Food safety: where from and where to?

15 downloads 274 Views 162KB Size Report
implications for reducing the economic and social burden of foodborne ..... E.C., Griffith, C.J. and Peters, A.C. (2000), “Use of social marketing techniques in the.
The current issue and full text archive of this journal is available at www.emeraldinsight.com/0007-070X.htm

BFJ 108,1

Food safety: where from and where to? Christopher J. Griffith

6

School of Applied Sciences, University of Wales Institute, Cardiff, UK Abstract Purpose – For nearly 150 years the study of food safety has been dominated by a microbiological approach, however, in many countries cases of foodborne disease are at record levels. The purpose of this paper is to review the history of food safety and present a model for studying food safety. Design/methodology/approach – The history of food safety is reviewed. Data from outbreak investigations and observational studies of food handling are analysed Findings – Whilst micro-organisms are a major factor in foodborne disease and microbiology an important research discipline, in order to reduce the incidence of foodborne disease additional research approaches should be used. Such strategies should include food handler behaviour and its links with food safety organisational culture, and food safety management systems. Practical implications – The findings highlight the limitations of the present approach and the need for additional data, using a wider range of research techniques Originality/value – A novel model for studying food safety is presented, which has practical implications for reducing the economic and social burden of foodborne disease. Keywords Food safety, Microbiology, Micro-organisms, Diseases Paper type Viewpoint

British Food Journal Vol. 108 No. 1, 2006 pp. 6-15 q Emerald Group Publishing Limited 0007-070X DOI 10.1108/00070700610637599

Background Food is essential to life but if contaminated can cause illness and even death. Fortunately, the latter only happens in a minority of cases, although the morbidity associated with the millions of cases of food related illness worldwide has significant social and economic consequences. A range of terms including food poisoning, foodborne illness and foodborne disease are encountered in the literature and can cause confusion (Roberts, 2002). Frequently, such terms are used interchangeably within official reports, publications and research notes, whilst some are considered as subsets of others. For the purpose of this paper foodborne disease, as defined by the World Health organisation (WHO) (Schmidt, 1995), will be used unless alternative terms have been used within the references quoted. The WHO definition embraces all food and waterborne illness regardless of the presenting symptoms and includes “any disease of an infectious or toxic nature caused by, or thought to be cause by, the consumption of food or water” (Schmidt, 1995). Foodborne disease therefore includes illness caused by various chemical, physical or microbiological hazards, which may be present in food or water. Some foods are naturally poisonous or toxic (Brownsell et al., 1989). Other foods may go through a prolonged and increasingly international process from farm/ producer to the point of consumption. At each step there is the potential for contamination with chemical, physical or microbiological hazards with or without growth of the latter. Food safety, synonymous with food hygiene, embraces anything in the processing, preparation or handling of food to ensure it is safe to eat. The food chain, like any other chain, is only as strong as its weakest link and the responsibility

for food safety lies not only with producers and processors of food, but also governments and consumers themselves (Griffith, 2000). Governments should pass, and then enforce, appropriate food safety legislation, as well as providing medical support for treating the victims. Additionally, they should also have a broader role and record and gather epidemiological and outbreak data, as well as making use of inspection results (Griffith, 2005). This information can be used to devise intervention strategies and educate industry and consumers. The latter also have an important role to play in preventing self harm. The home is the location for many cases of foodborne diseases and consumers must handle food hygienically (Redmond and Griffith, 2003).

