1. DHCA 2113 Food safety & Sanitation
Introduction to food safety

2. Learning outcome Explain the definition of food safety.
Identify the importance of sanitation in food preparation.
State the terms related to food safety.

3. What is Food safety
A scientific discipline describing handling, preparation, and storage of food in ways that prevent foodborne illness.
This includes a number of routines that should be followed to avoid potentially severe health hazards.

4. Why food safety is important to human?
Food borne diseases are a major contributor to the estimated 1.5 billion annual episodes of diarrhea in children under five.
diarrheal illnesses cause more than 3 million premature deaths each year.

5. Sanitation
Sanitation is the hygienic means of promoting health through prevention of human contact with the hazards of wastes.
Hazards can be either physical, microbiological, biological or chemical agents of disease. 
Water?

6. WHO on sanitation
Sanitation generally refers to the provision of facilities and services for the safe disposal of human urine and feces. Inadequate sanitation is a major cause of disease world-wide and improving sanitation is known to have a significant beneficial impact on health both in households and across communities. The word 'sanitation' also refers to the maintenance of hygienic conditions, through services such as garbage collection and waste water disposal.

7. The five key principles of food hygiene
Prevent contaminating food with pathogens spreading from people, pets, and pests.
Separate raw and cooked foods to prevent contaminating the cooked foods.
Cook foods for the appropriate length of time and at the appropriate temperature to kill pathogens.
Store food at the proper temperature.
Do use safe water and cooked materials

