FOOD SAFETY Suzette DeCastro,Ph.D student, MS, RD, LDWalden UniversityPUBH 8165-01Dr Robert Marinospring quarter 4/11/11

Purpose of this service based project Introduction to concepts and principles on how to Introduction to concepts and principles on how to

serve safe foodserve safe food Understanding the food safety risks faced in food Understanding the food safety risks faced in food

service establishmentsservice establishments Identifying risks in food service and finding ways Identifying risks in food service and finding ways

to reduce themto reduce them maintaining quality food services in ones maintaining quality food services in ones

operation as well as keeping customers and operation as well as keeping customers and employees safe.employees safe.

Learning Outcomes

Will Recognize the importance of food safetyWill Recognize the importance of food safety Will Recognize the risks associated with high risk Will Recognize the risks associated with high risk

populations populations Will Avoid potential hazards to food safetyWill Avoid potential hazards to food safety Will Understand the process of how food Will Understand the process of how food

becomes unsafebecomes unsafe Will understand prevention measures to keeping Will understand prevention measures to keeping

food safefood safe

Food Borne Illnesses

A disease transmitted to people by food.A disease transmitted to people by food. Two or more people get the same illness after Two or more people get the same illness after

eating the same food.eating the same food. Each year CDC estimates 1 in 6 or 48 million Each year CDC estimates 1 in 6 or 48 million

people will get sick from unsafe food.people will get sick from unsafe food. 128,000 are hospitalized and 3000 persons die 128,000 are hospitalized and 3000 persons die

from food borne illnesses (National Restaurant from food borne illnesses (National Restaurant Assoc, 2005)Assoc, 2005)

Foodborne Active Surveillance Network, United States, 1996–20092

                                                                                                                                                                

                    

Costs of Food Borne Illnesses

Illnesses cost the US billions of dollars each year. Illnesses cost the US billions of dollars each year. Associated costs are medical, lost productivity, Associated costs are medical, lost productivity, and death.and death.

Serious Health Issue according to the Economic Serious Health Issue according to the Economic Research Service of the USDAResearch Service of the USDA

Each year 6.9 billion in costs are associated with Each year 6.9 billion in costs are associated with five bacterial pathogensfive bacterial pathogens

Campylobacter, Salmonella, Listeria Campylobacter, Salmonella, Listeria monocytogenes, and types of E. Coli. monocytogenes, and types of E. Coli. (CDC, 2011) (CDC, 2011)

Figure 2. Changes in incidence of laboratory-confirmed bacterial infections, United States, 20091 compared with 1996–1998

                                                                                                                                                           

Rates of lab confirmed infections

•FOODNET SURVEILLANCE in 1996, CDC has seen important declines in infections caused by six of the seven bacterial pathogens tracked—Yersinia, Shiga toxin–producing Escherichia coli (STEC) O157, Shigella, Salmonella, Listeria, and Campylobacter.

•Salmonella, the most commonly diagnosed and reported food borne illness, continues to be a challenge. The incidence of Salmonella infections has declined by only 10% since FoodNet surveillance began. (CDC, 2011)

•Rates of infection were substantially higher for Vibrio in 2009 than in 1996–1998.

•Rates of infection were at least 25% lower for Shigella, Yersinia, Campylobacter, and Listeria than they were a decade ago.• •Rates of infection with STEC O157, which causes one of the •most severe forms of foodborne illness, decreased by 25% in 2009 compared with the most recent 3 years, reaching the lowest level since 2004.

(CDC, 2011)

Table 2. TOP five pathogens contributing to domestically acquired foodborne illnesses

PathogenEstimated number of illnesses

90% Credible Interval

%

Norovirus 5,461,731 3,227,078–8,309,480

58

Salmonella, nontyphoidal

1,027,561 644,786–1,679,667

11

Clostridium perfringens

965,958192,316–2,483,309

10

Campylobacter spp.

