1. Module 1: Introduction to Food Safety

2. Course Outline 13 modules, including a review
National Registry for Food Safety Professionals Exam
ANSI approved
Satisfies North Carolina requirement for certified food protection manager
Valid throughout the United States for five years
Explain that this exam is equivalent (based on the same standards) to the ServSafe exam and other certifications. NC Safe Plates is the training program, and the NRFSP is the certifying agency

3. Exam Exam is composed of 85 multiple choice questions
Only 80 count towards your score, but must answer all questions
2 hours to complete exam
Must bring valid, government-issued photo ID
Results are mailed ~10 business days from date of exam
Follow exam blueprint for studying
Five of the questions are on the exam are “test” questions that won’t count towards the final score. However, there is no indication as to which is which, so all questions must be answered. (

4. Module Basic Outline Real world case study Content instruction
Science based
Prevention, practice and control focused
Class discussion of your experience
Activities
Quiz questions and review

5. Please share your experiences with the class
Sharing Experience
News coverage
Outbreaks and recalls
Past work experience
Behind the scenes stories
Anyone who cooks or eats has seen good and bad examples of food safety.
Please share your experiences with the class

6. Working through the book is a great way to study.
Class Materials
Safe Plates Book
Modules follow book chapters
Application exercises
Practice quiz questions
Summary page
Glossary
Slide handouts
Working through the book is a great way to study.
It’s a good idea here to show participants what all is in the book, including what the application questions look like so they are fully aware of available resources

7. Class Materials Chapter Corresponding Module Chapter 1 Module 1
Modules 6 & 7
Chapter 7
Module 8
Chapter 8
Modules 9 & 10
Chapter 9
Module 11
Chapter 10
Module 12
It’s a good idea here to show participants what all is in the book, including what the application questions look like so they are fully aware of available resources

8. Why Is Food Safety Important?

9. What is Food Safety? What does food safety mean to you?
What do you think is included in food safety?
Safeguarding or protection of food from anything that could harm consumers’ health. This includes all the practical measures involved in keeping food safe and wholesome through all the states of production to the point of sale or consumption.
Try and get participants to give their personal opinions and experiences

10. Importance Of Food Safety
Foodborne illness sickens approximately 1 in 6 people in the United States every year
48 million illnesses
128,000 hospitalizations
3,000 deaths
Estimated annual cost $51 – 77.7 billion
Divide the class by 6 so you can say “out of X of us in this room, Y of us are statistically likely to get sick”
Foodborne illness is largely preventable
Despite these statistics, we have the safest food supply

11. Importance Of Food Safety
Many foodborne pathogen illnesses go unreported
Individuals recover and do not seek medical assistance
Estimated that there are approximately 30 cases of unreported foodborne illness for each reported case
How many of you go to the doctor every time you are nauseous, have diarrhea or throw up?
Many people don’t go to the doctor for these symptoms unless they are prolonged or severe
Most foodborne illnesses are self-resolving, meaning people get over them without treatment

12. Case Study
The Huffington Post, 7/17/2014 "About 40 minutes into my shift I felt nauseous. My mouth started watering, and I knew I was about to vomit. I ran into the restroom and vomited repeatedly,” Elizabeth Taff told The Huffington Post. Taff says she then summoned enough strength to get through the lunch rush, hoping to track down another employee to fill in for her. But no one else was available, she said.

13. How Should the Manager React?
Your employees need to understand this is not appropriate.
What do you think the manager should do about the sick worker?
What about the food she handled wearing that soiled shirt?

14. What Happened
She noticed vomit on her work clothes and, rather than take a pay cut for a new work shirt, phoned home for someone to bring her a clean outfit, she said. She also maintains she didn't leave work for fear of getting fired and losing her paycheck. "I went and let my manager know, [but] she told me to find my own replacement after lunch rush."

15. What Happened
"I was on my knees [on the grass outside the restaurant], while [the manager] berated me with remarks such as 'you're so stupid, if you can't handle working while feeling ill you don't need to work here, all you had to do was switch shirts and finish your shift,'" Taff told HuffPost. "She told me I was fired since I was unable to talk, due to vomiting all over the place."

16. Later, one of the employees took to Facebook to post a photo of Taff
Later, one of the employees took to Facebook to post a photo of Taff. The photo’s caption reads:
“If you planned on eating at the Freeport Subway today, I'd advice you not to. I witnessed an employee vomiting and her manager telling her just to switch shirts.After calling EMS, it was discovered she had been breathing and serving food with a stomach bug that is contagious!!!!! Then they had the nerve to fire her for calling the ambulance after shaking and passing out!! Sad part she didn't call them, we did [all sic].”

