1. FOOD SAFETY Suzette DeCastro, MS, RD, LD Walden University Environmental Health
My target audience for this presentation is for University students who have an interest in food safety and food science. As well as persons who work in the area of food and nutrition services. Providing the customer the safe, quality, and nutritious food is essential and extremely important for most humans as it is the basis of wellness and and good health. This topic has also been on the increase in the US as food borne illness outbreaks in the US have also increased over the past decade.

2. Purpose of this service based project
Introduction to concepts and principles on how to serve safe food
Understanding the food safety risks faced in food service establishments
Identifying risks in food service and finding ways to reduce them
maintaining quality food services in ones operation as well as keeping customers and employees safe.

3. Learning Outcomes Will Recognize the importance of food safety
Will Recognize the risks associated with high risk populations
Will Avoid potential hazards to food safety
Will Understand the process of how food becomes unsafe
Will understand prevention measures to keeping food safe
FATTOM
Food safety training program and personal hygiene of employees The audience will learn these outcomes by the end of this presentation.

4. Food Borne Illnesses A disease transmitted to people by food.
Two or more people get the same illness after eating the same food.
Each year CDC estimates 1 in 6 or 48 million people will get sick from unsafe food.
128,000 are hospitalized and 3000 persons die from food borne illnesses (National Restaurant Assoc, 2005)
National Restaurant association (2005) Servsafe Essentials (5th ed) Chicago, IL
Learning Objectives 1.- Recognize the importance of food safety 2. Recognize the risks associated with high risk populations. 3. Avoiding potential hazards to food safety 4. Understanding how food becomes unsafe 5. Understanding important prevention measures for keeping food safe.

5. Foodborne Active Surveillance Network, United States, 1996–20092
                                                                                                                                                                                    
CDC (2011) Food borne Active Surveillance Network, US Retrieved from .
Food service mangers have the the responsibility to the operation, employees, and customers

6. Costs of Food Borne Illnesses
Illnesses cost the US billions of dollars each year. Associated costs are medical, lost productivity, and death.
Serious Health Issue according to the Economic Research Service of the USDA
Each year 6.9 billion in costs are associated with five bacterial pathogens
Campylobacter, Salmonella, Listeria monocytogenes, and types of E. Coli (CDC, 2011)
CDC(2011) Food safety retrieved from safety Food borne illness is a disease transmitted to people by food

7. Rates of lab confirmed infections
Figure 2. Changes in incidence of laboratory-confirmed bacterial infections, United States, compared with 1996–1998
                                                                                                                                                           
CDC(2011) Rates of lab confirmed infections. Retrieved from www CDC.gov/foodsafety
Learning Objectives- Identify the types of pathogens that cause illness 2. What do pathogens need to grow? 3. The foods most likely to become unsafe. 4. The major food borne illnesses and their characteristics

8. FOODNET SURVEILLANCE in 1996, CDC has seen important declines in infections caused by six of the seven bacterial pathogens tracked—Yersinia, Shiga toxin–producing Escherichia coli (STEC) O157, Shigella, Salmonella, Listeria, and Campylobacter.
Salmonella, the most commonly diagnosed and reported food borne illness, continues to be a challenge. The incidence of Salmonella infections has declined by only 10% since FoodNet surveillance began (CDC, 2011)
Hazards to food can be biological, chemical, and physical. Prevention measures for keeping food safe are 1- controlling measures for keeping time and temp 2- prevent cross- contamination, practice personal hygiene, and purchase from approved suppliers
Harmful microorganisms are called pathogens and microorganisms are called pathogens

9. Rates of infection with STEC O157, which causes one of the
Rates of infection were substantially higher for Vibrio in 2009 than in 1996–1998.
Rates of infection were at least 25% lower for Shigella, Yersinia, Campylobacter, and Listeria than they were a decade ago.
Rates of infection with STEC O157, which causes one of the
most severe forms of foodborne illness, decreased by 25% in 2009 compared with the most recent 3 years, reaching the lowest level since 2004.
(CDC, 2011)
CDC(2011) Food safety: Foodnet surveillance. Retrieved from

10. Estimated number of illnesses 90% Credible Interval %
Table 2. TOP five pathogens contributing to domestically acquired foodborne illnesses
Pathogen
Estimated number of illnesses
90% Credible Interval %
Norovirus
5,461,731
3,227,078–8,309,480 58
Salmonella, nontyphoidal
1,027,561
644,786–1,679,667 11
Clostridium perfringens
965,958
192,316–2,483,309 10
Campylobacter spp.
845,024
337,031–1,611,083 9
Staphylococcus aureus
241,148
72,341–529,417 3
Subtotal 91
CDC(2011) Top five pathogens retrieved from