Food safety

7

Food safety: where from – an historical perspective The history of food safety (Table I) is probably nearly as old as human history itself and may have started with the recognition and subsequent avoidance of foods that were naturally toxic. Early humans, probably by trial and error, also started to develop basic forms of food preservation, which possibly also made food safer, e.g. drying, salting, fermentation. The Chinese reportedly preserved vegetables by fermentation in prehistoric times and Plinius preserved white cabbage in earthenware pots in Italy in the first century AD (Montville and Matthews, 2005). As human eating patterns, habits and foods changed, food safety became more formalised. The laws of ancient Israel included advice on foods to be avoided, methods of preparation and the importance of food hygiene. In 2000 BC the book of Leviticus tells us that Moses introduced laws to protect his people from food related disease, such as, the washing of clothes and bathing after the sacrificial slaughter of animals. It is also reported that Egyptians, Greeks and Romans also expressed similar concerns (Mossel et al., 1995). Subsequently throughout history, governments, the UK being typical (Table II), have passed legislation to protect consumers. Much of this early legislation was based upon the need to prevent adulteration of food (primarily chemical) and to ensure it was accurately described. Recognising and reporting the existence of micro-organisms by the so called father of microbiology, Antonie van Leeuwenhoek, initially had little impact on food safety. The origins of commercial heat processing started in the 1800s with the work of Appert and later Pasteur, and this, combined with advances in medicine, heralded the golden age of food microbiology, which still continues today (Table III). It is the intention of this paper to focus on food safety and readers are referred to more comprehensive reviews of the history of microbiology (Hartman, 2001; Marth, 2001a; Marth, 2001b).

50000 BC 4000 BC 2000 BC AD 1676 AD 1810 AD 1857 AD 1880 1880 to date

Early humans Various Leviticus Antonie van Leeuwenhoek Nicholas Appert Pasteur Gartner

Self preservation Early food fermentation Religious beliefs Origins of Microbiology Basis of commercial heat processing Early Food Microbiology First isolation of Salmonella from food poisoning outbreak Salmon, Russell, Frazier and many others Start of Golden Age of Food Microbiology

Table I. A timeline of food safety

BFJ 108,1

8

Table II. Some historical developments in UK (and related EU) food safety legislation

Date (AD )

Food legislation

1266 1760-1830 1820 1848 1860 1872 1875 1928 1938 1955 1976 1984 1990 1993 1995 2004

Assize of Bread and Ale Processes for the preservation of food invented A treatise on adulterations of food and culinary poisons First Public Health Act Adulteration of Food Act Adulteration of Food, Drink and Drugs Act Sale of Food and Drugs Act Food and Drugs (Adulteration) Act Food and Drugs Act Food and Drugs Act Food and Drugs (Amendment) Act Food Act Food Safety Act Council Directive EC 93/43 Food Safety (General Food Hygiene) Regulations Hygiene of Foodstuffs EC 852/2004

1870-1890 1890s 1892 1895 1900-1928 1930s/1940s 1944-1958 1957 1971-date Table III. Golden age of food microbiology timeline

Various Various Koch, Salmon and others Russell Russell Various Frazier Scott and others Baumann and others

Food Processing Dairy Bacteriology Veterinary Microbiology Food Processing/Microbiology First textbook of Dairy Bacteriology Food Microbiology One of the first food microbiology textbooks Food Processing/Microbiology Molecular Approach to Food Microbiology and dawn of the HACCP era Recognition of previously unknown foodborne pathogens – Campylobacter, Listeria, Norovirus, Prions and Mad Cow Disease

Some of the pathogens we know today are linked to the names of the important microbiologists of the time. For example, David E. Salmon, who worked on hog cholera, had the bacterial genus Salmonella – well known as a major food safety problem, named after him. Much of food microbiology had its origins in dairy microbiology with an emphasis on food processing and shelf life, rather than food safety (Marth, 2001a; Marth, 2001b). Frazier produced one of the earliest standard texts in food microbiology, although the 1944 edition contained little information on food safety. The 1956 edition, in addition to revising the earlier commodity and processing chapters contained three new safety related chapters; Food Poisonings and Infections, Investigation of Foodborne Disease Outbreaks and Microbiology of Food Plant Sanitation (Marth, 2001b). Since then, the influence of microbiology as a component of food safety has increased and is to an extent typified by Food Microbiology and Food Safety into the Next Millennium (Tuijtelaars et al., 1999). This presents the proceedings of the 17th International Conference of the International Committee on Food Microbiology and Hygiene (ICFMH). This 942 page book contains a wealth of information in 371 abstracts on food microbiology, for example:

The effect of organic acids, pH and nisin on the growth of Acrobacter butzleri

Food safety

Studies on E.coli O157:H7 adherence to beef muscle using laser scanning confocal microscopy and a magnetic meat fraction assay Cross protection of lactic acid bacteria by stress-preconditioning Use of nucleic acid typing for investigation of foodborne botulism outbreaks

9

Lipopolysaccharide released from Salmonella typhimurium by ethylenediaminetetraacetic acid and its characterisation by 31P-NMR Alcohol resistance of acidic bacteria

These encompass mycology, preservation, ecosystems, antibiotic resistance, etc. The thesis of the book and much of the existing approach to food safety and the prevention of foodborne diseases can be represented diagrammatically (Figure 1). Food safety: the present With several thousand years of experience of food safety combined with over 150 years of food microbiology and the latest molecular biology techniques it might be erroneously assumed problems of food safety would have been resolved. In fact the opposite is true with increased reports of foodborne disease (Griffith, 2000; Redmond and Griffith, 2003): Foodborne disease caused by microbiological hazards is a large and growing public health problem. Most countries with systems for reporting foodborne disease have documented significant increases (FAO/WHO Pan European Conference on Food Safety February 2002). Deeply concerned that foodborne illness associated with microbial pathogens, biotoxins and chemical contaminants in food present a serious threat to the health of millions of people in the world. (Resolution (EB105.R16) on Food Safety 53rd World Health Assembly May 2000.)

Doubts about the preventative value of some food microbiology research have been expressed for some time. It is reported (Mossel et al., 1995) that Sir Graham Wilson

Figure 1. Historical approach to food safety

BFJ 108,1

10

once asked a zealous young food microbiologist, who had just described a method for the microbiological examination of foods: “How many cases of foodborne disease would be prevented by the introduction of this procedure?”. The problem has more recently been neatly summarised by Woolen (Woolen, 1999) who wrote “millions of words of advice and millions of pounds spent but the problem is getting worse”. Furthermore problems of food safety have increased in developed and developing countries. Unlikely to be reported in some developing nations those countries that have epidemiological data collection systems have reported increased incidence of foodborne diseases. Data collection is important to understand the nature and extent of the problem. Egypt typically reports only about three cases per 100,000 population, whereas Sweden reports 5770. The difference is not due to better hygiene, in reality, the reverse is true, but due to better reporting and data collection. “If you do not look, you do not find”. The official figures for Egypt contrast with studies undertaken by tour operators, with Egypt topping the league table for travellers reporting stomach upsets after visiting holiday destinations (Cartwright, 2003). A range of reasons have been presented explaining why food poisoning has increased in developed countries: . Changing patterns of food consumption. . Proper/incorrect use of new cooking equipment. . More varied cuisine, including ethnic foods. . Change in cooking/shopping practices: weekly or monthly shops rather than daily. . Decreased use of preservatives and less processing. . Greater eating out. . Reduced consumer immunity: greater number of higher risk individuals in the population. . Lengthened gap between production and consumption. . Greater consumer awareness of foodborne disease. . Changes in farming practices. . Evolution of existing and new food pathogens. . Failure to accept responsibility. . Government failures. . Food industry failures. . Consumer negligence/ignorance. . Failures in management practices. . Lack of multidisciplinary research approach. It is possible all of these may contribute to the present high level of foodborne disease. Certainly new and evolving pathogens, often with a relatively low minimum infectious dose (MID), are increasingly reported. This can be illustrated (Figure 2) by the reporting of cases of Campylobacteriosis. Virtually unknown/unreported before 1980 Campylobacter is now the most frequently recorded cause of bacterial food poisoning in the UK and many other countries (Griffith, 2000) and may have an MID as low as 500 (Advisory Committee on the Microbiological Safety of Food (ACMSF), 2004).

