Food Safety for Professionals (Second Edition)

Creating Good News and Helping the Public—It's in our Hands

Preventive Strategy Against Infectious Diarrhea—A Holistic Approach

Access to sufficient safe food is a basic requirement for human health. Ensuring food safety and security in a highly globalized world presents increasingly difficult, and often under-appreciated challenges, for governments, commercial organizations and individuals alike.1,2 The risks of unsafe food are substantial, but can be difficult to quantify. Diarrhoeal diseases – both foodborne and waterborne – kill an estimated two million people annually, including many children in developing countries. Food contaminants, such as harmful parasites, bacteria, viruses, prions, chemical or radioactive substances, cause more than 200 diseases – ranging from infectious diseases to cancers.3 In parallel with the increasing size of the world population, consumer demand for a wider variety of foods is growing, entailing a longer and more complex food-chain. In this context, for the World Health Day, on 7 April 2015, the World Health Organization (WHO) has chosen to focus on food safety. Today, food ingredients often come from multiple countries, with each item having travelled thousands of kilometres from a field, farm or factory. Contamination at one end of the food-chain can affect populations on the other side of the world. Given the interaction of multiple actors separated by vast distances and potentially delayed impacts, multisectoral and international cooperation is essential. Food safety needs strengthening in many countries – but no country can do this alone. World Health Day is one of a series of actions that WHO is taking to raise awareness about the food safety agenda and to galvanize action. WHO, in collaboration with the United Nations Food and Agriculture Organization (FAO), has had a central international role in developing guidelines to strengthen and harmonize food systems, in particular through the jointly managed Codex Alimentarius Commission. Codex standards have become the de facto international standards for food safety. WHO and FAO also manage the International Food Safety Authorities Network (INFOSAN), which provides timely information during food safety emergencies4 and assists countries in building strong systems to prevent such incidents. WHO has also established the Global Foodborne Infections Network5 to promote integrated, laboratory-based surveillance and foster multisectoral collaboration. In 2010, the 63rd World Health Assembly adopted a resolution to advance food safety.6 As a result, a strategic plan was developed which requires WHO to: (i) provide the evidence base for measures to decrease foodborne health risks along the entire food-chain; (ii) improve international and national cross-sectoral collaboration, including communication and advocacy; and (iii) provide leadership and assist in the development and strengthening of risk-based, integrated national systems for food safety.7 In November 2014, the second International Conference on Nutrition8 reaffirmed the right for everyone to have access to safe, sufficient and nutritious food; the need to strengthen food production and distribution systems and the importance of fair trade practices. Recently, WHO has also provided guidance on food safety for food producers, transporters and consumers.9 There is a need to refocus attention and to re-energize commitments on food safety – especially coordinated and cooperative actions and communications across borders. Better data and methods are needed to estimate the health impact of foodborne diseases and to guide response and prevention actions. This year, WHO will release the first comprehensive estimates of the global burden of death and illness caused by foodborne diseases.10 More investment is needed in national food safety systems, reflecting the importance of food safety as a public health priority. Governments have several key roles to play. In addition to setting policies, they are critical for establishing and implementing the national food safety systems within which food producers and suppliers must operate. Consumers can stay informed, for example, through self-education and by reading labels on packaging. In the 21st century, collaboration is vital to achieving safe food-chains that cross national borders. This is why WHO works closely with FAO, the World Organization for Animal Health (OIE) and other international organizations to ensure food is safe to eat. This year’s World Health Day is an opportunity to strengthen food safety across all borders and stakeholders.

Food safety is an integral part of food and nutrition security. Foodborne diseases (FBD) can occur when food safety measures are not applied. Unfortunately, most of the burden of foodborne illness is shouldered by children under five years of age and people living in low- and middle-income countries (LMIC). The foundation of food safety is built upon a quality-safety culture, compliance with food laws, regulation, policy, traceability, and food safety management systems encompassing documentation, training, auditing, reporting and corrective action. This paper reviews four existing national policy documents in Nigeria, three of which include food safety components. The fourth document, the National Policy on Food Safety and Its Implementation Strategy (NPFSIS), is Nigeria’s principal food safety policy document and was reviewed in more detail. This review focuses on the situational and analytical concepts of the policy framework of the National Food Safety System (NFSS) in Nigeria. It also examines the status of the implementation of the NPFSIS 2014 and its alignment with international best practices. It was undertaken to assess existing food safety policy documents in Nigeria, identify gaps, make recommendations, and proffer solutions. Keywords: food safety, policy, foodborne diseases, gaps, Nigeria DOI: 10.7176/JLPG/110-07 Publication date: June 30 th 2021