845,024 337,031–1,611,083

9

Staphylococcus aureus

241,148 72,341–529,417

3

Subtotal 91

Populations at High Risk for Food borne Illnesses The ElderlyThe Elderly Infants and pre-school age childrenInfants and pre-school age children Pregnant womenPregnant women Persons with diagnosed medical condition Persons with diagnosed medical condition

that have a compromised immune system that have a compromised immune system such as AIDS patients and cancer patients such as AIDS patients and cancer patients (National Restaurant Assoc, 2005)(National Restaurant Assoc, 2005)

Safe Internal food temperatures

• CLEANClean your hands with soap and warm water before handling food. Clean surfaces before preparing food on them.

• SEPARATESeparate cooked foods from ready-to-eat foods. Do not use utensils on cooked foods that were previously used on raw foods and do not place cooked foods on plates where raw foods once were unless it has been cleaned thoroughly. (CDC, 2011)

Safe Internal Food temperatures

• CHILLChill foods promptly after serving and when transporting from one place to another. Keep your refrigerator at 40°F or below. Keep hot foods hot and cold foods cold.

• COOKCook foods to a safe internal temperature (see chart). Use a meat thermometer to make sure foods are cooked to a safe temperature. Color is not an indicator of doneness. ( CDC, 2011)

• If a public health official contacts you to find out more about an illness you had, your cooperation is important.

• In public health investigations, it can be as important to talk to healthy people as to ill people. Your cooperation may be needed even if you are not ill.

•For more information on preventing food borne illnesses

• visit FoodSafety.gov  , the federal gateway for food safety information. (CDC, 2011)

Safe food temperatures

• SAFE FOOD TEMPERATURES

•REPORT: Report suspected food borne illnesses to your local

• health department. The local public health department is an important part of the food safety system.

•Often calls from concerned citizens are how outbreaks are first detected. ( CDC, 2011)

THE FDA FOOD CODE

is issued by the FOOD and Drug Administration. It outlines the federal governments recommendations for food safety regulations for the food service industry.

Health inspectors from state health departments conduct food service inspections of food service establishments.

Self- Inspections- A well managed food service operation have frequent self inspections to keep food safe. (CDC, 2011)

FOOD Safety Regulations & Standards

The FDA Food Safety Modernization Act (FSMA) was signed into law by President Obama on January 4th, 2011.

It aims to ensure the U.S. food supply is safe by shifting the focus of federal regulators from responding to contamination to preventing it. (FDA, 2011)

Preventing Food Borne Illnesses Practicing Good Personal HygienePracticing Good Personal Hygiene Controlling the time and temperature of Controlling the time and temperature of

foodsfoods Avoiding cross contamination of foodsAvoiding cross contamination of foods Purchasing from approved reputable Purchasing from approved reputable

suppliers (National Restaurant Assoc, suppliers (National Restaurant Assoc, 2005) 2005)

                                                                                                                        

Potential Hazards to Food Safety

Biological- pathogens such as viruses, Biological- pathogens such as viruses, parasites, fungi, and bacteria.parasites, fungi, and bacteria.

These harmful microorganisms may These harmful microorganisms may produce poisons or toxins in the food or the produce poisons or toxins in the food or the host.host.

Chemical- cleaners and sanitizersChemical- cleaners and sanitizers Physical- foreign objects can get into food. Physical- foreign objects can get into food.

Moeller, 2005) Moeller, 2005)

How Food Becomes Unsafe?

Purchasing food from unsafe sources.Purchasing food from unsafe sources. Failing to cook food adequately.Failing to cook food adequately. Holding food at the incorrect temperatures.Holding food at the incorrect temperatures. Using contaminated equipmentUsing contaminated equipment Practicing poor personal hygiene (CDC, Practicing poor personal hygiene (CDC,

2011) 2011)

What Pathogens need to grow?

