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Food Safety

FOOD SAFETY

FOOD SAFETY. Food safety is a matter that affects anyone who eats food. Whether or not a person consciously thinks about food safety before eating a meal, a host of other people have thought about the safety of that food, from farmers to scientists to company presidents to federal government officials and public health officials. Ensuring the safety of food is a shared responsibility among producers, industry, government, and consumers. Safe food is food that is free not only from toxins, pesticides, and chemical and physical contaminants, but also from microbiological pathogens such as bacteria, parasites, and viruses that can cause illness.

Those working in the field of food safety are most concerned about microbial foodborne illness, a widespread but often unrecognized sickness that affects most people at one time or another. At least four factors are necessary for foodborne illness to occur: (1) a pathogen; (2) a food vehicle; (3) conditions that allow the pathogen to survive, reproduce, or produce a toxin; and (4) a susceptible person who ingests enough of the pathogen or its toxin to cause illness. The symptoms often are similar to those associated with the flunausea, vomiting, diarrhea, abdominal pain, fever, headache. Most people have experienced foodborne illness, even though they might not recognize it as such, instead blaming it on the stomach flu or a twenty-four-hour bug. Usually symptoms disappear within a few days, but in some cases there can be more long-lasting effects such as joint inflammation or kidney failure. In the most severe cases people die from foodborne illness.

Current estimates of foodborne illness in the United States are 76 million cases, 325,000 hospitalizations, and 5,194 deaths from foodborne pathogens per year. In cases when the pathogen is identified, bacteria cause 30 percent of foodborne illnesses, parasites 3 percent, and viruses 67 percent. But as far as deaths are concerned, bacterial pathogens are the leading cause of death, with 72 percent of total foodborne illness deaths attributable to bacteria. Fatality rates for two bacteria are particularly high; for Listeria 20 percent of the people may die, and for Vibrio vulnificus 39 percent. Just six pathogens account for over 90 percent of the deaths associated with foodborne illness: Salmonella (31 percent), Listeria (28 percent), Toxoplasma (21 percent), Norwalk-like viruses (7 percent), Campylobacter (5 percent), and Escherichia coli (3 percent). According to FoodNet data from 19961997, each person in the United States suffers 1.4 episodes of diarrhea per year. With a U.S. population of 267.7 million persons, that works out to 375 million episodes per year, many of them related to eating unsafe food. Factors that contributed the most to foodborne illness are improper holding temperatures, inadequate cooking, contaminated equipment, food from unsafe sources, and poor personal hygiene.

Factors Influencing the Safety of Food

Stories of foodborne illness have become much more prevalent throughout the world. Is food less safe than it used to be, and if so, what factors account for this? News travels fast these days, both electronically and through the news media. What were once isolated events and stories, now reach millions within hours. Diagnostic techniques are constantly improving, allowing for identification of diseases, foodborne and otherwise, that would have been of unknown origin in the past. But even considering these facts, public-health officials believe that the risk of foodborne illness has increased over the past twenty years (GAO, 1996). Some threats to food safety have been around since ancient times, while others are newer, the result of changing demographics and lifestyles, production practices, and even evolution of microorganisms themselves.

Demographics

The proportion of the population at serious risk of foodborne illness is increasing as the population ages and the number of people with weakened immune systems grows. People who are at higher risk of becoming seriously ill include infants, young children, the elderly, pregnant women, those taking certain medications, and those with diseases such as acquired immunodeficiency syndrome (AIDS), cancer, and diabetes that weaken their immune systems. Demographers predict that the proportion of people over sixty years old in industrialized countries such as the United States will rise from the current 17 percent of the population to 25 percent by 2025 (Kaferstein, 1999). In one survey, 89 percent of deaths with diarrhea as an underlying cause were adults fifty-five and over or children under the age of five (Morris, 1997).

While anybody can get sick from eating contaminated food, the severity of the illness depends on a number of factors. Most important among these are age, amount of contamination consumed, and health status of the individual. The body has a number of defenses to protect itself against harmful bacteria. The acidic gastric juices of the stomach are one of the first defenses against foodborne pathogens, as many bacteria cannot survive in an acidic environment. Very young infants and aging adults produce fewer, or less acidic, gastric juices than younger, healthy adults. The normal bacteria present in the gastrointestinal system form another protective barrier against foodborne illness by preventing harmful bacteria from colonizing the gut. Use of antibiotics, which destroy the protective bacteria normally present in the gastrointestinal tract as well as their target bacteria, make it easier for pathogenic bacteria to invade and cause illness. Finally, the human immune system, not fully developed at birth, gradually reaches maturity in puberty and then slowly begins to decline after about fifty years of age.

Consumer Lifestyles and Demand

As the pace of life quickens, we often eat meals on the run, and spend less time on food preparation, preferring instead restaurants, convenience foods, or already prepared meals. This means that by the time you eat your food, it may have been transported, cooked, cooled, stored, transported again, reheated, and touched by numerous individuals. Each processing step introduces new hazards that could allow for the survival and growth of pathogens. In the United States, two out of three people ate their main meal away from home at least once a week in 1998. The typical consumer over eight years of age ate food away from home at least four times per week (Collins, 1997). Americans spend fifty cents of every food dollar on food prepared outside the homefrom supermarkets, restaurants, or institutions.

