A while back I was awarded a contract to teach food safety in correctional institutions. I clearly remember an incident when I was talking about not going to work when you are ill as this poses a food safety risk and I went to explain why. Then this massive looking dude about the size of Terry Crews jumps out of his seat yelling at me. Apparently he had worked in the food service industry and had to support a family of five without having any sick time. So, when he was sick he went to work. Thereafter it was blur as 5 correctional officers jumped in the room to detain my friend as I soiled myself from fear…
Heather Williams writes
We put a lot of trust in the people who prepare and serve our food. We expect that our food is safe to eat and handled appropriately. In the United States, we have standards for food safety and many regulations in place. Why wouldn’t we trust those who prepare and serve our food? Unfortunately, a significant number of food workers have admitted to working while knowingly being sick. There are many reasons someone might do this. Some do it for financial reasons, others for sense of duty, and then there are some who fear they may lose their job if they do not cover their shift. Could foodborne illness cases dramatically decrease if food workers could have sick leave, which would allow them monetary compensation for identifying their illness and not passing it on to other unsuspecting patrons? Let’s explore this. Restaurants Are a Primary Source of Foodborne Outbreaks According to the Center for Disease Control and Prevention (CDC), an estimated 48 million people become ill in the United States each year from foodborne infection. Approximately 128,000 are hospitalized and foodborne illness claims about 3,000 lives each year. Over half of all foodborne outbreaks reported to the CDC can be linked back to eating in restaurants or delicatessens. In one study, a group of investigators gathered data from FoodNet. This resource is also known as the Foodborne Diseases Active Surveillance Network, a central database where participating sites report information regarding foodborne illness. In a study analyzing 457 foodborne disease outbreaks, 300 were restaurant related. 98% of the 300 had only one contributing factor causing the outbreak. The most common contributing factor resulting in 137 outbreaks was “handling by an infected person or carrier of pathogen.” This is a significant number considering one lapse can have such high statistical repercussions. The purpose of the study was to identify the contributing factors in restaurant-linked foodborne disease outbreaks. 75% of the outbreaks investigated were linked to Norovirus and Salmonella. These infections were predominately linked back to transmission by food workers. Significant resources are devoted to preventing contamination of food products before they make it to the point of service. Restaurants must ensure that staff have adequate training and understanding for how to handle the food once it becomes in their custody. Food worker health and hygiene were primary factors in contributing to foodborne illness.
Don and I started podcasting because it was kind of fun to chat with each other about nerd stuff every couple of weeks. It all started as part of IAFP’s 100 anniversary meeting in Milwaukee, Wisconsin where we recorded a 40 min conversation with each other for NPR’s StoryCorps (which we now refer to as Episode Zero). 133 episodes later, Food Safety Talk is still going strong with about 3000 subscribers.
Early on in our podcasting we appeared as guests on lots of other shows, including a bunch from Dan Benjamin’s 5by5 network. Others have joined us in the food safety podcasting world including the good folks at Food Safety Magazine who started Food Safety Matters a while back.
A couple of weeks ago I recorded a fun episode with Barbara VanRenterghem and we talked about how I got into food safety; some of the research we’re doing; and, evaluating safe food handling messages.
Today is our first full day of Fall, when it comes to scheduling, with both kids back in school.
I’m at home, just finished recording a podcast and have CNN on in the background. I’m watching the Hurricane Harvey coverage, in awe of the devastation of inches and inches of rain.
Last Fall, some of our close by communities in North Carolina experienced flooding following Hurricane Matthew.
I had never seen anything like it.
A couple of months later I traveled to the Greenville, North Carolina area with a few other extension folks and we shot a few videos about returning to a home after a flood. Stuff like cleaning dishes, pots and pans in Part 1; other kitchen items, including appliances, flatware and plastic, in Part 2; food for people and pets in Part 3; and refrigerators in Part 4. Amongst others.
We also have a few factsheets on disaster recovery here (including what to do with foods in refrigerators and freezers after the power has been out for a while)
I figured out about 45 years ago that going public was the best way to handle conflict.
I was throwing stones at the grill of a car in an abandoned lot in Brantford, Ontario (that’s in Canada), trying out cigarettes for the first time, and we got caught.
When I was 18-years-old, and went to jail, I had nothing to hide.
All incoming inmates had to strip naked in front of some deliberately inattentive guard, as part of admission.
