Objectives: to assess the trends of foodborne diseases in respect of the abolition of food handler certification by Italian Regions.
Design: rates of foodborne diseases recorded before and after the abolition of food handler certification were compared.
Setting and participants: the study included notifications collected in Italy through the national infectious disease surveillance system between 1996 and 2009.
Main outcome measures: annual rates of seven main foodborne diseases.
Results: a significant reduction in notifications of foodborne diseases occurred in most Italian Regions in the years after the abolition of the food handler certification.
Conclusions: the abolition of food handler certification coincided with no increase in the overall estimated incidence of foodborne diseases in the Italian population. Furthermore, the temporal and spatial patterns of notification rates suggest the possibility that other key factors have contributed to this result, including the heterogeneity of the surveillance system performance.