Public health advances step by step, as hazards are recognized and better control and prevention strategies are developed. How this happens, how new safety measures come into being, and how they are improved and become part of the way we live are the focus of this new book, Outbreak: Foodborne Illness and the Struggle for Food Safety.
Professor Timothy D. Lytton, a keen scholar of regulatory evolution, provides a lively and well-documented guide to 150 years of major advances in food safety regulation and prevention in the United States. He starts with the early efforts to cleanse and regulate the milk supply in the 19th century thatultimately led to near-universal pasteurization. Efforts to make canned food free of botulism in the 1920s led to a new focus on critical control steps in processing, using sufficient time and heat to eliminate the risk, and thus to a new general approach based on process control. Modernizing meat inspection with process control logic in the 1990s and the recent efforts to make fresh produce safer in the 2000s take the reader to the controversies of the present day.
industry and regulators to follow. He also deftly outlines the complex roles of third-party auditors, who provide information to one company about the safety practices of its suppliers, and provides a fresh perspective on the growing role that liability insurers may play in the future.
This is history that uplifts, showing how we honor those who suffered from and died of a foodborne disease that is now preventable in the form of better practices and safer food today. In the crucible of public action, it reminds us all how these advances begin and, with feedback and learning, how they can succeed.
Foodborne illness and the struggle for food safety, December 2019
My friend Ronald Doering, the first president of the Canadian Food Inspection Agency, writes persuasively in this Food in Canada column last week:
In September, there were several media reports of a survey by 3M that found that 32 per cent of Canadians are “skeptical of science.” The results were universally treated as “worrisome,” “alarming” and “depressing” because such a lack of trust in scientists might skew policy discussions to non-science considerations (bad) and perhaps, as well, undermine funding for scientists (very bad).
As readers of this column over the years will know, I have a different view. While, of course, it depends on what you mean by “science,” generally my opinion is that everyone should be more skeptical of science. I’m not saying that science is not important. CFIA scientists and their 10 laboratories are critical to the work of the agency. We can never have too much good science.
What I am saying is that there are many reasons why ordinary citizens, and especially consumers, should always be skeptical of science:
Most science is a lot more uncertain than is usually acknowledged. In food and nutrition science, for example, you name the issue and I can give you conflicting science. Over the years in this column, I have demonstrated vastly conflicting science on, for example, genetically engineered foods, food irradiation, the safety of BPA in food packaging, the safety of farmed salmon, the safety of water fluoridation and food additives. We have seen that Canada’s top two scientists on the safe level of salt in our diets disagree so intensely that they routinely resort to vicious name-calling. Canada and the U.S. consider the science on folic acid so clear that they require mandatory fortification of certain foods, while every EU country interprets the science to be so dangerous that they refuse to fortify; both groups insist their policy is “science-based.” It is illegal to sell raw milk in Canada and Australia but legal in England, Wales and Northern Ireland; both sides insist their policies are “science-based.” Nutrition science vacillates wildly. With such pervasive uncertainty, isn’t it just common sense to be skeptical?
Consumers get their science information on food and nutrition from newspapers, magazines, television and social media, none of which have trained science reporters anymore and all of which trade in alarmist “investigations,” food company bashing, celebrity advice and 45-second clips. Most consumers cannot understand most food labels. Health claims are more about marketing than health. Scientific illiteracy and innumeracy abound. As Mark Twain observed, if you don’t read magazines and newspapers you are uninformed, and if you do, you are misinformed. (Of course, this column is an exception). In the face of such widespread misinformation, isn’t it just common sense to be skeptical?
One of the most pervasive myths is that science and policy can be separated. When I was president of Canada’s largest science-based regulator, I dealt regularly with scientists who were seemingly unaware of how much their science advice was imbued with unstated policy considerations. Policy implications enter into the risk assessment at virtually every stage of the process. Moreover, in our system, scientists don’t make policy. After the scientist does the science-based risk assessment, elected politicians and their senior advisors carry out the policy-based risk management responsibility by weighing the science with the economic, political, legal, environmental, and ethical considerations. This is not the politicization of science; this is evidence-based policymaking. These two separate functions are often conflated and the outcome presented as driven purely by science. Isn’t it just common sense to be skeptical of this “science?”
A scientist friend recently highlighted another reason to be skeptical. The university system still insists that professors publish or perish, which accounts for why so much published science is both unread and unreadable, contributing nothing of value to the public that pays for it. It is certainly common sense, he says, to be skeptical of this science. Given the growing recognition of the importance of diet for health and the growing threat of foodborne illness, we need more and better science to aid in policymaking. Having said that, the public should always be skeptical of the science that comes their way.
