The goal of our national food safety program is the prevention and reduction of foodborne illness. Government oversight at the national level plays an integral role in providing safe food from farm to table. This article will describe activities by the U.S. Food and Drug Administration (FDA) that are intended to improve the safety of food in retail establishments.
Over the past seven years much has been done as part of President Clinton’s Food Safety Initiative to help ensure that the United States has one of the safest food supplies in the world. For the time period 1998 to 2000, for example, there has been a 20% decrease in illnesses due to the major bacterial food pathogens across the U.S. Despite this progress, however, foodborne illnesses continue to take a staggering toll on public health and more and more frequently we read news reports about outbreaks of foodborne illness. Why?
Investigations have found a variety of causes for these outbreaks, yet many never have a food vehicle identified or determine how the food became contaminated. One of the many locales that have been associated with foodborne outbreaks is the retail establishment. Epidemiological and outbreak data have identified the following risk factors related to employee behaviors and preparation practices in retail establishments that contribute to cases of foodborne illness:
• Improper holding temperatures
• Inadequate cooking, such as with raw shell eggs
• Contaminated equipment
• Food from an unsafe source
• Poor personal hygiene
According to the Centers for Disease Control and Prevention’s (CDC) 1993-1997 Surveillance Report for Foodborne Disease Outbreaks in the US., the most commonly reported food preparation practice that contributed to foodborne disease concerned improper holding temperature; and the second concerned inadequate cooking.[1] Food obtained from an unsafe source was the least commonly reported factor. In most outbreaks caused by bacterial pathogens, the food was stored at improper holding temperatures.
A new study by Mead, et al., from the CDC estimates that in the United States, foodborne disease causes 76 million illnesses, 325,000 hospitalizations and 5,000 deaths each year.[2] Some experts feel that the risk of foodborne illness in the U.S. is increasing, with changes in the global market, an aging population, increasing numbers of immunocompromised and immunosuppressed individuals, and changes in food production practices. Since much of the reported food- borne illness is attributed to food mishandled at retail, it is essential that we have effective intervention methods in place at retail.
Faced with these facts, a food safety objective to help reduce foodborne illness has been included in Healthy People 2010, the comprehensive, nationwide set of health promotion and disease prevention objectives designed to serve as a 10- year strategy for improving health in the U.S.[3] Healthy People 2010 objectives include reducing infections caused by foodborne pathogens, reducing outbreaks of foodborne illness, and improving food employee behaviors and food preparation practices that directly relate to foodborne illnesses in retail food establishments.
THE FDA FOOD CODE: BEST ADVICE FOR FOOD SAFETY ASSURANCE
The model FDA Food Code represents FDA’s best advice for a uniform system of regulation to ensure that food at retail is safe, and properly protected and presented. It is neither federal law nor federal regulation and is not preemptive. Although not federal requirements (until adopted by federal bodies for use within federal jurisdictions), the model Food Code provisions are designed to be consistent with federal food laws and regulations and are written for ease of legal adoption at all levels of government. Providing model food codes and model code interpretations and opinions is the mechanism through which FDA, as a lead federal food control agency, promotes uniform implementation of national food regulatory policy among the several thousand federal, state and local agencies and tribes that have primary responsibility for the regulation or oversight of retail level food operations.
The Food Code was first published in its current format by the FDA in 1993. It is updated every two years to coincide with the biennial meeting of the Conference for Food Protection, a group I of representatives from regulatory agencies at all levels of government, the food industry, academia and consumer organizations that works to improve food safety at the retail level. The FDA Food Code can be found here.
The FDA, the U.S. Department of Agriculture’s (USDA) Food Safety and Inspection Service (FSIS), and CDC endorse the Food Code because it provides public health and regulatory agencies with practical science-based advice and manageable, enforceable provisions for mitigating risk factors known to contribute to foodborne disease. It is recommended that the state, local and tribal jurisdictions that have responsibility for regulating retail establishments that sell or serve food should use the Food Code as a model to help develop or update their own food safety rules and provide consistency among jurisdictions.
We are pleased to announce that in addition to the many federal agencies and tribal governments that have adopted the Code, as of May 2001, 30 states and one U.S. territory have at least one agency that has adopted one of the four editions of the Food Code published since 1993. In addition, 15 more states and one territory are in the process of adoption.
FOOD CODE INTERVENTIONS
What do we do to help control the risk factors in retail food establishments? To help control the risk factors, the Food Code provides five key public health interventions:
• Demonstration of food safety knowledge by the manager
• Management of sick workers (employee health)
• Prevention of hand contact with foods as a vehicle of contamination
• Usage of time-temperature controls
• Advising consumers about the increased risk associated with eating raw or undercooked animal foods to especially vulnerable consumers.
There are a number of challenges to ensure safe food at retail. These include a large employee population with high rates of turnover, language barriers and non-uniform systems for training and certifying workers. Retail food employees’ use of safe food preparation and storage practices such as those spelled out in the Food Code should reduce outbreaks.