Food or an energy source.Food or an energy source. Acidity- Pathogens grow best in food that contains Acidity- Pathogens grow best in food that contains

no or little acid (ph of 4-7)no or little acid (ph of 4-7) Temperature- Pathogens grow well in food in the Temperature- Pathogens grow well in food in the

range known as the temperature danger zone (41F- range known as the temperature danger zone (41F- 135F)135F)

Time- Pathogens need time to grow especially Time- Pathogens need time to grow especially after four hours.( National Restaurant Assoc, after four hours.( National Restaurant Assoc, 2005)2005)

Cont.. What conditions do Pathogens need to grow?? Oxygen- Some pathogens need oxygen to grow. Oxygen- Some pathogens need oxygen to grow.

While others can grow in anaerobic conditionsWhile others can grow in anaerobic conditions Moisture- Pathogens need moisture in food to Moisture- Pathogens need moisture in food to

grow.grow. Viruses are leading cause of food borne illness, Viruses are leading cause of food borne illness,

such as with hepatitis A and the Norovirus. These such as with hepatitis A and the Norovirus. These illnesses are linked with ready to eat food and illnesses are linked with ready to eat food and shellfish (National Restaurant Assoc, 2005). shellfish (National Restaurant Assoc, 2005).

Bacteria and food borne illness

Bacteria can change into different forms Bacteria can change into different forms called spores that keep them from dying called spores that keep them from dying when they don’t have enough foodwhen they don’t have enough food

Other types of bacteria can produce toxins Other types of bacteria can produce toxins in food or in the host.in food or in the host.

National Restaurant Assoc, 2005) National Restaurant Assoc, 2005)

Causes of illness in 1,565 single food commodity outbreaks, 2003–2008

Foods identified in Food borne illnesses Bacillus cereus- cooked rice dishesBacillus cereus- cooked rice dishes

Listeriosis- raw meat and deli meatsListeriosis- raw meat and deli meats

Hemorrohagic colitsis- ground beefHemorrohagic colitsis- ground beef

Clostridium perfringens-meat and poultry Clostridium perfringens-meat and poultry (Moeller, 2005)(Moeller, 2005)

Cont. Foods identified in Food borne illnesses

Shigellosis- saladsShigellosis- salads

Staphylcoccal- deli meats and saladsStaphylcoccal- deli meats and salads

Vibrio vulnificus- oysters from contaminated Vibrio vulnificus- oysters from contaminated waterswaters

( Moeller, 2005) ( Moeller, 2005)

Foods contaminated with ParasitesFoods contaminated with Parasites

AnisakiasisAnisakiasis- raw and undercooked fish- raw and undercooked fish such as cod, mackerel and salmonsuch as cod, mackerel and salmon CryptosporidiosisCryptosporidiosis- produce and - produce and contaminated watercontaminated water GiardiasisGiardiasis- produce and contaminated - produce and contaminated water (National Restaurant assoc, water (National Restaurant assoc, 2005) 2005)

Foods identified in food borne illness Fungi, molds, and yeasts in produce, jams Fungi, molds, and yeasts in produce, jams

and jellies. and jellies. Some molds produce toxins such as Some molds produce toxins such as

aflatoxinsaflatoxins poisonous Mushrooms and plant toxinspoisonous Mushrooms and plant toxins ( Moeller, 2005)( Moeller, 2005)

Seafood and shellfish poisoning

PSP-paralytic shellfish poison, NSP- PSP-paralytic shellfish poison, NSP- neurotoxic shellfish, ASP- amnesic shellfishneurotoxic shellfish, ASP- amnesic shellfish

Clams, oysters, and scallopsClams, oysters, and scallops

Seafood toxins- Scombroid poisoning-tuna Seafood toxins- Scombroid poisoning-tuna fish also known as histamine poisoning fish also known as histamine poisoning

Ciguatera- jacks and red snapper (Moeller, Ciguatera- jacks and red snapper (Moeller, 2005)2005)

Chemical Contaminants

Some utensils and equipment contain toxic metals Some utensils and equipment contain toxic metals that contaminate acidic food.that contaminate acidic food.

