25 | Outcomes of fact-finding investigations under the 2022-2025 Regional Official Control Plan: availability of iodized salt and display of awareness posters in food businesses in the metropolitan area of Palermo

Background. Italian Law No. 55/2005 introduced iodized salt (IS) as a measure of iodine prophylaxis and ensured its widespread availability to the general population.1 To assess the food business operators’ compliance with the requirements regarding the availability of IS and the display of awareness posters (APs), the Sicilian Region mandated fact-finding inspections under the Regional Official Control Plan (ROCP).2,3 This study evaluated the outcomes of these inspections in food businesses (FBs) located in the metropolitan area of Palermo.

Materials and Methods. Ninety-nine inspections were conducted by the Food Hygiene and Nutrition Service of the Provincial Health Authority of Palermo under the 2022–2025 ROCP, assessing the availability and preferential supply of IS and the display of APs. These outcomes were analyzed according to the food business activity (points of sale [PS], collective catering [CC], and public catering [PC]), expressed as numbers and percentages, and the number of employees, expressed as median (M) and interquartile range (IQR). Statistical analyses were performed using R with ChatGPT-assisted code. Differences among groups for the qualitative variable “activity” were assessed using the Chi-square test or Fisher’s exact test, whereas differences for the quantitative variable “number of employees” were evaluated using the Mann–Whitney U test, reporting p-values and effect sizes as Cramer’s V and rank-biserial correlation coefficient (r) with the 95% confidence interval (95% CI).

Results. IS was available in 85.4% of FBs and preferentially supplied in 66.2%. APs were displayed in 61.8%. PS showed a higher availability of IS (99%, p< 0.001, V=0.68) than CC (88%) and PC (37%). Similarly, FBs with an M of 9 employees (IQR=5-14; p=0.008, r=-0.45 [95% CI =-0.71, -0.13]) were more likely to have IS available than those with an M of 5 (IQR=3-5). CC showed complete preferential supply of IS (100%, p=0.001, V=0.43) compared with PS (76%) and PC (27%). PS displayed APs more frequently (75%, p<0.001, V=0.45) than CC (43%) and PC (18%). Likewise, FBs with an M of 10 employees (IQR=6-15; p=0.026, r=-0.29 [95% CI=-0.54, -0.02]) displayed APs more often than those with an M of 5 (IQR=3-11).

Conclusions. PC and FBs with a smaller workforce showed lower compliance with Italian Law No. 55/20051. Targeted awareness-raising initiatives could increase compliance with the Law regarding the availability and preferential supply of IS and the display of APs in FBs.