Food Poisoning, Foodborne Illness Information and Research : International Food Safety Network : BarfBlog

Or something like that from George Clooney in the 2000 movie and Courtlynn favorite, O Brother Where Art Thou.

As far as the U.S. government is concerned, I am indeed somewhat more bona fide, having received my permanent residency (below), so let the food safety world tour begin.

First stop – the motherland, U.K., in early January. Amy has a conference in Manchester, so thought we’d see some of my relatives in Newport, some friends in Cardiff, and visit the statue of my now confirmed great-great-great-great grandfather, William ‘The Tipton Slasher’ Perry, bare-knuckle boxing champ of England in 1850 and 1856, in Birmingham.

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As take-out food continues to increase in popularity, new research from Kansas State University has found that safe handling labels can help restaurants and food providers distinguish themselves in a competitive marketplace.

"With leftovers, people need information the moment they pull that container or clamshell package from the fridge," said Doug Powell, a K-State associate professor of food safety. "How long has it been in the fridge? Is it still safe? Our approach was to provide practical information, right on the container."

Powell, along with former graduate student Brae Surgeoner and Tanya MacLurin of the University of Guelph in Canada, designed a safe food handling label for take-out food after consulting numerous experts and consumers (right; phone number and url don't work anymore -- dp). They then worked with 10 restaurants in Ontario to provide food safety stickers for take-out food and subsequently interviewed managers about the utility of the stickers.

For the purpose of this research, takeout was defined as food procured from a casual dining restaurant -- in other words, a sit-down restaurant -- but eaten elsewhere, including food ordered as takeout and leftover food packaged to be taken home.

The researchers concluded that such a safe food handling label for take-out food was a promising value-added investment for restaurant operators as long as the stickers were used consistently and employees supported the initiative.

"We strive to provide the right food safety message in the right setting," Powell said. "Hand washing information should go over sinks and the back door of toilet stalls. Food preparation information should go in the back kitchen. Stickers with safe food handling information should go on the clamshell containers that people take home and put in the fridge. That's where the learning moment is."

The results are published in the October 2009 issue of Food Protection Trends.

The abstract is below.

Assessing management perspectives of a safe food-handling label for casual dining take-out food
01.oct.09
Food Protection Trends, Vol 29, No 10, pages 620-625
Brae V. Surgeoner, Tanya MacLaurin, Douglas A. Powell
Abstract
Faced with the threat of food safety litigation in a highly competitive industry, foodservice establishments must take proactive steps to avoid foodborne illness. Consumer demand for convenience food, coupled with evidence that consumers do not always engage in proper food-safety practices, means that take-out food from casual dining restaurant establishments can lead to food safety concerns. A prescriptive safe food-handling label was designed through a Delphi-type exercise. A purposive sample of 10 foodservice managers was then used to evaluate the use of the label on take-out products. Semi-structured in-depth interviews focused on the level of concern for food safety, the value of labelling take-out products, perceived effectiveness of the provided label, and barriers to implementing a label system. Interviews were audiotaped and transcribed, and the data was interpreted using content analysis to identify and develop overall themes and sub-themes related to the areas of inquiry. It was found that labeling is viewed as a beneficial marketing tool by which restaurants can be differentiated from their competitors based on their proactive food safety stance.
 

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Food safety researcher and talk-show host Jon Stewart got it right back in 2002 when he said,

“If you think the 10 commandments being posted in a school is going to change behavior of children, then you think “Employees Must Wash Hands” is keeping the piss out of your happy meals. It's not.”

Instead, getting college students to wash hands, halt disease, requires giving them proper tools and spreading the word in ways that get attention: the path to poor hand sanitation is paved with good intentions, according to researchers from Kansas State and North Carolina State Universities.

As college campuses prepare for an expected increase in H1N1 flu this fall, the researchers said students' actions will speak louder than words.

"Many students say they routinely wash their hands," said Douglas Powell, an associate professor of food safety at Kansas State University. "But even in an outbreak situation, many students simply don't."

In February 2006, Powell and two colleagues — Ben Chapman, an assistant professor at North Carolina State University, and research assistant Brae Surgeoner — observed hand sanitation behavior during an outbreak. What was thought to have been norovirus sickened nearly 340 students at the University of Guelph in Canada.

Hand sanitation stations and informational posters were stationed at the entrance to a residence hall cafeteria, where the potential for cross-contamination was high. The researchers observed that even during a high-profile outbreak, students followed recommended hand hygiene procedures just 17 percent of the time. In a self-reported survey after the outbreak had subsided, 83 of 100 students surveyed said they always followed proper hand hygiene but estimated that less than half of their peers did the same.

The results appear in the September issue of the Journal of Environmental Health.

Powell said that in addition to providing the basic tools for hand washing – vigorous running water, soap and paper towels — college students, especially those living in residence halls, need a variety of messages and media continually encouraging them to practice good hand hygiene.

"Telling people to wash their hands or posting signs that say, 'Wash your hands' isn’t enough," said Ben Chapman, an assistant professor at North Carolina State University. "Public health officials need to be creative with their communication methods and messages."

