Updated

Millions of children eat in school cafeterias that don't get the twice-yearly health inspections required by Congress to help prevent food poisoning.

Schools are supposed to get two visits from health inspectors every year. But one in 10 schools didn't get inspected at all last year, according to Agriculture Department data obtained by The Associated Press. Thirty percent were visited only once.

"Do you want to go to a restaurant that hasn't been inspected?" asked Ken Kelly, attorney for the Center for Science in the Public Interest, a consumer group that has studied cafeteria safety.

Fewer inspections don't necessarily translate into more cases of food poisoning — "but it contributes to all the other little things — temperatures, rat droppings — to all those things that could make your child sick," Kelly said.

Inspections are meant to ensure cafeteria workers wash their hands properly and that they keep lunchtime staples like pizza hot or milk cold to prevent germs from growing.

Common violations in cafeterias involve wrong temperatures — failing to keep hot food hot enough or cold food cold enough — or things like having an open Dumpster outside the cafeteria.

Kelly's group issued a report in January that found:

—Rhode Island schools were commonly cited for cross-contamination of utensils, improper holding temperatures and the presence of vermin;

—Washington, D.C., schools had hot and cold holding equipment that needed repair; and

—Schools in Hartford, Conn., have been cited for having dirty floors that needed repair and inadequate handwashing stations and sanitation.

Recent outbreaks of food poisoning in kid favorites like peanut butter — and not-so-favorite spinach — have renewed the focus on safety.

In school cafeterias, the news is not all bad: Sixty-one percent of schools got two or more inspections in the 2005-2006 school year. That was the first year Congress required two inspections; the old requirement was one inspection per year.

"We have some good news here, in terms of what states have already done, but now it's time to go and look at where we have challenges," said Agriculture Department spokeswoman Jean Daniel.

The inspection rules apply to all schools that participate in the federal school lunch program, which provides free and reduced-price meals to low-income children.

Nearly every public school participates in the program, which is run by the Agriculture Department. Half of the nation's 60 million students eat lunches prepared in school, according to the department.

According to the department, of 94,132 schools reporting in the 2005-2006 school year:

—Ten percent, or 9,498 schools, were not inspected at all.

—Twenty-nine percent, or 27,184 schools, were inspected once.

—Sixty-one percent, or 57,450 schools, were inspected at least twice.

No data was reported by 7,309 schools.

The missed visits mirror a drop-off in food safety inspections by the Food and Drug Administration. A recent AP analysis found FDA inspections fell by nearly half between 2003 and 2006.

When inspections don't happen in cafeterias, it's not the school's fault. Cafeteria workers don't inspect themselves. It's up to state and local health authorities to schedule inspections, and many health departments are severely understaffed, particularly those in small towns and rural areas.

In some places, "we could get down on our hands and knees and beg, but they are only staffed to do certain things, and you cannot get them to come twice a year," said Janey Thornton, president of the School Nutrition Association and a child nutrition director in Hardin County, Ky., public schools.

When Congress doubled the inspection requirement, lawmakers didn't provide any money for more inspections.

"This was a federal mandate which came down with no resources to support increased levels of inspection," said Paul E. Jarris, executive director of the Association of State and Territorial Health Officials.

Schools are also lower on the priority list for health departments, because there are fewer outbreaks in schools than in restaurants, government data indicate. School cafeterias were the source of only about 3 percent of the 7,390 food poisoning outbreaks reported between 1990 and 1999, say congressional investigators and the Centers for Disease Control and Prevention.

"The system in many states, left to work on its own, would inspect schools perhaps less frequently than it would a more high-risk setting," Jarris said. "A number of states and locals would look at this as an arbitrary rule and really not a rule based on performance."

Among the more well-known outbreaks, hundreds of Michigan school children and teachers got sick from hepatitis A-tainted strawberries in 1997, and 11 children in Finley, Wash., got sick in 1998 from school tacos made with ground beef that had been contaminated with E. coli.

Thornton contends cafeteria workers are generally better trained than restaurant workers.

She pointed out that schools are the only retail food service operations required by federal law to have food-safety plans similar to those required in meat and poultry plants. The standards require a scientific look at vulnerable places in the production chain and constant monitoring of those points.

"We do daily self-inspection and record all temperatures of foods when foods are put on the line. They're checked for temperatures every 30 minutes," Thornton said. "We don't know ever when the health department is going to come. Therefore, we're not operating for the health department."

While outbreaks in schools are rare, children are at greater risk for complications from E. coli, salmonella and other foodborne germs, said Iowa Sen. Tom Harkin, chairman of the Senate Agriculture Committee.

"For that reason, we have to remain vigilant and do all that we can to ensure that our school food safety system provides the best possible protection for our kids," Harkin said.