A person who eats this food can get toxic-metal A person who eats this food can get toxic-metal poisoningpoisoning

Illness is caused by storing or prepping food with Illness is caused by storing or prepping food with equipment contaminating heavy metals such as equipment contaminating heavy metals such as Lead, Copper, and Zinc.Lead, Copper, and Zinc.

Cleaners, sanitizers, polishes, and machine Cleaners, sanitizers, polishes, and machine lubricants should be kept ot stored away form food.lubricants should be kept ot stored away form food.

( Moeller, 2005)( Moeller, 2005)

Common Food Allergens

Milk and Dairy productsMilk and Dairy products EggsEggs Fish and shellfishFish and shellfish WheatWheat Soy productsSoy products Nuts (National Restaurant assoc, 2005) Nuts (National Restaurant assoc, 2005)

Food Allergens

The number of people in the US is The number of people in the US is increasing who have allergies to food.increasing who have allergies to food.

It is the body’s negative reaction to a food It is the body’s negative reaction to a food protein.protein.

symptoms such as hives, rashes, breathing symptoms such as hives, rashes, breathing difficulties, swelling of face, abdominal difficulties, swelling of face, abdominal cramps, and death with severe reactions cramps, and death with severe reactions (National Restaurant assoc, 2005)(National Restaurant assoc, 2005)

Prevent Food Contamination

Avoid cross contaminationAvoid cross contamination Avoid time –temperature abuseAvoid time –temperature abuse Use of the correct types of thermometers in Use of the correct types of thermometers in

food preparationfood preparation Use of proper personal hygieneUse of proper personal hygiene Purchasing from approved reputable Purchasing from approved reputable

suppliers (Partnership for Food Safety suppliers (Partnership for Food Safety Education, 2011)Education, 2011)

Food Safety Management Systems Develop and implement a personal hygiene Develop and implement a personal hygiene

programprogram Establish supplier selection and a Establish supplier selection and a

specification programspecification program Implement a sanitation and pest and rodent Implement a sanitation and pest and rodent

control program (National Restaurant control program (National Restaurant assoc, 2005)assoc, 2005)

Food service management

Establish facility design and equipment Establish facility design and equipment maintenance programmaintenance program

Implement a food safety training programImplement a food safety training program Implement a food defense program in times Implement a food defense program in times

of emergency or crisisof emergency or crisis (National Restaurant association, 2005)(National Restaurant association, 2005)

Taking an active managerial control approach Mangers need to consider risk factorsMangers need to consider risk factors Mangers need to create policies and Mangers need to create policies and

proceduresprocedures Mangers need to monitor policies and Mangers need to monitor policies and

proceduresprocedures Employees and mangers need to verify the Employees and mangers need to verify the

system (National Restaurant Association, system (National Restaurant Association, 2005)2005)

HACCP (Hazard Analysis and Critical Control Points) A system used to control risks and hazards A system used to control risks and hazards

throughout the flow of food.throughout the flow of food.

It is based on identifying significant It is based on identifying significant biological, chemical and physical hazards at biological, chemical and physical hazards at specific points within a products flow.specific points within a products flow.

( Moeller, 2005)( Moeller, 2005)

HACCP continued

Created by the National Advisory Created by the National Advisory Committee on Microbiological Criteria for Committee on Microbiological Criteria for FoodsFoods

Once hazards are identified they can Once hazards are identified they can prevent, eliminate, and reduce them to safe prevent, eliminate, and reduce them to safe levels.levels.

