Food Safety and Foodborne Disease in the 21st Century

Canadian Institute of Public Health Inspectors, White Rock, British Columbia This paper is modified from a submission awarded the Stanier Prize by the Stanier Institute/Institut Stanier. Correspondence and reprints: Ms S Bourne, c/o Canadian Institute of Public Health Inspectors, PO Box 75264, 15180 North Bluff, White Rock, British Columbia V4B 5L4. Telephone 519-873-5122, fax 519-873-5020, e-mail shawna.bourne@ene.gov.on.ca THE PUBLIC HEALTH INSPECTOR PERSPECTIVE In today’s global arena the last line of defense in food safety is always the consumer. An educated and resourceful client has the ability to compensate for any weak links in the food safety chain. The role of effectively disseminating information on food safety falls into the domain of the public health inspector (PHI), within the local health unit. However, this responsibility is often overlooked because PHIs and other government regulators seek to make producers, suppliers and retailers more responsible for the quality and safety of the food that we, as Canadians, enjoy and take for granted. The mandate of the Canadian Institute of Public Health Inspectors (CIPHI) is to “...protect the health of all Canadians on environmental issues while promoting the science of environmental health and the profession” (1). We meet this mandate through education and the enforcement of food safety standards. Environmental Health Officials also undertake the challenge of ensuring accountability from primary producer to processor. This dual role of educator and enforcer is a difficult act to balance, yet important to achieve our goal of optimal food safety. Information describing the extent of food safety problems is limited. The best current information for health professionals, planners, and public health agencies responsible and accountable for local food safety is the estimate that 2.2 million Canadians suffer from food borne illnesses each year (2), but these data are very incomplete. The Canadian Institute for Health Information (CIHI) annual report (3) noted a fundamental information gap in public health exists in the area of food and water safety. We don’t know “how many Canadians become ill each year because of unsafe food or water [and] what are the shortand long-term health consequences of their illness?” (3). Dr Douglas Powell (4) of the University of Guelph notes:

Indigenous populations are often at higher risk for foodborne illness than the general Canadian population. To investigate the extent of the literature on the link between food safety and the occurrence of foodborne and waterborne illness in Canadian Indigenous populations. A scoping review was conducted using search strings in five databases and grey literature to identify all papers that studied a Canadian Indigenous population and referred to any potential associations between food safety (including consumption and preparation of traditional foods and retail foods) or water safety practices and food or waterborne illness. Two authors screened papers based on inclusion and exclusion criteria. Included documents were analyzed for emergent themes. From 1,718 unique records identified, 21 documents were selected. Foodborne illness was most common in children up to 14 years old. Walrus, seal, caribou and whale were the most common traditional foods tied to foodborne illness and were primarily associated with botulism and trichinosis. Aside from consuming the food raw, fermentation was the most common traditional preparation method linked to foodborne illness. There was concern about the safety of retail food but no clear link was identified with foodborne illness. Lastly, although there was concern about tap water, the use of alternate water sources, such as untreated brook water, and hygiene and cleaning practices in communities with boil water advisories were the most common risk behaviours associated with waterborne illness. Consumption of certain game meats, as well as the use of traditional fermentation practices may lead to an increased risk of foodborne illness among Indigenous populations. Concern about tap water may lead to use of unsafe alternate water sources. Further research is needed to examine potential culturally appropriate food and water safety opportunities.

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Introduction: Food borne illnesses comprise a broad spectrum of diseases and are responsible for substantial morbidity and mortality worldwide. The global incidence of food borne disease is difficult to estimate, but it has been reported that 2.1 million people died each year from diarrheal diseases and contaminated food contributes to 1.5 billion cases of diarrhea in children each year, resulting in more than three million premature deaths. In developing countries, up to an estimated 70% of cases of diarrheal diseases are associated with the consumption of contaminated foods. Approximately 10 to 20% of food-borne disease outbreaks are due to contamination by the food handler. Objective: This study was conducted to assess food safety practices and associated factors of food handlers working in substandard food establishments of Gondar town, Northwest Ethiopia, 2013/14. Methods: Institution based cross sectional study design was conducted to assess food safety practices and associated factors of food handlers. Four hundred three food handlers were taken randomly as study subjects and data were collected by observation by using standardized questionnaire and observational check lists. Ordinal logistic regression model was fitted to analyze the predictor variables. Results: The overall level of food safety practices (good-30.30%, fair- 47.60% and poor-22.10%) was reported. Of a number of predictor variables analyzed age, marital status, service year, monthly income, food hygiene and safety training, attitude, knowledge and depth of knowledge were identified as factors affecting food safety practices. Conclusion and recommendations: Compared to other similar studies, Low level of food safety practice (good-30.30%, fair- 47.60% and poor-22.10%) was reported. Therefore, Environmental health practitioners, the local Medias and the managers should do a lot to improve food safety practices of the food handlers. They should also design and implement food safety awareness creation programs.