Add to this the mishandling of food that occurs after a consumer purchases food and takes it home, and the likelihood of illness increases. Approximately 20 percent of reported foodborne illness cases occur from food cooked at home. Experts believe that this number is actually much higher, but that most people do not report cases of illness caused by foods cooked at home (Knabel, 1995; Doyle, 2000). As people cook less, they pass on less knowledge of cooking to their children, who are nevertheless increasingly responsible for preparing meals. This has grave implications for the future of food safety. In a survey of consumer food safety knowledge and practices, 86 percent of respondents knew that they should wash their hands before preparing food, but only 66 percent reported actually doing so. Only 67 percent of respondents reported washing or changing cutting boards after cutting raw meat or poultry. Older adults practiced safe behaviors more often than did younger adults (Altekruse, 1995). In an Australian study in which researchers asked people about their food safety and kitchen habits, and then filmed them preparing food, there were large differences in what people said they did and what they actually did. Almost half the people who said they washed their hands after handling raw meat did not, and when they did it was often without soap. Nineteen percent of the households that claimed to have soap in the kitchen did not (Jay, 1999).

Consumers are increasingly demanding fresh and natural products, prepared with fewer preservatives. Without the traditional preservatives and processing methods that prevent microbial growth, modern all-natural and fresh products are more perishable. Food processing, mainly canning, freezing, and pasteurizing, not only extends the shelf-life of foods, but also inhibits bacterial growth, making food safer. As an example, fresh apple cider has been associated with several foodborne disease outbreaks. An outbreak of Escherichia coli O157: H7 in which a child died was associated with raw unpasteurized apple juice from a company that built its reputation on the naturalness of its products.

As the role of fresh fruits and vegetables in a nutritious diet has become evident, people are including them in their diet more. In 1993 Americans ate 27 percent more fresh produce than they did in 1973. An increase in the number of foodborne illness outbreaks associated with fresh produce has accompanied this increase in consumption. In the last twenty years of the twentieth century, the number of identifiable outbreaks in which produce was the food vehicle doubled (Tauxe et al., 1997). Most produce only grows in the United States in certain seasons, yet this seasonal availability has almost disappeared from our supermarkets as consumers demand year-round availability of produce. From 1996 to 1998 Cyclospora cayetanensis sickened more than 2,400 people throughout twenty states and Canada. The only common food vehicle among these individuals was raspberries imported from Guatemala. Smaller outbreaks of Cyclospora have been traced to basil and mesclun lettuce grown in the United States.

Food Production and Economics

In the past, outbreaks of foodborne illness were relatively small and local. Illness could be traced back to local events such as weddings, church dinners, and other gatherings where a large number of people ate the same food. Today's food is produced in vastly different ways from those of even several decades ago. Food used to be grown, produced, and distributed on a local basis. Food production is now centralized and on a larger scale than in the past. Products made in a single processing plant in mass quantities are shipped all over the country, sometimes throughout the world. A mistake made in the processing will be felt nationwide instead of just locally. In 1994 an estimated 224,000 people throughout the nation became ill from Salmonella enteritidis after eating ice cream produced at one ice cream processing facility in Minnesota, but shipped around the country (Hennessy, 1996). Recalls from processing plants are on a larger and larger scale. In 1998 Sara Lee recalled 35 million pounds of hot dogs and lunch meat due to the presence of Listeria. This is food contamination on a scale unprecedented a generation ago.

Even the manner in which farmers raise animals can contribute to an increase in food safety problems. A large number of animals are often crowded together, increasing their stress levels and weakening their immune systems. This crowding also facilitates the spread of disease from one animal to another. In the old days a sick animal would be fairly isolated and if it became sick it would not pass on illness to the rest of the flock or herd. But with closer animal-to-animal contact, disease can quickly spread throughout the whole group.

New and Evolving Pathogens

As recently as fifty years ago scientists had identified four foodborne pathogens. Today five times that number are on the list. Twenty years ago scientists did not even recognize three of the four pathogens that the Centers for Disease Control considers the most important in causing foodborne illnessCampylobacter jejuni, Listeria monocytogenes, and E. coli O157:H7. C. cayetanensis first appeared in 1979 and is still not well understood. It is likely that scientists will discover new foodborne pathogens as laboratory techniques improve.

As living organisms, pathogens are constantly evolving. With better ability to trace outbreaks, scientists are discovering that some bacteria survive in environments previously thought safe. For example, E. coli O157:H7, originally called "hamburger disease" because of its presence in undercooked ground beef, has shown up in foods as diverse as salami, apple cider, raw milk, and lettuce. It also survives in lower pH conditions than originally thought, leading to the outbreaks in acidic foods such as salami and apple cider. It is now known that Yersinia enterocolitica and L. monocytogenes can survive and multiply at refrigeration temperatures.

Some foods long considered safe have recently been implicated in foodborne outbreaks. For years scientists believed the inside of an egg was sterile and that Salmonella enteritidis was not of concern. Now however, they know that chickens infected with Salmonella pass this infection along in their eggs, so that the bacteria can be found inside the raw egg, making it unsafe to eat raw or undercooked eggs. This was not known until 1989. Knowledge of this fact caused food safety experts to advise people to cook eggs thoroughly or to use liquid pasteurized eggs.

Bacteria have long been capable of evolving to thwart attempts to eliminate them. Some pathogens are now becoming resistant to common antimicrobial agents. It is thought that the resistance may be related to the sub-therapeutic use of these antibiotics in animals. We are seeing this same adaptability in foodborne bacteria. Salmonella typhimurium DT104 is widely distributed in wild and farm animals, especially in Europe, and is resistant to several common antibiotics. There has been a parallel increase with people getting sick from this type of drugresistant Salmonella.

History of Food Safety

Very little about foodborne illness or food safety is found in historical records. Scientists did not begin to understand bacteria, and their relationship to disease, until the late nineteenth century. People did recognize that food spoils, but the reasons for that and the potential for becoming ill from food were not known. The history of food safety is really the history of the numerous discoveries, inventions, and regulations that all led to the present knowledge.