8. Importance of Food Safety
 8.      Almost all cases of actual foodborne illness cases are reported.
a. True b. False
9.      Foodborne illness in a military unit can have a significant impact on:
a. effectiveness b. morale
c. mission accomplishment d. all of the above
10. One of the most cost‑effective means available to the military for preventing disease and improving soldiers’ well‑being is:
a. practicing good sanitation b. buying cheap sanitizers
c. serving only canned foods d. buying expensive sanitizers
11. The Army document providing standards for food protection and is enforced by the installation medical authority is:
a. TB MED 264 b. TB MED 530
c. TB MED 585 d. TB MED 710
12. Clean means:
a. free of microorganisms b. free of visible soil
c. free of mold and mildew d. sterile
13. To reduce the number of microorganisms to a safe level either through heat or chemicals is to:
a. clean b. shrink
c. sterilize d. sanitize.
14.    A surface completely void of microorganisms is said to be:
a. sanitized b. sterilized
c. homogenized d. pasteurized
15. The mere presence of harmful substance in food is called:
a. spoilage b. cross-contamination
c. unadulterated d. contamination
16. The transfer of a harmful substance from one food to another by direct or indirect contact is called:
a. contamination b. cross-contamination
c. spoilage d. sanitation
17. Potentially Hazardous Foods:
a. have a water activity below 0.5
b. almost always have a pH between 2-4
c. allow the rapid growth of bacteria
d. are always mesophilic
18. Damage to the edible quality of a food is known as:
a. cross-contamination b. contamination
c. foodborne outbreak d. spoilage
19. The Temperature Danger Zone is between _____________.
a. 40 and 140 degrees Fahrenheit b. 40 and 140 degrees Celsius
c. 45 and 165 degrees Fahrenheit d. 45 and 165 degrees Celsius
20. A foodborne illness outbreak is defined as the laboratory confirmed incidence of clinical illness involving _____or more people that ate a common food.
a. two b. five
c. ten d. twelve
21. Blood from thawing ground beef dripping onto fresh produce stored on a shelf below is an example of:
a. a good storage practice b. foodborne illness
c. cross-contamination d. potentially hazardous food
22. The three general groups causing foodborne disease are:
a. food, people, and facilities b. bacteria, fungi, and toxins
c. hands, knives, and slicers d. Shigella spp, dinoflagellates and
aflatoxins
23. Two of the eight leading causes of foodborne illness as identified by the Centers for Disease Control are:
1. Cross-contamination between raw and ready-to-eat foods
2. Inadequate re-heating of potentially hazardous foods
3. Seafood toxins that are heat stable
4. Aflatoxins found in breads and grain foods
a. 1 & 2 above c. 1 & 3 above
b. 2 & 3 above d. 3 & 4 above
24. Two of the eight leading causes of foodborne illness as identified by the Centers for Disease Control are:
1. Foods left in the temperature danger zone (TDZ) too long
2.      Foods prepared immediately before consumption
3.      Raw, contaminated ingredients used without further cooking
4.      Aflatoxins found in breads and grain foods
25. Two of the eight leading causes of foodborne illness as identified by the Centers for Disease Control are:
1. Cooling foods in 4 hours or less to below 40 degrees Fahrenheit
2. Heating leftovers to 165 degrees Fahrenheit
3.      Foods prepared too far in advance.
4. Infected food handlers and poor work habits
26. The number one cause of Foodborne Outbreaks in the United States is:
a. failure to properly cool food
b. foods prepared too far in advance
c. heating of potentially hazardous foods
d. seafood
27. Service members can be highly susceptible to disease:
a. After taking the APFT
b. when they are deployed or participating in extended field training exercises
c. if they are taking certain types of vitamins
d.      while on a medical profile for a broken bone
28. The person responsible for providing safe food under clean and sanitary conditions is the:
a. food service facility manager b. veterinary food inspector
c. preventive medicine specialist d. Installation Commander
29. Who ensures that food service contracts include requirements for the contractor person-in-charge, food employees, and kitchen police to receive required sanitation training? They also assist the Contract Officer Representative (COR) in developing food sanitation and safety standards and evaluating contractor performance of food service sanitation and safety requirements. They also provide the IMA with distribution and dissemination instructions for inspection reports and evaluation of contract food operations.
a. The Installation Food Advisor (IFA) b. Veterinary Activity
c. Preventive Medicine Activity d. Installation Commander
30. Which of the following conducts official food safety inspections; provides medical examination of food service personnel; provides technical guidance and assistance for sanitation training of non-supervisory personnel; establishes a formal training program for certification of supervisory food service personnel; participates in an integrated pest management program and recommends non-chemical controls; and conducts epidemiological investigations of suspected foodborne illness outbreaks?
a. Installation Commander b. Preventive Medicine Activity
c. Veterinary Activity d. food service facility manager
31. Who conducts necessary sanitation inspections for food procurement, processing, storage, shipment, receipt, and distribution?
32. A person-in-charge may be:
a.       a shift leader or intermediate supervisor
b.      a KP soldier from the training battalion
c.       a person from the preventive medicine activity
d.      a person from the veterinary activity
33. TB MED 530 requires the person-in-charge to:
a. be knowledgeable in foodborne disease and prevention
b. ensure that standards are achieved.
c. supervise all food service workers to observe hygiene, food handling, and
sanitation practices.
d. all of the above.
34. Who is responsible for pesticide application when non-chemical measures have failed?
a. Food Service Facility Manager
b. Department of Public Works
c. Veterinary Activity Personnel
d. Preventive Medicine Activity Personnel
35. Metal shavings in a can that have the potential to be consumed would be considered a:
a.       biological hazard
b.      chemical hazard
c.       physical hazard
d.      no hazard at all
36. Leaching of a galvanized metal container containing orange juice would be considered a:
a. biological hazard
b. chemical hazard
c. physical hazard
d. no hazard at all
37. Preparing food with an open sore on your hand would be considered a:
38. Blood from thawing ground beef dripping onto fresh produce stored on a shelf below is an example of a:   
39. Certain chemicals may cause significant reactions and illness in some individuals. These are called:
a.       contaminants
b.      biological hazards
c.       physical hazards
d.      allergens
40. Which of the following is not considered one of the three layers of protection associated with food protection and preventing foodborne illness?
a.    Personal hygiene and work habits
b.    Time and temperature discipline
c.    Maintaining food in the temperature danger zone
d.    Proper cleaning and sanitizing
41. Supervisors must identify unsanitary and unhealthy personnel. Things to look for include:
a. oozing sores, pimples, or boils
b. sunburn on hands or arms
c. facial cuts
d. all of the above
42. Supervisors must identify unsanitary and unhealthy personnel. Things to look for include:
a. cuts or burns on fingers, hands, and arms
b. significant coughing or sneezing.
c. Neither a and b
d. Both a and b
43. Food service workers must report which of the following diseases/symptoms and should be kept from food handling duties:
a. facial cuts
b. sunburn on hands and arms
c. diarrhea, and sore throat with fever
44. Food service workers must report which of the following diseases/symptoms and should be kept from food handling duties:
a.       Hepatitis A infections
b.      Shigella species infections
c.       Both A & B
d.      Neither A or B
45. The only authorized jewelry to be worn by food handlers is:
a. earrings
b. a plain, smooth wedding band
c. facial piercings
d. belly button piercings
46. Persons with no hair on their head are not required to wear any headgear whatsoever.
a. True b. False
47. Which of the following is authorized to be worn by food handlers?
a.       false fingernails
b.      fingernail adornments
c.       fingernail polish
d.      medical alert bracelet or necklace
48. According to the CDC, “the single most important means of preventing the spread of infection is _________________.
a.       proper handwashing
b.      changing clothes
c.       wearing hair restraints
d.      minimizing pest infestations
49. In accordance with TB MED 530, food service workers must wash their hands after which of the following?
a.       between different food handling tasks
b.      between each sandwich you prepare
c.       after putting on a pair of latex gloves
d.      none of the above
50. In accordance with TB MED 530, food service workers must wash their hands after which of the following?
a. when you get home from work
b. before dawning disposable gloves
c. after putting on a pair of latex gloves
d. none of the above
51. Handwashing procedures require lathering all exposed skin up to mid-forearm for a minimum of:
a. 10 seconds
b. 20 seconds
c. 30 seconds
d. 60 seconds
52. Hot and cold running water must be present at a handwashing sink where food handlers wash their hands.
a. True b. False
53. Glass thermometers are the most accurate and should be used for measuring food temperatures.
54. The most preferred method for thawing frozen food properly is:
a.       the ice-water method
b.      in a refrigeration unit set at an ambient temperature of 38 oF
c.       Thawing as part of the conventional cooking process
d.      placing the item under potable running water that is set at 90 oF or less
55. TB MED 530 allows a maximum of ____ hours in which a potentially hazardous food can be held in the danger zone before it must be discarded.
a.       1
b.      2
c.       4
d.      8
56. All products containing poultry; stuffed foods, such as stuffed noodle shells and bell peppers; and all leftovers intended to be eaten hot must be cooked to an internal product temperature of _____ oF for ____________.
a.       145°F for 15 seconds
b.      155°F for 15 seconds
c.       165°F for 1 minute
d.      165°F for 15 seconds
57. Pork roasts/chops; ground beef; and eggs prepared in bulk must be cooked to ______________________.
a. 145°F for 15 seconds
b. 155°F for 15 seconds
c. 165°F for 1 minute
d. 165°F for 15 seconds
58. Whole muscle meats, such as beef and lamb; fish and seafood; and made-to-order eggs must be cooked to an internal temperature of ______________________.
59.    Since all potentially hazardous foods entering the facility are essentially sterile, time and temperature discipline is only important if we accidentally contaminate foods.
60.    Items in hot holding or on the serving line that fall below the 140 oF standard should be :
a. immediately thrown away
b. re-heated to 165 oF or discarded once a cumulative time of 4 hours in the TDZ has occurred.
c. of no concern, since 120°F is the cutoff requirement for reheating
d. microwaved for 3 minutes to kill any bacteria that may have started to grow
61. Items that have fallen below 140 oF on the serving line and re-heated to 165 oF are considered as leftovers and:
a. can be retained for an additional 24 hours
b. can be retained for an additional 72 hours
c. cannot be retained for an additional 24 hours
62. Leftovers that will be held for 24 hours must be rapidly cooled to:
a. prevent any existing spores from becoming vegetative
b. keep molds from growing
c. lower water tension
d. slow enzymatic activity
63. Rapid cooling can be accelerated by :
a. using large pots to increase contact with cold surfaces
b. cooling food to 110 degrees in the steam table for 4 hours first then refrigerating
c. increasing the surface area of a product.
64. Hot items must be cooled from temperatures that are above oF to 70 oF within ___ hours, then from 70 oF to 40 oF or below within an additional ____ hours.
a.       4 and 2
b.      2 and 4
c.       1 and 4
65. The order of use for each compartment of a 3-compartment sink would be:
a.       rinsing, cleaning, sanitizing, drying
b.      drying, rinsing, cleaning, sanitizing
c.       cleaning, rinsing, sanitizing, drying
d.      sanitizing, rinsing, cleaning, drying
66. The wash sink must contain:
a. hot water that is at least 180 oF
b. clean water that is at room temperature
c. hot, soapy water that is at least 180 oF
d. hot, soapy water that is at least 110oF
67. Chlorine Bleach for immersion sanitizing should be prepared at
a. 25 parts per million
b. 50 parts per million
c parts per million
d parts per million
68. Quaternary ammonia compounds for immersion sanitizing should be prepared at:
69. Items being sanitized with chlorine should be immersed for at least:
a.       10 seconds
b.      15 seconds
c.       30 seconds
d.      1 minute
70. Items being sanitized with quaternary ammonia should be immersed for at least:
b. 15 seconds
d. 1 minute