Most students surveyed perceived at least one barrier to following recommended hand hygiene procedures. More than 90 percent cited the lack of soap, paper towels or hand sanitizer. Additional perceived barriers were the notion that hand washing causes irritation and dryness, along with just being lazy and forgetful about hand washing. Fewer than 7 percent said a lack of knowledge of the recommended hand hygiene procedures was a barrier.

"Providing more facts is not going to get students to wash their hands," Powell said. "Compelling messages using a variety of media – text messages, Facebook and traditional posters with surprising images — may increase hand washing rates and ultimately lead to fewer sick people."

University students’ hand hygiene practice during a gastrointestinal outbreak in residence: What they say they do and what they actually do
01.sep.09
Journal of Environmental Health Sept. issue 72(2): 24-28
Brae V. Surgeoner, MS, Benjamin J. Chapman, PhD, and Douglas A. Powell, PhD
http://www.neha.org/JEH/2009_abstracts.htm#University_Students%92_Hand_Hygiene_Practice_During_a_Gastrointestinal_Outbreak_in_Residence:_What_They_Say_They_DO_and_What_They_Actually_Do
Abstract
Published research on outbreaks of gastrointestinal illness has focused primarily on the results of epidemiological and clinical data collected postoutbreak; little research has been done on actual preventative practices during an outbreak. In this study, the authors observed student compliance with hand hygiene recommendations at the height of a suspected norovirus outbreak in a university residence in Ontario, Canada. Data on observed practices was compared to post-outbreak self-report surveys administered to students to examine their beliefs and perceptions about hand hygiene. Observed compliance with prescribed hand hygiene recommendations occurred 17.4% of the time. Despite knowledge of hand hygiene protocols and low compliance, 83.0% of students indicated that they practiced correct hand hygiene during the outbreak. To proactively prepare for future outbreaks, a current and thorough crisis communications and management strategy, targeted at a university student audience and supplemented with proper hand washing tools, should be enacted by residence administration.

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That’s the title of a book chapter that’s just been published and attempts to answer the question: what does it take for farmers, processors and retailers to pay attention to food safety risks – in the absence of an outbreak?

Last week, trade magazine The Packer did a story about Earthbound Farms, the producer of E. coli O157:H7 tainted-spinach in 2006, which quoted president Charles Sweat as saying,

“Now that we are three years beyond that, it’s almost always hard to go back and put our mind where it was in 2005 and 2006 because we know so much more today than we knew then.”

What Ben Chapman, Casey Jacob and I asked in the book chapter is, why didn’t companies like EarthBound know a lot more about microbial food safety before over 200 became ill and four died in 2006?

In October, 1996, a 16-month-old Denver girl drank Smoothie juice manufactured by Odwalla Inc. of Half Moon Bay, California. She died several weeks later; 64 others became ill in several western U.S. states and British Columbia after drinking the same juices, which contained unpasteurized apple cider -- and E. coli O157:H7. Investigators believed that some of the apples used to make the cider might have been insufficiently washed after falling to the ground and coming into contact with deer feces (Powell and Leiss, 1997).

Almost 10 years later, on Sept. 14, 2006, the U.S. Food and Drug Administration announced that an outbreak of E. coli O157: H7 had killed a 77-year-old woman and sickened 49 others (United States Food and Drug Administration, 2006). The FDA learned from the Centers for Disease Control and Wisconsin health officials that the outbreak may have been linked to the consumption of produce and identified bagged fresh spinach as a possible cause (Bridges, 2006a).

In the decade between these two watershed outbreaks, almost 500 outbreaks of foodborne illness involving fresh produce were documented, publicized and led to some changes within the industry, yet what author Malcolm Gladwell would call a tipping point -- "a point at which a slow gradual change becomes irreversible and then proceeds with gathering pace" (http://en.wikipedia.org/wiki/Tipping_Point) -- in public awareness about produce-associated risks did not happen until the spinach E. coli O157:H7 outbreak in the fall of 2006. At what point did sufficient evidence exist to compel the fresh produce industry to embrace the kind of change the sector has heralded since 2007? And at what point will future evidence be deemed sufficient to initiate change within an industry?

We conclude:

Ultimately, investigators showed that the E. coli O157:H7 was found on a transitional organic spinach field and was the same serotype as that found in a neighboring grass-fed cow-calf operation. These findings, coupled with the public outcry linked to the outbreak and the media coverage, sparked a myriad of changes and initiatives by the industry, government and others. What may never be answered is, why this outbreak at this time? A decade of evidence existed highlighting problems with fresh produce, warning letters were written, yet little was seemingly accomplished. The real challenge for food safety professionals, is to garner support for safe food practices in the absence of an outbreak, to create a culture that values microbiologically safe food, from farm-to-fork, at all times, and not just in the glare of the media spotlight.

Powell, D.A., Jacob, C.J., and Chapman, B. 2009. Produce in public: Spinach, safety and public policy in Microbial Safety of Fresh Produce: Challenges, Perspectives, and Strategies ed. by X. Fan, B.A. Niemira, C.J. Doona, F.E. Feeherry and R.B. Gravani. Blackwell Publishing.

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It’s food safety month in September, so expect to hear lots of sanctimonious statements about how simple food safety is if only the people would do things the right way.

But what’s the right way?

Food safety is not simple.

Anyone who says so is full of it.