Food preservation methods such as drying, smoking, freezing, marinating, salting, and pickling have their beginnings thousands of years ago. Whether these methods were employed solely to keep food for later use, to improve flavor, or for other reasons is not known; but for whatever reason they were developed, they also had the effect of keeping food safer. Even cooking can be viewed as an ancient method of making food safer. The Chinese Confucian Analects of 500 B.C.E. warned against consumption of sour rice, spoiled fish or flesh, food kept too long, or insufficiently cooked food. The Chinese disliked eating uncooked food, believing that anything boiled or cooked cannot be poisonous. It is possible that the practice of drinking tea originated because tea required using hot water, which would make it safer than using unheated contaminated water (Trager, 1995). Doubtless other cultures in antiquity, while oblivious to the causes or prevention of foodborne disease, experienced it and prescribed methods to avoid it.

Much of the present knowledge about pathogens and foodborne illness is built on a foundation of scientific discoveries spanning back over three centuries. Italians Francisco Redi and Lazzaro Spallanzani performed experiments that dispelled the theory of spontaneous generation of organisms. The discovery of bacteria in the late nineteenth century, the increased understanding of bacteria's role in disease, and the realization that there is a connection between human diseases and animal diseases led to the ideas that cleanliness is important and that unsanitary conditions can contribute to disease. A leader in this effort was Hungarian physician Ignaz Semmelweiss, who in 1847 required hospital doctors to wash their hands before delivering babies. As a result, maternal death rates plummeted from 10 to 1.5 percent. His colleagues greeted his theory that doctors were carrying disease from person to person with ridicule. Instead they attributed maternal deaths to a phenomenon arising from the combustible nature of pregnant women. Lack of personal hygiene remains one of the main causes of foodborne illness 150 years later.

Louis Pasteur further elucidated the link between spoilage, disease, and microorganisms with his work on fermentation and pasteurization in the 1860s and 1870s. In 1872 German scientist Ferdinand Julius Cohn published a three-volume treatise on bacteria, essentially founding the science of bacteriology. But this new field of bacteriology needed bacteria on which to conduct experiments and study. It took Robert Koch in the 1880s to perfect the process of growing pure strains of bacteria in the laboratory. At first he used flat glass slides to grow the bacteria. His assistant, Julius Richard Petri, suggested using shallow glass dishes with covers, now commonly called Petri dishes. Koch also established strict criteria for showing that a specific microbe causes a specific disease. These are now known as Koch's Postulates. Using these criteria scientists can identify bacteria that cause a number of diseases, including foodborne diseases. In 1947 Joshua Lederberg and Edward Lawrie Tatum discovered that bacteria reproduce sexually, opening up a whole new field of bacterial genetics (Asimov, 1972).

Even though Antonie van Leeuwenhoek, a Dutch biologist and microscopist, had improved the microscope to the degree that small microscopic organisms could be seen as far back as 1673, the discovery of foodborne disease causing microorganisms developed slowly. Although James Paget and Richard Owen described the parasite Trichinella spiralis for the first time in 1835, and German pathologists Friedrich Albert von Zenker and Rudolph Virchow noted the clinical symptoms of trichinosis in 1860, the association between trichinosis and the parasite Trichinella spiralis was not realized until much later. The English scientist William Taylor showed in 1857 that milk can transmit typhoid fever. In 1885, United States Department of Agriculture (USDA) veterinarian Daniel Salmon described a microorganism that caused gastroenteritis with fever when ingested in contaminated food. The bacteria was eventually named Salmonella (Asimov, 1972). August Gärtner, a German scientist, was the first to isolate Bacillus enteritidis from a patient with food poisoning, in 1888. The case was the result of a cow with diarrhea slaughtered for meat; fifty-seven people who ate the meat become ill (Satin, 1999). Emilie Pierre-Mare van Ermengem, a Belgian bacteriologist, was the first to isolate the bacteria that causes botulism, Clostridium botulinum, in 1895. The case concerned an uncooked, salted ham served at a wake in Belgium. Twenty-three people became ill, and three died. In a perhaps overzealous use of the scientific method, M. A. Barber demonstrated that Staphylococcus aureus causes food poisoning. After each of three visits to a particular farm in the Philippines in 1914, he became ill. Suspecting cream from a cow with an udder infection, Barber took home two bottles of cream, let them sit out for five hours, drank some of the cream, and became ill two hours later with the same symptoms as on the farm. He isolated a bacterium from the milk, placed it in a germ-free container of milk, waited awhile, and then convinced two hapless volunteers to drink the milk with him. Sure enough, they all became ill with the same symptoms (Asimov, 1972). In 1945 Clostridium perfringens was first recognized as a cause of foodborne illness. It was not until the years 1975 to 1985 that scientists first recognized some of today's major foodborne pathogensC. jejuni, Y. enterocolitica, E. coli O157:H7, and Vibrio cholerae.

Food Safety Regulations

The earliest food safety regulations in the United States were motivated not by a desire to provide safe food to consumers, but rather out of foreign trade concerns. In 1641 Massachusetts passed the Meat and Fish Inspection Law to assure foreign trading partners that the colony produced high-quality food products. Until the late nineteenth and early twentieth century state and local governments regulated food. Most food was grown and produced locally, so local laws were adequate to deal with problems. As the population changed from rural to urban, and people no longer had a personal connection with food producers, the food supply became more national in scope and distribution. This national scope necessitated national regulation.