CBS News reports the rapid spread of a stomach virus through the Greater Albany School District has forced the closure of all schools in the district for the rest of the week. The closure comes days after a Colorado school district of about 22,000 students was forced to close after a similar viral outbreak tore through its 46 schools.
CBS Portland affiliate KOIN-TV reported the school district in Linn County, Oregon, was trying to contain the spread of the virus, which causes vomiting and diarrhea.
The district disinfected buildings over the weekend, but kept Periwinkle Elementary School closed Monday after consulting with the Linn County Health Department. On Monday evening, the Greater Albany district said on Facebook that after consulting with state and county health officials — and noting a jump in absences in their other schools — that all schools would close and reopen December 2.
Officials said cleaning teams will continue to disinfect and sanitize throughout the closure.
In Colorado, hundreds of students were sickened by symptoms similar to those of norovirus, a highly-contagious virus that causes vomiting and diarrhea. After the illness jumped quickly from school to school, officials were forced to take the unusual step of closing all 46.
“When we have 20 kids actively vomiting in a school that already has 17% gone we know that we’ve got a problem. We have to stop the exposure,” said Tanya Marvin, the head of nursing for the school district.
No good journal does that. They have lots of submissions.
The spam emails highlight the wild west of predatory journals, often with names that try to imitate real journals. Today’s was the “New American Journal of Medicine”, a not-so-subtle variation of the New England Journal of Medicine or the American Journal of Medicine. It looks like that journal has published a total of 8 papers in 2019. I looked at one of them and ‘crap’ is my generous assessment. It’s a paper that recommends a treatment for pregnant women and it’s one page long, does not disclose the funding source, fails to fulfill pretty much every standard reporting requirement for a clinical trial and reports essentially no specific data or analysis. But, it’s ‘published data’ and on someone’s CV.
The state of the scientific literature is pretty messed up. “Show me the study” has been a common refrain, but it’s not as useful these days because anything can get published.
Too many journals.
Good journals screen out the weak articles. High impact journals publish a minority (5-25% of submissions…and most often people only send their best papers to those journals). Some journals are still good quality and take lower impact papers that are still good science. Some journals take whatever they can get, trying to screen out the bad science.
Others…they take whatever they can get, as long as the authors can pay. Sadly, there are literally thousands of those.
Some people don’t realize we don’t get paid to write scientific papers. Some journals publish at no cost, but increasingly, there are publication fees that may range from a few hundred to a few thousand dollars. That, itself, isn’t necessarily the problem. Some journals charge fees so that the papers can be open access (available to anyone, without a need for a subscription). However, some journal charge a couple thousand dollars, make a nice profit and don’t particularly care about the science.
As someone who’s an associate editor, editorial board member and frequent reviewer for many journals, I see the good and bad.
I see papers that should be published accepted.
I see good quality papers rejected by good journals, knowing they’ll still end up in another good journal.
I see bad papers rejected.
However, I also see…
Horrible quality papers rejected that I know will end up published somewhere.
It’s frustrating to be reviewing a paper that’s complete crap, knowing it will find a home in a journal eventually. Yes, it will most likely be in a bottom feeder journal that many of it of us in the scientific community know is dodgy. However, not everyone will realize that and there will still be ‘published data’ to refer back to. Sometimes, that’s just frustrating, because poor quality science shouldn’t be published. However, when it deals with clinical matters (e.g. diagnosis, treatment…) it can be harmful, since poor quality or invalid data shouldn’t form the basis of decisions. Yet, it happens.
There have been a couple ‘stings’, where fake (and clearly garbage) papers have been submitted to journals. The highest profile was one that was published in Science (Bohannon, 2013). The author submitted a paper to various journals, with the following set-up “Any reviewer with more than a high-school knowledge of chemistry and the ability to understand a basic data plot should have spotted the paper’s short-comings immediately. Its experiments are so hopelessly flawed that the results are meaningless.” More than 50% of open access journals accepted it.
There are many reasons these dodgy journals are used.
“Publish or perish” isn’t quite true but it’s pretty close. Junior faculty need to show productivity to keep their positions or move into the increasingly elusive tenured positions. Scientific papers is a key metric, because it’s easy to count.
Some people get taken advantage of, not realizing the journal is predatory (or that fees are so high, until after the paper is accepted).
Commercial profit. Companies want to say their products are supported by published data. If the data aren’t any good, the amount of money that it takes to get something published is inconsequential for most companies.
