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Cockroaches are an unwanted sight in a restaurant, but there's a better chance that improper food heating, cooling and storage methods will make diners sick.

Research into which food safety rules are most linked to foodborne illness is giving Twin Cities restaurant inspectors new tools to target unsafe kitchen activities that put customers particularly at risk. Inspectors for Minneapolis and St. Paul found more than 4,800 such violations at about 1,500 restaurants last year, according to a Star Tribune analysis.

"Each time you have one of these, that's like buying a … ticket to the foodborne illness lottery," said Dan Huff, environmental health director for the city of Minneapolis.

The foodborne illness risk factors, outlined by the Food and Drug Administration and the Centers for Disease Control, are a smaller subset of rules than those deemed "critical" under the state's food code. They center on inadequate cooking, food kept at the wrong temperatures, dirty equipment, food from unsafe sources and poor personal hygiene.

Minneapolis has recently begun analyzing those violations more closely, hoping to give them priority in determining which restaurants need extra attention. The Minnesota Department of Health is also crafting updates to the state's food code that would give the most weight to violations that could lead to illness.

Not having a plumbing device that prevents a sink from sucking up dirty water is a critical violation, for example, but it is not considered a top risk factor for illness. Cooling a vat of hot soup too slowly, however, is both a critical violation and a foodborne illness risk since it can lead to bacteria growth that sickens customers. The new approach would prioritize the soup temperature over the sink.

Tougher inspections

Minneapolis' analysis comes after the city revamped its food inspections in the wake of a poor 2010 state audit. It now has eight more inspectors who speak a multitude of languages and spend more time on educating restaurant employees. A re-evaluation from the state this winter resulted in perfect or near-perfect grades.

"We got a lot better as inspectors, which means we got a lot stricter," Huff said.

The number of illness-risk violations has dropped, based on the city's preliminary review. In 2014, inspectors doled out six or more such violations to 61 percent of the city's restaurants. In 2015, only 9.4 percent of restaurants received that many.

Case studies from 2015 show that restaurants cited for the most illness-risk problems were largely in compliance by the end of the year, which is why the Star Tribune is not publishing a full list.

The city hopes to release food inspection data online later this year to give the public real-time insight into restaurants' performance.

The Star Tribune requested all the illness-risk violations issued in 2015 to restaurants in Minneapolis and St. Paul, which is overseen by the Minnesota Department of Health. The most common problem by far, with more than 900 violations, was not storing potentially hazardous foods below 41 degrees. Those foods include meat, seafood, rice, eggs and cooked vegetables.

Other common violations include failing to mark the date on potentially hazardous foods to ensure they are consumed within seven days of preparation and allowing mold to build up inside ice machines.

Shifting the focus to violations more likely to sicken diners puts the spotlight on different restaurants. Among the 20 Minneapolis restaurants that had the worst scores under the existing system, based heavily on "critical" violations, just seven also made the top 20 list of illness-risk violators.

There were four confirmed outbreaks of foodborne illness — with at least two people sick from the same food — tied to Minneapolis restaurants in 2015, according to Hennepin County data. But such numbers are difficult to track because many cases go unreported.

"Outbreaks happen because of mistakes," said Minneapolis inspector Bill Kass. "Nobody ever makes anybody sick on purpose."

Fixing violations

One of the Minneapolis restaurants with the most illness-risk violations in 2015 was Fresh Wok on 46th Street and Nicollet Avenue. Inspectors tagged the restaurant 21 times, most often for not properly cooling foods like rice and chicken.

Inspectors also found kitchen employees not washing their hands between tasks — such as cutting raw chicken — and in one instance keeping spoiled chicken on the production line.

The manager there, Ying Guo, said they now refrigerate foods sooner and have made other reforms to comply with the inspector's orders. Their last inspection resulted in zero critical violations.

The News Room, a popular Nicollet Mall restaurant, was also among the top violators of illness-risk rules, primarily with problems around cooling temperatures and date marking. Those issues were resolved before the restaurant's last inspection in 2015. General Manager Brad Schwichtenberg said they are now refrigerating foods in containers made of metal instead of plastic, and in smaller portions, ensuring the food cools faster.

"We welcome [inspectors] in our kitchen at any point on any day," Schwichtenberg said. "Because if there is a problem, I want to know about it. Because I want to fix it."

Hennepin County, which oversees many restaurants outside Minneapolis, flags illness-risk violations for priority during reinspections and intends to focus on them even more when the state food code changes, said Duane Hudson, the county's manager of environmental health.

Temporary closures

Minneapolis also ordered 13 restaurants to temporarily shut down in 2015 due largely to cockroaches, mice, and refrigeration problems. The Minnesota Department of Health issued no similar emergency closure orders in St. Paul, which in part reflects a different approach to handling pest infestations.

Minneapolis' rules about cockroaches, which spread disease, are very specific. The city can close a restaurant if inspectors find six or more live cockroaches in the kitchen or storage areas — or if just one ends up in the food. That alone led to six closures last year, in one case because 15 cockroaches were "observed in various life stages" at a Cedar-Riverside coffee shop.

Closures are rare in St. Paul, where Wendy Spanier, environmental supervisor at the Minnesota Department of Health, said the focus is on long-term compliance. For example, inspectors would ensure a restaurant with a pest problem gets a contract with an exterminator.

"Six cockroaches doesn't mean that there's an imminent health hazard," Spanier said. "We would only close a business if there was an imminent health hazard."

Eric Roper • 612-673-1732

Twitter: @StribRoper