The year 1906 was an important one for federal food safety regulation with the passage of both the Pure Food and Drug Act and the Federal Meat Inspection Act. The public was fed up with shocking disclosures of unsanitary conditions in meatpacking plants and the use of poisonous preservatives and dyes in foods. In A Popular Treatise on the Extent and Character of Food Adulterations consumers read that almost every food they purchased was adulterated or mislabeled. The Poison Squad, a group of USDA chemists formed in 1902 to study preservatives used in food products by eating the foods themselves, revealed that many of the chemicals used in food production were harmful to human health. Upton Sinclair's 1906 novel, The Jungle, highlighted the horrible working conditions of the nation's working class by describing in lurid detail the filthy conditions and adulteration of meat that was common in the Chicago meat industry. The public was more horrified at the thought of rats and other undesirables mixed in with their sausage than of the poor treatment of workers. Sinclair later wrote, "I aimed at the public's heart and by accident hit it in the stomach." Meat sales dropped by half within weeks after the book's publication.

The Federal Meat Inspection Act protected consumers by "assuring that meat and meat food products are wholesome, not adulterated, and properly marked, labeled, and packaged." The act established sanitary standards and mandated continuous inspection of cattle, sheep, goats, and equines before, during, and after slaughter. The 1906 Pure Food and Drug Act forbade the adulteration of foods, drinks, and drugs in interstate commerce. Foods were considered misbranded if they were labeled so as to deceive the public, if the contents in terms of weights and measures were either incorrect or not present on the package, or if the label contained any false or misleading statement concerning the ingredients of a food.

Although it was a good start, the Pure Food and Drug Act had some very large flaws. Since it did not set standards as to what exactly should be in a particular food, it was almost impossible to prove adulteration of a food. For example, without knowing how much strawberry was supposed to be in strawberry jam, federal lawyers could not prove that a product with almost no strawberry in it was not strawberry jam. The act required the government to prove that offenders intended to deceive or poison consumers with their product. When brought to court defendants pleaded ignorance of the results of their actions. These deficiencies led to a renewed push for regulatory reform in the 1930s.

In 1933 Arthur Kallet and F. J. Schlink published the immensely popular book 100,000,000 Guinea Pigs: Dangers in Everyday Foods, Drugs and Cosmetics. Written in true muckraking style, it stirred the public's ire at the condition of the food they were eating. The basic premise of the book was that the federal government was unable to protect consumers from bad food and drugs, both due to incompetence and to the lack of adequate laws.

As with passage of the 1906 act, public opinion played a strong role in sending the message to Congress that reform was needed. Since much of the media sided with the food manufacturing industry against reform, the Food and Drug Administration (FDA) took its message directly to the people, speaking at women's clubs, to civic organizations, and on the radio. The FDA collected hundreds of products (both food and drug) that had injured or cheated consumers, emphasizing that the 1906 act did not regulate these products enough to prevent such occurrences. The exhibits were photographed and converted into posters to illustrate the need for new laws. They were displayed at FDA talks and at a museum in FDA headquarters. The exhibit was christened the "Chamber of Horrors," leading to the publication of The American Chamber of Horrors by the FDA's Chief Educational Officer, Ruth deForest Lamb, in 1936. Ms. Lamb recounted some of the little-known, and sickeningly lurid, behind-the-scenes details of the food industry. In arguing the need for a new food and drug law, she noted that the 1906 laws were outdated due to new modes of living, new kinds of products, new methods of manufacturing and selling, new tricks of sophistication, and new scientific discoveries, all demanding a more modern method of control.

Finally, in 1938, Congress passed the Federal Food, Drug, and Cosmetic Act (FDCA). This act, with a number of adjustments and amendments, is still the major force regulating foods. It continued with many of the intentions of the 1906 act, but broadened the scope of federal regulation and plugged many of the loopholes. For the first time the law defined adulteration to include bacteria or chemicals that are potentially harmful; allowed the FDA to inspect food manufacturing and processing facilities; required ingredients of nonstandard foods to be listed on labels; prohibited the sale of food prepared under unsanitary conditions; gave the FDA the authority to monitor animal drugs, feeds, and veterinary devices; and authorized mandatory standards for foods. Few laws have as great an impact on the life and health of Americans as does the Food, Drug, and Cosmetic Act. The overall function of the law was to prevent the distribution of harmful or deceptive food and drug products.

Seafood regulation came about on a voluntary basis with the Seafood Inspection Act of 1934. In the early 1930s, canned shrimp processors found that the FDA was seizing increasingly large amounts of their product because of decomposition. Poor fishing practices and poorly supervised packing operations contributed greatly to the spoilage of shrimp products. As the canners could not themselves influence fishermen and packers to improve their handling of the product, they requested that Congress enact an inspection law. Packers of any seafood product could request an inspector to examine the premises, equipment, methods, containers, and materials used. If the inspection was favorable, they could use that information on their label. The new seafood inspection program had an almost immediate favorable effect on the canned seafood industry. Product quality improved and the industry was able to regain consumer confidence in its product.

In August 1996, Congress signed into law the Food Quality Protection Act (FQPA), fundamentally changing the way the Environmental Protection Agency (EPA) regulates pesticides used in the production of food. The FQPA sets special provisions concerning pesticide ingestion for infants and children. Because little data exist on pesticide intake for children, an additional safety factor of up to tenfold, if necessary, is to be used. All existing tolerances are to be reviewed within ten years, and consideration of children's special sensitivity and exposure to pesticide chemicals must be taken into account when setting tolerance levels. The EPA is now required to periodically review pesticide registrations, with a goal of establishing a fifteen-year cycle, to ensure that all pesticides meet updated safety standards. Most importantly, the new law establishes a health-based safety standard for pesticide residues in all foods. It uses "a reasonable certainty that no harm" will result from all combined sources of exposure, including drinking water, as the general safety standard. This last facet of the FQPA is perhaps the most important because it eliminates the Delaney Clause of the Food, Drug, and Cosmetic Act, which prohibited the addition of any cancer-causing substance, no matter how small the amount, from being added to foods.

