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Food Safety: A Public Health Priority

Introduction: Food safety is the assurance that food and food

products when consumed in the usual way does not pose a threat

to human health and well-being. More than 200 known foodborne

diseases or illnesses are transmitted as a result of eating or

drinking contaminated food (1). The causes of foodborne

illnesses include viruses, bacteria, parasites, toxins, metals

and prions. Some of the common symptoms of foodborne illnesses

range from mild gastroenteritis to life-threatening

neurological, hepatic and renal syndromes. According to the

Caribbean Epidemiology Center (CAREC), foodborne diseases have

been reported to double over the past three years in Trinidad,

with the highest incidence occurring in 2005 (2). The World

Health Organization has reported that 1.8 million people from

developing countries die each year as a result of foodborne

diseases.

In the United States, foodborne diseases have been estimated to

cause 6 million to 81 million illnesses and up to 9,000 deaths

each year (3-6). However, ongoing unexpected changes in the food

supply, the identification of new foodborne diseases and the

re-emergence of dormant or existing foodborne diseases have made

these figures obsolete and have unnerved the need for fresh

insights into food safety.

It is undisputable fact that foodborne disease takes a major

toll on human health and well being, especially on fragile

health care systems in the Caribbean and other developing

countries. Thousands of millions of people are afflicted with

foodborne diseases, fall ill and many die as a result of eating

unsafe food. In a response to this concern, the Fifty-third

World Health Assembly (May, 2000) adopted a resolution calling

upon the World Health Organization (WHO) and its Member States

including Trinidad and Tobago to recognize food safety as an

essential public health function with the aim of reducing the

burden of foodborne disease globally (3-6).

Food Safety: A Basic Human Right The United Nations and WHO have

deemed the availability of safe food a basic human right (7).

Safe food contributes to health, which in turns translates into

economic productivity that may serve to alleviate poverty. The

poor and the underprivileged persons in communities, societies,

populations and countries are the most vulnerable to ill health.

Food and waterborne diarrhoeal diseases, for example, are

leading causes of illness and death among the poor and

unprivileged, killing an estimated 1.8-2.2 million people

annually, most of whom are children (7). Diarrhea is the most

common symptom of foodborne illness, but other serious

consequences may include kidney, liver failure, brain and neural

disorders often resulting in death. The debilitating long-term

complications of foodborne diseases may have a devastating

effect on families, communities, populations and countries often

leading to decreased productivity, increased economic burden on

fragile economies and health care systems.

Economic Consequences of Foodborne Diseases: There are only

limited data on the economic consequences of food contamination

and foodborne disease in developing countries. In studies in the

USA in 1995, it was estimated that the annual cost of the 3.3-12

million cases of foodborne illness caused by seven pathogens was

US $6.5-35 billion. The medical costs and the value of the lives

lost during just five foodborne outbreaks in England and Wales

in 1996 were estimated at UK£ 300-700 million. The cost of the

estimated 11, 500 daily cases of food poisoning in Australia was

calculated at AU$ 2.6 billion annually (7).

Causes of Increased Incidence of Foodborne Diseases: The

increased incidence of foodborne diseases due to microbiological

hazards and other physical and chemical hazards is the result of

a multiplicity of factors, all associated with our fast-changing

world.

 Demographic profiles are being altered, with increasing

proportions of people who are more susceptible to microorganisms

in food.

 Changes in farm practices, more extensive food

distribution systems and the increasing preference for meat and

poultry in developing countries all have the potential to

increase the incidence of foodborne illness. Extensive food

distribution systems raise the potential for rapid, widespread

distribution of contaminated food products.

 Changes in food production result in new types of food

that may harbour less common pathogens. Intensive animal

husbandry technologies, introduced to minimize production costs,

have led to the emergence of new zoonotic diseases, which affect

humans.

 Safe disposal of manure from large-scale animal and

poultry production facilities is a growing food safety problem

in much of the world, as manure frequently contains pathogens.

 Changes in eating patterns, such as a preference for

fresh and minimally processed foods, the increasingly longer

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interval between processing and consumption of foods and the

increasing prevalence of eating food prepared outside the home

all contribute to the increased incidences of foodborne illness

ascribed to microbiological organisms.

 The emergence of new pathogens and pathogens not

previously associated with food is a major public health

concern. E. coli O157:H7 was identified for the first time in

1979 and has subsequently caused illness and deaths (especially

among children) owing to its presence in ground beef,

unpasteurized apple cider, milk, lettuce, alfalfa and other

sprouts, and drinking-water in several countries. Salmonella

typhimurium DT104 has developed resistance to five commonly

prescribed antibiotics and is a major concern in many countries

because of its rapid spread during the 1990s (7).

 New technologies, such as genetic engineering,

irradiation of food, ohmic heating and modified atmosphere

packaging, may be used to increase agricultural production and

extend shelf life. Their potential benefit for public health is

great: for example, genetic engineering of plants has the

potential to increase the nutrient content of foods, decrease

their allergenicity and improve the efficiency of food

production. However, the potential long-term public health

effects of these technologies are questionable and have raised

concerns globally during the past decade (7).

References: 1. Bryan FL. Diseases transmitted by foods.

Atlanta: Centers for Disease Control; 1982. 2. CAREC.

Communicable Disease Feedback Report. Port of Spain: Trinidad;

2001. 3. Archer DL, Kvenberg JE. Incidence and cost of foodborne

diarrheal disease in the United States. J Food Protect

1985;48:887-94. 4. Bennett J, Holmberg S, Rogers M, Solomon S.

Infectious and parasitic diseases. In: Amler R, Dull H, editors.

Closing the gap: the burden of unnecessary illness. New York:

Oxford Univ Press; 1987: 102-14. 5. Todd ECD. Preliminary

estimates of costs of foodborne disease in the United States. J

Food Protect 1989;52:595-601. 6. Foodborne pathogens: risks and

consequences. Ames, IA: Council of Agricultural Science and

Technology; 1994. 7. WHO global strategy for food safety: safer

food for better health. Geneva: WHO; 2002.

About the author:

Dr Pattron is a Public Health Scientist, Ministry of Health

Trinidad