Foodborne illnesses in this province already account for 41,000 visits to hospital emergency rooms and 137,000 more to physicians’ offices each year. Contaminated food kills about 70 people in Ontario annually and sends another 6,600 to hospital.

Symptoms of foodborne illnesses range from mild nausea and stomach pains to, in rare cases, long-term health problems, and even death. Most people have had a mild case of food poisoning at one time or another without being aware of it— according to 2014 Public Health Ontario statistics, an estimated 96% of cases go unreported. Contamination of food can happen at any point in the food-supply chain, from the farm to transport to preparation and packaging. Meat, for example, can be rendered unfit by unclean conditions at slaughterhouses, or by contamination at meat-processing plants. Water runoff and sprays containing bacteria, pesticides, and other chemicals can affect the purity of farm produce. In addition, food at “food premises,” which Ontario law defines as any “premises where food or milk is manufactured, processed, prepared, stored, handled, displayed, distributed, transported, sold or offered for sale,” can be contaminated with bacteria from the use of unsanitary utensils and improper cooking methods. In Ontario, prevention of foodborne illness is the responsibility of all three levels of government, which license and inspect food producers and food premises as follows:

• Meat, produce, fish and dairy produced, processed and consumed only in Ontario are generally the responsibility of the Ontario Ministry of Agriculture, Food and Rural Affairs (Ministry of Agriculture).

• Food premises are inspected by 35 Public Health Units in municipalities across Ontario that are funded by the Ontario Ministry of Health and by the municipalities in which they are based.

• Food imported into Ontario from other provinces or countries, or produced in Ontario for export outside the province, is inspected by the federal Canadian Food Inspection Agency (CFIA). Forty-five percent of agriculture food products sold in Ontario are produced or processed within the province; the remaining half is imported from other provinces and countries, which means it is licensed and inspected by the federal CFIA. It is important that the Ministry of Agriculture do an effective job of licensing and inspecting producers to ensure that food produced in this province for sale to Ontarians is free of any contamination that might affect their health. Similarly, the Public Health Units have an important responsibility to make sure that 338 Chapter 3

• VFM Section 3.06 food is handled hygienically and prepared correctly to protect consumers. The Ministry of Agriculture spent about $39.5 million in the 2018/19 fiscal year on foodsafety licensing, inspections and other related services, while the Ministry of Health and municipalities spent about $63.1 million the same year to fund the Public Health Units. Total average annual spending by the two ministries and municipalities over the last five years on food safety was about $105.7 million. While the risk of a mass foodborne-illness outbreak in Ontario is likely low, small-scale food incidents could have the potential to occur because it would take only one diseased animal or one unclean restaurant. Our audit identified several areas where improvements could further minimize food-safety risks to Ontarians. We noted, for example, the following issues with respect to Ministry of Agriculture licensing and inspection of Ontario producers:

• Ninety-eight percent of meat tested negative for harmful drug residue, but in the 2% of cases of positive drug-residue test results, there was no follow-up with the farmers who raised the animals to prevent repeat occurrences. Since April 2015, about 300 meat samples (representing about 2% of the meat tested) taken from provincially inspected slaughterhouses were found to contain drug residues above prescribed standards. The lack of an appropriate process to follow up and educate farmers whose animals have tested positive increases the risk of such meat entering the food chain.

• Some pesticides banned for use in groundskeeping for health and safety reasons are found in Ontario-grown produce in levels exceeding Health Canada’s allowable limits. The Cosmetic Pesticides Ban Act lists 131 pesticides that cannot be used for cosmetic groundskeeping, in parks and yards, for example, because of potential health and environmental concerns. However, their use is allowed in agriculture for operational and economic reasons. Between 2014 and 2018, the Ministry of Agriculture tested about 1,200 Ontario-grown produce samples and found residues of 14 banned pesticides that exceeded Health Canada limits a total of 76 times.

• Current legislation provides limited enforcement tools to compel fish processors to address food-safety infractions, resulting in repeat offences. Fish processors who sell only in Ontario do not require a licence to operate. The Ministry of Agriculture, therefore, may not be able to close them because there is no licence to revoke if inspectors identify serious food-safety deficiencies. The Ministry also has no legal power to issue fines or compliance orders. Our sample review of 182 inspection reports on fish-processing plants found that two-thirds of the infractions noted in 2018/19 were repeat offences that had also been observed in each of the two previous years.