The Economics of Enteric Infections: Human Foodborne Disease Costs

<p>This paper is a comparative survey of the National Food Safety Systems (NFSS) of the European Union (EU) Member-States (MS) and the Central EU level. The main organizational structures of the NFSS, their legal frameworks, their responsibilities, their experiences, and challenges relating to food safety are discussed. Growing concerns about food safety have led the EU itself, its MS and non-EU countries, which are EU trade-partners, to review and modify their food safety systems. Our study suggests that the EU and 22 out of 27 Member States (MS) have reorganized their NFSS by establishing a single food safety authority or a similar organization on the national or central level. In addition, the study analyzes different approaches towards the establishment of such agencies. Areas where marked differences in approaches were seen included the division of responsibilities for risk assessment (RA), risk management (RM), and risk communication (RC). We found that in 12 Member States, all three areas of activity (RA, RM, and RC) are kept together, whereas in 10 Member States, risk management is functionally or institutionally separate from risk assessment and risk communication. No single ideal model for others to follow for the organization of a food safety authority was observed; however, revised NFSS, either in EU member states or at the EU central level, may be more effective from the previous arrangements, because they provide central supervision, give priority to food control programs, and maintain comprehensive risk analysis as part of their activities.</p>

The globalization of trade, which has contributed to food availability and diversification throughout the world, has also increased the chances that the food produced in one place will affect the health and diet of people living in another. As a result, global food safety and nutrition measures applicable across borders, institutions and disciplines, including the establishment of evidence-based international standards on food safety and nutrition, are more important than ever before. Since its inception in 1963, the Codex Alimentarius Commission has developed hundreds of such standards and provided guidance for improving food safety and nutrition in each of its member states and globally. The Commission, whose 186 members represent 99% of the world’s population, is the principal body of the Joint Food and Agriculture Organization of the United Nations (FAO)/World Health Organization (WHO) Food Standards Programme.1 In addition to international food safety and nutrition standards, it develops guidelines and codes of practice, also intended to protect consumers’ health as well as to ensure fair practices in the food trade. Its standards and related texts cover an impressively wide range of subjects of international relevance having to do with biotechnology, pesticides, pathogens, additives and contaminants, food labelling, reference values for nutrients (particularly those related to the risk of noncommunicable diseases) and many other areas. In 1995, the World Trade Organization Agreement on the Application of Sanitary and Phytosanitary Measures called on members of the World Trade Organization to harmonize their national regulations to Codex standards,2 which have since become international benchmarks for food safety. Over the decades the Commission has benefited from the scientific and technical advice provided by WHO. In collaboration with FAO, WHO has convened international meetings of experts to address emerging or emergency issues and provide independent risk assessments, and the recommendations from these meetings feed directly into the Commission’s standard-setting process. Four expert groups meet regularly: the Joint FAO/WHO Expert Committee on Food Additives has carried out risk assessments related to food additives, contaminants, natural toxins and veterinary drug residues in food since 1956; the Joint FAO/WHO Meeting on Pesticide Residues has assessed since 1963 the potential health effects of pesticide residues and recommends safe maximum residue levels for specific food commodities; the Joint FAO/WHO Expert Meeting on Microbiological Risk Assessment has focused since 2000 on risk assessments for selected pathogen–commodity combinations, and the recently-established Joint FAO/WHO Expert Meetings on Nutrition provide scientific advice on nutritional matters. Although Codex standards are sometimes viewed as “trade standards”, their primary purpose is to protect consumers’ health by ensuring the safety and nutritional quality of food products traded worldwide. The importance of this work is evidenced by the large burden of food- and diet-related disorders and illness. Foodborne and waterborne diarrhoeal diseases kill an estimated 2.2 million people annually, most of them children3 and food containing harmful levels of chemicals can cause serious health problems, including cancer. Excessive intake of calories can lead to obesity and to conditions such as diabetes mellitus, coronary heart disease, cancer, hypertension and stroke.4,5 On the other hand, lack of sufficient food and vitamin and mineral deficiencies also cause enormous numbers of deaths and disability. Stunting, a mark of chronic undernutrition, affects 165 million children younger than 5 years and an estimated 35% of all deaths among children in this age group are associated with undernutrition.6 Foodborne diseases and malnutrition undermine not only human health and productivity, but also countries’ potential for sustainable development. As the Commission celebrates 50 years of successful work, it may be a good time to reflect on its trajectory and how it can serve the public interest even better. Over the years the Commission has become more inclusive. Thanks to the work of the FAO/WHO Project and Trust Fund for Enhanced Participation in Codex, launched in 2003, more countries in development and with economies in transition are actively participating in the Commission. The openness, transparency and precision of its reporting and prioritization procedures have been improved. Nonetheless, today’s rapid changes in trade, travel and commerce call for an international standard-setting system that is able to respond more quickly to new situations. One way to achieve this might be through better use of modern information technology. Stronger support of national Codex contact points is needed as well, but equally necessary are heightened political will and an acknowledgement of the importance of food safety and nutrition in public health. Because trade, nutrition and food safety are so closely connected, closer collaboration between different sectors and strengthened interactions between the Codex and other global players will be essential.