Open access isn’t inherently bad. There are excellent open access journals that charge a couple thousand dollars per paper but have high standards. Open access is ideal as it means the science is available to everyone. It just has to be acceptable science, and that’s where things start to fall apart.
Anyway…enough ranting. I always like to say “don’t talk about a problem without talking about a solution” but I don’t have an easy solution. More awareness is the key, which is why sites that track predatory journals, such as Beall’s List, are important. It’s a good update on a sad state of affairs.
I have so many Larry stories that I’d probably get sued now that he’s a big shot.
But when I was teaching him and Kevin, about 1995 (I may have noticed Chapman joined my lab about 1999, it’s all a purple haze, but I got those 70 peer-reviewed papers out and made full-professor) so here’s Larry, now that he’s returned to Guelph (that’s in Ontario, Canada) and maybe you have a chat with Malcolm, see about getting my $750,000 returned and we can do some fun research.
Despite appearances, experts say a recent rise in major recalls is not a sign of food supply problems, but the result of a more active investigative body and better testing tools — though they add more can be done.
“This is proof that the system is working well,” said Lawrence Goodridge, a professor focusing on food safety at The University of Guelph, speaking about the recent meat recall.
Yet, he believes that “in Canada, we have to get to a place where we can actually stop the food from going to retail in the first place.”
Since Sept. 20, a investigation by the Canadian Food Inspection Agency into possible E. coli 0157:H7 contamination in some beef and veal products sold by Ryding-Regency Meat Packers Ltd. and St. Ann’s Foods Inc. has led to the recall of nearly 700 products.
The CFIA suspended the Canadian food safety license for St. Ann’s meat-processing plant, as well as Ryding-Regency’s slaughter and processing plant, both in Toronto, in late September.
No illnesses have been reported in association with the products, according to the CFIA, but symptoms of sickness can include nausea, vomiting, abdominal cramps.
This is the CIDRAP summary of the latest CDC number crunching on microorganisms that lead to barfing.
The Centers for Disease Control and Prevention (CDC) late last week released a summary of foodborne illnesses in 2017 based on an annual analysis of data from the Foodborne Disease Outbreak Surveillance System, and norovirus was the most common pathogen reported, responsible for 46% of illnesses. Salmonella and Shiga toxin–producing Escherichia coli were also linked to a substantial number of outbreaks.
In 2017, the CDC tracked 841 foodborne outbreaks, which included 14,481 illnesses, 827 hospitalizations, 20 deaths, and 14 food product recalls. A single etiologic agent was confirmed in 395 outbreaks (47%), which are defined as two or more related cases.
Tainted seafood and poultry were tied with causing the most outbreaks, with mollusks (41 outbreaks), fish (37), and chicken (23) the specific food items most often implicated. The most outbreak-associated illnesses were from turkey (609 illnesses), fruits (521), and chicken (487), the CDC said.
California had the most outbreaks (107), followed by Ohio (69), and Washington state (67).
As in past years, restaurants with sit-down dining were the most commonly reported locations for food preparation associated with outbreaks (366).
My friend Tim Caulfield, a Canada Research Chair in Health Law and Policy at the University of Alberta, author of “Is Gwyneth Paltrow Wrong About Everything?: How the Famous Sell Us Elixirs of Health, Beauty & Happiness” (Beacon, 2015) and host of “A User’s Guide to Cheating Death” on Netflix (that’s a long bio) writes for NBC News, humans need water but the marketing of water as a detoxifying, energizing, health-enhancing, miracle beverage has become a lucrative business. Over the past few years the booming wellness industry (aka Big Wellness) has coopted this most basic of biological needs to sell products and promises of miraculous improved health. But is there any evidence to support the hydration hype?
Before I dump on the water business, let’s give a nod to the positives. There is growing recognition that sugary beverages are not a good choice, nutrition wise. Evidence suggests that consumption of sugary beverages, especially soft drinks, is associated with a range of health issues, including obesity and heart disease. As a result, there is a broad consensus among nutrition and public health experts about the value of limiting the consumption of these calorie-dense and relatively nutrition-free beverages.
So, in this context, the shift to water is a very good thing. But that doesn’t mean we have to buy what the “premium” water market is selling.
But before we get to the fancy packaging, we need to talk about volume. Do you actually need to drink eight glasses of water a day? In a word: Nope.
