June 2010 Issue

Food Safety Update — Report Underscores Need for Enhanced Legislation to Protect Americans
By David Yeager
Today’s Dietitian
Vol. 12 No. 6 P. 42

Governing bodies aim to improve more than just the safety of produce as they take steps toward instituting stricter regulations.

From bags of spinach to products containing peanuts and hydrolyzed vegetable protein, numerous food recalls have made news in the last four years. At times, it seems as though a biblical plague has been set upon our daily bread. And with food recalls continuing to grab headlines, the finding of a report issued on March 3 by the Produce Safety Project at Georgetown University should come as no surprise: The cost of food-borne illness is higher than previously estimated.

The report found that food-borne illness costs Americans an estimated $152 billion each year, of which $39 billion is directly attributable to produce. That cost includes doctor and hospital visits, medications, lost wages and productivity, functional disabilities, and death. While most studies look only at a few types of pathogens, this study looked at a more comprehensive set—bacteria, parasites, and viruses—and included in its calculations food poisoning cases from unknown sources as well as broader cost measures. These factors are a significant reason for the higher estimate. And while the numbers are attention grabbing, they don’t necessarily mean that our food is less safe.

In fact, despite the higher cost estimates, the Centers for Disease Control and Prevention (CDC) estimates that the actual number of food-borne infections has remained unchanged since 1999, with 76 million illnesses, 325,000 hospitalizations, and 5,000 deaths each year. But because information flows more freely than ever before, cases of suspected food poisoning reach the public at lightning speed, drawing more attention to the issue. “It’s interesting. All of the testing and manufacturing controls are much better than they were 10 years ago, but reporting is way up,” says Peter Schaffer, president and CEO of Food Source, Inc, a distributor of spices, seasonings, dehydrated vegetables, and other food ingredients. “I think consumers are more aware of the signs and symptoms of food-borne illness.”

However, there is widespread agreement throughout the food industry and among consumer groups that more can be done to improve food safety. Unfortunately, it’s a difficult puzzle to solve. “[T]he presence of pathogens in food is a complicated problem involving numerous, not fully understood vectors of contamination,” wrote Robert L. Scharff, an assistant professor in the department of consumer sciences at Ohio State University, a former FDA economist, and the report’s author. “[S]ociety has limited resources with which to solve the problems it faces; and … it has limited information on the extent, causes, and adequacy of methods available to prevent foodborne disease.”

According to a 2009 report by the Center for Science in the Public Interest (CSPI), produce is the largest source of food-borne illness among single-ingredient foods, followed by poultry, pork, beef, and seafood. In each of these groups, the CSPI report found that the rates of attributable illness were about the same or lower than 2000 levels, although there were years when poultry and seafood spiked significantly. And even though it ranked first, there was a significant drop over that time in illnesses attributed to produce.

Rather than sound the alarm about food poisoning, Scharff’s report is intended to help focus the debate about possible prevention steps. “Economic analysis can help us set priorities regarding which foodborne illness problems to tackle first, even as we continue to strive to achieve the ultimate goal of eliminating these illnesses. Given that we have to make choices and set priorities, the use of economic analyses designed to reflect consumer preferences is a reasonable way to make those choices,” wrote Scharff. “By providing more comprehensive cost-per-case values for all pathogens and specifically for produce-related illnesses … this report can contribute to assessments about whether current food safety proposals make sense or what priority should be placed upon those proposals.”

Defining the Problem
In addition to the overall cost of food-borne illness, Scharff calculated the cost for each state. Not surprisingly, he found many cost variations among states. Factors such as the cultural food preferences of different regions and the cost of medical care in a particular state can influence the geographic prevalence of certain types of food-borne illness and the treatment costs. But these factors tell only a small part of the story. While the cost of food-borne illness is not shared evenly among states, pinpointing specific hot spots is problematic because food contamination can occur anywhere in the food supply chain.

“If you’re talking about fresh fruits and vegetables, it could be contaminated water that’s used to irrigate. It could be manure that’s not sufficiently composted. It could be wild animal manure somewhere on the field. That’s just looking at the production side. Food can get contaminated all along the production chain from other products or sources,” says Sandra Eskin, director of the Pew Health Group’s Food Safety Campaign. “For example, a possible source of Listeria monocytogenes in a food production facility could be a leaking air conditioner. And in that condensation, there is bacteria that drips onto a belt.”

Even stringent testing can miss incidences of food contamination. “We’re finding that standard test procedures at a manufacturing level, even if you’re using a third-party accredited, No. 1 test laboratory, can come back completely clean, with all of your results pathogen free and microbiological limits within acceptable values, and you can have specific spots within a specific product that may be positive,” says Schaffer. “And the reason is because you can only sample so much.”