And any food safety nerd knows there are major disagreements about all levels of food safety minutia.

Eating Well magazine asked 10 questions of some food safety types earlier this year and a bunch of stories are now on-line.. The differences in the answers reveal how un-simple food safety is, and how different people talk with journalists.

The Eating Well piece poses some questions, but doesn’t address the hard ones: Who is an expert (a word I hate)? Who is competent to offer advice about anything? Who am I to answer anything, to offer an opinion?

At bites.ksu.edu and barfblog.com, we actually have a policy on how to answer questions, how we provide advice, and it’s being updated.

The magazine has its 10 commandments of food safety, but like fallen angels, commandments are open to interpretation. Judge for yourselves.

Your contestants are:

Ming Tsai, owner, Blue Ginger, his award-wining East-meets-West restaurant in Wellesley Massachusetts.

Bill Marler, managing partner and personal injury lawyer at Marler Clark.

Linda Kender, an associate professor in the College of Culinary Arts at Johnson & Wales University in Providence, R.I.

Richard Vergili, a professor in hospitality management at The Culinary Institute of America (CIA)

Catherine Donnelly, a professor of nutrition and food science at the University of Vermont.

Donna Rosenbaum, co-founder and executive director of Safe Tables Our Priority (S.T.O.P.).

Marion Nestle, professor in the Department of Nutrition, Food Studies, and Public Health at New York University.

Scott Donnelly, a product safety authority with more than two decades of food industry experience.

Douglas Powell, Ph.D, associate professor, food safety, Kansas State University.

Try to distinguish the wordy from the brief, the fact-based and the faith-based approaches to food safety. Match up the bios with the responses and spot the hypocricy.

Eating Well asked, do you always:

1. Use a “refrigerator thermometer” to keep your food stored at a safe temperature (below 40°F).

Tsai: At Blue Ginger, yes, and [a thermometer] is built in the Sub-Zero fridges we use at home.
Marler: Yes.
Kender: I check the temperature of my refrigerator once a week, especially during the summer months.
Vergili: Yes, unless I plan to use the food within a couple of hours.
Donnelly: Yes. I consider my refrigerator to be my most important food-safety device. Knowing the temperature of the refrigerator you use to store food is critical to keep food safe. Many refrigerators in the U.S. operate at unsafe temperatures, and the warmer foods are stored, the more quickly bacteria, including pathogens, can grow.
Rosenbaum: Yes. Appliance thermometers are easy to find in hardware stores. I recommend using one in the freezer as well. It is especially important to check the internal temperatures of secondary refrigerators/freezers kept in basements, garages or other places of more extreme room temperature.
Nestle: No. I live in a tiny apartment in New York and have a small refrigerator. Nothing stays in it that long.
Donnelly: No.
Powell: Fridges fluctuate and thermometers are the only way to acquire accurate data.

2. Defrost food in the refrigerator, the microwave or in cold water, never on the counter.

Tsai  Yes.
Marler: Yes.
Kender: Mostly I defrost in the refrigerator, but there have been occasions that I had to resort to the cold running water method.
Vergili: No, I will occasionally let something begin to defrost on the counter when I am home. For example, today I had some frozen wrapped spare ribs sitting out for a little over [an] hour that [were] still partially frozen. [I] then seasoned and refrigerated [the ribs] for dinner tonight.
Donnelly: Yes. When defrosting any potentially hazardous food, particularly meats or poultry, it is important to make sure juices are contained by using sealed bags or containers. Juices can contain harmful pathogens which can contaminate surfaces and people coming into contact with these juices. Again, the warmer potentially hazardous foods are stored, the more potential growth for dangerous bacterial pathogens to levels which can cause disease.
Rosenbaum: Yes. This is especially important with meat, poultry & seafood. When defrosting meat, poultry or seafood in the refrigerator, however, it is important to make sure that it is on a platter or tray and cannot drip raw juices as it defrosts onto or into foods stored below.
Nestle: Not exactly. I don’t have much counter space so I’m most likely to leave it out in a bowl.
Donnelly: I rarely defrost. When I do, I leave the food out on the counter for less than 4 hours.
Powell: I defrost on the counter. I just don’t leave it there very long.

3. Always use separate cutting boards for raw meat/poultry/fish and produce/cooked foods.

Tsai: Definitely—especially because of food allergies, too, on cross contamination.
Marler: Yes.
Kender: No. I always wash, rinse, and sanitize my cutting board when switching proteins or going to a no cook product.
Vergili: No, I will thoroughly clean the same cutting board and use the same board for both raw and cooked products.
Donnelly: Yes, and I make sure to regularly clean and sanitize these boards after use.
Rosenbaum: I do, but this isn’t always practical. It’s more important to clean and sanitize cutting boards thoroughly between uses, even if you only use it for one type of item. Also, inspect your cutting boards from time to time. When they develop deep knife grooves it may be harder for cleaning solutions to reach and kill any bacteria present and then it’s time to replace the board.
Nestle: No. I wash the one I have in between [uses].
Donnelly: Yes. Or I clean and sanitize the same board.
Powell: No, but I clean cutting boards thoroughly.