Must be based on a written plan.(National Must be based on a written plan.(National Restaurant Assoc, 2005)Restaurant Assoc, 2005)

HACCP Principles

Conduct a hazard analysisConduct a hazard analysis Determine critical control points (CCP’s)Determine critical control points (CCP’s) Establish critical limitsEstablish critical limits Establish monitoring proceduresEstablish monitoring procedures

National Restaurant Association, 2005)National Restaurant Association, 2005)

HACCP Principles continued

Identify corrective actionsIdentify corrective actions

Verify that the system worksVerify that the system works

Establish procedures for record keeping and Establish procedures for record keeping and documentationdocumentation

( National Restaurant Association, 2005)( National Restaurant Association, 2005)

Implement a Food Safety Program for Employees

Topics to be provided and reviewedTopics to be provided and reviewed personal hygienepersonal hygiene safe food preparationsafe food preparation proper cleaning and sanitizing of kitchen and proper cleaning and sanitizing of kitchen and

equipmentequipment (Partnership for Food safety Education, 2011) (Partnership for Food safety Education, 2011)

Preparing for a Food Borne Illness Outbreak Implementation of a food safety program Implementation of a food safety program

for all stafffor all staff Develop a food borne illness incident report Develop a food borne illness incident report

formform Train staff to fill out incident formsTrain staff to fill out incident forms Prepare an emergency contact listPrepare an emergency contact list Develop and implement a crisis- Develop and implement a crisis-

communication plancommunication plan

CURRENT FOOD SAFETY CHALLENGES CHALLENGES TO FOOD SAFETY WILL CONTINUE TO ARISE LARGELY DUE TO:

•Changes in our food production and supply

•Changes in the environment leading to food contamination

•Rising number of multistate outbreaks

•New and emerging germs, toxins, and antibiotic resistance• •New and different contaminated foods, such as prepackaged raw cookie dough, bagged spinach, and peanut butter, causing illnesses

( CDC, 2011)

Future Estimates/Implications in Food Borne Illnesses Need for improvements and new innovations Need for improvements and new innovations Future investments and innovations in surveillance Future investments and innovations in surveillance

and data analysis could help increase the accuracy and data analysis could help increase the accuracy of estimates. of estimates.

Future efforts can also be directed toward Future efforts can also be directed toward quantifying the illnesses caused by long-term quantifying the illnesses caused by long-term effects of food borne infections and toxins and to effects of food borne infections and toxins and to estimate the economic costs associated with food estimate the economic costs associated with food borne illness. ( CDC, 2011)borne illness. ( CDC, 2011)

Research in Food Science

• The need for more detailed information on norovirus will better inform future estimates due to the availability of improved surveillance and special studies conducted in the United States. Most of the data underlying the norovirus estimates is from other countries. • • A need for improved information on the cases of acute gastroenteritis that are reported during FoodNet survey.

•Telephone interviews will be needed to help discern whether they might be caused by noninfectious conditions.  (CDC, 2011)

Food safety and Terrorism

• Accounting for illnesses caused by some of the unspecified agents that do not result in acute gastrointestinal illness, as such illnesses were not included in the current estimates.

• Refining estimates of the degree of underreporting of hospitalizations and deaths.

• Drinking water and food supplies is a means to dispersing biological agents such as Clostridium botulinum toxin and Staphylococcus enterotoxin B

• . ( Moeller, 2005)

Food Safety and Terrorism

The American Medical Association has The American Medical Association has developed a CD-Rom that provides state of the art developed a CD-Rom that provides state of the art medical and clinical information for dealing with medical and clinical information for dealing with both biological and chemical attacksboth biological and chemical attacks

Diseases that have been linked to biological agents Diseases that have been linked to biological agents in food are Q fever(Coxiella burnetti), Brucellosis in food are Q fever(Coxiella burnetti), Brucellosis from brucellla species, Burkholderia from brucellla species, Burkholderia mallei(glanders), ricin toxin (Ricinus communis or mallei(glanders), ricin toxin (Ricinus communis or castor beans) , epsilon toxin from Clostridium castor beans) , epsilon toxin from Clostridium perfingens species (Moeller, 2005) perfingens species (Moeller, 2005)

Deliberate contamination of Food

People may try to tamper with food using People may try to tamper with food using biological, chemical, or physical contaminants.biological, chemical, or physical contaminants.

