Lesson 6. Food Protection - University of Washingtoncourses.washington.edu/envsc296/Lessons/Lesson06.pdf · Lesson 6: Food Protection January 25, 2005 ENVIR 202: Population & Health

Lesson 6: Food Protection January 25, 2005

ENVIR 202: Population & Health 1

ENVIR 202: Lesson 6 1

FoodborneIllness

Chuck TreserChuck TreserDepartment of EnvironmentalDepartment of Environmental

& Occupational Health Sciences& Occupational Health Sciences

January 25, 2005January 25, 2005

Lesson 6. Food Protection


Lesson Overview

Three Questions

Why do foods present a healthrisk?

How big is the problem?

What can be done about it?


Lesson ObjectivesKnow the four most importantfactors in preventing foodborneillnesses . . .

Proper hand washing

Proper cooking andreheating of foods

Eliminate cross contamination

Proper cooling of foods




Food Properties Food should be . . .

Safe

Attractive

Abundant

Nutritious


Food Properties Continued

However, food issusceptible to:

Spoilage

Contamination

Adulteration

which can render it unfitto eat

E. coli Bacterium


Foodborne Disease

There are twotypes of foodborneillness

Infections

Intoxications




Foodborne Disease Continued

Infections are caused by:

The presence of micro-organisms in large numberswhich multiply in the gut andoverwhelm the body’sdefenses


Foodborne InfectionsAmebic Dysentery

Brucellosis

Campylobacterenteritis

Diarrhea(Acute)

Viralgastroenteritis


Foodborne Infections Continued

Salmonellosis

Shigellosis

Trichinosis

Typhoid Fever

Infectious Hepatitis

Mallon as she was portrayed in an

illustration in the June 20, 1909,edition of The New York American




Foodborne Disease Continued

Intoxications are caused bychemicals or “toxins”

Produced by micro-organisms,or by

Contamination with natural ormanufactured chemicals


Foodborne IntoxicationsBotulism

Staphylococcalfood poisoning

Clostridiumperfrigens

Bacillus cereus


Foodborne Intoxications Continued

Scromroid fish poisoning (Histamine)

Ciguatera fish poisoning

Paralytic shellfishpoisoning (PSP)

Amnesic shellfishpoisoning (domoic acid)

Puffer fish poisoning(tetrodotoxin)




Types of PathogensSporeforming Bacteria

Clostridium botulinum

Clostridium perfringens

Bacillus cereus

Non-sporeformingBacteria

Salmonella spp.

Campylobacter

E. coli O157:H7

Staphylococcus aureus

Listeria monocytogenes

Viruses

Hepatitis A

Norovirus


Normal Symptomsof Foodborne Disease

Nausea

Vomiting

Diarrhea

Cramps

Headache

Fever

Chills

Body Aches


Complicationsof Foodborne Illnesses

Kidney Damage

Blood Poisoning

Pneumonia

Arthritis(2% will trigger)

HUS(5-20K cases/yr)

Guillian BarreSyndrome

ChronicSporadicToxoplasmosis

NeurologicalDamage

PancreaticInfections

Chronic Illness -likely to occur in 2-3%of FBIs




High Risk IndividualsInfants

Children

Pregnant Women

Senior Citizens

People takingmedications:

Antibiotics

Antacids

Immuno-suppressivedrugs

Immuno-compromisedpeople:

Recent major surgery

Pre-existing or chronicillness

HIV / AIDS

Diabetes

Cancer

Liver or Kidney Damage

Ulcers


Contributing FactorsFactors Contributing to an increasedrisk of Foodborne Illness

