First time compliance inspections to evaluate an artificial trans fat ban in Nassau County
BACKGROUND: In 2007, Nassau County, New York, restricted the use of artificial trans fats in food establishments licensed by the Nassau County Department of Health (NCDH). The regulation took effect April 1, 2008. OBJECTIVE: This study assesses first-time inspection compliance rates with the trans fat ban and examines barriers to enforcement. METHODS: A sample of food service establishments was inspected by an NCDH employee for labels documenting trans fat. Surveys that examined operator awareness and attitudes toward the ban were administered. A separate survey was conducted among the NCDH Office of Food Protection public health sanitarians to determine organizational barriers to enforcement. All inspections and surveys were conducted in Nassau County from June to September 2010. RESULTS: A total of 360 food service establishments were randomly selected for inspection; 328 completed the operator surveys. Compliance was 81%, even though 52% of operators were not aware of the ban. Of those who were aware, 57% heard about the regulation from the media, and almost all (92%) reported that compliance with the ban was easy. Of noncompliant respondents, 59% cited lack of knowledge regarding the ban as the primary reason for noncompliance. Of those who indicated they had received any customer feedback (9%), almost all reported the feedback to be positive. Knowledge of trans fats was not associated with compliance, but owners who were aware of the ban were more likely to be in compliance. Among the 23 participating sanitarians, 96% believed the ban was effective; language barriers were cited as the primary obstacle to enforcement. CONCLUSIONS: As assessed through surveys and inspections, the trans fat ban in Nassau County yielded relatively high compliance rates within 2 years and was accepted by sanitarians, establishment operators, and consumers.