9. Food Safety Hazards
Only a small percentage of actual foodborne illness cases ever get reported.
CDC estimates 76 million illnesses annually
result in approximately 325,000 hospitalizations and 5,000 deaths
estimated 14 million illnesses and 1,800 deaths are caused by known pathogens:
Salmonella
Listeria
Toxoplasma
Unknown agents account for the remaining 62 million illnesses
 Only a small percentage of actual foodborne illness cases ever get reported. The Centers for Disease Control and Prevention conducted a study in 1999, compiling and analyzing information from multiple surveillance systems and medical sources. They concluded that an estimated 76 million illnesses are caused by foodborne diseases every year in the United States. These illnesses result in approximately 325,000 hospitalizations and 5,000 deaths. An estimated 14 million illnesses and 1,800 deaths are caused by known pathogens: primarily Salmonella, Listeria, and Toxoplasma species. Unknown agents account for the remaining 62 million illnesses. Overall, foodborne diseases appear to cause more illnesses but fewer deaths than previously estimated.
Even in the military, documenting the occurrence of foodborne illnesses is a challenge. During peacetime only about ten percent of all foodborne illnesses are reported or properly diagnosed. From the physician side, many cases of foodborne illness are dismissed as the 24-hour flu. Between 1998 and 1999, the Army had documented over 800 cases involving food or waterborne diseases.
The impact of a foodborne illness outbreak within a unit can be very devastating. In 1998 a foodborne outbreak occurred in Saudi Arabia from an Army dining facility supporting operations. One hundred and ten soldiers were hospitalized for at least 24 hours as they suffered from abdominal pain, fever, vomiting, and severe diarrhea. Forty percent came from a single infantry unit. Had this occurred during Desert Storm, Operation Just Cause in Panama, or Somalia, the readiness of the unit would have been significantly impaired and could have resulted in mission failure.