Aging Populations

Lifestyles of the Public

New and Emerging Pathogens

Increase in High Risk Individuals

New Processing Methods for Foods

New Sources of Foods - Geographic


24%

2%

5%

1%68%

Bacterial

Viral

Chemical

Parasitic

Unknown

Bacteria24%Viral

68%

Chemical5%

Foodborne Disease OutbreaksUnited States, 1993-1997




50%

5%1%3%

41%

Bacterial

Viral

Chemical

Parasitic

Unknown

Bacteria50%

Viral41%

Parasitic Chemical Unknown

Foodborne Disease CasesUnited States, 1993 - 1997


Foodborne Disease

Reported IncidenceBelieved to be onlythe tip of theiceberg

1% or less are evenreported

76 million casesannually Image courtesy of Douglas

Armand Digital Imaging

Used with permission


0

100

200

300

400

500

600

700

800

900

Home Food Service School Picnic Church Camp Other Unknown

Bacterial

Viral

Chemical

Parasitic

Unknown

Foodborne Disease OutbreaksUnited States, 1993-1997

Home Food School Picnic Church Camp Other Unknown Service




Deaths from FoodUnited States, 1988 - 1992

0

2

4

6

8

10

12

14

16

18

20

Number

1988 1989 1990 1991 1992

Y e a r

Unknown

Viral

Parasitic

Chemical

Bacterial

1988 1989 1990 1991 1992


Distribution of OutbreaksUnited States, 1995

129


Foodborne Illness in Washington

Estimated Annual Number of Food-borne Illnesses in Washington State(extrapolated from CDC U.S. estimates - 2000)

1.5 million illnesses

6500 hospitalizations

100 deaths




32

4751

126

145

134

112

104

59

91

6668

0

20

40

60

80

100

120

140

160

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

YEAR

NU

MB

ER

Foodborne Outbreaks1990-2001


31.1%

23.7%

20.3% 19.7%18.0%

12.8% 12.8% 12.7%11.5%11.5%

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

Perc

enta

ge o

f O

utb

reaks w

/

Fa

cto

r

Inad

equa

te H

andw

ashi

ng

(C-1

5)

Inad

equa

te H

ot H

olding

(P-6

)

Inad

equa

te R

efrig

erat

ion

(P

-3)

Slo

w C

oolin

g (P-2

)

Cro

ss C

onta

min

atio

n (

C-9

)

Bar

e Han

d Con

tact

(C

-10)

Ill o

r Inf

ecte

d Per

son

(C-1

2)

Roo

m T

empe

ratu

re S

tora

ge (P

-1)

Inad

equa

te C

lean

ing

of E

quip

men

t (C

-13)

Prio

r Pre

para

tion

(P-4

)

Contributing Factors

N=695

Major Factors Associated with FBDO's

WA State 1990-1999


7.20%6.60%

5.90%

2.20%1.70% 1.00% 0.90% 0.70%

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

35.00%

Perc

en

tag

e o

r O

utb

reaks w

/

Facto

r

Con

tam

inat

ed R

aw In

gred

ient

(C-7

)

Inad

equa

te C

ooking

(S-1

)

Inad

equa

te R

ehea

ting

(S-2

)

Poole

d Egg

s (C

-17)

Con

tam

inat

ed In

gred

ient

(C-6

)

Nat

ural

Tox

ican

t (C-1

)

Toxin

Acc

iden

tally

Add

ed (C-3

)

Impr

oper

Tha

win

g

(S-4

)

Exc

ess

Qua

ntity

Tox

ic C

hem

ical

(C-4

)

Inse

ct/ R

oden

t Con

tam

inat

ion

(C-1

8)

Prolo

nged

Col

d Sto

rage

(P-5

)

Contributing Factors N=695

Minor Factors Associated with FBDO's

WA State 1990-1999




Foodborne Disease Outbreaks by Place,1990 -1999, Washington State

Restaurant46%

Caterer14%

Prison/Jail8%

Camp5%

Food Store4%

Home4%

Food Processor3%

School3%

Health Care Facility3%

Other10%

Other includes places that were under 3%.In decreasing order they are: Growers,Temporary Food Service Establishment,Private Club, Community or Confernececenter, Homeless Shelter/Mission, Church,College/University, MobileFSE, Fair, CoffeeStand, Private Dinner and Picnic.