Food-borne diseases are a large and growing public health problem. Most countries with a robust system for recording and reporting food-borne diseases have documented and reported a significant increase in the incidence of these diseases characterized by microorganisms in foods. According to World Health Organization report in 2008, the incidence of food-borne disease has had a growing trend. Incidence of food-borne disease in countries such as Australia and Spain Background: Foods go through many changes from production to table and continuous control is necessary to maintain food safety and supply foods with good quality. The aim of this study was to evaluate the quality of some foods with high consumption in Zanjan city within 5 years from 2009 to 2013. Methods: In a case-control descriptive study with an annuallycontrolled program within 5 years from 2009 to 2014, some food samples including pasteurized milk, vegetable oils, flour, kebab, salt, confectionary products and a special cookie called nan-chay were collected and analyzed in food control laboratory of Zanjan university of medical sciences. Results: According to national standard of Iran, of Nan-chay, salt, vegetable oils, kebab, confectionary products, and pasteurized milk samples 68.4%, 46%, 24.3%, 10.4%, 9.3%, 5% were out of national standard limits and unacceptable, respectively. All flour samples had good standard quality. Mean± sd values of pH in Nan-chay samples were 7.5 and 1.19, respectively. Mean± sd values of the degree of purity in salt samples were 98.21 and 1.75, respectively. Conclusion: Results showed that among the 7 types of collected foods in Zanjan city, the most nonstandard cases were of Nan-chay samples and the best quality was seen in flour samples. Journal of Human, Environment, and Health Promotion

Background: Food-borne illnesses are a major cause of morbidity and death worldwide, and food safety and hygiene play a critical role in maintaining and improving consumer health. One significant factor in the prevalence of food-related illnesses associated with unclean food is the way food vendors handle their inventory. As a result, this study evaluated the level of food handlers' adherence to cleanliness and safety standards, as well as the variables affecting them in the city of Nnewi. This study evaluated degree of safety and hygiene practices, as well as the factors influencing them, among food handlers in the Nnewi metropolis.Methodology: A cross-sectional study of 428 consenting food handlers was carried out in Nnewi metropolis utilizing quantitative data gathering methodologies and non-probability method of sampling. A well-structured and pre-tested questionnaire was interviewer-administered to collect information on sociodemographic characteristics, food safety and hygiene practices, knowledge of food safety, and observational checklists that covered cleaning, sanitation and personal hygiene. Evaluation of safety and hygiene practices was done using a four-point scale of responses from participants, with scores equal and above the 50th percentile classified as good practices, while scores less than the 50th percentile as poor practices Data were analyzed using Minitab version 21.2 and SPSS version 27.0. P value < 0.05 was considered significant.Results: The mean age of the 428 food handlers who responded, was 33.89±10.29 years, with female preponderance (83.4%, n=357). A total of 217 (50.7%) respondents were adjudged to be of good practices of food safety while 211 (49.3%) were of bad practices. Statistical analysis showed that food safety and cleanliness habits were significantly associated with age, marital status, and gender (p<0.05). The presence of running water and the type of vending establishment (branded and unbranded) were also significantly associated with food safety practices while factors such as education level of respondents, prior training in food safety, knowledge of food safety policy in Nigeria, and duration of employment as food handlers, were not significantly associated with food safety practices (p>0.05).Conclusion: The data indicate that certain demographic factors significantly impact food safety practices, pointing to potential areas for intervention, such as enhancing training and monitoring, particularly among younger, married, and less-educated food handlers, and ensuring the presence of running water in the vending premises. Food safety and cleanliness standards need to be raised because maintaining and enhancing health depends on food's wholesomeness and maximum safety.

ABSTRACTFood safety presents a global challenge, contributing to 600 million cases of foodborne diseases and 420,000 fatalities annually worldwide. In developing countries, such as Nepal, addressing food safety is particularly intricate and arduous because of the prevalent issues of food insecurity, poverty, illiteracy, and regulatory hurdles. The objectives of this comprehensive review are to evaluate the prevalent foodborne and waterborne illnesses, examine the existing regulations and institutional frameworks, and identify the challenges associated with food safety in Nepal. Additionally, this review aims to propose strategies to enhance food safety measures in the country. An electronic search was conducted using relevant keywords to include articles and literature pertinent to the topic. Common foodborne illnesses in Nepal include cholera, typhoid fever, hepatitis, worm infections, and poisoning from mushrooms, heavy metals, and pesticides. While existing rules, regulations, and government infrastructure exist, they often face limitations in effectively addressing these multifaceted challenges. Food safety in developing countries, such as Nepal, faces several challenges, including inadequate regulatory frameworks, limited surveillance and monitoring, rural–urban disparities, and high incidences of foodborne illness. Additional issues stem from weak law enforcement, poor food safety practices, limited infrastructure, informal sector challenges, cross‐border trade, limited access to clean water, and the impacts of climate change. A multisectoral One Health approach involving collaboration among government agencies, food industry stakeholders, consumers, and civil society organizations is imperative to enhance food safety in developing countries such as Nepal.

Aim:Foodborne illnesses have a significant global burden and can be life-threatening, with higher risk in vulnerable groups such as children. SafeConsume is an EU-funded, transdisciplinary project aiming to improve consumers’ food safety behaviour. Developing educational resources on food safety for use in schools has potential to improve teaching of our young consumers. The aim of this study was to explore school educators’ attitudes, behaviours and knowledge towards food hygiene, safety and education.Methods:Focus groups and interviews in England, France, Portugal and Hungary explored educator knowledge, skills, intentions and beliefs around educating young people (11–18 years) about food safety. Data were analysed using NVivo and emerging themes were applied to the Theoretical Domains Framework.Results:A total of 48 educators participated. Knowledge, confidence and skills to teach food safety to young people varied depending on background and training. Educators reported they had a role to teach food safety to young people, were positive about delivering education and optimistic they could improve students’ food safety behaviour. Barriers to teaching included lack of national curriculum coverage, limited time and money, and lack of facilities. Educators reported that social influences (family, celebrity chefs, public health campaigns and social media) were important opportunities to improve young peoples’ awareness of food safety and consequences of foodborne illness.Conclusion:Educator food safety expertise varied; training could help to optimise educator knowledge, confidence and skills. Ministries of Health and Education need encouragement to get food safety incorporated further into school curricula across Europe, so schools will be motivated to prioritise these topics.