10. Food service personnel must practice sanitation/safety to:
Protect the health of soldiers
Good personal hygiene is a critical measure against foodborne illness
establish a systematic approach to training and supervising workers
Protect food service workers
obligated to protect customers and workers from individuals who have health problems or personal habits that can affect food safety
a healthy worker with poor personal habits is very likely to cause food contamination

11. Food service personnel must practice sanitation/safety to:
Legal Obligation - Federal, State, and local governmental agencies set regulations and standards to protect the public from foodborne illness
The U.S. Food and Drug Administration has a model ordnance, the Food Code
The Army uses a similar system, TB MED 530, which provides standards for protection and is enforced by the installation medical authority.

12. Food Sanitation and Safety Terms
Clean - free of visible soil
Sanitize - reduce the number of microorganisms to a safe level using heat or chemicals
 Sterilize - to make free of microorganisms
In food service we do not sterilize food contact surfaces.
 Contamination - the presence of harmful substance in food
(1) Clean. Free of visible soil.
(2) Sanitize. To reduce the number of microorganisms to a safe level either through heat or chemicals.
(3) Sterilize. To make free of microorganisms. In food service we do not sterilize food contact surfaces.
(4) Contamination. The presence of harmful substance in food.
(5) Cross-contamination. The transfer of a harmful substance from one food to another by direct or indirect contact. (This is a common mistake in army dining facilities from poor work habits.) Direct cross-contamination involves the transfer of a harmful agent from raw foods to cooked or ready-to-eat foods. An example of direct contact: blood from thawing ground beef dripping onto fresh produce stored on a shelf below the beef in the walk-in refrigerator. If the fresh produce is not disinfected (sanitized) prior to use on the salad bar, pathogens from the blood (i.e., E. coli) may be present on the product, resulting in a foodborne illness. Indirect cross-contamination involves the transfer of a harmful agent to foods by hands, utensils, or equipment. An example of indirect contact: raw chicken prepared with a knife and cutting board may have pathogens, such as Salmonella or Campylobacter, already present on the product. These pathogens are transferred to the knife and cutting board during preparation. If the knife and cutting board are not cleaned and sanitized after use, pathogens may be transferred onto other products (i.e., fresh produce for salad bar), resulting in a foodborne illness.
(6) Spoilage. Damage to the edible quality of a food. Meat that is unsafe to eat will not always smell or taste spoiled.
(7) Potentially Hazardous Foods (PHF’s). Foods that allow the rapid growth of bacteria. There are several physical and environmental characteristics that will make a food potentially hazardous. We will discuss these characteristics later in this lesson.
(8) Temperature Danger Zone. Temperature range where bacteria can grow and reproduce rapidly (between 40 and 140 degrees F, or between 5 and 60 degrees C.) Potentially hazardous foods should be kept at temperatures below 40 oF or above 140 oF.
(9) Foodborne Illness. Illness transmitted to humans due to the ingestion of food that contains harmful pathogens or their byproducts (toxins).
(10) Foodborne Illness Outbreaks (FBIOs). Generally, we think of a foodborne illness outbreak as involving 20, 50, or even hundreds of individuals. In reality, an outbreak is defined as the laboratory confirmed incidence of clinical illness involving two or more people that ate a common food.

13. Food Sanitation and Safety Terms
Spoilage. Damage to the edible quality of a food. Meat that is unsafe to eat will not always smell or taste spoiled.
Potentially Hazardous Foods (PHF’s). Foods that allow the rapid growth of bacteria. There are several physical and environmental characteristics that will make a food potentially hazardous. We will discuss these characteristics later in this lesson.

14. Food Sanitation and Safety Terms
Temperature Danger Zone. Temperature range where bacteria can grow and reproduce rapidly (between 40 and 140 degrees F, or between 5 and 60 degrees C.) Potentially hazardous foods should be kept at temperatures below 40 oF or above 140 oF.
Foodborne Illness. Illness transmitted to humans due to the ingestion of food that contains harmful pathogens or their byproducts (toxins).

15. Food Sanitation and Safety Terms
Foodborne Illness Outbreaks (FBIOs). Generally, we think of a foodborne illness outbreak as involving 20, 50, or even hundreds of individuals. In reality, an outbreak is defined as the laboratory confirmed incidence of clinical illness involving two or more people that ate a common food

16. Food Sanitation and Safety Terms
Cross-contamination - the transfer of a harmful substance from one food to another by direct or indirect contact
Direct cross-contamination involves the transfer of a harmful agent from raw foods to cooked or ready-to-eat foods
example of direct contact: blood from thawing ground beef dripping onto fresh produce stored on a shelf below
Indirect cross-contamination involves the transfer of a harmful agent to foods by hands, utensils, or equipment.
example of indirect contact: raw chicken prepared with a knife and cutting board and knife and cutting board are not cleaned and sanitized after use