11. Populations at High Risk for Food borne Illnesses
The Elderly
Infants and pre-school age children
Pregnant women
Persons with diagnosed medical condition that have a compromised immune system such as AIDS patients and cancer patients (National Restaurant Assoc, 2005)
National Restaurant Association (2005) Servsafe Essentials Chicago, IL 4 types of pathogens- viruses, bacteria, parasites, and fungi

12. Safe Internal food temperatures
CLEAN Clean your hands with soap and warm water before handling food. Clean surfaces before preparing food on them.
SEPARATE Separate cooked foods from ready-to-eat foods. Do not use utensils on cooked foods that were previously used on raw foods and do not place cooked foods on plates where raw foods once were unless it has been cleaned thoroughly (CDC, 2011)
TSC food are better for pathogen growth Viruses are the leading cause of food borne illness as they can survive cooler and freezer temps. Key to prevent the spread of viruses.

13. Safe Internal Food temperatures
CHILL Chill foods promptly after serving and when transporting from one place to another. Keep your refrigerator at 40°F or below. Keep hot foods hot and cold foods cold.
COOK Cook foods to a safe internal temperature (see chart). Use a meat thermometer to make sure foods are cooked to a safe temperature. Color is not an indicator of doneness ( CDC, 2011)

14. Safe food temperatures
If a public health official contacts you to find out more about an illness you had, your cooperation is important.
In public health investigations, it can be as important to talk to healthy people as to ill people. Your cooperation may be needed even if you are not ill.
For more information on preventing food borne illnesses
visit FoodSafety.gov  , the federal gateway for food safety information (CDC, 2011)
CDC(2011) Food safety retrieved from
Learning objectives- Preventing cross- contamination 2- Preventing time-temperature abuse. 3. Use of correct and accurate thermometers to take temperatures.

15. SAFE FOOD TEMPERATURES
REPORT: Report suspected food borne illnesses to your local
health department. The local public health department is an important part of the food safety system.
Often calls from concerned citizens are how outbreaks are first detected ( CDC, 2011)
Conditions that pathogens need to grow FATTOM food, acidity, temp, time, oxygen, and moisture. Danger Zone- 41F- 135F or 5C – 57C

16. THE FDA FOOD CODE
is issued by the FOOD and Drug Administration. It outlines the federal governments recommendations for food safety regulations for the food service industry.
Health inspectors from state health departments conduct food service inspections of food service establishments.
Self- Inspections- A well managed food service operation have frequent self inspections to keep food safe. (CDC, 2011)
FDA(2011) Food safety Modernization Act retrieved from
Learning Objectives 1- Purchase form approved reputable suppliers, Use criteria to accept or reject food during receiving 3- Labeling and dating of food 4. Proper Storing of food and nonfood items

17. FOOD Safety Regulations & Standards
The FDA Food Safety Modernization Act (FSMA) was signed into law by President Obama on January 4th, 2011.
It aims to ensure the U.S. food supply is safe by shifting the focus of federal regulators from
responding to contamination to preventing it.
(FDA, 2011)
5 ways to control risks- knowledge, staff health controls, controlling hand sanitation, TM and temp parameters, consumer advising

18. Preventing Food Borne Illnesses
Practicing Good Personal Hygiene
Controlling the time and temperature of foods
Avoiding cross contamination of foods
Purchasing from approved reputable suppliers (National Restaurant Assoc, 2005)
National Restaurant Assoc(2005) Servsafe Essentials Chicago, IL
Cross contamination- the food handler transfers the pathogen from one surface or food to another.

19. Listeria monocytogenes, Listeria monocytogenes,
The Costs of Foodborne Illness
The Costs of Foodborne Illness
Foodborne illness is much more than the “stomach flu”, and it is a serious health issue and economic burden for consumers. According to the Economic Research Service (ERS) of the USDA, each year $6.9 billion in costs are associated with five bacterial pathogens,
Foodborne illness is much more than the “stomach flu”, and it is a serious health issue and economic burden for consumers. According to the Economic Research Service (ERS) of the USDA, each year $6.9 billion in costs are associated with five bacterial pathogens,
Campylobacter,
Campylobacter,
Salmonella,
Salmonella,
Listeria monocytogenes,
Listeria monocytogenes,
E. coli O157:H7, and
E. coli O157:H7, and
E. coli non-O157:H7 STEC (2000).
E. coli non-O157:H7 STEC (2000).
USDA standard internal temperatures for meats ,poultry, and pork
Learning Objectives 1- Thawing food correctly 2- Preventing cross- contamination and time- temperature abuse 3- Cooking food to a minimum internal temperature 4 Cooling and reheating food to the right temperature in the right amount of time.
These costs are associated with medical expenses, lost productivity, and even death.
These costs are associated with medical expenses, lost productivity, and even death.