Food safety

11

Figure 2. Campylobacter incidence 1985-1998

In real terms, illness caused by viruses, e.g. Norovirus may be even more important. It has been suggested that only 1 in every 1500 cases of the latter are reported. Although direct person-to-person spread may be responsible for general virus dissemination, for many cases, food and eating have also been implicated (Isakbaeva et al., 2005). Historically, based on end product testing, strategic changes towards a more preventative approach to food safety management started as early as the 1920s (Mossel et al., 1995), although these strategies were largely unsuccessful. Although there was a renewed emphasis on preventative food safety in the 1930s, it is only since the 1970s that this approach has really been adopted, leading to the use of HACCP (Bauman, 1994). There is evidence that businesses adopting a food safety management approach based on HACCP and pre-requisite programmes (PRPs) produce better microbiological quality food (Little et al., 2002; Little et al., 2003). However, considering management systems is only part of the multidisciplinary approach that needs adoption. Documented food systems explain how things “should be done” but what people “actually do” is a manifestation of the food safety organisational culture (Griffith, 2000). This is a complete integration of the individual food handlers’ knowledge, attitudes and practices with the culture or standards set by the manager/owner of the business (Figure 3). Food safety organisational culture is influenced by many things, including the facilities available (e.g. for hand-washing), as well as the time available to implement food safety practices. Within the food service context, this can be a greater problem, where staff may need to supply food to order rather than from stock. Studies involving outbreak investigations have suggested that poor food handling practices may be implicated in up to 97 per cent of foodborne illness in food service establishments and the home (Howes et al., 1996). Other studies based on self report (Clayton et al., 2002), which is known to overestimate food safety behaviour, included

BFJ 108,1

12 Figure 3. Food safety is a multidisciplinary problem

an admission that in the UK 4 per cent of food handlers “often did not carry out all known food safety behaviour at all appropriate times”. This should be viewed in the context of, for example in the UK, up to three million food handlers working for 365 days of the year, often implementing over 1,000 food handling actions a day. Observational studies using techniques, such as notational analysis (Clayton and Griffith, 2004), confirm that food handlers frequently do not use/implement appropriate known food safety practices. The role of training in improving food safety practices is not a simple linear one and how, why and what training is delivered to optimally improve food safety needs to be carefully considered (Worsfold et al., 2004). Food safety: where to? The future Whilst food microbiology is rightly an important component of food safety, even more so with the development of rapid microbiological techniques and the identification of new pathogens, the last 20 years has seen the recognition that food safety is a multidisciplinary problem requiring new approaches (Mortlock et al., 2000) (Table IV). Identifying the genome of a pathogen may only be of limited value in preventing it from causing illness. Systems or approaches to managing food systems are changing

Table IV. A multidisciplinary range of food safety techniques

A FP M RT PRPs HACCP RA RR NA SCM HEA SM OC CBA TNA WTP

Auditing Food Processing Microbiology Rapid Testing Pre-requisite Programmes Hazard Analysis Critical Control Points Risk Assessment Risk Re-enactment Notational Analysis Social Cognition Models Human Error Analysis Social Marketing Organisational Culture/Climate Cost Benefit Analysis Training Needs Analysis Willingness to Pay