There was nothing left to hide, and there isn’t now.
I know lots of people who hide behind their vanity; I know few whom are truly public, warts and all.
Whether it’s some academic institution or a local hockey club, bring it on; your rumors only ferment your own failures.
Julia Glotz of The Grocer in the UK writes that in the hepatitis E outbreak, supermarket X is Tesco.
Julia is referring to explosive claims that, as initially reported by the Sunday Times, hepatitis E is sickening Brits at an alarming rate.
But that didn’t stop Public Health England from sticking its fingers in its ears and loudly singing ‘la la la’ for the best part of a week. It didn’t want to name ‘supermarket x’ because the findings of its hepatitis E study do ‘not infer blame on the supermarket’.
Oh okay. Fair enough. I see the strategy here. So instead of some uncomfortable articles about a possible link between hep E infections and retail pork products, we’re going for a week of near-hysterical coverage shouting Silence On Banger Virus, and insinuating an agency tasked with protecting public health is refusing to drop a big supermarket in it. What must these brutes at Tesco be doing to poor PHE to force it into silence? Round of applause, everyone.
Anyway, the kitty is now firmly out of the bag, so it’s time to reflect on some lessons from the whole saga. After all, hepatitis E is far from the only food scandal in town right now. And, in PHE’s defence, this is really tricky territory. Risk communication is notoriously hard, and informing the public about risks related to food can be especially thorny. Food regulators and agencies across the globe struggle with it.
Doug Powell, a former professor of food safety who runs the wonderfully named BarfBlog (yes, it’s about people getting sick from dodgy food), has an entire section on his website called ‘Going public’. In it, he chronicles example after example of public disclosure foul-ups from food regulators around the world: vague press releases rushed out after hours; vital information made available too late for the sake of double, triple and quadruple checking; and bare facts and stats dumped on the public without context to help them make sense of risk.
Powell is also the co-author of a fascinating article published in the Journal of Environmental Health earlier this year, which examines how regulators approach public comms during food scares. It concludes there is widespread confusion – and hugely varying standards – largely because there is little concrete guidance on food risk disclosure. Too many decisions are made ad hoc; what little guidance there is is couched in flabby, unhelpful language like ‘timely release of information’, without defining what ‘timely’ means.
So does that mean PHE should have named Tesco right from the start? Not necessarily. Its study did not establish that Tesco products were the direct cause of hepatitis infections; it was a statistical analysis only. There are valid concerns about the potential for premature information to mislead consumers and do significant harm (though it’s worth pointing out Powell’s report found no evidence to support a paternalistic approach where members of the public are protected from ‘too much’ information). ‘Naming and shaming’ of individual companies could potentially distract consumers from other, more important information about how they can protect themselves. Might a shopper who doesn’t buy ham and sausages at Tesco, for example, tune out and not pay attention to cooking advice to minimise the risk of hepatitis E infections?
It’s a fair question. So by all means don’t name names in your scientific paper. But accept that a paper like it will very likely get media pick-up – and once it’s out in the public domain, the game is up. You have to come clean. “To support consumer decision making, available information must support what consumers want and need to know, which might or might not be what information authorities want to relay,” Powell writes in his JEH article. And in this case, consumers wanted to know who ‘supermarket x’ was.
“While PHE may have reasons for not going public – whether legislative or bureaucratic – whoever is involved will eventually be found out,” Powell added when I caught up with him about the case this week. “Trust is earned, not given, and consumers have a right to know – especially if it’s a public health issue like hepatitis E in pork.”
It’s not all down to the regulators, though. Industry, too, has a part to play in this. If there’s any risk to public health, information disclosure must be led by the relevant agencies, says Chris Elliott of the Institute for Global Food Security. But when there is no (or a very remote chance) of a food safety problem, “then I think supermarket x should take the lead in the comms,” he adds. “But this should be agreed with the regulator, so no contradiction or confusion should result.”
It’s undoubtedly a difficult balance to get right. In Powell’s article, the killer line comes from epidemiologist Paul Mead: “Food safety recalls are always either too early or too late. If you’re right, it’s always too late. If you’re wrong, it’s always too early.”
So yes, it can be a poisoned chalice. But regulators can’t dodge it – and they have to start dealing with it more assuredly than they often do at the moment.