• The Ministry of Agriculture did not receive sufficient information to provide sufficient oversight of the Dairy Farmers of Ontario (DFO). The Ministry delegated inspection of cow-milk producers to the DFO in 1998. However, the Ministry did not consistently receive sufficient information from DFO to provide adequate oversight of the organization. We found that DFO’s reports to the Ministry were high-level summaries that did not specifically identify non-compliant producers whose test samples repeatedly exceeded regulatory bacteria limits. In addition, the reports did not say what actions DFO took to address the issue of repeat offenders.

• The Ministry of Agriculture did not have complete details about the activities of produce farmers in Ontario to select appropriate producers for sample-testing. The Ministry’s inventory of farmers did not contain complete information on production volumes, type of crops grown, and where the produce Food Safety Inspection Programs 339 Chapter 3

• VFM Section 3.06 was sold. Such data would be useful to determine a risk-based food-sample-testing plan. We noted the following issues with Public Health Units, which are responsible to inspect food premises:

• Public Health Units did not investigate complaints of foodborne illnesses on a timely basis. Based on our review of inspection reports from 2016 to 2018 at five Public Health Units, we found that for those foodborne-illness complaints that required food premises inspections, the Public Health Units consistently did not inspect 20% of food premises within two days of receiving the complaint. The Public Health Units we visited informed us that a two-day timeline is considered a best practice.

• Different inspection-grading systems for food premises among Public Health Units provided inconsistent information to the public across Ontario. The degree of public disclosure of inspection results for food premises, along with the inspection-grading systems used by the 35 Health Units, varied across the province. The variations can be confusing to the public.

• While not all special events require inspections, only about 12% of them within the jurisdictions of the five Public Health Units we visited were inspected in 2018, and only about 15% in 2017. Public Health Units are required to assess food safety risks at temporary food premises, which include special events such as summer fairs and festivals, to determine if these premises require an inspection. However, we found that there are currently no minimum provincial requirements for the frequency of inspections of special events as there are for fixed food premises, such as restaurants. According to the US Centers for Disease Control and Prevention, special events can be high risk because the usual safety features of a kitchen, such as the ability to monitor food temperatures and washing facilities, may not be available at outdoor events.

• Some food premises were never inspected until Public Health Units received complaints from the public. The lists of food premises kept by the five Health Units were not up to date. At the five Health Units we visited, we found 253 complaints received between 2016 and 2018 relating to food premises whose existence the Health Units were unaware of until they received the complaints. There were also several areas where current regulations and standards may be insufficient. For example:

• Businesses operating solely within Ontario can market their products as “organic” even if they are not certified to the Canadian Organic Standards. The CFIA requires certification for products labelled as organic when they are sold across provincial or international borders—but Ontario allows the sale of non-certified products labelled as organic within the province. In comparison, Quebec, Manitoba, Alberta, British Columbia, New Brunswick and Nova Scotia all have laws requiring that organic food be certified to the Canadian Organic Standards even when it is sold only within their borders. Based on our research, there are at least 34 organic producers in Ontario that are not certified to the Canadian Organic Standards but are advertising their products as “organic.” The majority of these organic growers sell their products through farmers’ markets. We also noted that routine sample testing of produce for pesticides residue is not required for the CFIA organic certification process. • Sheep milk and non-chicken eggs are not subject to mandatory regulation or inspection for quality assurance. Milk from cows and goats, along with eggs from chickens, is regulated and inspected by the federal or Ontario governments, or both. However, 340 Chapter 3

•VFM Section 3.06 there is no mandatory regulation or inspection of milk from sheep and water-buffalo, or of eggs from other fowl. In comparison, Manitoba and Alberta regulate all animals kept for the purpose of producing milk. Finally, we noted gaps in the inspections carried out by the different government entities responsible for food safety. We found, for example, that although the Ministry of Agriculture and the CFIA check for federal food-labelling requirements regarding allergens in provincial food-processing plants, they do not verify other labelling requirements, such as place of origin and nutritional value.