Another problem is that food can travel long distances before reaching its final destination, which makes it extremely difficult to track food-borne illness to its source. One hundred years ago, most of what Americans ate was grown or raised fairly close to where they lived. Walk into most American grocery stores today and you’ll find an array of foods not only from across the United States but from all over the world. This makes tracing a batch of tainted food much more complicated. Problems with food ingredients, such as red and black pepper in salami or hydrolyzed vegetable protein in multiple products, and packaging add another layer of complexity.

Steps Toward Change
The FDA and the USDA, which between them handle a large majority of the food regulation responsibilities that are currently spread among 15 different agencies, have several protocols in place for inspecting food from inside or outside our borders. And both agencies have had their resources increased in the past year, but they are still considering ways to improve their food safety processes. The FDA, the USDA’s Food Safety and Inspection Service, and the CDC held a public workshop on March 30 to consider improved methods of food safety assessment.

Also, on February 18, the FDA and the USDA issued a joint statement that they will work together to improve produce safety rules. The FDA is currently accepting public comments “about current practices and conditions for the production and packing of fresh produce and practical approaches to improving produce safety.” In addition, the USDA’s Agricultural Marketing Service is evaluating a proposed nationwide marketing agreement for the leafy greens industry, which several major produce trade associations support.

Industry has turned its attention to food safety as well. The Consumer Goods Forum, which is comprised of more than 400 manufacturers, retailers, foodservice companies, and service providers and does $2.9 trillion in business annually, launched the Global Food Safety Initiative (GFSI) in 2000 with the goal of providing a consistent set of food safety standards across the entire food supply chain. The GFSI originated in Europe but has since expanded to 150 countries on five continents. In 2007, several large companies, including Wal-Mart, gave the GFSI a significant boost when they agreed to stock only products that meet GFSI standards. When large companies embrace these measures, it encourages their suppliers to follow suit because they know there’s a buyer for their certified goods.

Certification to one of the GFSI-recognized schemes is based on “creating a program that is risk based, assesses hazards within the operation, develops appropriate controls, monitors and measures those controls, and then does appropriate verification through certification and also [the company’s] own internal auditing programs,” says Donna Garren, PhD, vice president of food safety programmes for the Consumer Goods Forum. “And that can be done anywhere along the supply chain.”

But Schaffer notes that even large companies such as Kraft, General Mills, and Nestlé that are up-to-date on food safety protocols such as testing and sampling requirements have been hit with recalls. He believes legislation that requires more detailed tracking and provides for more inspectors will improve food safety because companies will know that they’re being monitored. He also believes it will improve the competitive balance between companies that already follow high safety standards and companies that don’t.

“If you go to a grocery store, 95% of the buyers see a product on the shelf for $1.50 and then, right next to it, they see that same product, say from Kraft or General Mills, for $3.75,” says Schaffer. “That person’s going to say, ‘Wow. $1.50 vs. $3.75. I can buy two and still save 75 cents!’ not taking into account everything that Kraft or General Mills put into it to ensure their food safety.”

Eskin also believes government oversight is necessary. “[Voluntary programs are] important, but I think we’ve seen the limits of voluntary systems. We still continue to have outbreak problems. Not as many smaller and midsized production facilities have these systems in place, and the concern is that you should have a level playing field across the food supply; food products should be safe, whatever the size of the facility or farm that produces them,” says Eskin. “The only way you’re going to get that is by having a mandatory program. And certainly all of those voluntary programs inform whatever the mandatory one is going to look like.”

“Many regulatory bodies in Europe use [certification] as a tool, such as focusing their inspection or determining the audit frequency based on those that are certified or noncertified or being able to resource allocate better,” Garren says. “So we see ourselves more as a partner, not as a replacement by any means.”

There is pending legislation in Congress that would strengthen food safety laws. The Food Safety Enhancement Act, already passed by the House of Representatives, calls for, among other things, facilities to establish food safety plans based on Hazard Analysis and Critical Control Points systems, the establishment of a new food tracking system, food facility inspections determined by a risk-based schedule, and new analytical food testing requirements.

On the Senate side, the FDA Food Safety Modernization Act proposes many of the same reforms. Both the House and Senate legislation deal strictly with the FDA, which is responsible for regulating about 80% of the U.S. food supply. The Senate bill is currently awaiting passage, but there is broad support for it. However, even if it passes as expected, it will take some time before it affects consumers. “Even once the bill is passed, there are a lot of regulations that need to be implemented by the FDA, so the process isn’t over yet,” says Eskin.