Hazard Analysis and Critical Control Points (HACCP)

In 1996 USDA issued its Pathogen Reduction: Hazard Analysis and Critical Control Points (HACCP) System rule. This rule requires that all 6,500 meat and poultry processing plants in the United States operate under a HACCP system. The FDA began its own HACCP regulations with a 1995 rule that mandated seafood processing facilities must have in place a HACCP plan by 1997. The 1999 FDA Food Code incorporates HACCP principles and in 2001 the FDA mandated that all producers of fruit and vegetable juices use HACCP principles by 2004.

Since the passage of the Meat Inspection Act in 1906, inspectors had visually examined and smelled meat to determine if it was safe or not. Such methods are not effective against the main threat to the safety of food todaybacteria so small that they cannot be seen or smelled. The failure of inspection methods in the United States came to the fore in 1993 when an outbreak of E. coli O157:H7 in hamburgers in the northwestern United States sickened over five hundred people and killed four. This provided the final push needed for the U.S. Department of Agriculture (USDA) to issue the Pathogen Reduction: Hazard Analysis and Critical Control Points (HACCP) System rule in 1996. Under HACCP regulations, the food processing industry assumes primary responsibility for the safety of the food it produces. The government's role is to verify that the industry is carrying out its responsibility, and to initiate appropriate regulatory action if necessary.

HACCP started from a National Aeronautics and Space Administration (NASA) food safety program in the 1960s. NASA needed to come as close as possible to 100 percent assurance that the foods astronauts consumed while on space missions would be free of bacterial or viral pathogens. NASA, the U.S. Army Natick Laboratories, and the Pillsbury Company began to develop these first space foods. While Pillsbury researchers struggled with problems such as how to keep food from crumbling in zero gravity, they also realized that traditional food quality control programs would not provide the degree of safety desired. To produce the safest food possible, they needed to have control over their production process, the raw materials, the environment, and their employees. To provide this level of control, in 1971 they introduced the HACCP system.

A typical HACCP system identifies critical points during food processing where contamination is likely to occur.Then, controls can be put in place to focus on these critical areas. Traditionally, industry and regulators depended on spot-checks of manufacturing conditions and random sampling of final products to ensure safe food. This approach, however, tends to be reactive, rather than preventive. HACCP is a preventive, systematic approach to food safety, rather than a reactive method. One key advantage of HAACP is that it focuses on identifying and preventing hazards that may contaminate food, thereby allowing control to be exerted in the manufacturing phase, rather than after food is produced. HAACP permits more efficient and effective government regulation, primarily because record keeping allows investigators to see how well a firm is complying with food safety laws over a given extended period rather than only on a given day. HACCP has achieved international recognition as the most effective means of controlling foodborne disease. The National Academy of Sciences, the joint Food and Agriculture Organization/World Health Organization Codex Alimentarius Commission, and the U.S. National Advisory Committee on Microbiological Criteria for Foods (NACMCF) all endorse the use of HACCP.

HACCP involves seven principles:

  1. Analyze potential hazards (biological, such as a microbe; chemical, such as a toxin; or physical, such as ground glass or metal fragments) associated with a food and determine measures to control those hazards.
  2. Identify critical control points in the production of a foodfrom its raw state through processing and shipping to consumptionat which it is possible to control or eliminate the potential hazard. Examples are cooking, cooling, packaging, and metal detection.
  3. Establish preventive measures with critical limits for each control point. For a cooked food, this might include setting the minimum cooking temperature and time required to ensure elimination of harmful microbes.
  4. Establish proceduressuch as how cooking time and temperature should be checked, and by whomto monitor critical control points.
  5. Establish corrective actions to be taken when monitoring shows that a critical limit has not been metfor example, reprocessing or disposing of food if the minimum cooking temperature is has not been attained.
  6. Establish procedures to verify that the system is working properlyfor example, testing time and temperature recording devices to make sure that a cooking device is working properly.
  7. Establish effective record keeping to document that the HAACP system is working properly, by maintaining records of hazards, methods to control them, monitoring to ensure safety requirements are met, and actions taken to control potential problems.

To protect the public from foodborne illness, more and more of the U.S. food industry is operating under voluntary or mandatory HACCP controls. The Food and Drug Administration issued HACCP regulations requiring seafood processing facilities to have a HACCP plan in place by 1997. The 1999 FDA Food Code incorporated HACCP principles, and much of the retail food industry is moving toward implementation of HACCP requirements. In 2001, the FDA implemented HACCP regulations for fruit and vegetable juices after several high-profile foodborne illness outbreaks from the consumption of contaminated juice. The dairy industry is also moving toward adopting a HACCP systems, as are other sectors of the food industry

Food Safety at the International Level

Several international organizations interact to improve the safety of the world's food supply. The Food and Agricultural Organization (FAO) was founded as part of the United Nations in 1945 to raise levels of nutrition and standards of living, to improve agricultural productivity, and to better the condition of people in rural areas. Food safety is an important part of FAO's mission since foodborne disease is one of the most widespread threats to human health, as well as an important cause of reduced economic productivity. The World Health Organization (WHO), founded in 1948, has as its mission to set global standards of health and to aid governments in strengthening national health programs. WHO recognizes that protecting consumers from contaminants and preventing foodborne diseases are two of the most important strategies for overcoming malnutrition in the world. WHO's activity in food safety issues centers around development of national food safety policies and infrastructures, food legislation and enforcement, food safety education, promotion of food technologies, food safety in urban settings and in tourism, surveillance of foodborne diseases, and monitoring of chemical contaminants in food. FAO and WHO collaborate on many food safety issues as joint FAO/WHO committees and conferences.