17. Factors That Contribute to Foodborne Disease
Eight leading causes of Foodborne Illness identified by CDC were:
 1) Cross-contamination between raw and cooked and/or ready-to-eat foods. It generally results from poor personal hygiene (worker’s hands), or from using unsanitized equipment
 2) Inadequate re-heating of potentially hazardous foods. All leftovers intended to be served hot must be re-heated to 165 oF within a 2-hour period
The Centers for Disease Control and Prevention conducted a study to determine what causes a foodborne illness. They found that not one but many factors were traced to food handlers. The eight leading causes were identified as:
1) Cross-contamination between raw and cooked and/or ready-to-eat foods. It generally results from poor personal hygiene (worker’s hands), or from using unsanitized equipment.
2) Inadequate re-heating of potentially hazardous foods. All leftovers intended to be served hot must be re-heated to 165 oF within a 2-hour period.
 3) Foods left in the temperature danger zone (TDZ) too long. Time in the TDZ is cumulative. After 4 hours the potentially hazardous foods must be discarded.
4) Raw, contaminated ingredients used without further cooking. Examples of this are sliced melons, salad vegetables, and raw eggs used in sauces and salad dressings.
5) Foods prepared too far in advance. This is generally coupled with holding food in the TDZ too long.
6) Infected food handlers and poor work habits. Between September 1998 and May 2000, there were two confirmed foodborne illness outbreaks in Army dining facilities attributed to cross-contamination of food by infected employees; At least 200 soldiers were hospitalized.
7) Failure to properly heat or cook food.
8)      Failure to properly cool food is the number one cause of FBIOs in the United States.
9) Poor cooling practices result in potentially hazardous foods held in the TDZ for long periods of time.
23. Two of the eight leading causes of foodborne illness as identified by the Centers for Disease Control are:
1. Cross-contamination between raw and ready-to-eat foods
2. Inadequate re-heating of potentially hazardous foods
3. Seafood toxins that are heat stable
4. Aflatoxins found in breads and grain foods
a. 1 & 2 above c. 1 & 3 above
b. 2 & 3 above d. 3 & 4 above
24. Two of the eight leading causes of foodborne illness as identified by the Centers for Disease Control are:
1. Foods left in the temperature danger zone (TDZ) too long
2.      Foods prepared immediately before consumption
3.      Raw, contaminated ingredients used without further cooking
4.      Aflatoxins found in breads and grain foods
25. Two of the eight leading causes of foodborne illness as identified by the Centers for Disease Control are:
1. Cooling foods in 4 hours or less to below 40 degrees Fahrenheit
2. Heating leftovers to 165 degrees Fahrenheit
3.  Foods prepared too far in advance.
4. Infected food handlers and poor work habits
26. The number one cause of Foodborne Outbreaks in the United States is:
a. failure to properly cool food
b. foods prepared too far in advance
c. heating of potentially hazardous foods
d. seafood

18. Factors That Contribute to Foodborne Disease
 3) Foods left in the temperature danger zone (TDZ) too long. Time in the TDZ is cumulative. After 4 hours the potentially hazardous foods must be discarded
 4) Raw, contaminated ingredients used without further cooking. Examples of this are sliced melons, salad vegetables, and raw eggs used in sauces and salad dressings

19. Factors That Contribute to Foodborne Disease
5) Foods prepared too far in advance. This is generally coupled with holding food in the TDZ too long
 6) Infected food handlers and poor work habits. Between September 1998 and May 2000, there were two confirmed foodborne illness outbreaks in Army dining facilities attributed to cross-contamination of food by infected employees; over 200 soldiers were hospitalized

20. Factors That Contribute to Foodborne Disease
7) Failure to properly heat or cook food
 8)   Failure to properly cool food is the number one cause of FBIOs in the United States. Poor cooling practices result in potentially hazardous foods being held in the TDZ for long periods of time

21. Highly Susceptible Populations
Other factors that contribute to the onset of foodborne illness
individuals’ susceptibility
age, weight, current state of health, stress, and fatigue. Infants, young children, pregnant women and elderly people are more susceptible
Medications, antibiotics, antacids, and immuno-suppressive drugs, reduce ability to fight off new infections
Soldiers highly susceptible when deployed in extended ftx’s
Physical/emotional stress and fatigue weakens immune system
exotic diseases or extreme conditions 
Other factors that contribute to the onset of a foodborne illness are the individuals’ susceptibility. Human resistance to disease and illness depends on many factors: age, weight, current state of health, medications, stress, and fatigue. Infants and young children are more susceptible because they do not have a fully developed immune system. Pregnant women are also more susceptible because of the chemical and physiological changes occurring in their bodies. Foodborne pathogens and toxins may have adverse effects on the unborn fetus as well as the mother. Elderly people may have a depressed immune system due to chronic illness, medications, or simply as a result of the aging process. Their bodies are not as resistant to new infections as younger individuals, and they are less resilient in their recovery when exposed to foodborne toxins.
Medications, such as antibiotics, antacids, and immuno-suppressive drugs, reduce the body’s ability to fight off new infections. Individuals taking medications are already sick or injured and their immune system is weakened in its fight to recover.
Service members are classified as highly susceptible when they are deployed or participating in extended field training exercises. Physical and emotional stress weakens the immune system, as does fatigue. These situations can be further aggravated by soldiers taking medications and/or exposed to exotic diseases or extreme environmental conditions.
27. Service members can be highly susceptible to disease:
a. After taking the APFT
b. when they are deployed or participating in extended field training exercises
c. if they are taking certain types of vitamins
d.      while on a medical profile for a broken bone