Going public: Early disclosure of food risks for the benefit of public health
Mar.17
NEHA, Volume 79.7, Pages 8-14
Benjamin Chapman, Maria Sol Erdozaim, Douglas Powell
Often during an outbreak of foodborne illness, there are health officials who have data indicating that there is a risk prior to notifying the public. During the lag period between the first public health signal and some release of public information, there are decision makers who are weighing evidence with the impacts of going public. Multiple agencies and analysts have lamented that there is not a common playbook or decision tree for how public health agencies determine what information to release and when. Regularly, health authorities suggest that how and when public information is released is evaluated on a case-by-case basis without sharing the steps and criteria used to make decisions. Information provision on its own is not enough. Risk communication, to be effective and grounded in behavior theory, should provide control measure options for risk management decisions. There is no indication in the literature that consumers benefit from paternalistic protection decisions to guard against information overload. A review of the risk communication literature related to outbreaks, as well as case studies of actual incidents, are explored and a blueprint for health authorities to follow is provided.
NSW Health and NSW Food Authority have started using whole genome sequencing technology to more quickly identify a foodborne outbreak and connect it with its source, which could reduce illnesses and even deaths.
“[It’s] a significant breakthrough that could help revolutionise how food-borne illnesses are identified, understood, tracked and managed,” said Dr Craig Shadbolt, the Food Authority’s acting chief executive.
“This will be invaluable in terms of achieving the NSW Government’s Food Safety Strategy goal of reducing foodborne illnesses caused by salmonella, campylobacter and listeria by 30 per cent by 2021.”
That sounds nice, but some practical steps, like not using raw eggs in mayo, aoili, or baked Chinese ice cream, would go farther. In Australia, rates of foodborne salmonella poisoning have climbed from 38 per 100,000 people in 2004 to 76 per 100,000 in 2016, with a record-breaking 18,170 cases last year, according to the National Notifiable Diseases Surveillance System.
Truth in Advertising (TINA) announced Tuesday that they’ve investigated Goop’s marketing tactics, and found that “the company claims, either expressly or implicitly, that its products (or those it promotes) can treat, cure, prevent, alleviate the symptoms of, or reduce the risk of developing a number of ailments,” according to a press release.
“The problem is that the company does not possess the competent and reliable scientific evidence required by law to make such claims,” the release says.
TINA says that they initially contacted Goop about their “unsubstantiated, and therefore deceptive, health and disease-treatment claims” on Aug. 11, and because the company did not make enough changes to their site in the 11 days since, TINA has filed a complaint letter with the California Food, Drug and Medical Device Task Force.
A spokesperson from Goop tells PEOPLE that they wanted to work with TINA to correct the wording on their site, but the timeframe given was too limited.
“Goop is dedicated to introducing unique products and offerings and encouraging constructive conversation surrounding new ideas. We are receptive to feedback and consistently seek to improve the quality of the products and information referenced on our site. We responded promptly and in good faith to the initial outreach from representatives of TINA and hoped to engage with them to address their concerns. Unfortunately, they provided limited information and made threats under arbitrary deadlines which were not reasonable under the circumstances.”
“Nevertheless, while we believe that TINA’s description of our interactions is misleading and their claims unsubstantiated and unfounded, we will continue to evaluate our products and our content and make those improvements that we believe are reasonable and necessary in the interests of our community of users.”
A consortium of big-food types including Dole, Unilever, Walmart, Golden State Foods, Kroger, Nestle, Tyson Foods, McLane Company, and McCormick and Company – along with IBM, has announced plans to cut down on the time it takes to pinpoint the source of foodborne illness and eradicate it.
But, according to Coin Desk, unlike many other blockchain groups that have launched over the years, the consortium is formally launching with a fully integrated enterprise-grade platform, according to Walmart’s vice president of food safety, Frank Yiannas.
“IBM has spent a lot of time coding and creating a real product that you can start using,” said Yiannas. “There’s legitimate framework and substance in terms of the product, the technology that’s available. It’s substantial and real.”
If successful, the project, which will extend Walmart’s own custom blockchain proof-of-concept for food safety and traceability to the other partners, stands to cut down on the time it takes to track down dangerous food from weeks to just seconds.
Drawing on multiple IBM pilots in production, the consortium then aims to identify and prioritize different ways that distributed ledger tech can save global food suppliers money via increased traceability of their products.