17. Discussion
What kind of atmosphere did the Subway manager create at their food establishment?
Bullying is not an effective means to influence long term, positive behavior change
This management style probably didn’t promote positive food safety

18. Think About The Case Study
What are the potential negative impacts of foodborne illness?
Hospitalization
Fatality
Law suits
Legal action (business closed)
Increased insurance cost
Food discarded
Loss of customers
Loss of employment

19. Food Safety Culture
Food safety culture is a set of shared values that managers and their staff follow to produce and provide food in the safest manner.
Managers and staff:
Know the risks associated with the products or meals they produce
Know why managing the risks is important
Demonstrate they effectively manage those risks
This is just like the culture of any other place. Ex: In your home do you clean your dishes as you go or leave them to pile up?
Knowing the risks and why managing them is important mean nothing unless something is done about them
Ex: You can know that the road ends in a mile, you can know that if you drive off the road you’ll wreck your car and be injured, but none of that means anything if you don't stop your car and turn around

20. Key Terms
Person in Charge (PIC) - The individual present at a food establishment who is responsible for the operation at the time of an inspection. A certified PIC should be present during all hours of operation.
Active Management Control - The responsibility of providing safe food for the consumer by developing and implementing food safety management systems to prevent, eliminate, or reduce the occurrence of foodborne illness risk factors.
Reasonable Care - Management’s responsibility to take all reasonable precautions and care to avoid committing a violation of FDA Model Food Code.
These are definitions per the FDA Food Code 2013
Participants don’t need to memorize these definitions, but should be familiar in case they are used in an exam question

21. Federal Regulatory Control
Food and Drug Administration (FDA) is responsible for non-animal foods (some exceptions apply)
FDA Model Food Code is produced every four years. Code provides guidance for food establishment operation and inspections. States adopt versions of the code as they see fit.
United States Department of Agriculture (USDA) is responsible for regulating the safety of animal products and federally funded feeding programs.
Centers for Disease Control and Prevention (CDC) is responsible for the investigation of foodborne illness outbreaks in partnership with local health departments.
Information is not on the exam, but for participants’ information.
These are the regulatory bodies that govern food safety in the US and in the state of NC
It is best practice to purchase food in compliance with the regulatory authority, as we will discuss in the next module
NC facilities must also comply with NC regulations

22. Local Regulatory Control
NC Dept. of Ag. And Consumer Services (NCDA&CS) regulates food products in partnership with the FDA, but not responsible for food service establishments.
NC Dept. of Health and Human Services (NCDHHS) is responsible for food service establishments.
Local Health Departments are responsible for the inspection of food service establishments, enforcing compliance to the FDA Food Code and investigation of food safety complaints and illnesses.
These are the regulatory bodies that govern food safety in the US and in the state of NC
It is best practice to purchase food in compliance with the regulatory authority, as we will discuss in the next module
NC facilities must also comply with NC regulations

23. Potential Hazards in Food

24. Where Can Things Go Wrong?
Food safety can be compromised throughout the flow of food
Purchasing
Receiving
Storage
Preparation
Service
Safe Plates is laid out to follow the flow of food

25. Key Terms
Food Establishment - An operation that stores, prepares, packages, serves, vends food directly to the consumer, or otherwise provides food for human consumption such as a satellite or catered feeding location.
Food - Anything edible that people consume including water and ice.

26. Key Terms
Hazard - anything that could cause harm to consumers. There are three general categories: physical, chemical and biological.
Contamination - presence of any harmful or objectionable substance or object in food
Vehicles of contamination - hands, utensils, items that can carry microbes onto food and cause contamination

27. Key Terms
Foodborne illness/disease - illness caused by consumption of contaminated food
Case - an instance of a person becoming ill from food; suspected or confirmed
Foodborne disease outbreak - two or more cases of a similar illness that result from eating a common food

28. Types Of Hazards Physical Metal, glass, plastic Rock, wood
Bone, shell, feather
Chemical
Allergens (Big 8)
Pesticides
Cleaners and sanitizers
Additives
Chemical leaching
Naturally occurring toxins
Plants, fish, shellfish, mushrooms
There are three main types of contamination
Physical and Chemical contamination
Physical contamination is more associated with injury
Chemical contamination is more associated with shorter term illnesses or discomfort

29. Types Of Hazards Biological Bacteria Fungi (molds, yeasts) Viruses
Parasites
Pathogens are microorganisms that cause disease
Most microorganisms are helpful, many are necessary for our health and production of foods
Most of the class is based controlling biological contamination and hazards
Think back to high school biology. What is the difference between these microorganisms?
Bacteria are single celled, living microorganisms. Under the right conditions they can replicate quickly. In un-ideal conditions they will replicate slowly or die
Fungi are not of as great a concern in foodborne illness as they are in food spoilage. Fungal spores can travel through the air.
Viruses are not alive but are not actually dead. They don’t replicate outside of a host cell, but can persist on surfaces for weeks. They are much harder to destroy.
Parasites only replicate in a host, but can survive outside of a host
Pathogens are microorganisms that cause disease. Not all microorganisms will make people sick, many are necessary for health and wellness
Bacteria in the body aids in digestion and the immune system
Bacteria is required for fermented foods like yogurt, pickles and hard cheese, while yeast is used in breads, soft cheese, wine, etc