and a HACCP requirement is being incorporated into the food safety legislation of a number of countries. For food service operations, this type of legislation may need adaptation, as such industries have been implemented as the most frequently cited locations for outbreaks of foodborne disease, and where classical HACCP may be inappropriate (Griffith, 2000). One area destined to increase will be auditing. HACCP has, as one of its principles, verification, and auditing HACCP plans is an important element of verification. This may be combined with the development of international standards for HACCP (ISO 22000) or as part of global food quality systems such as SQF or BRC. By virtue of their external auditing component, these should provide greater retailer and consumer confidence in international trade. At a governmental and strategic level, greater use will be made of risk analysis and risk assessment and is likely to include judgements of what level of disease is acceptable. However, more information is needed for these models with data on the spread and transmission of pathogens leading to cross contamination, being a recognised “Achilles heel” of many existing risk assessments (Paoli, 2005). More information on this can be obtained from risk re-enactment and studies using notational analysis (Redmond et al., 2004; Clayton and Griffith, 2004). The recognition of human behaviour linked to organisational culture has triggered new approaches to improving food safety. These include the application of psychological models, e.g. social cognition models, human error analysis to understand, possibly predict and then to change/improve behaviour. Training may involve a greater social marketing element where the information communicated considers the recipient of the information more fully (Redmond et al., 2000). The same is likely to be true of consumer food safety campaigns, many of which have been relatively unstructured and uncoordinated in the past. Initiatives based on general food safety awareness, coupled with social marketing approaches for specific target groups, are likely to become more common. Convincing managers to improve food safety, and that it is not a cheap option to ignore it, will involve greater use of cost benefit analysis and studies on consumer willingness to pay. This may be linked to consumer choice and publication of inspection reports as well as outbreak data (Griffith, 2005). Recognising the link between individual and corporate behaviour means greater use and understanding of models of food safety organisational culture and the role of managers in setting standards. Summary/conclusions Although it is very important, food safety is more than just food microbiology and after a golden age of food microbiology, foodborne illness is, in many countries, at or near an all time high. Whilst it is difficult to predict events, strategies and research in the future are likely to recognise not only the importance of food safety management systems, but the role of individuals, working with their peers and superiors, within a business food safety culture. These new fields of study still lack essential data, and the use of additional research techniques to understand and achieve behavioural change is required. Almost implicit is that this actively involves the businesses and managers themselves and they must consider the active and subliminal food safety messages they communicate to their employees. Failure to do so will result in stubbornly high

Food safety

13

BFJ 108,1

levels of foodborne disease and the following types of newspaper accounts from the past also being a feature of tomorrow’s newspapers: Some people were on drips in their hotel rooms. Grown men were on their knees crying with pain.

14

We watched people go down like flies within 24 hours of arriving – we did not think we were going to get off the Island alive (Mail on Sunday).

References Advisory Committee on the Microbiological Safety of Food (ACMSF) (2004), Draft 2nd Report on Campylobacter, FSA, London. Bauman, H.E. (1994), “The origin of the HACCP systems and subsequent evaluation”, Food Science and Technology Today, Vol. 8, pp. 66-72. Brownsell, V.L., Griffith, C.J. and Jones, E. (1989), Applied Science for Food Studies, Longman, London. Cartwright, R.Y. (2003), “Food and waterborne infections associated with package holidays”, Journal of Applied Microbiology, Vol. 94, pp. 1-12. Clayton, D. and Griffith, C.J. (2004), “Observation of food safety practices in catering using notational analysis”, British Food Journal, Vol. 106, pp. 211-27. Clayton, D., Griffith, C.J., Price, P. and Peters, A.C. (2002), “Food handlers’ beliefs and self-reported practices”, International Journal of Environmental Health, Vol. 12, pp. 25-39. Griffith, C.J. (2000), “Food safety in catering establishments”, in Farber, J.M. and Todd, E.C.D. (Eds), Safe Handling of Foods, Marcel Dekker, New York, NY. Griffith, C.J. (2005), “Are we making the most of inspections: a glimpse into the future”, British Food Journal, Vol. 107, pp. 132-9. Hartman, P. (2001), “The evolution of food microbiology”, Food Microbiology: Fundamentals and Frontiers, 2nd ed., ASM Press, Washington DC, pp. 3-12. Howes, M.S., McEwen, S., Griffiths, M. and Harris, L. (1996), “Food handler certification by home study: measuring changes in knowledge and behaviour”, Dairy Food Sanitation, Vol. 16, pp. 737-44. Isakbaeva, E.T., Widdowson, M., A, ., Beard, R.S., Bulens, S.N., Mullins, J., Monroe, S.S., Bresee, J., Sassano, P., Cramer, E.H. and Glass, R.I. (2005), “Norovirus transmission on cruise ship”, Emerging Infectious Diseases, Vol. 11, pp. 154-7. Little, C.L., Barnes, J. and Mitchell, R.T. (2002), “Microbiological quality of take-away cooked rice and chicken sandwiches: effectives of food hygiene training of the management”, Communicable Disease and Public Health, Vol. 5, pp. 289-98. Little, C.L., Lock, D., Barnes, J. and Mitchell, R.T. (2003), “Microbiological quality of food in relation to hazard analysis systems and food hygiene training in UK catering and retail premises”, Communicable Disease and Public Health, Vol. 6, pp. 250-8. Marth, E.H. (2001a), “The emergence of food microbiology: its origin in dairy microbiology”, Dairy, Food and Environmental Sanitation, Vol. 21, pp. 818-24. Marth, E.H. (2001b), “The emergence of food microbiology: from dairy microbiology to food microbiology”, Dairy, Food and Environmental Sanitation, Vol. 21, pp. 886-96. Montville, T.J. and Matthews, K.R. (2005), Food Microbiology: An Introduction, ASM Press, Washington DC.