4. Always cook meat to proper temperatures, using a calibrated instant-read thermometer to make sure.

Tsai: No, I love my burgers rare and my lamb and steak medium rare. I will be struck by lightning or chomped by a great white before undercooked meats get me!
Marler: Yes.
Kender: No. In my house we like our steaks medium rare and our burgers pink in the middle. No one in the high-risk category lives in my home.
Vergili: I have a preference for many grilled foods to be undercooked such as tuna and pasture-raised porterhouse pork chops.
Donnelly: Most of the time. When grilling, I purchase low-risk products (intact muscle meats as opposed to ground beef) and insure that the outsides of these products (where contamination resides) are well cooked. For poultry and roasts, I always use a meat thermometer.
Rosenbaum: Yes, I always use a thermometer. In regards to beef, it is impossible to tell when it is safe to eat without using a thermometer. The color of the cooked meat is a very inaccurate indicator for safety. Different types of beef require different cooking temperatures and the type of thermometer used may also vary. Very thin beef patties, for instance, are best checked with a thermocouple (a type of temperature sensor) while roasts and steaks can use a larger-gauge thermometer.
Nestle: I cook it hot enough but don’t use a thermometer.
Donnelly: No. I use visual cues based on experience.
Powell: Yes. Color is a lousy indicator. I feel naked without a thermometer.

5. Avoid unpasteurized (“raw”) milk and cheeses made from unpasteurized milk that are aged less than 60 days.

Tsai: No, I love the flavor of unpasteurized. See above for lightning and shark.
Marler: Yes!
Kender: Yes, absolutely. I also avoid unpasteurized cider and fruit juices as well.
Vergili: As a rule yes, but I have gone out of my way to buy “certified” raw milk on rare occasions and tasted cheese from a known cheese maker as well. Frankly, there are some questions surrounding cheese made from raw milk and listeriosis despite 60 days of aging.
Donnelly: I do not consume raw milk as I know this is a high-risk product, and most producers are exempt from requirements specified in the Pasteurized Milk Ordinance which greatly enhance milk safety. For raw milk cheeses aged for less than 60 days, if they are AOC or PDO cheeses which I am purchasing and consuming in Europe, I have great confidence in the regulations and production procedures/processes which include stringent microbiological criteria, thus I know these cheeses pose a low food-safety risk. Cheeses made by unlicensed manufacturers and distributed illegally pose a great public health risk and I would not consume such products.
Rosenbaum: Yes. I believe the risk inherent in any raw dairy product far outweighs any potential benefit. This is especially important for pregnant women to avoid as they are at risk for contracting Listeriosis from raw dairy products, which carries a high rate of premature labor and spontaneous abortion.
Nestle: Not always. If I know the supplier, I’ll take the small risk.
Donnelly: Raw milk cheese is safe; raw milk is not.
Powell: Yup. Not worth the risk, especially for pregnant women, and my wife had a baby six months ago.

6. Never eat “runny” eggs or foods, such as cookie dough, that contain raw eggs.

Tsai: No, again, shark and lightning. But at BG, we do use pasteurized eggs and egg whites for desserts (like sabayon and in the hollandaise we make once a year for the Greater Boston Food Bank's Super Hunger Brunch).
Marler: Correct.
Kender: I never eat runny eggs or anything that contains raw eggs. I even prepare my own Caesar salad dressing using pasteurized egg yolks.
Vergili: No, I will eat classic scrambled eggs which are a bit runny, as well as a poached egg cooked less than the 145ºF [that] the codes call for.
Donnelly: Yes. I avoid consumption of raw eggs. There are excellent pasteurized egg products available to consumers which substantially reduce risks posed by pathogens such as Salmonella, Campylobacter and Listeria.
Rosenbaum: This is difficult to answer with the word “never” in it. My answer would depend on whether or not pasteurized eggs were used. When dining out, I always ask whether raw eggs were used in dishes such as sauces, mousses, tiramisù and dressings. If so, then I would avoid these foods unless I knew the facility was using pasteurized eggs. At home, pasteurized-in-shell eggs have become available in my area and I use these whenever I want to enjoy foods that would be risky if using regular eggs and not cooking thoroughly. Interested consumers can request that their grocers carry in-shell pasteurized eggs.
Nestle: Don’t be silly. I’m human.
Donnelly: Eggs should be cooked.
Powell: Nope.

7. Always wash your hands in warm soapy water for at least 20 seconds before handling food and after touching raw meat, poultry or eggs.

Tsai: Yes, definitely!
Marler: Yes.
Kender: I must admit that at my home I may not get through “Happy Birthday” twice before working with some food items, but absolutely always after working with raw meats and poultry!
Vergili: Yes, this is one of the easiest ways to prevent the spread of both pathogenic bacteria and viruses without compromising the culinary preference for a food.
Donnelly: Yes, and I prefer to use antibacterial soaps after handling these products.
Rosenbaum: Yes, or use hand sanitizer. It’s important to thoroughly clean the faucet handle if you’ve touched it after handling raw foods, too. Also, take along hand sanitizers when going to picnics and barbecues away from home where soap and warm running water would be hard to find.
Nestle: Wash hands, yes, but I don’t count seconds.
Donnelly: Yes.
Powell: Nope. 20 seconds is too long and water temperature doesn’t matter; but I do wash my hands routinely.