The resulting efficiencies could not only reduce the revenue lost from unnecessarily pulling of safe food from shelves, but also spur a drop in the number of deaths blamed on toxic food in the first place.
“We’re all in the business of trying to improve the quality of life of people that we serve around the world,” he said. “So, on these issues, it’s pre-competitive.”
But while there’s a philanthropic element to the work, the result of delays in identifying dangerous food can also hit deep into a food supplier bottom lines.
During a demo of the enterprise-grade application, IBM’s vice-president of blockchain business development, Brigid McDermott, broke down into three categories what she said were the global financial costs of current supply-chain tracking inefficiencies.
The first, which drives the most cost, is the human loss of health and life.
For example, earlier this month, a salmonella outbreak traced back to contaminated papaya fruit was blamed for infecting 173 people, leading to 58 hospitalizations and one death, according to a Centers for Disease Control and Prevention (CDC) report. On average, 420,000 people die each year from food poisoning, according to the World Health Organization.
The second and third costs of supply-chain inefficiencies result from the potential threat to the health of consumers, according to McDermott.
Specifically, she said the cost of recalling a tainted good is typically footed largely by the offending producer. But when identifying the dangerous items can take weeks, prices can drop and people will frequently stop buying the product altogether, resulting in a financial cost to the proprietors of even the safest products.
These losses can be so costly that recent estimates on the total economic impact of foodborne illnesses on the U.S. economy alone have varied between as low as about $4.4 billion per year to as high as $93.2 billion.
Following what was largely deemed a successful test of tracking pork sales in China and mangos in the U.S., Yiannas realized the limits of being able to identify dangerous food within its own supply chain, if others were still using the traditional system to trace the food to its origin.
While competitors and even other members of the same supply chain took weeks to identify the source of the problem, global prices of the food frequently plummeted, resulting in losses to the entire industry that could sometimes take years to fully recover from.
So, after the early Walmart tests were complete, IBM Blockchain general manager Marie Wieck said she was contacted by the company with a new problem: to help form a collective of industry players, representing more than just different aspects of the supply chain, but potentially competing aspects of the supply chain.
Wieck explained how crucial the wider network is if you want to do more than just identify the source of the problem, adding, “You need the entire industry network to start engaging in order to be able to do both the proof that you can trace back to the farm, but then have the entire supply chain address it.”
Yiannas added, “If you’re a food safety guy who’s been doing this for 30 years, the power of how much information is at your fingertips is really impressive and exciting.”
In a risk communication fiasco reminiscent of the 1999 dioxin-in-chicken-feed scandal in the EU, millions of eggs have been pulled from supermarket shelves across Europe after contamination with a banned insecticide.
A joint Dutch-Belgian task force conducted raids at eight poultry farms in the Netherlands, according to the Dutch prosecution service.
The investigation “focused on the Dutch company that allegedly used Fipronil, a Belgian supplier as well as a Dutch company that colluded with the Belgian supplier,” according to the prosecutor.
Heather Hancock, chairman of the UK Food Standards Agency said: “Our advice remains clear – there’s no need to change how you buy or consume eggs. We are responding very quickly to any new information, to ensure that any products left that contain egg from the affected farms is withdrawn immediately. We’re doing this because Fipronil is not authorised for use in food producing animals, not because we are concerned about any risk to health.”
No risk messages are risky.
So is commercial exploitation.
Robert Chapman, who packs four million eggs a week under the Farmlay label from his West Cockmuir farm at Strichen, Aberdeenshire, urged buyers to learn a lesson from the incident, adding, “Price is obviously a major factor why so many imported eggs come into Britain, but the fact that so many have been found to be contaminated is a major issue. Surely processors and retailers will take this on board and source more eggs from UK producers whose standards are second to none.”
British Free Range Egg Producers Association chief executive Robert Gooch said, “British egg producers follow stringent production standards to ensure that what they produce is perfectly safe and nutritious for consumers to eat.”
There’s a reason Walmart and Costco and Kroger stopped selling raw sprouts: they suck, meaning that, like raw milk, they cause a disproportionate percentage of illness based on low consumption rates.
The U.S. Food and Drug Administration (FDA) set out to collect and test sprouts in 2014 as part of a new proactive and preventive approach to deploying its sampling resources with the ultimate goal of keeping contaminated food from reaching consumers.
