incidence of poisoning from Salmonella eteritis, the Centers for Disease Control and Prevention estimates that 75% of foodborne illnesses are the result of unknown agents (1). For example, in 1997 and 1998,1,700 people, mostly schoolchildren, experienced gastrointestinal illness after eating burritos served for school lunch. After an extensive investigation, a specific pathogen was not identified as the sole cause of the contamination (3).
According to The American Dietetic Association, changes in demographics and lifestyles have contributed to the increase in foodborne illness observed during the past 2 decades (4). Americans now consume more meals from commercial foodservice establishmentswhere high employee turnover, an unskilled foodservice labor force, and increased demand present more opportunity for cross-contamination of food items-than ever before (4). The globalization of the food market has also increased the number of potential bacterial contaminants in the US food supply. These trends make food safety practices increasingly important.
One aspect of food safety is the proper sanitation of dishware on which food is served. The 1999 Food and Drug Administration (FDA) Food Code (5) specifies air drying of all dishware as an important step in preventing bacterial growth on food contact surfaces. The code states that "items must be allowed to drain and to airdry before being stacked or stored. Stacking wet items such as pans prevents them from drying and may allow an environment where microorganisms can begin to grow" (5). This stacking of dishes before completely air-dried is called wet-nesting.
Sanitarians evaluate foodservice operations based on the FDA Food Code, however to our knowledge no scientific evidence implicating wet-nesting as a food safety concern has been gathered. The purpose of this study, therefore, was to determine whether wet-nesting of serving plates poses a potential health hazard by increasing the incidence of foodborne illness.
MATERIALS AND METHODS
The study consisted of samples taken from 100 randomly selected breakfast serving plates returned to the Veterans Affairs Medical Center, Portland, Ore,...