8. Always heat leftover foods to 165ºF.

Tsai: Yes.
Marler: Yes.
Kender: Never have leftovers at my home.
Vergili: No, as stated, this is one of the most misunderstood regulations. The recommendation basically pertains to leftover items in large volumes like chili or thick soups that need to be reheated slowly to ensure quality. A piece of beef previously cooked, such as a serving of prime rib, need not be reheated to 165ºF (it becomes more like pot roast).
Donnelly: Yes.
Rosenbaum: I do not generally use a thermometer for leftovers. I do re-cook soups and liquids until they boil, and heat other leftovers until they are steaming. It’s important to stop midway and stir food reheated in the microwave due to cold spots and uneven heating.
Nestle: I get them steaming hot, but don’t measure.
Donnelly: No. I use common sense.
Powell: Nope. 140ºF is sufficient if it has already been cooked.


9. Never eat meat, poultry, eggs or sliced fresh fruits and vegetables that have been left out for more than 2 hours (1 hour in temperatures hotter than 90°F).

Tsai: Fruits and veggies, fine. Meat and seafood, no! At BG, we are always very cognizant of the temperature danger zone; everything is refrigerated and/or cooled down properly.
Marler: Yes.
Kender: Never….especially during summer here in New England. I insist that all our outdoor activities, such as cookouts, have ice, and lots of it, that is used to keep the salads and other food items cold.
Vergili: No, if [it’s] at a group gathering, I would consider eating a raw vegetable or fruit that has been served unrefrigerated (assuming it hasn’t become oxidized, [which I find] unappealing).
Donnelly: Yes, Adherence to proper storage temperatures and the 2-hour rule are proven food-safety measures.
Rosenbaum: Yes. The rule in our house is, “If in doubt, throw it out!” I try to have several trays of the same food prepared when I entertain so they can be rotated and refrigerated in between.
Nestle: You don’t say whether these are cooked or uncooked or what the ambient temperature might be. Microbial growth rates depend on those factors.
Donnelly: No. I use common sense. 4 hours is the limit
Powell: did not offer a response (shurley sum mistake – dp)


10. Whenever there’s a food recall, check products stored at home to make sure they are safe.

Tsai: Yes.
Marler: Yes.
Kender: Yes. I receive recall notices at work and take that information home with me and always double check what I’ve purchased
Vergili: Yes, I would do that.
Donnelly: Yes. In fact, I just returned some cookie dough to a retail outlet for a refund.
Rosenbaum: Yes, and since recall information on food products is very difficult for consumers to obtain, my organization constantly looks for recalls and sends them in daily e-alerts to email inboxes. Anyone can sign up to receive them by sending a request to mail@safetables.org or go to our website daily at www.safetables.org to view them. Some stores post food recalls, while others send text messages or mailed notices. It is important for consumers to throw away or return for refund any product subject to a recall, as these products have either already made people sick or have a high likelihood of being contaminated. If you believe someone in your family has already eaten the product and/or gotten ill, you should keep the product and safely wrap and store it for the health authorities to test.
Nestle: I’ve never had a product involved in a recall except the can of recalled pet food given to me as a research gift for my book, Pet Food Politics.
Donnelly: I purchase locally grown, fresh foods.
Powell: Sure.

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The editor of Nieman Watch at the Nieman Foundation for Journalism at Harvard University tracked me down in Florida a couple of weeks ago -- it's not hard, I'm always plugged in, zing -- and asked me to pen the following, which he greatly improved with some editing. Below, Powell's take on the top-5 food-safety questions journalists should be asking.

Food safety is not a trivial issue. The World Health Organization (WHO) reports that up to 30 per cent of individuals in developed countries acquire illnesses from the food and water they consume annually. Active disease surveillance by U.S., Canadian and Australian authorities suggests this estimate is accurate.

WHO has identified five factors of food handling that contribute to these illnesses: improper cooking procedures; temperature abuse during storage; lack of hygiene and sanitation by food handlers; cross-contamination between raw and fresh ready-to-eat foods; and acquiring food from unsafe sources.

There has been some excellent media coverage of microbial food safety issues since the 1993 E. coli O157:H7 outbreak linked to Jack-in-the-Box that killed four and sickened over 600; there has also been some terribly misleading coverage.
Reporters interested in covering this important story should be asking these five questions:

1. Will more government involvement mean fewer sick people?

While the Internet and the mainstream media were all excited about the potential passage of new food safety legislation by the U.S. House in early August -- it passed -- I was hanging out with some food safety dudes at Publix supermarkets HQ in Lakeland, Florida. And I saw far more in Lakeland that would impact daily food safety than anything the politicians, bureaucrats and hangers-on were talking about.

When it comes to the safety of the food supply, I generally ignore the chatter from Washington, as well as the Internet commentaries and conspiracy theories. If a legislative proposal does emerge, such as the creation of a single food inspection agency, or the bill that passed the House – and just the House –  I ask, Will it actually make food safer? Will fewer people get sick?

As the Government Accountability Office pointed out in a report a year ago, “The burden for food safety in most … countries lies primarily with food producers, rather than with inspectors, although inspectors play an active role in overseeing compliance. This principle applies to both domestic and imported products.”