The new approach, detailed in the Background section of this report (page 4), centers on the testing of a statistically determined number of samples of targeted foods over a relatively short period of time, 12 to18 months, to ensure a statistically valid amount of data is available for decision making. This approach helps the agency determine if there are common factors – such as origin, season, or variety – associated with pathogen findings.
The FDA issued the sprouts assignment in January 2014 under its new sampling model. The assignment targeted sprouts at three points in the production process (seeds, finished product and spent irrigation water),with the aim of collecting and testing 1,600 samples to determine the prevalence of select pathogens in the commodity. As background, the FDA designed its sampling plan such that if contamination of one percent or greater was present in the commodity, the agency would detect it. The FDA monitored the assignment closely to gather lessons learned and make changes to its sampling procedures if needed to address trends or food safety issues. About one year into the assignment, the FDA decided to stop its collection and testing at 825 samples because it had already collected samples on more than one occasion from many of the sprouting operations known to the agency and its state partners. The sample set acquired was sufficient for the FDA to estimate the bacterial prevalences in the commodity with a 95 percent confidence interval of 0% to 2% for a one percent contamination rate.
The FDA tested only domestically grown sprouts for this assignment because virtually all sprouts eaten in the United States are grown domestically due to the commodity’s delicate nature and relatively short shelf-life. Of note, the industry features a preponderance of relatively small operations.
The FDA tested the sprout samples for three pathogens: Salmonella, Listeria monocytogenes and Escherichia coli (E. coli) O157:H7. Based on the test results, the FDA found the prevalence of Salmonella in the finished product sprouts to be 0.21 percent. The agency also found that the prevalence of Salmonella in seeds (2.35%) was significantly higher than in finished product (0.21%) and in spent irrigation water (0.54%). Based on the test results, the FDA found the prevalence of Listeria monocytogenes in the finished product to be 1.28 percent. There was no significant difference in the prevalence of Listeria monocytogenes based on point in the production process. None of the samples tested positive for E. coli O157:H7. The agency did not test seed for E. coli O157:H7 due to limitations associated with the test method.
Among the FDA’s other findings, the agency found most of the positive samples at a small number of sprouting operations. Specifically, the FDA found violative samples at eight (8.5%) of the 94 sprouting operations visited for purposes of this assignment. The fact that the agency found multiple positive samples at some of these operations underscores the need for sprouting operations to comply with the agency’s Produce Safety Regulation (published November 2015), which seeks to prevent outbreaks of foodborne illness and improve sprout safety.
To address the positive samples, the FDA worked with the firms that owned or released the affected product to conduct voluntary recalls or to have their consignees destroy it, and then followed up with inspections. Of particular note, this sampling assignment helped detect and stop an outbreak of listeriosis while it still entailed a small number of cases, as described in the Public Health Impact section of this report (page 14). This assignment also prompted six product recalls.
The FDA will continue to consider microbial contamination of sprouts andhow best to reduce it. Such contamination remains a concern to the FDA given the aforementioned outbreak and the recalls initiated. Going forward, the FDA intends to inspect sprouting operations to ensure they are complying, as applicable, with the Produce Safety Rule, which includes new requirements for sprouts growers. The agency has no plans to conduct additional large-scale sampling of sprouts at this time but may sample the commodity in accordance with its longstanding approach to food sampling, which centers on (but is not limited to) the following criteria:
A firm has a previous history of unmitigated microbial contamination in the environment (e.g., human illness, recalled or seized product, previous inspectional history, or environmental pathogens without proper corrective actions by the facility), or
Inspectional observations that warrant collection of samples for microbiological analyses.
The United Nations‘ General Assembly will discuss in Sept. whether to establish a World Food Safety Day.
The U.N.’s Food and Agriculture Organization has already adopted a draft resolution that puts the wheels in motion for this international day. The resolution has been forwarded to the secretary-general of the United Nations so that it can be added to the organization’s September agenda. If the resolution passes through the General Assembly, World Food Safety Day would be set for June 7 of each year, the F.A.O. says.
World Food Safety Day would “raise awareness of the global threat posed by foodborne diseases and reinforce the need for governments, the food industry, and individuals to do more to make food safe and prevent these diseases,” said Ren Wang, director of F.A.O.’s Department of Agriculture and Consumer Protection.
The draft resolution clearly states that “there is no food security without food safety, and that in a world where the food supply chain has become global, any food safety incident has global negative effects on public health, trade, and the economy.”