This strange and incredibly durable myth seems to have emerged from a misinterpretation of a 1945 US Food and Nutrition Board recommendation. That document suggested a “suitable allowance of water for adults is 2.5 litres daily” (i.e., roughly eight glasses a day). But what is almost always overlooked is that the recommendation — which was not based on a robust body of research — also noted “[m]ost of this quantity is in prepared foods.” In other words, you already get the bulk of your needed water from the food you eat.
In reality, there is no magical amount of water. We do need to stay appropriately hydrated, of course. And as our climate and activities change, so does the amount of water we lose through sweating etc. But our bodies are good at telling us how much and when we should drink. (Thanks, evolution.) And all liquids — coffee, tea, that weird fluid inside hotdogs — count toward your daily consumption of water. My body can’t tell if an H20 molecule came from a fresh-water spring on the side of a remote Himalayan mountain or from a cup of gas station java (which isn’t, despite conventional wisdom to the contrary, dehydrating).
But even if water is found in a lot of foods and beverages, pure bottled water is still better for us, right? Wrong again.
Yes, drinking plain water is almost always a better choice than some other, sugar-infused, beverage. But the water you drink doesn’t need to come out of a plastic, glass, or 24-karat gold (yes, that is a thing) bottle.
But bottled water tastes better, you say! Actually, blind taste tests have consistently found that to be untrue too. To cite just one example, only one-third of the participants in a Boston University study, were able to correctly identify tap water. One third thought it was bottled water and one third couldn’t tell the difference.
But bottled water tastes better, you say! Actually, blind taste tests have consistently found that to be untrue too.
And now we get to what is probably the biggest scam. Wellness wonks have been pushing absurd diets, supplements and potions for decades. Now that same thinking has come to water, with alkaline, hydrogen, gluten and GMO-free water brands hitting the supermarket and health food store shelves near you.
Nope, nope and — sigh — nope.
Alkaline water is part of the larger multimillion-dollar alkaline diet fad embraced by celebrities like New England Patriots quarterback Tom Brady. Proponents claim that humans can become too acidic and, as such, we need to consume foods and beverages that will lower the pH of our bodies. By doing so, we will improve our health and reduce the incidence of disease and cancer, the theory goes.
Problem two: You can’t change the pH of your body through food and beverages. So the entire premise is scientifically absurd. Your body tightly regulated the pH of your blood. It doesn’t need the help of overpriced bottled water.
Queen Elizabeth has a crafty way to avoid getting poisoned at the dinner table. A new documentary called Secrets of the Royal Kitchen explores the ins and outs of Buckingham Palace’s kitchens, including the lengths royal staffers go to keep Elizabeth safe. Here’s a quick look at all the interesting elements that go into a state banquet with the Queen.
During state banquets, Her Majesty’s staff are required to follow a serious protocol to keep her safe – and the lengths they go for her safety might surprise you.
A personal chef at the palace prepares the dishes for all of the guests. According to the New York Post, Elizabeth’s staff members then chose a random plate for her in an effort to prevent someone from poisoning her food.
The only way someone would be able to poison Queen Elizabeth is if they contaminated all of the dishes. This tactic has paid off so far, though we couldn’t imagine why someone would want to poison the Queen.
“After everything is plated up, a page chooses at random one of the plates to be served to her majesty,” Emily Andrews, a correspondent for the royals, shared. “So if anyone did want to poison the monarch they’d have to poison the whole lot.”
The documentary also revealed that banquet guests are required to follow some strict rules while dining with Elizabeth Queen.
This includes finishing their plates before Her Majesty is done eating. This is an old tradition that used to be more of an issue in the past as guests would race to finish their food. It is unclear if the palace requires visitors to follow this protocol or if they have gotten more flexible in recent years.
There are, of course, plenty of other traditions guests are required to follow whenever they are eating with the Queen.
For starters, nobody sits down until Elizabeth has been seated. You also cannot start eating until she has taken her first bite.
Elizabeth also has a personal menu that has been crafted to her liking. She schedules her meals three days in advance to give the palace chef plenty of time to gather ingredients.
When picking her dining options, Elizabeth crosses out dishes she doesn’t like. She also crosses out entire pages whenever she has a royal event that evening and will not be dining in the palace.
Eva Saiz of El Pais reports the owners of the food company responsible for the worst-ever listeriosis outbreak in Spain were arrested on Wednesday for manslaughter.
Since August, the outbreak has killed three people, caused seven miscarriages, and infected more than 200 people. The source of the bacterial infection was traced to a Seville-based company called Magrudis, which sold a contaminated pork loin product called carne mechada under the brand name La Mechá. Three more products produced by the company also tested positive for Listeria monocytogenes.