Mortlock, M.P., Peters, A.C., Griffith, C.J. and Lloyd, D. (2000), “Evaluating impacts of food safety control on retail butchers”, in Hooker, N.H. and Murano, E.A. (Eds), Interdisciplinary Food Safety Research, CRC Press, Boca Raton, FL. Mossel, D.A.A., Corry, J.E.L., Struijk, C.B. and Baird, R.M. (1995), Essentials of the Microbiology of Foods: A Textbook for Advanced Studies, John Wiley & Sons, Chichester. Paoli, G. (2005), “Workshop contribution on risk modelling”, paper presented at the 105th ASM Meeting, June, Baltimore, MD. Redmond, E.C. and Griffith, C.J. (2003), “Consumer food handling in the home: a review of food safety studies”, Journal of Food Protection, Vol. 66, pp. 130-61. Redmond, E.C., Griffith, C.J. and Peters, A.C. (2000), “Use of social marketing techniques in the prevention of specific cross contamination actions in the domestic environment”, 2nd NSF Conference on Food Safety, Savannah, GA, October. Redmond, E., Griffith, C.J., Slader, J. and Humphrey, T. (2004), “Microbiological and observational analysis of cross contamination risks during domestic food preparation”, British Food Journal, Vol. 106, pp. 581-97. Roberts, C. (2002), Food poisoning versus foodborne disease, Foodsafe Listserv, available at: http://lists.foodsafetyweb.info/ (accessed 5 September, 2002). Schmidt, K. (1995), WHO Surveillance Programme for Control of Foodborne Infections and Intoxications in Europe, Federal Institute for Health Protection of Consumers and Veterinary Medicine, Berlin, 6th Report 1990-1992. Tuijtelaars, A.C.J., Samson, R.A., Rombouts, F.M. and Notermans, S. (1999), “Food microbiology and food safetyinto the next millennium”, Proceedings of the 17th International Conference of the International Committee on Food Microbiology and Hygiene (ICFMH), Veldhoven. Woolen, A. (1999), “Safety and the Y2K”, Food Processing, February, p. 20. Worsfold, D., Griffith, C.J. and Worsfold, P. (2004), “A survey of environmental health officers’ views of food hygiene training”, British Food Journal, Vol. 106, pp. 51-64. Corresponding author Christopher J. Griffith is the corresponding author and can be contacted at: [email protected]

To purchase reprints of this article please e-mail: [email protected] Or visit our web site for further details: www.emeraldinsight.com/reprints

Food safety

15