The best way to protect food is to make it hard for The best way to protect food is to make it hard for someone to tamper with it.someone to tamper with it.

A food defense program should deal with the A food defense program should deal with the points in your operation where food is at risk. points in your operation where food is at risk.

(National restaurant assoc, 2005)(National restaurant assoc, 2005)

References

CDC(2011) Food Safety retrieved from CDC(2011) Food Safety retrieved from http://www.cdc.gov/foodsafety/http://www.cdc.gov/foodsafety/

FDA(2011). Food Safety Modernization Act FDA(2011). Food Safety Modernization Act retrieved from http://www.fda.govretrieved from http://www.fda.gov

National Restaurant Association (2008). Servsafe National Restaurant Association (2008). Servsafe Essentials (5Essentials (5thth ed) Chicago, IL ed) Chicago, IL

Partnership for Food Safety Education (2011) Partnership for Food Safety Education (2011) Food safety campaigns. Retrieved from Food safety campaigns. Retrieved from www.fightbac.orgwww.fightbac.org

USDA (2011) Food Safety & Inspection USDA (2011) Food Safety & Inspection Service. Trends in Food Borne Illnesses Service. Trends in Food Borne Illnesses retrieved from www.fsis.usda.govretrieved from www.fsis.usda.gov

Moeller, Dade (2005)Environmental Health Moeller, Dade (2005)Environmental Health (3(3rdrd ed) Cambridge, MA Harvard University ed) Cambridge, MA Harvard University PressPress

References continued

Sources for further reading

Loaharan, P(2003) Irradiated foods(5Loaharan, P(2003) Irradiated foods(5 thth ed) ed) American Council on Science & Health, American Council on Science & Health, NY, NYNY, NY

Metcalfe, D (2003) “Intro:What are the Metcalfe, D (2003) “Intro:What are the issues in addressing the allergenic potential issues in addressing the allergenic potential of gentically modified foods” of gentically modified foods” Environmental Health perspectives 111(8) Environmental Health perspectives 111(8) 1110-11131110-1113

Suggested readings

Red Tide Research Group(2002) “The Red Tide Research Group(2002) “The current of Red Tide research” current of Red Tide research” Environmental Health perspectives. Environmental Health perspectives. 110(3)A 132-A133110(3)A 132-A133

FDA (1995) Food Code. Springfield, VA FDA (1995) Food Code. Springfield, VA National Technical Information serviceNational Technical Information service

Food Net retrieved from Food Net retrieved from http:www.cdc.gov/foodnet/http:www.cdc.gov/foodnet/

Further readings

Food Safety retrieved from Food Safety retrieved from http://www.foodsafety.govhttp://www.foodsafety.gov

HACCP Overview retrieved from HACCP Overview retrieved from http://www.fda.gov/food/foodsafetyhttp://www.fda.gov/food/foodsafety

US EPA Pesticides & Food retrieved from US EPA Pesticides & Food retrieved from http://www.epa.gov/pesticides/foodhttp://www.epa.gov/pesticides/food

Arizona Department of Health Services( 2011) Arizona Department of Health Services( 2011) Ricin:Bioterrorism agent profile for Health acre Ricin:Bioterrorism agent profile for Health acre workers retrieved from http://www.azdhs.govworkers retrieved from http://www.azdhs.gov

Sources for Further Reading

Bad Bud Book retrieved from Bad Bud Book retrieved from http://www.fda.gov/food/foodsafetyhttp://www.fda.gov/food/foodsafety

Bryan, F(2002) Reflections on a career in Public Bryan, F(2002) Reflections on a career in Public health:Evolving food borne pathogens, health:Evolving food borne pathogens, environmental health, & food safety programs. environmental health, & food safety programs. Journal of Environmental Health 65(5) 14-25Journal of Environmental Health 65(5) 14-25

WHO Food Safety retrieved at WHO Food Safety retrieved at http:www.whoint/food safety/enhttp:www.whoint/food safety/en