20. Retrieved from www.fsis.usda.gov Danger Zone 41F – 135F
                                                                                                                        
USDA (2011) Food safety & Inspection service: Recommended Internal cooking temperatures
Retrieved from Danger Zone 41F – 135F

21. Potential Hazards to Food Safety
Biological- pathogens such as viruses, parasites, fungi, and bacteria.
These harmful microorganisms may produce poisons or toxins in the food or the host.
Chemical- cleaners and sanitizers
Physical- foreign objects can get into food Moeller, 2005)
Moeller, D (2005) Environmental Health. Cambridge, MA Harvard University press

22. How Food Becomes Unsafe?
Purchasing food from unsafe sources.
Failing to cook food adequately.
Holding food at the incorrect temperatures.
Using contaminated equipment
Practicing poor personal hygiene (CDC, 2011)
CDC(2011) Food safety retrieved from safety.
CDC has identified the 5 most common risk factors that cause food borne illness

23. What Pathogens need to grow?
Food or an energy source.
Acidity- Pathogens grow best in food that contains no or little acid (ph of 4-7)
Temperature- Pathogens grow well in food in the range known as the temperature danger zone (41F- 135F)
Time- Pathogens need time to grow especially after four hours.( National Restaurant Assoc, 2005)
National Restaurant Association(2005) Sersafe Essentials(5th ed) Chicago, IL FAT TOM

24. Cont.. What conditions do Pathogens need to grow??
Oxygen- Some pathogens need oxygen to grow. While others can grow in anaerobic conditions
Moisture- Pathogens need moisture in food to grow.
Viruses are leading cause of food borne illness, such as with hepatitis A and the Norovirus. These illnesses are linked with ready to eat food and shellfish (National Restaurant Assoc, 2005).
National Restaurant Association (2005) Sersafe Essentials (5th ed) Chicago, IL

25. Bacteria and food borne illness
Bacteria can change into different forms called spores that keep them from dying when they don’t have enough food
Other types of bacteria can produce toxins in food or in the host.
National Restaurant Assoc, 2005)
National Restaurant association(2005) Servsafe essentials (5th ed) Chicago, IL Good personal hygiene such as hand washing, hand care, glove use and hair net. And bare hand contact

26. Causes of illness in 1,565 single food commodity outbreaks, 2003–2008
CDC(2011) Causes of food borne illness retrieved from

27. Foods identified in Food borne illnesses
Bacillus cereus- cooked rice dishes
Listeriosis- raw meat and deli meats
Hemorrohagic colitsis- ground beef
Clostridium perfringens-meat and poultry (Moeller, 2005)
Moeller, D (2005)Environmental Health 3rd ed, Cambridge, MA Harvard University Press
Separate equipment, clean and sanitize, prep food at different times, buy prepared food Pathogens grow faster at 70F to 125F

28. Cont. Foods identified in Food borne illnesses
Shigellosis- salads
Staphylcoccal- deli meats and salads
Vibrio vulnificus- oysters from contaminated waters
( Moeller, 2005)
Moeller, D(2005) Environmental Health 3rd ed, Cambridge, MA Harvard University press

29. Foods contaminated with Parasites
Anisakiasis- raw and undercooked fish
such as cod, mackerel and salmon
Cryptosporidiosis- produce and
contaminated water
Giardiasis- produce and contaminated
water (National Restaurant assoc,
2005)
Purchase from approved reputable suppliers GMP GAP, stamped by USDA

30. Foods identified in food borne illness
Fungi, molds, and yeasts in produce, jams and jellies.
Some molds produce toxins such as aflatoxins
poisonous Mushrooms and plant toxins
( Moeller, 2005)
Moeller, D(2005) Environmental Health 3rd ed, Cambridge, MA Harvard University press