One of the most important joint FAO/WHO commissions is the Codex Alimentarius Commission. This body has as its task the development of uniform food standards that can be used by governments throughout the world. This food code is known as the Codex Alimentarius. The Codex Alimentarius consists of food standards for commodities, codes of practice for hygiene and technology, pesticide evaluations and limits for pesticide residues, evaluations of food additives, guidelines for contaminants, and evaluations of veterinary drugs. Although the main goal of the Codex is to set uniform regulatory standards in the interests of international trade, it has also served to raise food safety standards in many countries. One hundred forty member nations accept its standards and follow its codes of practice.

See also Codex Alimentarius ; FAO (Food and Agriculture Organization) ; Government Agencies, U.S. ; International Agencies ; Labeling, Food ; Pesticides .

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Olsen, Sonja J., Linda C. MacKinon, et al. "Surveillance for Foodborne-Disease OutbreaksUnited States, 19931997." Morbidity and Mortality Weekly Report. 49 (17 March 2000): 162. Available at http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/ss4901a1.htm

Proceedings of the Fourth ASEPT International Conference, Laval, France, 1996. Edited by A. Amgar, pp. 185195.

Rawson, Jean M., and Donna U. Vogt. Food Safety Agencies and Authorities: A Primer. Congressional Research Service Report for Congress; 98-91 ENR. Washington, D.C.: Congressional Research Service, 1998. Available at http://www.cnie.org/NLE/CRSreports/Agriculture/ag-40.html.

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United States Food and Drug Administration. Food Safety: A Team Approach. Washington, D.C.: Dept. of Health and Human Services, 24 September 1998. Available at http://vm.cfsan.fda.gov/lrd/foodteam.html.

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Vetter, James L. Food Laws and Regulations. Manhattan, Kans.: American Institute of Baking, 1996.

Cynthia A. Roberts

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Food Safety

Food Safety

One of the many luxuries Americans enjoy is access to the safest and most abundant food supply in the world. This stems from many advances and improvements in food safety, sanitation, and crop production that reduce the chance of food-safety problems, including food-borne illness, pesticide contamination, or infectious disease. There are many reasons why food safety has become an issue. First, medical advances have made it possible for people to live longer, creating an aging population more susceptible to disease. Second, labor in the food industry is more diverse and less skilled. Learning barriers, personnel turnover, and limited food-preparation skills create challenges in training. Third, the U.S. food supply has expanded globally, and many types of food come from areas where food safety standards are less stringent than those in the United States. Other concerns for food safety stem from terrorist threats, food irradiation, and genetically modified foods.

Concerns exist about the use of radioactivity in food irradiation, the presence of possible subsequent toxicity, and the development of more virulent bacteria . These concerns, however, are unfounded and the benefits outweigh the risks. Evidence from over four decades of research in the United States shows the benefits to include a decrease in food-borne pathogens , an increase in the shelf life of some fruits and vegetables, and less fumigant use for controlling insect pests.

Control and Oversight

The Food and Drug Administration (FDA) ensures that injury, such as disease or illness, will not result from substances in food by closely monitoring the food supply. This differs from monitoring for food hazards (the responsibility of the food handler), where harm is possible under normal conditions. Potential food hazards could include improper storage conditions and serving food at unsafe temperatures. The food handler is directly involved in controlling these potential hazards during receiving, storage, preparation, cooking, and service.

The primary agencies that monitor the safety of the U.S. food supply are the FDA, the U.S. Department of Agriculture (USDA), the Environmental Protection Agency, and the U.S. Fish and Wildlife Service. When monitoring the food supply, the FDA focuses first on microbial food-borne illness, followed by natural toxins in food, and residues in food, including environmental contaminants, pesticides, and animal drugs. Nutritional composition and intentional food additives are monitored more closely as artificial food products enter the market. The FDA Food Code, which is published every two years, provides guidance for restaurants, grocery stores, and institutions such as nursing homes on how to prevent food-borne illness. Managers and supervisors of these institutions are now required to be certified in food safety and sanitation. Local, state, and federal regulators use the Food Code as a model to develop their own food safety rules.

Food-Borne Illness

Each year, millions of people become ill from food-borne illness, the most common food safety-issue, although many cases are not reported. Food-borne illness is caused when toxic levels of pathogens or bacteria are present in food. Microbial food-borne illness, commonly called food poisoning , is monitored closely because the cases of food poisoning far outweigh any other type of food contamination. In the case of an infection from a pathogen such as Salmonella, contamination and food-borne illness results when a pathogen in a food product multiplies and infects the human body after ingestion. These microorganisms can multiply in food during agricultural production, transportation, preparation, and storage, or within the digestive tract after a person eats the contaminated food. Factors that contribute to food toxicity include the amount of the initial contamination, the time held in unsafe conditions, and the use of processes to inactivate or remove toxins and pathogens. The Centers for Disease Control and Prevention (CDC) reports that most food-borne illness outbreaks occur from improper handling of food in the retail area of the food industry (e.g., schools, restaurants). Equally important is safe food-handling by consumers who purchase food and consume it at home, since most cases of food poisoning are a result of improper handling or cooking after purchase.

For many victims, food-borne illness results only in discomfort or lost time from the job. Those at higher riskpre-school-age children, older adults in health care facilities, and those with impaired immune systemsfood-borne illness is more serious and may be life threatening. Symptoms of food-borne illness vary, but can include nausea , vomiting, abdominal cramps, headache, and in some cases difficulty speaking and swallowing. Some instances could result in paralysis or death. Fever fatigue and jaundice occur after several days in hepatitis cases.