Publix, with over 1,000 supermarkets, its own processing plants, and thousands of food products moving through its shelves, can’t afford the luxury of chatter. After a  visit to headquarters in Lakeland, Fla., I went to the local Publix in St. Petersburg Beach to verify what I’d heard at HQ. Sure, the bosses know food safety, but do the front-line staff?

I ordered some shaved smoked turkey breast from the deli, and the sealable bag the meat was delivered in bore the following message:

“The Publix Deli is committed to the highest quality fresh cold cuts & cheeses; Therefore we recommend all cold cuts are best if used within three days of purchase; And all cheese items are best if used within four days of purchase.”

This was the first time I’d seen a retailer provide information to consumers on the accurate shelf-life of sliced deli meats. It didn’t require Congressional hearings; it didn’t require some hopelessly-flawed consumer education campaign; it required the company’s food safety officials to say, this is important, let’s do it.

Same thing with fresh fruits and vegetables -- the leading cause of foodborne illness in the U.S. for the past decade.

Late last month, U.S. regulators announced plans to strengthen safety protocols for fresh fruits and vegetables -- except those plans are simply extensions of plans published by the U.S. Food and Drug Administration in 1998. Plans and guidelines don’t make food safe: people do.

It’s nice that food safety is once again a priority in Washington and that politicians are trying to set a tone. But chatting doesn’t mean fewer sick people -- actions do.

Journalists can hold politicians, producers and industry accountable. There are lots of plans and proposals, but will any of them translate into fewer sick people?

2. Is local/natural/sustainable/organic/raw food really any better than other types of food?

A U.S. government extension agent with a PhD and at a prominent university e-mailed the other day to ask if I had any data on foodborne illness from farmers’ markets because she was preparing for a presentation and was, “trying to make the case that there are very few cases of foodborne illness from local foods relative to our globally based food system.”

But the idea that food grown and consumed locally is somehow safer than other food, either because it contacts fewer hands or any outbreaks would be contained, is the product of wishful thinking.

Barry Estabrook of Gourmet magazine recently invoked the local-is-pure fantasy, writing: “There is no doubt that our food-safety system is broken. But with the vast majority of disease outbreaks coming from industrial-scale operations, legislators should have fixed the problems there instead of targeting small, local businesses that were never part of the problem in the first place.”

But whenever you hear someone say there’s “no doubt” in this field, you should be filled with doubt. Foodborne illnesses are vastly underreported. Someone has to get sick enough to go to a doctor, the doctor has to be bright enough to order the right test, the state has to have the known foodborne illnesses listed as reportable diseases, and so on. For every known case of foodborne illness, there are an estimated 10 to 300 other cases, depending on the severity of the bug. Most foodborne illness is never detected. It’s almost never the last meal someone ate, or whatever other mythologies are out there. A stool sample linked with some epidemiology or food testing is required to make associations with specific foods.

Maybe the vast majority of foodborne outbreaks come from industrial-scale operations because the vast majority of food and meals is consumed from industrial-scale operations. To accurately compare local and other food, a database would have to somehow be constructed so that a comparison of illnesses on a per capita meal or even ingredient basis could be made.

Then there are the whoppers that are repeated daily, somewhere, like this one by raw milk advocate Sally Fallon, who said, “Raw milk is like a magic food for children. … Without the green grass, you're missing a lot of vitamins. Also, it's much safer. When cows are eating green grass, you don't find pathogens in their milk.”

With such statements, public advocacy becomes public health risk.

The natural reservoir for E. coli O157:H7 and other verotoxigenic E. coli is the intestines of all ruminants, including cattle -- grass or grain-fed -- sheep, goats, deer and the like. The final report of the fall 2006 spinach outbreak identifies nearby grass-fed beef cattle as the likely source of the E. coli O157:H7 that sickened 200 and killed four.

A table of raw dairy outbreaks is available at http://www.foodsafety.ksu.edu/articles/384/RawMilkOutbreakTable.pdf. Kids are often the ones that get sick.

And be wary of claims that food is local.

3. Is that food safety advice really accurate?

Everyone eats, so everyone’s an expert when it comes to food. Food, Inc. may be a popular movie among the foodies, but has some terrible food safety advice. Microorganisms that make people sick exist in whatever kind of food production and distribution system we smart humans come up with. But government, industry and academic advice can often be of limited use -- or wrong. Do people really need to wash their hands for 20 seconds -- or will 10 seconds suffice? It will.  Does the water have to be warm? No. Are paper towels better than blow driers at removing pathogens? Yes, it’s the friction that counts. Food safety types argue about these things all the time. If someone says, “food safety is simple, just follow this advice,” don’t believe it. Question everything.

4. With all of the attention, resources and talk, why hasn't there been a reduction in the estimated incidence of foodborne illnesses in the past five years?

The U.S. Centers for Disease Control reported in April 2008 that foodborne illness remains a significant public health issue in the U.S., with Salmonella infections increasingly problematic: “Although significant declines in the incidence of certain foodborne pathogens have occurred since 1996, these declines all occurred before 2004,” the CDC reported.

“Outbreaks caused by contaminated peanut butter, frozen pot pies, and a puffed vegetable snack in 2007 underscore the need to prevent contamination of commercially produced products. The outbreak associated with turtle exposure highlights the importance of animals as a nonfood source of human infections. To reduce the incidence of Salmonella infections, concerted efforts are needed throughout the food supply chain, from farm to processing plant to kitchen.”