Significant Food Ingredients for FBDO's

WA State 1990-1999

19.60%

13.40%

12.10%11.50%

10.80%

7.70%

4.70%

3.80%3.20% 3.20%

2.50%2.20%

0.00%

2.00%

4.00%

6.00%

8.00%

10.00%

12.00%

14.00%

16.00%

18.00%

20.00%

Poultry

Intro

duced B

y W

orker

Starc

hy Foods

Beef

Other V

ehicle

Shellfis

h

Finfis

hPork

Eggs

Other S

eafood

Green L

eafy V

egetable

s

Dairy

Significant Ingredient

The following significant ingredients

were excluded from this graph

because they were less than 2%.

(Beverages, Fruits, Other, and Other

Vegetables)

N = 530**376 FBDO's were excluded from the

data before analysis.


26.00%

22.20%

14.30%

11.80%

4.80%3.00% 3.00%

2.00%

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

Introduced

by Worker

Beef Poultry Starchy

Foods

Other

Vehicle

Shellfish Finfish Pork

N= 6807** From 530 outbreaks with significant ingredientsOthers (< 2% of cases): Eggs, Other Seafood, Green Leafy

Vegetables, Dairy, Beverages, Fruits, Other, OtherVegetables)

Cases of IllnessSignificant Food Ingredients in Foodborne Disease

Outbreaks in Washington State 1990-1999




TrendsIn the 80’s…

Was beef

Was turkey

Was roast beef andturkey

Some viruses

Was Salmonella

Some Mexican/Chinese

Was cooling

E. coli emerged

No Fruit/Vegetableoutbreaks

In the 90’s…Now hamburger

Now chicken

Now RTE foods & Starchyfoods

Now nearly 1/2 the casesare viral

Still Salmonella

Increased Mexican/Chinese + others

Now handwashing

O157:H7, Crypto, Etc.,

Lots of F/V– sprouts, juice, melons,green leafys, etc…


Disease Causation FactorsFood Handling Practices:

Poor Handwashing

Cross Contamination

Improper Heating

Improper Cooling


Disease Causation FactorsContinued

Diversity in the Food Industry

Changes in eating habits

More types of foods (ethnic, seasonal)

Greater shelf life (transportation)

More foods are imported

New food products are coming out

New food processes




Questions

??


Lesson 6. Food Protections

FoodSafety

Chuck TreserChuck TreserUniversity of WashingtonUniversity of Washington

Department of Environmental &Department of Environmental &

Occupational Health SciencesOccupational Health Sciences

January 27, 2005January 27, 2005


Disease Causation FactorsInherent properties of food:

Most foods are grown or raised in

proximity to bacteria and other micro-organisms in the soil and water

A nutrient source by definition

Moisture + Nutrients

a substrate for bacteria and other micro-organisms




Hazardous Foods

6.1 Potentially Hazardous Food.(a) "Potentially hazardous food" means a food that is natural orsynthetic and that requires temperature control because it is in aform capable of supporting:

(i) The rapid and progressive growth of infectious or toxigenicmicroorganisms;

(ii) The growth and toxin production of Clostridium botulinum;or

(iii) In raw shell eggs, the growth of Salmonella enteritidis.

(b) "Potentially hazardous food" includes an animal food (a food ofanimal origin) that is raw or heat-treated; a food of plant originthat is heat-treated or consists of raw seed sprouts; cut melons;and garlic-in-oil mixtures that are not modified in a way thatresults in mixtures that do not support growth as specified underSubparagraph (a) of this definition.