How RDs Can Best Inform Clients
In the meantime, dietitians can help their clients take steps to protect themselves from food-borne illness. “In regards to products that [consumers] buy, I think they need to feel free and open to discuss that with their local retailers and their local foodservice companies. And those companies are very open and willing to provide information on what they do to ensure their supply chain,” says Garren. Dietitians can remind their clients to be wise consumers. “Ask questions. If you have concerns, ask. And be politically active as well. Contact Congress and tell them you want food safety legislation passed.”

In addition to lobbying legislators and talking to the people from whom they purchase their food, following safe food preparation guidelines can decrease consumers’ risk of food-borne illness. Ximena Jimenez, MS, RD, LD, a spokesperson for the American Dietetic Association, says proper food preparation begins at the grocery store. To begin, if a product looks or smells bad, consumers shouldn’t buy it. They should also avoid dented cans. “You want to check the use-by date on the product,” Jimenez says. “And if you’re going to be shopping for a while, you want to leave the cold products on your list—the ones that need refrigeration—for last.”

Jimenez is an accredited ServSafe instructor, which certifies her to teach food safety practices to food handlers and foodservice managers. She says proper hand washing with plenty of soap and warm water is imperative. “This is the most important part of the food preparation process to prevent illness. And the next thing is utensils. Anything that has to do with food preparation, you want it to be clean and sanitized,” she says.

If the food needs to be cooked, Jimenez says it should be cooked thoroughly and evenly to the correct temperature. She suggests using a thermometer. The temperature will vary according to the type of food, but a list of recommended food temperatures is available on the CDC’s Web site (see sidebar).

Once food is prepared, it’s important to maintain the proper temperature. “[Consumers] want to make sure to keep the cold foods cold and the hot foods hot,” says Jimenez. “Bacteria likes a certain temperature, what is called the temperature danger zone—usually from 41˚ to 135˚F.”

Finally, RDs should remind their clients to store leftovers in shallow containers and not to allow them to linger for too long. “You don’t want to leave leftovers in the refrigerator for more than three or four days. In the freezer, they can last longer, but in the refrigerator, you don’t want to leave them for more than a few days,” Jimenez says. “And basically you don’t want to reheat them more than once.”

But even though proper food-handling practices can reduce exposure to food-borne illness, says Eskin, we still need to commit the public resources necessary to ensure safety throughout the food chain. “A lot of foods that we buy—spinach, tomatoes, fruits, and vegetables, generally—are intended to be eaten raw, so we have no kill step, like cooking, that can kill bacteria,” she says. She also notes that consumers cannot, in most cases, determine whether a food is contaminated with food-borne pathogens because they can’t see, smell, or taste them.

“And the bottom line is,” says Eskin, “while there’s a lot we can do to try to minimize or try to prevent the spread of food-borne bacteria, food items are reaching our kitchens contaminated. That’s why legislation is needed.”


— David Yeager is a freelance writer and editor based in Royersford, Pa.


• Centers for Disease Control and Prevention’s FoodNet: www.cdc.gov/foodnet

• Center for Science in the Public Interest’s Outbreak Alert! http://cspinet.org/new/pdf/outbreakalertreport09.pdf

• FDA Food Safety Modernization Act: www.opencongress.org/bill/111-s510/show

• FDA Public Workshop on Measuring Progress on Food Safety: www.fda.gov/Food/NewsEvents/WorkshopsMeetingsConferences/ucm201102.htm

• FDA/USDA Joint Statement on Produce Safety: www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm200965.htm

• Food Safety Enhancement Act: www.opencongress.org/bill/111-h2749/show

• Foodborne Illness Cost Map: www.makeourfoodsafe.org/cost_map

• Global Food Safety Initiative: www.mygfsi.com

• How to Comment on the FDA’s Produce Safety Rule: www.fda.gov/RegulatoryInformation/Dockets/Comments/default.htm

• National Leafy Greens Marketing Agreement: www.nlgma.org

• Produce Safety Project:www.producesafetyproject.org


Food is safely cooked when it reaches an internal temperature high enough to kill the harmful bacteria that cause illness.

Safe Cooking Temperatures (as measured with a food thermometer)

Ground Meat and Meat Mixtures

Beef, pork, veal, and lamb


Turkey and chicken


Fresh Beef, Veal, and Lamb

Medium rare




Well done



Chicken and turkey, whole


Poultry parts


Duck and goose


Stuffing (cooked alone or in bird)


Fresh Pork



Well done



Fresh (raw)


Precooked (to reheat)


Eggs and Egg Dishes


Cook until yolk and white are firm

Egg dishes



Fin fish

145°F or until opaque and flakes easily with fork

Shrimp, lobsters, and crabs

Flesh pearly and opaque

Clams, oysters, and mussels

Shells open during cooking


Milky white or opaque and firm

Leftovers and Casseroles


— Source: Centers for Disease Control and Prevention