The CDC data show existing efforts to reduce foodborne illness have stalled. Signs stating “Employees must wash hands” may not be the most effective way to compel good food safety behavior. New messages using new media should be explored to really create a culture that values microbiologically safe food.

5. Why don’t producers, processors, and retailers market microbial food safety directly to consumers?

There’s lots of marketing of food safety, but it is done indirectly. One of the reasons people buy organic/natural/local/whatever is they perceive such food to be safer -- in the absence of any microbiological data. Grocery stores say all food is safe, yet the weekly outbreaks of foodborne illness -- the ones that consumers hear about -- suggest otherwise. The best farms, processors, retailers and restaurants should brag about their microbial food safety efforts and accomplishments. With so many sick people each year, there’s an attentive audience out there.

Dr. Douglas Powell is an associate professor of food safety at Kansas State University. He also runs barfblog.com, a blog about food safety.
 

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I’ve been hanging out with the visiting Egyptians since Thurs.

The U.S. Department of Agriculture has this Cochran Fellows program that provides U.S.-based agricultural training opportunities for senior and mid-level specialists and administrators from public and private sectors who are concerned with agricultural trade, agribusiness development, management, policy, and marketing.

After spending over 30 hours to reach Kansas from Egypt, with a variety of travel headaches, the three food scientists and one professor have been taking in the best Manhattan has to offer: dinner at the Little Apple Brewing Company, viewing the animals at the Riley County Fair, shopping, taking in the Kaw Valley Rodeo Saturday night, and my lectures.

Sunday, the Fellows came to our house for some American-style BBQ and hospitality. I showed them how to cook a hamburger with a tip-sensitive digital thermometer, they told me about cooking and hospitality in Egypt.

Baby Sorenne was the star attraction.

And it's been a huge honor hanging out with the accomplished gentlemen and learning.

 

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The following letter appeared in the Dining and Wine section of this morning’s N.Y. Times:

Re “The Perfect Burger and All Its Parts” July 1:

The only thin piece of metal that should be stuck into the side of a hamburger is a tip-sensitive digital thermometer. Chef Seamus Mullen’s recommendation to put any thin piece of metal into the side of a burger, and “If it’s barely warm to the lips, it’s rare. If it’s like bath water, it’s medium rare,” only demonstrates the divide between food safety and food pornography.

Color is a lousy indicator of burger safety, as is the taste of metal sticks. Rather than putting E. coli O157:H7 on precious testing lips, use a thermometer.

Dr. Douglas Powell
Manhattan, Kan.

The writer is an associate professor of food safety at Kansas State University.

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Your Health columnist Kim Painter wants to know in USA Today tomorrow if the spike in handwashing compliance after SARS hit Toronto in 2003 will be replicated with swine flu in 2009 – and will it last?

In summer 2003, researchers descended on airport bathrooms in the USA and Canada and discovered a dirty truth: More than 20% of restroom visitors left without washing their hands.

But there was one big exception: In Toronto, which had just endured a deadly outbreak of severe acute respiratory syndrome (SARS), fewer than 5% of people left dirty-handed. During that outbreak, public health officials had repeatedly urged people to protect themselves by washing their hands.

Doug Powell, a food scientist at Kansas State University, said if changing handwashing behavior was simple, "we wouldn't have so many people getting sick each year."

The story summarizes handwashing compliance advice for businesses, schools and hospitals as:

•The voice of authority. Just as federal health officials enlisted Obama to endorse handwashing, Dan Dunlop, president of Jennings, a North Carolina marketing company that has designed handwashing promotions for hospitals, has enlisted hospital CEOs and medical chiefs to inspire handwashing in their troops. School principals, PTA presidents and restaurant managers could do likewise, he says.

•The audience. "With younger people, what seems to work is being blunt and gross," Powell says. Powell, who writes at barfblog.foodsafety.ksu.edu, tells his students that when they eat without washing their hands first, they may be eating feces. (But he uses another word.)

•Social pressure. In one unpublished study, Craig found that petting-zoo visitors who left a barn through a crowded exit washed their hands more often than those who left by a less-crowded door.

•Keeping supplies up. Powell says he hears often about bathrooms in schools, college dormitories and other germ hotspots that lack soap (or paper towel – dp).

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The Centers for Disease Control reported today that foodborne illness remains a significant public health issue in the United States, and that, “fundamental problems with bacterial and parasitic contamination are not being resolved.”

Douglas Powell, an associate professor of food safety at Kansas State University, says that more training, testing and inspecting is not the answer.

"There are way too many people getting sick," Powell said. "The CDC data show existing efforts to reduce foodborne illness have stalled. We need new messages using new media to really create a culture that values microbiologically safe food."

Powell publishes barfblog.com and conducts research on human food safety behavior from farm-to-fork. He can be reached by phone at 785-317-0560, or e-mail dpowell@k-state.edu.

His bio is at
http://www.k-state.edu/media/mediaguide/bios/powellbio.html
 

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I'm a total food safety nerd. I even use big food safety events to remember when things in my life happen.  Had I not emailed Doug in the winter of 2000 looking for an on-campus summer job at Guelph, I'm sure I wouldn't be doing that.