Hazardous Foods Continued

(c) "Potentially hazardous food" does not include:(i) An air-cooled hard-boiled egg with shell intact;

(ii) A food with an Aw value of 0.85 or less;

(iii) A food with a pH level of 4.6 or below when measured at 24°C (75°F);

(iv) A food, in an unopened hermetically sealed container, that is commerciallyprocessed to achieve and maintain commercial sterility under conditions of non-refrigerated storage and distribution; and

(v) A food for which laboratory evidence demonstrates that the rapid andprogressive growth of infectious or toxigenic microorganisms or the growth of S.enteritidis in eggs or C. botulinum can not occur, such as a food that has an awand a pH that are above the levels specified under Subparagraphs (c)(ii) and (iii)of this definition and that may contain a preservative, other barrier to thegrowth of microorganisms, or a combination of barriers that inhibit the growth ofmicroorganisms.

(vi) A food that does not support the growth of microorganisms as specified underSubparagraph (a) of this definition even though the food may contain aninfectious or toxigenic microorganism or chemical or physical contaminant at alevel sufficient to cause illness.



Increasing Demand Leads to:

Greater use of pesticides

Greater use of fertilizers

Use of growth promoters

Use of growth regulators

“Bio-engineered” foods





Nature of the Food Service Industry

Employee turnover

Insufficient supervision & training

Improper food handling

Time/Temperature abuse

Poor sanitation practices



Food HandlingPractices:

Poor hand washing

Crosscontamination

Improper heating

Improper cooling


Contributing FactorsFactors Contributing to an increasedrisk of Foodborne Illness

Aging Populations

Lifestyles of the Public

New and Emerging Pathogens

Increase in High Risk Individuals

New Processing Methods for Foods

New Sources of Foods - Geographic




Production&

Processing

Transport

Preparation

Service &Consumption

Foodborne Disease Causation


Food ProtectionWe need to do something to reduce theburden of foodborne disease in our state

High risk establishments are extremelyimportant

If we know what is causing the people tobecome ill then we can effect change(regulatory, inspectional and educationalemphasis)

Concentrate our efforts where they will dothe most good –the most bang for thebuck!


Food Hazards10 most frequently observed hazards1. Improper cooling

2. Prolonged holding of prepared foods(danger zone 70-120 F for 4 or morehours)

3. Poor personal hygiene

4. Failure to rapidly reheat food beforeserving

5. Improper hot holding




Food Hazards Continued

Most frequently observed hazards6. Contaminated raw foods or

ingredients.

7. Use of food from unapproved sources

8. Improper cleaning of utensils

9. Cross-contamination from raw tocooked foods

10.Inadequate cooking times.


The Big FourHandwashing

Cross contamination

Improper heating / hot holding

Improper cooling / cold holding


What Can Be Done?

“Food Safety:

You Make the Difference”

Video designed and produced by the Seattle-King

County Department of Public Health for food serviceworkers

Shows how these four simple concepts areput into practice




HACCP

Hazard

Analysis and

Critical

Control

Points


HACCP Approach

A food protection system largely used in thefood processing industry.

Looks at the whole chain of events in a foodoperation.

Identify and concentrate on the “critical”control points, i.e.,

If everything else goes wrong, what is the onething we can do to keep people from getting sick?


HACCP - 7 stepsConduct a hazard analysis of high riskfoods (create a flow diagram)

Identify critical control points(cooking, chilling, sanitation, etc.)

Establish critical limits (boundaries ofsafety)

Develop critical control pointmonitoring procedures




HACCP Continued

Pre-set corrective action

Create effective record keepingsystem

Establish verification procedures tomake sure the system is working.


HACCP Example


HACCP Example

thaw

prep

cook cool

prep prep

Re-heat cool

serve




HACCP Worksheet


HACCP Worksheet


HACCP Worksheet




Lesson SummaryFoods inherently present a healthrisk.

The problem is huge, but not usuallyfatal.

There are simple yet effectivesolutions to most food safetyproblems


Questions

??


Next Lesson

Water &Water &

WastewaterWastewater

Lesson 6. Food Protection - University of Washingtoncourses.washington.edu/envsc296/Lessons/Lesson06.pdf · Lesson 6: Food Protection January 25, 2005 ENVIR 202: Population & Health

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