31. Seafood and shellfish poisoning
PSP-paralytic shellfish poison, NSP- neurotoxic shellfish, ASP- amnesic shellfish
Clams, oysters, and scallops
Seafood toxins- Scombroid poisoning-tuna fish also known as histamine poisoning
Ciguatera- jacks and red snapper (Moeller, 2005)

32. Chemical Contaminants
Some utensils and equipment contain toxic metals that contaminate acidic food.
A person who eats this food can get toxic-metal poisoning
Illness is caused by storing or prepping food with equipment contaminating heavy metals such as Lead, Copper, and Zinc.
Cleaners, sanitizers, polishes, and machine lubricants should be kept ot stored away form food.
( Moeller, 2005)

33. Common Food Allergens Milk and Dairy products Eggs Fish and shellfish
Wheat
Soy products
Nuts (National Restaurant assoc, 2005)
National restaurant Association(2005) Servsafe essentials 5th ed Chicago, IL

34. Food Allergens
The number of people in the US is increasing who have allergies to food.
It is the body’s negative reaction to a food protein.
symptoms such as hives, rashes, breathing difficulties, swelling of face, abdominal cramps, and death with severe reactions (National Restaurant assoc, 2005)
National restaurant Association (2005) Servsafe essentials 5th ed Chicago, IL cross contact – allergens are not transferred from food containing an allergen to the food served to the customer

35. Prevent Food Contamination
Avoid cross contamination
Avoid time –temperature abuse
Use of the correct types of thermometers in food preparation
Use of proper personal hygiene
Purchasing from approved reputable suppliers (Partnership for Food Safety Education, 2011)
Partnership for Food safety Education(2011) Food safety retrieved from

36. Food Safety Management Systems
Develop and implement a personal hygiene program
Establish supplier selection and a specification program
Implement a sanitation and pest and rodent control program (National Restaurant assoc, 2005)
National Restaurant Association(2005) Servsafe essentials 5th ed Chicago, IL
Learning Objectives 1- Food safety management system 2- Crisis- management plan

37. Food service management
Establish facility design and equipment maintenance program
Implement a food safety training program
Implement a food defense program in times of emergency or crisis
(National Restaurant association, 2005)

38. Taking an active managerial control approach
Mangers need to consider risk factors
Mangers need to create policies and procedures
Mangers need to monitor policies and procedures
Employees and mangers need to verify the system (National Restaurant Association, 2005)
Learning Objectives 1- Who is involved in creating and enforcing food safety regulations 2- How regulatory and self- inspection works

39. HACCP (Hazard Analysis and Critical Control Points)
A system used to control risks and hazards throughout the flow of food.
It is based on identifying significant biological, chemical and physical hazards at specific points within a products flow.
( Moeller, 2005)
Moeller, D (2005) Environmental Health 3rd ed, Cambridge. MA Harvard University press
Learning Objectives Kitchen layout can affect food safety 2- Select materials and equipment that are safe for use in food service 3. Maintaining equipment 3 How to avoid food safety hazards caused by utilities 4. How to maintain your facility

40. HACCP continued
Created by the National Advisory Committee on Microbiological Criteria for Foods
Once hazards are identified they can prevent, eliminate, and reduce them to safe levels.
Must be based on a written plan.(National Restaurant Assoc, 2005)
System used to control risks and hazards throughout the flow of food.

41. HACCP Principles Conduct a hazard analysis
Determine critical control points (CCP’s)
Establish critical limits
Establish monitoring procedures
National Restaurant Association, 2005)
A plan is required when there is a variance such as pasteurized juice on site.

42. HACCP Principles continued
Identify corrective actions
Verify that the system works
Establish procedures for record keeping and documentation
( National Restaurant Association, 2005)
A written plan which identifies hazards at specific points throughout the flow of food.

43. Implement a Food Safety Program for Employees
Topics to be provided and reviewed
personal hygiene
safe food preparation
proper cleaning and sanitizing of kitchen and equipment
(Partnership for Food safety Education, 2011)
Partnership for Food safety education( 2011) Food safety programs retrieved from
Learning Objectives How to clean and sanitize surfaces 2- Methods of sanitizing 3- How to wash items in a dishwasher or three compartment sink 4- How to use and store cleaning tools and supplies 5 How to develop a cleaning program

44. Preparing for a Food Borne Illness Outbreak
Implementation of a food safety program for all staff
Develop a food borne illness incident report form
Train staff to fill out incident forms
Prepare an emergency contact list
Develop and implement a crisis- communication plan
Learning Objectives- Making sure staff is trained and on an ongoing basis 2- Identify specific training needs 3- Identify tools for food safety training 4- Maintaining food safety training records