22. Food Safety Responsibilities
TB MED outlines responsibilities and duties of leaders and support elements, as well as food service mangers and workers
Installation Commander
maintains the sanitary control of all food and beverages served or dispensed on the installation
Commanders
ensures that construction, alteration, or modification of facilities have been reviewed and approved by the installation medical authority
ensures that all food service personnel are adequately trained and have been medically cleared to handle and serve food
Ensuring safe food is not the sole responsibility of the food service worker. TB MED 530 outlines the responsibilities and duties of leaders and support elements, as well as food service mangers and workers. The Installation Commander maintains the sanitary control of all food and beverages served or dispensed on the installation. This includes fixed food service facilities, mobile, and vending operations. The commander ensures that the construction, alteration, or modification of food service facilities are accomplished only after the plans have been reviewed and approved by the installation medical authority (I MA). The commander also ensures that all food service personnel are adequately trained and have been medically cleared to handle and serve food.
The IMA, or Preventive Medicine Service, advises the commander on the food sanitation and food safety implications of military operations. Preventive Medicine conducts official food safety inspections; provides medical examination of food service personnel; provides technical guidance and assistance for sanitation training of non-supervisory personnel; establishes a formal training program for certification of supervisory food service personnel; participates in an integrated pest management program and recommends non-chemical controls; and conducts epidemiological investigations of suspected foodborne illness outbreaks.
Similar to the duties of Preventive Medicine, the Veterinary Activity conducts necessary sanitation inspections in accordance with (IAW) AR for food procurement, processing, storage, shipment, receipt, and distribution. Veterinary personnel also investigate reports of food infested, adulterated, or damaged by pests.
The Installation Food Advisor (IFA) ensures that food service contracts include requirements for the contractor person-in-charge, food employees, and kitchen police to receive required sanitation training. The IFA assists the Contract Officer Representative (COR) in coordination with the IMA in developing food sanitation and safety standards and evaluating contractor performance of food service sanitation and safety requirements. The IFA also provides the IMA with distribution and dissemination instructions for inspection reports and evaluation of contract food operations.
The food service facility manager is responsible for providing safe food under clean and sanitary conditions. Managers must be able to demonstrate their knowledge of foodborne disease prevention and the application of food risk management principles (HACCP). Managers must ensure all food service personnel are trained in the principles of food service sanitation IAW TB MED 53O; supervise and enforce employee personal hygiene practices; and retain a copy of TB MED 530 in the facility.
The person-in-charge may be a shift leader or intermediate supervisor subordinate to the dining facility manager. The new TB MED 530 requires the person-in-charge to be knowledgeable in foodborne diseases and their prevention. It is generally the responsibility of the person-in-charge to ensure that the standards of TB MED 530 are achieved. The person-in-charge closely supervises all food service workers to observe hygiene, food handling, and sanitation practices.
In coordination with the Preventive Medicine Activity, the Department of Public Works (DPW, also referred to as the facility engineers) is responsible for pesticide application when non-chemical measures have failed. Applying chemical controls is the responsibility of ONLY trained, certified pest management personnel. TB MED 530 strictly prohibits food service personnel from applying pesticides in food preparation or service areas. DPW is also the agent responsible for executing work orders for structural deficiencies in the food service facility.
28. The person responsible for providing safe food under clean and sanitary conditions is the:
a. food service facility manager b. veterinary food inspector
c. preventive medicine specialist d. Installation Commander
29. Who ensures that food service contracts include requirements for the contractor person-in-charge, food employees, and kitchen police to receive required sanitation training? They also assist the Contract Officer Representative (COR) in developing food sanitation and safety standards and evaluating contractor performance of food service sanitation and safety requirements. They also provide the IMA with distribution and dissemination instructions for inspection reports and evaluation of contract food operations.
a. The Installation Food Advisor (IFA) b. Veterinary Activity
c. Preventive Medicine Activity d. Installation Commander
30. Which of the following conducts official food safety inspections; provides medical examination of food service personnel; provides technical guidance and assistance for sanitation training of non-supervisory personnel; establishes a formal training program for certification of supervisory food service personnel; participates in an integrated pest management program and recommends non-chemical controls; and conducts epidemiological investigations of suspected foodborne illness outbreaks?
a. Installation Commander b. Preventive Medicine Activity
c. Veterinary Activity d. food service facility manager
31. Who conducts necessary sanitation inspections for food procurement, processing, storage, shipment, receipt, and distribution?
32. A person-in-charge may be:
a.       a shift leader or intermediate supervisor
b.      a KP soldier from the training battalion
c.       a person from the preventive medicine activity
d.      a person from the veterinary activity
33. TB MED 530 requires the person-in-charge to:
a. be knowledgeable in foodborne disease and prevention
b. ensure that standards are achieved.
c. supervise all food service workers to observe hygiene, food handling, and
sanitation practices.
d. all of the above.
34. Who is responsible for pesticide application when non-chemical measures have failed?
a. Food Service Facility Manager
b. Department of Public Works
c. Veterinary Activity Personnel
d. Preventive Medicine Activity Personnel