The use of commercial complementary food (CCF) in humanitarian emergencies is an emerging topic in nutrition policy. Food safety guidance is helpful for the prevention of foodborne illnesses in infants and young children, but whether current global operational guidance on infant and young child feeding in emergencies (IYCF-E) adequately addresses food safety for CCF in humanitarian emergencies is unknown. The aim of this review was to identify and synthesize available food safety guidance on the use of CCF in humanitarian emergencies. A narrative review that included a systematic content analysis and thematic synthesis of global operational guidance on IYCF-E was conducted. Fourteen global guidance documents were selected. Forty-nine excerpts specific to CCF were identified, of which 10 (20%) were rated as relevant to the prevention of foodborne illness. Assessment of inter-rater reliability showed 80% agreement, with a Cohen's kappa coefficient (κ) of 0.52 (moderate agreement). Content was synthesized in 3 themes: donations of CCF, quality assurance and quality control, and water, sanitation, and hygiene principles. Little salient guidance for the safe use of CCF in emergencies was identified. Global operational guidance on IYCF-E should be updated by incorporating food safety considerations for the use of CCF.

<p>This paper is a comparative survey of the National Food Safety Systems (NFSS) of the European Union (EU) Member-States (MS) and the Central EU level. The main organizational structures of the NFSS, their legal frameworks, their responsibilities, their experiences, and challenges relating to food safety are discussed. Growing concerns about food safety have led the EU itself, its MS and non-EU countries, which are EU trade-partners, to review and modify their food safety systems. Our study suggests that the EU and 22 out of 27 Member States (MS) have reorganized their NFSS by establishing a single food safety authority or a similar organization on the national or central level. In addition, the study analyzes different approaches towards the establishment of such agencies. Areas where marked differences in approaches were seen included the division of responsibilities for risk assessment (RA), risk management (RM), and risk communication (RC). We found that in 12 Member States, all three areas of activity (RA, RM, and RC) are kept together, whereas in 10 Member States, risk management is functionally or institutionally separate from risk assessment and risk communication. No single ideal model for others to follow for the organization of a food safety authority was observed; however, revised NFSS, either in EU member states or at the EU central level, may be more effective from the previous arrangements, because they provide central supervision, give priority to food control programs, and maintain comprehensive risk analysis as part of their activities.</p>

In an increasingly interconnected world, ensuring the safety of the global food supply has emerged as a paramount concern. With foodborne illnesses affecting millions annually and international trade in food products reaching unprecedented levels, the need for robust food safety standards has never been more pressing. This abstract explores the vital role of international collaboration and policy harmonization in enhancing global food safety standards, with a focus on the mechanisms, challenges, and potential solutions involved. At the heart of global food safety efforts lie collaborative endeavors among nations facilitated by international organizations such as the World Health Organization (WHO), the Food and Agriculture Organization (FAO), and the Codex Alimentarius Commission. These entities serve as platforms for harmonizing food safety regulations by developing science-based standards, guidelines, and codes of practice. Through regular consultations, expert committees, and consensus-building processes, these organizations foster agreement on key principles and practices governing food safety across diverse national contexts. However, achieving harmonization in food safety policies poses significant challenges. Divergent regulatory frameworks, varying levels of institutional capacity, and disparities in resources among countries can impede efforts to establish uniform standards. Moreover, geopolitical tensions and trade disputes may hinder cooperation, leading to fragmentation in global food safety governance. Addressing these challenges requires concerted efforts to build trust, enhance communication, and promote transparency among stakeholders. Technological innovations offer promising avenues for overcoming barriers to international collaboration and policy harmonization in food safety. Blockchain technology, for instance, enables transparent and tamper-proof recording of food supply chain data, enhancing traceability and accountability. Internet of Things (IoT) devices provide real-time monitoring of food storage and transportation conditions, helping to prevent contamination and spoilage. Artificial Intelligence (AI) algorithms analyze vast datasets to identify emerging food safety risks and inform regulatory decision-making. By leveraging these technologies, countries can strengthen their capacity to implement harmonized food safety standards and improve compliance with international regulations. Furthermore, public-private partnerships play a crucial role in advancing global food safety initiatives. Collaboration between governments, industry stakeholders, academia, and civil society organizations facilitates knowledge sharing, capacity building, and resource mobilization. By pooling expertise and resources, these partnerships enable more effective surveillance, response, and mitigation of food safety risks on a global scale. Moreover, they promote information exchange and best practice dissemination, fostering a culture of continuous improvement in food safety management. Policy harmonization efforts must also embrace risk-based approaches to prioritize interventions and allocate resources effectively. By identifying and assessing food safety hazards based on their likelihood and severity, countries can tailor their regulatory measures to address the most significant risks. Moreover, regular monitoring, evaluation, and review of food safety policies are essential to ensure their relevance, effectiveness, and adaptability in the face of evolving threats and challenges. Enhancing global food safety standards requires sustained international collaboration and policy harmonization. By fostering consensus, leveraging technology, and fostering partnerships, the international community can strengthen the resilience of the global food system, protect public health, and promote equitable access to safe and nutritious food for all.