The story would be a lot cooler if I had sought out Powell as a potential employer because I was interested in the stuff he did, but I didn't. I had no idea what he did -- and being a bit of an idiot, I didn't bother to look it up. I emailed Doug on the advice of a friend, and former Powell Lab-ite, Lindsay Core. Lindsay knew I was desperately looking for a job, and didn't tell me much else about the dude or what he filled his days with. Lindsay just said "I think you two will get along".  I didn't really know what that meant, but really had no other prospects.  So I emailed him. And he hired me to pull news.

Pulling news meant that I surfed through the tubes of the interweb for anything food risk-y (food safety, GE crops, animal disease, etc) and the stories I found (along with the other news pullers) become the content for FSnet and the other listserv postings Doug puts together every day.  Doug's philosophy fit in with what I was looking for -- he never really cared where I was as long as I could be found with an email and that I would get something to him when he needed it.

About three weeks in, I fell in love with the content and became hooked on food safety communication. That's when an E.coli O157 outbreak linked to Walkerton Ontario's town water system hit. I was already interested in disease (maybe it was because of Outbreak or the Hot Zone?), but the coverage and discussion within the Powell lab around Walkerton (how the outbreak was handled and communicated to the folks drinking the water) drew me in. I knew it was time to move from molecular biology and genetics to food safety. So finding what I really liked is linked in my mind to the 2000 Walkerton outbreak.

That's where it all started.

I equate a May 2003 trip to Dani's graduation from Dalhousie in Halifax with the news of the first Canadian BSE case. On the way home, I saw Doug on the in-flight CBC newscast talking about how CFIA has handled things (and thought, even when I'm away from Guelph for three days Powell and food safety follow me).

In 2006 I was about to leave for a trip to Kansas to visit Doug, and begin the initial evaluation of the food safety infosheets, when the E.coli O157:H7/spinach outbreak broke. When I arrived in Manhattan it was all E.coli O157 and spinach for us. The picture that Christian created with the skull and leafy greens (right) became a signature picture amongst the food safety infosheet pilot participants. Those pilots, and conversations with Doug and Amy in their living room, evolved into video observation of food safety practices -- one of the things I've spent the past couple of years on.

I'll always remember 2008 for a bunch of personal things (having a kid, getting hitched, getting a position at NC State and moving to North Carolina) -- and will probably equate it to Maple Leaf Foods, Listeria monocytogenes and Michael McCain (who was just named Canadian Business Newsmaker of the Year -- kind of like OJ being named US Sports Newsmaker of the Year?).

In my time spent in the various incarnations of FSN/iFSN/barfblog/Powell's lab, I've seen Doug's hair catch on fire; been accosted in a hot-tub (not by him) while in Phoenix with him; got lost on a trip with him in snowy, -20C Montreal without my coat; threw up in his backyard; talked about a ridiculous amount of pop culture with him; started a company with him and Katija; translated Kiwi accents for him; and, maybe most importantly, went to see Neil Young with him.

We've golfed, played squash and hockey together. Each of which he beat me at, and often reminds me of it. He also likes to point out, and I never argue with him, that I owe him. I do; although it's a bit like owing something to Tony Soprano.

There's lots of stuff I've left out of the post because it's hard to write about 8 years in 750 or so words, but through all the fun stuff and late-night emails, Doug has shown me how to create a lifestyle around food safety where working and vacations blend together.

Doug's got lots of friends, former friends and never-friends. The ratio is probably about 1:1:1. Some food safety folks have told me that they wish he was nicer. I'm glad he's not. His skepticism and cynicism (and sometimes lack of tact) makes him great at what he does, and have made him the perfect mentor for me.

So enough of this post being about Doug, it's really about me. On Monday I start a faculty position in the Department of 4-H Youth Development and Family & Consumer Sciences at NC State University as food safety extension specialist.  I'm excited as I get to support extension agents throughout North Carolina; develop food safety programs to be delivered from farm-to-fork; and, conduct applied research on food safety. It doesn't sound like a job to me. $550 for season tickets to the Hurricanes, and about three hours to Myrtle Beach are added bonuses.

Dani, Jack and I left Canada a week ago for the USA. Our furniture will arrive sometime next week, so for now we're minimalists. We're currently camping indoors, with only an air mattress, lawn chairs and a 42" television (I guess the TV isn't really camping equipment, but whatever).

On Tuesday night we picked a whole chicken up at Target and decided we'd roast it, but forgot that in our equipment-less situation we didn't have our trusty PDT 300 to take the temp. 

The juices were running clear.  The chicken was piping hot (even a bit crispy) but after I had my first couple of bites I noticed that the meat close to the center looked pretty raw.

We went and got an interim thermometer at Target yesterday.


The Monday start date hinges on me not coming down with Campylobacter or Salmonella.

Doug sent me an email a couple of nights ago (while we were chatting about the fantastic Canada/US World Junior Hockey Tournament game) that said "you your own dude at NC State" (he's one arm typing with Sorenne lately).  Yep. That's true, but I wouldn't be my own dude here if it wasn't for him, and I'm excited to work on more great stuff together.

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