30. Sources Of Pathogens Food handlers Raw (not cooked or processed) foods
Contaminated water or ice
Soil
Pests and pets
Air, dust, dirt and food waste

31. Top Five Foodborne Pathogens CDC 2011 Estimate
NUMBER OF CASES
% OF TOTAL ILLNESSES
Norovirus
5,461,700
58%
Salmonella
1,027,500
11%
Clostridium perfringens
965,900
10%
Campylobacter
845,000 9%
Staphylococcus aureus
241,100 3%
What stands out here?
Norovirus is the leading cause of foodborne illness in the US. So if we could control norovirus we would have drastically fewer illnesses overall

32. How Pathogens Make Us Sick
Foodborne Infection - illness caused by consuming pathogenic microorganisms that live and multiply in your body, making you sick.
Foodborne Intoxication - illness caused by consuming toxins (poisons) produced by pathogenic microorganisms in food. The pathogen does not need to be present to make you sick, only the toxin.
Toxin-mediated Infection - illness caused by consuming pathogenic microorganisms live that produce toxins in stomach or intestine, making you sick
There are several mechanisms by which microorganisms can cause illness
Foodborne infections usually take longer to develop because pathogens have to grow to a certain level in the body. Think about an infected cut. Infections don’t happen instantly, they take time to grow.
Foodborne intoxications are the quickest to develop since they are the ingestion of poison. Think about if someone ingests too much alcohol, or maybe accidentally consumes a cleaner or sanitizer. Illness will begin rather quickly.
Toxin-mediated infections can cause severe illness from infection and intoxication

33. Foodborne Infection Foodborne Intoxication Toxin-mediated Infection
There are several mechanisms by which microorganisms can cause illness
Foodborne infections usually take longer to develop because pathogens have to grow to a certain level in the body. Think about an infected cut. Infections don’t happen instantly, they take time to grow.
Foodborne intoxications are the quickest to develop since they are the ingestion of poison. Think about if someone ingests too much alcohol, or maybe accidentally consumes a cleaner or sanitizer. Illness will begin rather quickly.
Toxin-mediated infections can cause severe illness from infection and intoxication

34. Microorganism Growth and Control
The factors that influence microorganism growth and control:
Food, Acidity, Temperature, Time, Oxygen, Moisture
These six factors are the basis by which we preserve and prepare food for safe consumption
Food is obvious one, microorganisms either need food or a host as a source for nutrients
Acidity is the amount of acid present. Just like with people, too much acid and too much base can destroy microorganisms, or at least prevent their growth
Most microorganisms thrive in the same types of temperatures that people also enjoy. At warm temperatures, bacteria will grow and/or produce toxin
The amount of time a pathogen is held at any given condition will also influence whether or not it grows and/or produces toxin
Most microorganisms need oxygen to survive. However, there are some that only grow or produce toxin in the absence of oxygen
Available water is also important for microorganism growth.
All of these factors will be addressed in future modules.

35. Factors Contributing to Foodborne Illness
Centers for Disease Control and Prevention (CDC) identified the most common factors for foodborne illness as being:
Food purchased from unsafe sources
Failure to cook food to correct temperature
Improper holding temperatures
Contaminated equipment
Poor personal hygiene
This list is agreed upon by the CDC, FDA, USDA and WHO
Most of our case studies can be traced back to one or more of these factors
Most of the regulations are based on controlling these factors

36. Highly Susceptible Populations
People who are more likely than the general population to experience foodborne diseases
Young (preschool age and younger)
Old (elderly)
Pregnant women and unborn babies
Immune compromised (weakened immune systems)
YOPI individuals are more likely to experience any type of illness
Pregnant women are not explicated stated as highly susceptible per the food code, but pregnancy is immunocompromising in nature. Also, some pathogens can cross the placenta and infect an unborn baby
Immunocompromised can be anything from an autoimmune disorder, chronic illness, medication or even a cold

37. Remember Our Case Study?
"I was on my knees [on the grass outside the restaurant], while [the manager] berated me with remarks such as 'you're so stupid, if you can't handle working while feeling ill you don't need to work here, all you had to do was switch shirts and finish your shift.’”
Food safety can seem complicated:
Know the risks
Know why it's important
Manage and minimize the risks