23. Food Safety Responsibilities
Preventive Medicine Service
advises the commander on the food sanitation and food safety implications of military operations
conducts official food safety inspections
provides medical examination of food service personnel
provides technical guidance and assistance for training of non-supervisory personnel
establishes a formal training program for certification of supervisory food service personnel
integrated pest management programs
conducts epidemiological investigations

24. Food Safety Responsibilities
Veterinary Activity
conducts sanitation inspections IAW AR for food procurement, processing, storage, shipment, receipt, and distribution
Veterinary personnel investigate reports of food infested, adulterated, or damaged by pests

25. Food Safety Responsibilities
Installation Food Advisor (IFA)
ensures that food service contracts include requirements for foodservice personnel to receive required sanitation training
assists Contract Officer Representative (COR) in developing food sanitation/safety standards and evaluating contractor performance
The food service facility manager
is responsible for providing safe food under clean and sanitary conditions
must be able to demonstrate their knowledge of foodborne disease prevention
must ensure all food service personnel are trained
The Installation Food Advisor (IFA) ensures that food service contracts include requirements for the contractor person-in-charge, food employees, and kitchen police to receive required sanitation training. The IFA assists the Contract Officer Representative (COR) in coordination with the IMA in developing food sanitation and safety standards and evaluating contractor performance of food service sanitation and safety requirements. The IFA also provides the IMA with distribution and dissemination instructions for inspection reports and evaluation of contract food operations.
The food service facility manager is responsible for providing safe food under clean and sanitary conditions. Managers must be able to demonstrate their knowledge of foodborne disease prevention and the application of food risk management principles (HACCP). Managers must ensure all food service personnel are trained in the principles of food service sanitation IAW TB MED 53O; supervise and enforce employee personal hygiene practices; and retain a copy of TB MED 530 in the facility.

26. Food Safety Responsibilities
person-in-charge
may be a shift leader or intermediate supervisor subordinate to the dining facility manager
required to be knowledgeable in foodborne diseases and their prevention
supervises all food service workers to observe hygiene, food handling, and sanitation practices
Department of Public Works (DPW)
responsible for pesticide application when non-chemical measures have failed.
responsible for executing work orders for structural deficiencies
The person-in-charge may be a shift leader or intermediate supervisor subordinate to the dining facility manager. The new TB MED 530 requires the person-in-charge to be knowledgeable in foodborne diseases and their prevention. It is generally the responsibility of the person-in-charge to ensure that the standards of TB MED 530 are achieved. The person-in-charge closely supervises all food service workers to observe hygiene, food handling, and sanitation practices.
In coordination with the Preventive Medicine Activity, the Department of Public Works (DPW, also referred to as the facility engineers) is responsible for pesticide application when non-chemical measures have failed. Applying chemical controls is the responsibility of ONLY trained, certified pest management personnel. TB MED 530 strictly prohibits food service personnel from applying pesticides in food preparation or service areas. DPW is also the agent responsible for executing work orders for structural deficiencies in the food service facility

27. Recognizing the Threat
There are three categories of hazards that are responsible for causing foodborne illnesses and/or injuries:
 Biological
Chemical
Physical 
Now that we have discussed the factors that contribute to foodborne illnesses, we must now take a closer look and the agents in food that can lead to illness or injury. Most foodborne outbreaks result from poor sanitation, worker hygiene, and food handling practices. There are three categories of hazards that are responsible for causing foodborne illnesses and/or injuries:
1) Biological Hazards. Of the three categories, biological hazards present the most significant threat, accounting for at least two thirds of foodborne illnesses. Biological hazards are discussed in greater detail in Chapter’s 8 and 9.
2) Chemical Hazards. Chemical hazards involve intoxication due to chemical contamination of food. These chemicals are often in the form of residues on food or food contact surfaces. Pesticides and metal residues are the primary hazards in this category, however, other chemicals, such as cleaning compounds, camouflage paint can also present a chemical hazard to food.
Metal residues produce a toxic effect in minute quantities. Foods can become contaminated by using the wrong equipment in the dining facility. For example, if a galvanized container is used to prepare or store acidic foods, such as orange juice, lemon aid, or tomato sauce, a chemical reaction can occur, causing the zinc to leach out of the metal coating and contaminate the product. Lead-based flatware and crystal can present a similar problem. People have also become sick by using refrigerator shelves, containing cadmium, as barbecue grills. When we prepare foods, we must use only equipment designed for that use.
Residues from detergents, cleaning solutions, or concentrated sanitizers may also present itself as a problem. Managers must ensure that food service personnel use only chemicals approved by the Environmental Protection Agency (EPA) for food service. Also, all chemicals should be used IAW the manufacturers’ label and proper HAZCOM procedures must be followed for handling and storage.
Chemicals can get into our foods by misusing pesticides either on the farm or in our facility. One example of this is using bug spray in food preparation areas. Food service workers are prohibited by TB MED 530 to apply pesticides in food storage, preparation, or service areas. The best control measures to reduce the potential of pesticide residue intoxication are to purchase food only from veterinary approved sources and to wash all fresh fruits and vegetables regardless of their source.
3) Physical Hazards. Physical hazards involve injuries caused by chewing or ingesting foreign objects in food. Although physical hazards are serious to the individual affected, it is not as significant as biological hazards. Unlike bacteria, the threat of a physical hazard impacts fewer people because it does not multiply or spread on its own. Some examples of physical hazards include metal shavings that can get into food by using a worn can-opener. Other metal objects, such as magnets, packing staples, tacks, and pins, can accidentally fall into food. Glass can get into ice if we use a glass as an ice scoop. Unprotected light bulbs can also present a problem if the bulb is shattered. Particulates such as hair, fingernails, and sputum do not cause physical injury when consumed, however, they do transport biological contaminants and are considered physical hazards. Wood, stones, bones or any other foreign matter are also physical hazards that can be found in food. The accidental swallowing of un-frilled and frilled toothpicks have occurred when eating meatballs or sandwiches. Good facilities planning and the training of personnel in safe operating procedures can reduce many of these physical hazards.
35. Metal shavings in a can that have the potential to be consumed would be considered a:
a.       biological hazard
b.      chemical hazard
c.       physical hazard
d.      no hazard at all
36. Leaching of a galvanized metal container containing orange juice would be considered a:
a. biological hazard
b. chemical hazard
c. physical hazard
d. no hazard at all
37. Preparing food with an open sore on your hand would be considered a:
38. Blood from thawing ground beef dripping onto fresh produce stored on a shelf below is an example of a:

28. Recognizing the Threat
1) Biological Hazards.
Of the three categories, biological hazards present the most significant threat, accounting for at least two thirds of foodborne illnesses.
Biological hazards are discussed in greater detail in Chapter’s 8 and 9
1) Biological Hazards. Of the three categories, biological hazards present the most significant threat, accounting for at least two thirds of foodborne illnesses. Biological hazards are discussed in greater detail in Chapter’s 8 and 9.

29. Recognizing the Threat
2) Chemical Hazards.
intoxication due to chemical contamination of food
residues on food or food contact surfaces
pesticides and metal residues
cleaning compounds, camouflage paint
Metal residues
can produce toxic effect in minute quantities
galvanized containers w/ acidic foods causes zinc to leach out
Lead-based flatware and crystal can present similar problems
Residues from detergents, cleaning solutions, or concentrated sanitizers

30. Recognizing the Threat
Misuse of pesticides either on farm or in facility
bug spray in food preparation areas
Food service workers are prohibited by TB MED 530 to apply pesticides in food storage, preparation, or service areas
purchase food only from approved sources and wash all fresh fruits and vegetables
Chemicals can get into our foods by misusing pesticides either on the farm or in our facility. One example of this is using bug spray in food preparation areas. Food service workers are prohibited by TB MED 530 to apply pesticides in food storage, preparation, or service areas. The best control measures to reduce the potential of pesticide residue intoxication are to purchase food only from veterinary approved sources and to wash all fresh fruits and vegetables regardless of their source.

31. Recognizing the Threat
Physical Hazards
involve injuries caused by chewing or ingesting foreign objects in food
not as significant as biological hazards because threat impacts fewer people
Examples: metal shavings packing staples, tacks, and pins, glass, hair, fingernails, wood, stones, toothpicks
3) Physical Hazards. Physical hazards involve injuries caused by chewing or ingesting foreign objects in food. Although physical hazards are serious to the individual affected, it is not as significant as biological hazards. Unlike bacteria, the threat of a physical hazard impacts fewer people because it does not multiply or spread on its own. Some examples of physical hazards include metal shavings that can get into food by using a worn can-opener. Other metal objects, such as magnets, packing staples, tacks, and pins, can accidentally fall into food. Glass can get into ice if we use a glass as an ice scoop. Unprotected light bulbs can also present a problem if the bulb is shattered. Particulates such as hair, fingernails, and sputum do not cause physical injury when consumed, however, they do transport biological contaminants and are considered physical hazards. Wood, stones, bones or any other foreign matter are also physical hazards that can be found in food. The accidental swallowing of un-frilled and frilled toothpicks have occurred when eating meatballs or sandwiches. Good facilities planning and the training of personnel in safe operating procedures can reduce many of these physical hazards.

32. Allergens FDA classifies food additives as allergens
cause some people to become ill
MSG, nitrates, and sulfating agents, are used as flavor enhancers or food preservatives
Peanuts
In the past, food additives were listed as a chemical hazard to food. Today, however, the Food and Drug Administration classifies food additives as allergens. Food additives, such as monosodium glutamate (MSG), nitrates, and sulfating agents, are used as flavor enhancers or food preservatives. They are important for us to note because they do cause some people to become ill; therefore, they should be limited in their use. Latex gloves have also been linked to causing significant allergic reactions and illness in some individuals. You can prevent food service workers and consumers from being victims of a glove reaction by using only food-grade disposable plastic gloves instead of latex. It is important to note that the cost of plastic disposable gloves is significantly less than that of latex gloves. Other food-grade gloves, such as disposable vinyl and nitrile, are available as an alternative to latex and offer the same close/snug fit as a latex glove.
39. Certain chemicals may cause significant reactions and illness in some individuals. These are called:
a.       contaminants
b.      biological hazards
c.       physical hazards
d.      allergens

33. The end