NEHA October 2022 Journal of Environmental Health

16 Volume 85 • Number 3 A D VANC EME N T O F T H E SCIENCE Introduction The Centers for Disease Control and Prevention (CDC, 2020) estimates that 48 million people get sick from a foodborne illness (FBI) annually. Between 2009 and 2015, the Foodborne Disease Outbreak Surveillance System received reports of 5,760 outbreaks that caused 100,939 illnesses, 5,699 hospitalizations, and 145 deaths. Dewey-Mattia et al. (2018) included the specific location for food preparation for 5,022 outbreaks and showed that restaurants were the most common location (61%), followed by catering/banquet facilities (14%). FBI outbreaks are chronically underreported, however, because individuals and health professionals do not report a sizable number of cases to public health channels (CDC, 2018a). Therefore, there is a need for investigators to use novel and innovative methods to identify food safety issues and potential areas for improvement. While individuals who have a case of FBI might not report their cases to public health o“cials, prior studies suggest that reviews— posted by restaurants patrons on online restaurant review forums such as—contain information related to FBI events (Nsoesie et al., 2014). Previous studies have used Yelp reviews as a tool to identify FBI outbreaks and have compared these reviews with health inspection scores (Harris et al., 2017; Park et al., 2016). No studies yet, however, have explored food safety or restaurant cleanliness issues in customer-generated reviews and examined how these issues ašect customer satisfaction. Consequently, our primary research objectives were to 1) explore customer-generated reviews on an online review platform (i.e., Yelp) to identify FBI and restaurant cleanliness issues and 2) examine the relationship of FBI and restaurant cleanliness issues with customer satisfaction. For our study, we collected and analyzed a database containing 231,381 Yelp reviews of 954 restaurants in the Greater Houston area from 2005–2017. We selected Houston as the city for our research because it is one of the best U.S. food cities and has been recognized as a dynamic dining destination (Nelson, 2016). Research Background Food Safety Regulations The Food and Drug Administration (FDA, 2022) created the Food Code to serve as a model set of food safety regulations for U.S. states and municipalities to adopt for good food safety practices in food service establishments. The Food Code lists the following as the five major risk factors that cause the majority of FBI outbreaks: 1. improper holding temperatures, 2. inadequate cooking (e.g., undercooking raw shell eggs or chicken), 3. contaminated equipment, 4. food from unsafe sources, and 5. poor personal hygiene. The Food Code (U.S. Department of Health and Human Services, 2017) serves as a baseline set of regulations and individual jurisdictions can modify these regulations to fit the needs of their states. For example, in 2015 Texas legislators modified the Texas Food Establishment Rules (2021) and stipulated that all food service workers, regardless of their job descriptions, have to be food handler certified by September 2016. Companies such as ServSafe (National Restaurant Association Educational Foundation, 2019) that create food safety training programs design their curriculum to ensure all food handlers have a basic understanding of food safety as per the Food Code. Topics that are covered in these training programs include the following components: 1. basic food safety, 2. personal hygiene, Jack R. Hodges Minwoo Lee, PhD Agnes DeFranco, PhD Sujata A. Sirsat, PhD Conrad N. Hilton College of Global Hospitality Leadership, University of Houston Exploring Foodborne Illness and Restaurant Cleanliness Reporting in Customer-Generated Online Reviews Using Business Analytics Abs t r ac t Foodborne illness cases are chronically underreported, and it is crucial to investigate nontraditional strategies and approaches to identify food safety challenges that could lead to outbreaks. This point is especially important in the context of the food service industry because 61% of all foodborne illness outbreaks are attributed to restaurants. The overarching goal of our study was to data mine customer-generated restaurant reviews on an online review website and analyze the frequency at which restaurant patrons report specific terms related to foodborne illness and restaurant cleanliness. Our data analysis indicated statistically significant inverse correlations between the increased frequency of keywords in online reviews and customer satisfaction. The results from our study can be used to incentivize restaurateurs to implement enhanced food practices. Furthermore, the text mining methodology can be used in future studies to monitor food safety reporting in global markets.