45. Changes in our food production and supply
CURRENT FOOD SAFETY CHALLENGES
CHALLENGES TO FOOD SAFETY WILL CONTINUE TO ARISE LARGELY DUE TO:
Changes in our food production and supply
Changes in the environment leading to food contamination
Rising number of multistate outbreaks
New and emerging germs, toxins, and antibiotic resistance
New and different contaminated foods, such as prepackaged raw cookie dough, bagged spinach, and peanut butter, causing illnesses
( CDC, 2011)
CDC(2011) Food safety retrieved from
Prep, response, and reconvert when have out breaks

46. Future Estimates/Implications in Food Borne Illnesses
Need for improvements and new innovations
Future investments and innovations in surveillance and data analysis could help increase the accuracy of estimates.
Future efforts can also be directed toward quantifying the illnesses caused by long-term effects of food borne infections and toxins and to estimate the economic costs associated with food borne illness ( CDC, 2011)
CDC(2011) Future estimates in food borne illnesses retrieved from
Crisis management includes food borne illness , defense issues, product recalls, water interpretation, power outage, sewage backup and flooding plans

47. Research in Food Science
The need for more detailed information on norovirus will better inform future estimates due to the availability of improved surveillance and special studies conducted in the United States. Most of the data underlying the norovirus estimates is from other countries. 
A need for improved information on the cases of acute gastroenteritis that are reported during FoodNet survey.
Telephone interviews will be needed to help discern whether they might be caused by noninfectious conditions.  (CDC, 2011)
CDC(2011)Food net retrieved from

48. Food safety and Terrorism
Accounting for illnesses caused by some of the unspecified agents that do not result in acute gastrointestinal illness, as such illnesses were not included in the current estimates.
Refining estimates of the degree of underreporting of hospitalizations and deaths.
Drinking water and food supplies is a means to dispersing biological agents such as Clostridium botulinum toxin and Staphylococcus enterotoxin B
( Moeller, 2005)
Water safe to drink- potable-

49. Food Safety and Terrorism
The American Medical Association has developed a CD-Rom that provides state of the art medical and clinical information for dealing with both biological and chemical attacks
Diseases that have been linked to biological agents in food are Q fever(Coxiella burnetti), Brucellosis from brucellla species, Burkholderia mallei(glanders), ricin toxin (Ricinus communis or castor beans) , epsilon toxin from Clostridium perfingens species (Moeller, 2005)
3pts that a food defense program focus on to prevent threats to food- human element, building interior, building exterior

50. Deliberate contamination of Food
People may try to tamper with food using biological, chemical, or physical contaminants.
The best way to protect food is to make it hard for someone to tamper with it.
A food defense program should deal with the points in your operation where food is at risk.
(National restaurant assoc, 2005)
MSDS requirements for using chemicals in food . Cleaning program in place-master schedule, train employees and monitor program

51. References
CDC(2011) Food Safety retrieved from
FDA(2011). Food Safety Modernization Act retrieved from
National Restaurant Association (2008). Servsafe Essentials (5th ed) Chicago, IL
Partnership for Food Safety Education (2011) Food safety campaigns. Retrieved from

52. References continued
USDA (2011) Food Safety & Inspection Service. Trends in Food Borne Illnesses retrieved from
Moeller, Dade (2005)Environmental Health (3rd ed) Cambridge, MA Harvard University Press

53. Sources for further reading
Loaharan, P(2003) Irradiated foods(5th ed) American Council on Science & Health, NY, NY
Metcalfe, D (2003) “Intro:What are the issues in addressing the allergenic potential of gentically modified foods” Environmental Health perspectives 111(8)

54. Suggested readings
Red Tide Research Group(2002) “The current of Red Tide research” Environmental Health perspectives. 110(3)A 132-A133
FDA (1995) Food Code. Springfield, VA National Technical Information service
Food Net retrieved from

55. Further readings Food Safety retrieved from http://www.foodsafety.gov
HACCP Overview retrieved from
US EPA Pesticides & Food retrieved from
Arizona Department of Health Services( 2011) Ricin:Bioterrorism agent profile for Health acre workers retrieved from

56. Sources for Further Reading
Bad Bud Book retrieved from
Bryan, F(2002) Reflections on a career in Public health:Evolving food borne pathogens, environmental health, & food safety programs. Journal of Environmental Health 65(5) 14-25
WHO Food Safety retrieved at safety/en