As part of an effort to promote food safety culture under the New Era of Smarter Food Safety blueprint, the U.S. Food and Drug Administration (FDA) has commissioned a literature review to address overarching questions about the concept.

A total of 79 articles were included in the literature review. Specifically, the researchers sought to answer:

1. What is food safety culture?
2. How is food safety culture developed and maintained?
3. How is food safety culture assessed?

The most common definition of “food safety culture” cited in the available literature was “The aggregation of the prevailing, relatively constant, learned, [and] shared attitudes, values, and beliefs contributing to the hygiene behaviors used within a particular food handling environment.” Different than food safety management systems (FSMS), culture looks beyond processes to human behavior. However, the dynamic created by an organization’s FSMS and food safety culture creates what is called a “food safety climate,” which is often associated with an extended period, framed as “the prevailing beliefs, behaviors, assumptions, and practices of the organization.”

Food safety culture is almost exclusively discussed in the literature at the organizational level. Very few studies look at the concept at the national level, and none of the literature addresses culture at the individual consumer level.

In the available literature, researchers have identified numerous key determinants (also referred to as elements or components) that contribute to food safety culture: leadership; communication; commitment to food safety; risk awareness; environment; accountability; and employee knowledge, attitudes, behaviors, and values. Additionally, the literature acknowledges challenges and barriers to establishing and maintaining a strong food safety culture: over-reliance on FSMS, prioritization of cost-saving and money-earning; organization size; frequent staff turnover; and optimistic bias.

Best practices to promote food safety culture mentioned in the review include: promoting culture as a necessary and critical business matter for all employees; branding the organization’s commitment to culture; framing culture with an “ownership mentality,” and promoting culture throughout the organization’s supply chain.

The report also cited international research that has shown that government regulatory agencies’ policies and procedures can influence an organization’s culture, with stronger food safety culture generally found in countries with more food safety regulations.

Regarding the assessment of food safety culture, the majority of tools developed were surveys to be distributed to an organization’s employees. Other methods mentioned in the literature for assessing food safety culture include third-party audits, verifications of certain kinds of data, focus groups, and observations of actual behavior.

Many survey instruments were developed and validated using mixed methods, including literature reviews, focus groups with food safety experts, and psychometric analyses. Some researchers combined multiple methods such as surveys, interviews, and audits. Many of the assessment tools adapted concepts from organizational culture frameworks and applied them within a food safety context.

The review provides the Food Safety Maturity Models as an example of an assessment tool, developed by Lone Jespersen, Ph.D. and Carol A. Wallace, Ph.D., which evaluate an organization’s commitment to culture on a 5-point continuum across five capability areas: values and mission, people systems, adaptability, consistency, and risks and hazards.

There is only one assessment tool developed by a government agency, a 2012 toolkit from the UK Food Standards Agency (FSA). The goal of the toolkit was to help enforcement officers assess safety culture, attitudes, and behaviors. However, a qualitative study with thirty industry stakeholders found the toolkit complicated, repetitive, lacking employee feedback, and not adaptable to different sizes and types of businesses.

Finally, the literature review highlights three prominent case studies of foodborne illness outbreaks that link poor food safety culture as a key contributor to those outbreaks. The review also identifies few empirical studies that directly examine the relationship between food safety culture and outcomes such as microbiological hygiene, safety behavior, and economic impact. Two of the studies found that improved culture or leadership support for culture improved employee food safety behavior. One study found that restaurants with good culture had fewer study-assessed food safety violations than restaurants with poor culture. Only one study found a significant positive relationship between culture and risk associated with microbiological hygiene.

Research areas related to food safety culture that are lacking and require further exploration are: what a strong and effective culture would look like among general consumers; how culture is defined in a regulatory agency; how employees’ diverse political, familial, racial and other cultural identities may influence an organization’s food safety culture; the validity of existing food safety culture assessment tools across different organizational settings and countries; and the connection between culture and outcomes, including microbiological and other risks for foodborne illness outbreaks, reductions in contamination incidents, and improved economic effects.