To protect consumers from food-borne disease, efforts must focus on each point in the farm-to-table chain to better predict and prevent food-borne hazards, and to monitor and rapidly react to outbreaks of food-borne diseases. A food-service establishment should have an effective food-safety program to prevent hazards before they occur. For example, the Hazard Analysis Critical Control Point (HACCP) program is a proactive program initiated by the FDA to ensure food safety for the astronauts in the space program. The process starts by reviewing a food service's standard operating procedures to be sure that food hazards are controlled during receiving, storage, preparation, service, and cooling of foods for later use. An examination of sanitation, as well as food handlers' personal hygiene and work practices are important as well.

Pesticides and Biotechnology

The use of pesticides to control damage of food crops and enhance production has created a controversy related to potential hazards to consumers. While pesticides can be part of a safe food-protection program, they can be hazardous when handled or used inappropriately. High doses of pesticides applied to laboratory animals cause birth defects, sterility, tumors, organ damage, and central nervous system impairment. As with antibiotics , the targeted insects become resistant and can survive exposure, emerging with increased vigor to again attack the crop. The same effects arise from herbicides and fungicides used on crops. New labeling laws introduced by the FDA in October 2002 have caused some organic producers to drop the term organic from their label, finding the requirements too restrictive.

Genetically modified foods have been a cause of concern in many parts of the world since their introduction, particularly in Europe. Campaigns have been launched by many groups opposing the practice of genetically altering enzymes , amino acids , and genes in foods for the purposes of increasing crop yields, nutritional quality, and profits while decreasing food waste. Whether it is about changing the degree of saturation in oils or adding amino acids to corn to make it a more complete protein source, food technologists are working hard to change the chemical make-up of food.

Organic farming groups and others will likely continue to fight against the use of pesticides and genetic modification in food production for years. When trying to feed the world, one must weigh the risks and benefits of both when establishing food-safety regulations.

Bioterrorism

With the advent of vaccines and antibiotics, many people in developed countries had become complacent about infectious diseases . However, the increase in acts of worldwide terrorism has caused food security to become a major concern for the food industry and for public health officials. Deliberate biological or chemical contamination of food or water remains the easiest method for widespread terrorism, according to the CDC, and since everyone eats, all are open to an attack. Bioterrorism and the emergence of strains of diseases that have become resistant to antibiotic therapy (such as

1897 Tea Importation ActCustoms inspection for purity
1890 First U.S. Legislation on Meat Inspection
1906 Certified Color Regulationslisted 7 artificial colors found suitable for foods
1907 Federal Meat Inspection Actarose out of unsanitary conditions in meatpacking plants, use of poisonous preservatives and dyes in food, and cure-all claims for worthless and dangerous medicines
1923 Filled Milk Act
1938 Federal Food, Drug, and Cosmetic Act
1939 First Food Standards for canned tomatoes, tomato puree, tomato paste for consistency
1944 Public Health Service Actcovered a broad spectrum of health concerns including regulation of biological products and control of communicable disease
1954 Pesticide Amendment Actfollowed recall of cranberries found with pesticide that can cause cancer
1954 Radiological Examination of Foodbrought on by reports that tuna suspected of being radioactive were being imported from Japan following atomic blasts in the Pacific
1957 Poultry Products Inspection
1958 Food Additives Amendmentrequired manufactures of new additives to establish safety
1960 Color Additive Amendmentssimilar to food additives, identified safe colors
1966 Fair Packaging and Labeling Actrequired honest labels
1967 Wholesome Meat Actstate (intrastate) inspections to match the federal inspection guidelines and closed loopholes in the 1906 act which required only interstate inspection
1968 Wholesome Poultry Productsincluded interstate and intrastate inspection guidelines for poultry
1970 Egg Products Inspection Act
1980 Swine Health Protection Act
1990 Sanitary Food Transportation Act

tuberculosis and some food-borne infections) constitute growing threats to health and life around the globe. An attack through plant or animal disease would have significant economic impact.

Current systems that detect food-borne illness outbreaks and link them to their source need to be enhanced for defense against food bioterrorism. However, the potential for an undetected contamination in industrialized countries is relatively low. Once food has been processed and readied for distribution, quick identification of any contamination and isolation from distribution is required. Imported food products may be more likely to be contaminated with a pathogen by terrorist groups. Another concern is deliberate infection of crops and herds.

Citizens must rely on government security and public health measures such as emergency preparedness, secure food and disinfected water supplies, and good medical care to reduce the likelihood of contamination. In response to an increased risk of terrorism, the Alliance for Food Security has partnered with the FDA and the National Food Processors Association to provide domestic food and water security. In addition, the FDA has published a guide that outlines strategies to minimize contamination, providing guidance in seven areas of food service, from management to operations.

History and Purpose of Food Safety Regulations

The U.S. Public Health Service Commissioned Corp (PHS) is a uniformed service of the United States comprised of health professionals and led by the Office of the Surgeon General. The origins of the agency can be traced to a 1798 act that was passed to provide care for sick and injured merchant seamen. Formalized in 1889, it oversaw quarantines and medical examinations of immigrants. The agency commissioned officers to control the spread of contagious diseases such as smallpox and yellow fever through the 1900s. It also conducted biomedical research, provided health care to deprived groups, and supplied medical assistance to victims of natural disasters.

The PHS began its food-protection activities in the early 1900s with studies on the role of milk in the spread of disease. Model food codes and other regulations soon evolved to ensure food quality and safety. These include sanitary practices at processing plants, safety standards for ingredients, and labeling laws to assist state and local governments in initiating and maintaining effective programs for the prevention of food-borne illness.

see also Additives and Preservatives; Biotechnology; Genetically Modified Foods; Irradiation; Organisms, Food-Borne; Pesticides; Regulatory Agencies.