The owners of Magrudis, José Antonio Marín Pince and his two children Sandro and Mario, have been accused, to different degrees, of involuntary manslaughter, crimes against health and causing injury to a fetus.
“When the crisis broke, we reminded the business by email that one of their samples had been contaminated much earlier. Given that they did nothing, we passed on this information to the courts,” José Antonio Borrás, the owner of the Microal Group laboratory, told EL PAÍS.
The laboratory handed a report to the court in early September, and according to sources close to the investigation, the contents prompted Judge Pilar Ordóñez, who is overseeing the case, to take action on Tuesday.
Neither laboratories nor companies are legally obliged to warn the authorities if a product is found to test positive, but a company does have a duty to adopt measures to correct the problem. Investigators want to find out why the owners of Magrudis did not do this, and why, more importantly they hid the positive test results from health inspectors who visited the factory after the alert was raised. In public appearances, both Marín and his son Sandro claimed that the company had successfully passed all sanitary controls.
Traces of listeria were found in tests carried out on the Magrudis production line, including the oven carts used to transport the meat during the preparation process, and the larding needles used to inject the pork with fat before cooking. The crisis was complicated by the fact that the company’s products had been sold on to another firm and prepared for sale as an own-brand product in a supermarket chain without the proper labelling.
Food safety training is like psychotherapy: Sure, I understand the theory, the neural pathways, the addictive brain, but will that change my behavior (shurley not).
But there’s always hope – in place of well-designed studies that measure success, failure, and actual experiments with novel approaches. Most studies get tossed on the rhetorical pile of we-need-more-education crap.
Here’s the abstracts for two recent papers:
Effectiveness of food handler training and education interventions: A systematic review and analysis
Journal of Food Protection vol. 82 no. 10
Ian Young, Judy Greig, Barbara J. Wilhelm, and Lisa A. Waddell
Improper food handling among those working in retail and food service settings is a frequent contributor to foodborne illness outbreaks. Food safety training and education interventions are important strategies to improve the behaviors and behavioral precursors (e.g., knowledge and attitudes) of food handlers in these settings.
We conducted a comprehensive systematic review to identify, characterize, and synthesize global studies in this area to determine the overall effectiveness of these interventions. The review focused on experimental studies with an independent control group. Review methods included structured search strategy, relevance screening of identified abstracts, characterization of relevant articles, risk of bias assessment, data extraction, meta-analysis of intervention effectiveness for four outcome categories (attitudes, knowledge, behavior, and food premise inspection scores), and a quality of evidence assessment.
We identified 18 relevant randomized controlled trials (RCTs) and 29 nonrandomized trials. Among RCTs, 25 (64%) unique outcomes were rated as high risk of bias, primarily owing to concerns about outcome measurement methods, while 45 (98%) nonrandomized trial outcomes were rated as serious risk of bias, primarily because of concerns about confounding bias. High confidence was identified for the effect of training and education interventions to improve food handler knowledge outcomes in eight RCT studies (standardized mean difference = 0.92; 95% confidence interval: 0.03, 1.81; I2 = 86%). For all other outcomes, no significant effect was identified. In contrast, nonrandomized trials identified a statistically significant positive intervention effect for all outcome types, but confidence in these findings was very low due to possible confounding and other biases.
Results indicate that food safety training and education interventions are effective to improve food handler knowledge, but more evidence is needed on strategies to improve behavior change.
Gaps and common misconceptions in public’s food safety knowledge
Background: Incidence rates of some foodborne illnesses (FBIs) in BC still remain on the rise despite numerous initiatives to prevent FBIs. This rise over the years has been attributed to gaps in the public’s food-safety knowledge and practices. In order to decrease incidence rates and prevent future FBIs, efforts should be made to identify common misconceptions in the public’s food safety knowledge. With a focus on the Metro Vancouver population, common misconceptions in food safety were found and their knowledge level towards the misconceptions was analyzed.
Methods: An in-person survey was conducted in three locations in Metro Vancouver. The survey asked for demographics information, perceived food safety knowledge and food safety misconceptions. ANOVA and Independent Sample T-test were administered to analyze results.
Results: No statistically significant difference in food safety knowledge was found between groups by gender, age, and geographic region. The majority of participants rated their food safety knowledge as moderate but they demonstrated a poor knowledge level in food safety.
Conclusion: The public’s knowledge level should be improved to prevent further rises of FBIs. Initiatives involving the provincial Foodsafe certification program, secondary school curriculums and health authority websites can be utilized to educate the public.