In view of the CGIAR's identification of food safety as an area requiring priority attention to safeguard the economic interests of smallholder farmers and the poor, this paper aims to provide a general overview of the level of research and development attention accorded by the scientific and development community to this theme. This baseline survey of work undertaken exposes the nature of the problem; the food safety situation of the poor; food safety concerns in technology and policy research in the CGIAR; the role of capacity-building; and, subsequently, attempts to provide pointers to the CGIAR research community along which it could proceed. It is clear that within the CGIAR System, there has been no set strategy to provide guidance on the topic, and that work done to date has been largely of an ad hoc nature. The formulation of a strategic framework to guide the incorporation of food safety considerations in CGIAR research is now essential and would prevent duplication, capture synergies from the currently isolated activities and promote greater efficiency.

These foreign students are highly concerned with food safety and food handling knowledge as they are presumably involved in perilous eating behaviours, which exposes them to the risk of foodborne diseases. The present cross-sectional study aimed to evaluate the awareness and practices regarding food safety and food handling among the foreign students of Universiti Sains Malaysia (USM), Penang. A self-administered questionnaire was used to collect demographic information and to assess awareness of food safety and food handling among foreign students. Questionnaires were distributed into five sections that concealed key food safety apprehensions. A total of 328 students received the questionnaires, and 203 (61.89%) responded. Cleanliness of eating tables, food temperature, smoke-free environment and food handler appearance are the key food safety considerations for the respondents. The results showed that a high percentage of male respondents (57.98%) experienced food poisoning, and considered food from restaurants is the cause of foodborne diseases. Respondents have utmost awareness about the cleanliness of utensils and kitchen surfaces, hand hygiene, and preclusion of cross-contamination, however, described a poor knowledge concerning the temperature and heat treatment of the food. Good understanding regarding food poisoning symptoms was observed among the respondents, especially in a female group. The outcome revealed that foreign students, irrespective of gender, demonstrated comparable food safety and food handling knowledge. The study laid emphasis on education and training as an optimum way to foster awareness and encourage students’ food safety knowledge and practices.

Benchmarking Global Food Safety Performances: The Era of Risk Intelligence

Emerging needs and opportunities in foodborne disease detection and prevention: From tools to people

Foodborne illness afflicts 48 million people annually in the US alone. More than 128,000 are hospitalized and 3000 die from the infection. While preventable with proper food safety practices, the traditional restaurant inspection process has limited impact given the predictability and low frequency of inspections, and the dynamic nature of the kitchen environment. Despite this reality, the inspection process has remained largely unchanged for decades. CDC has even identified food safety as one of seven “winnable battles”; however, progress to date has been limited. In this work, we demonstrate significant improvements in food safety by marrying AI and the standard inspection process. We apply machine learning to Twitter data, develop a system that automatically detects venues likely to pose a public health hazard, and demonstrate its efficacy in the Las Vegas metropolitan area in a double‐blind experiment conducted over three months in collaboration with Nevada's health department. By contrast, previous research in this domain has been limited to indirect correlative validation using only aggregate statistics. We show that the adaptive inspection process is 64 percent more effective at identifying problematic venues than the current state of the art. If fully deployed, our approach could prevent more than 9000 cases of foodborne illness and 557 hospitalizations annually in Las Vegas alone. Additionally, adaptive inspections result in unexpected benefits, including the identification of venues lacking permits, contagious kitchen staff, and fewer customer complaints filed with the Las Vegas health department.