Marilyn K. Dahl

Bibliography

Jackson, R. (1997). Nutrition and Food Services for Integrated Health Care. Gaithersburg, MD: Aspen.

National Restaurant Association Foundation (2002). ServSafe Essentials, 2nd edition. Chicago: Author.

Sizer, Francis, and Whitney, Eleanor (2003). Nutrition Concepts and Controversies, 9th edition. Belmont, CA: Wadsworth/Thomson.

Internet Resources

U.S. Food and Drug Administration, Center for Food Safety and Applied Nutrition. FDA Food Code. Available from <http://www.dfsan.fda.gov>

U.S. Food and Drug Administration, Center for Food Safety and Applied Nutrition. "Retail Food Stores and Food Service Establishments: Food Security Preventative Measures Guidance." Available from <http://www.dfsan.fda.gov>

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Food Safety

Food safety

Food is a source of nutrients not only to humans but to microorganisms as well. The organic compounds and moisture that are often present in foods present an ideal environment for the growth of various microorganisms. The monitoring of the raw food and of any processing steps required prior to the consumption of the food are necessary to prevent transmission of disease-causing microorganisms from the food to humans.

Bacteria , viruses , parasites , and toxin by-products of microorganisms, chemicals, and heavy metals can cause food-borne maladies. These agents are responsible for over 200 different foodborne diseases. In the United States alone, foodborne diseases cause an estimated 75 million illnesses every year, and 7,000 to 9,000 deaths.

Aside from the human toll, the economic consequences of foodborne illnesses are considerable. In 1988, for example, human foodborne diarrheal disease in the United States cost the U.S. economy an estimated five to seven billion dollars in medical care and lost productivity.

The threat from foodborne disease causing agents is not equal. For example, the Norwalk-like viruses cause approximately 9 million illnesses each year, but the fatality rate is only 0.001%. Vibrio vulnificus causes fewer than 50 cases each year but almost 40% of those people die. Finally, the bacteria Salmonella, Listeria monocytogenes, and Toxoplasma gondii cause only about 20% of the total cases but are responsible for almost 80% of the total deaths from foodborne illnesses.

The Centers for Disease Control data has demonstrated that Campylobacter jejuni is the leading cause of foodborne illness in the United States. Another bacteria, Salmonella is the next leading cause. The third cause of foodborne illness is the bacterium Escherichia coli O157:H7. Poultry and ground meat are prime targets for bacterial contamination . Indeed, monitoring studies have demonstrated that some 7090% of poultry carry Campylobacter jejuni.

Food safety needs to consider the influences of the microbial pathogen, the human host and the exposure of the food to the environment that promotes contamination. The environment can include the physical parameters such as the temperature, moisture, or other such factors. As well the environment can be the site of the foodstuff, such as the farmyard or the processing plant. Ensuring safety of food from microbial threat must consider all three of the influences. For example, reducing the length of time that a food is exposed to a questionable environment, but doing nothing to remove microbes from the environment only slightly reduces the risk of food contamination. Significant protection of foods depends on reducing the risk from the environment, microorganism of interest and of the human host.

The treatment of foods prior to consumption is a vital factor in ensuring food safety. Some of these treatments have been known for a long time. Salting of meats and drying of foods on long sea voyages was practiced several centuries ago, for example. The canning of foods began in the eighteenth century. Within the last 150 years, the link between hygienic conditions and the quality and safety of foods was recognized. Some of the advances in food safety arose from the need for foods on long military campaigns, such as those undertaken by Napoleon in the nineteenth century. Also, advances were spurred by the demands of the nascent food industry. As the distance between the farm and the market began to grow larger, and the shipping of food became more commonplace, the problems of food contamination became evident. Practices to render food safe for shipping, storage and subsequent consumption were necessary if the food industry was to grow and flourish.

The heat treatment of milk known as pasteurization began in the 1890s. Pasteurization is the transient exposure of milk to temperatures high enough to kill microbes, while preserving the taste and visual quality of the milk. Milk is now routinely pasteurized before sale to kill any bacteria that would otherwise growth in the wonderful growth medium that the liquid provides. Within the past thirty years the use of radiation to kill microbes in food has been utilized. While a very effective method to ensure food safety, irradiation is still subject to consumer uncertainty, which has to date limited its usefulness. As a final example, within the past two decades, the danger posed by intestinal bacterial pathogens, particularly Escherichia coli O157:H7 has resulted in the heightened recognition of the need for proper food preparation and personal hygiene .

Food safety is also dependent on the development and enforcement of standards of food preparation, handling and inspection. Often the mandated inspection of foods requires the food to be examined in certain ways and to achieve set benchmarks of quality (such as the total absence of fecal coliform bacteria). Violation of the quality standards can result in the immediate shut down of the food processing operation until the problem is located and rectified.

Most of the food safety legislation and inspection efforts are aimed at the processing of food. It is difficult to monitor the home environment and to enforce codes of hygiene there. Yet, food safety in the home is of paramount importance. The improper storage of foods prepared with raw or undercooked eggs, for example, can lead to the growth of microorganisms in the food. Depending on the microbe and whether toxins are produced, food poisoning or food intoxication can result from eating the food dish. Additionally, improper cleaning of cutting and other preparation surfaces can lead to the cross-contamination of one food by another. Good hygienic practices are as important in the home as on the farm, in the feedlot, and in the processing plant.

See also BSE and CJD disease; BSE and CJD disease, advances in research; BSE and CJD disease, ethical issues and socio-economic impact; Enterotoxin and exotoxin; Food preservation; Transmission of pathogens

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