NHM 372 Chapter 8

Hep A

10-50 days, 1-2 week illness, source humans and water, Hepatitis is a common disease that affects the liver, causing inflammation. The liver does not function normally and jaundice, yellowing of the skin, results. Hepatitis A, B, and C are the three main types of viral hepatitis. Type A, or infectious hepatitis, is one of the most conta-gious types and often occurs in children and young adults. It is caused by: • Drinking polluted water • Eating food cooked or washed in polluted water • Eating food contaminated by individuals infected with the Hepatitis virus • Touching a contaminated cup or eating utensil and then putting hands in the mouth or touching a cut or open sore • Eating shellfish, clams, mussels, and oysters that live in polluted waters Consuming even a small quantity of the virus can infect a person. Although infected individuals may not show symptoms for several weeks, they can be very infectious to others prior to show-ing symptoms themselves.

rotovirus

1-3 day, 4-8 day illness, source humans, There are six identified types of rotoviruses; three (Group A, B, C) are known to cause gastroenteritic reactions in humans. They are found in the feces of an infected person and are transmitted to others because of poor hygiene by one person, which results in the contamina-tion of food for another. The most commonly reported cases have been in nursing facilities and day care centers. Ready-to-eat products such as salads, sandwiches, and desserts are common carriers as these products are not cooked after being contaminated.

hygiene 2

A foodservice employee personal hygiene program should include three major compo-nents: maintaining personal cleanliness, wearing proper work attire, and following hygienic hand practices (NRA Education Foundation, 2013). Personal cleanliness involves proper bath-ing and hair washing. Proper work attire includes using proper hair restraints, having clean and appropriate clothing, wearing proper shoes (closed toed, nonskid soles), removing aprons when leaving work areas, and removing jewelry. Because the most critical aspect of personal cleanli-ness is frequent and thorough handwashing, proper methods should be emphasized in training programs. Although regulations vary in local areas, most indicate that fingernails should be short and clean, false fingernails and nail polish cannot be used, and cuts or wounds on hands need to be covered with clean bandages and finger cots or gloves. Using gloves can give a false sense of security because the food handler might not change the gloves after handling a contaminated product, resulting in cross-contamination of other products. Many local regulations stipulate that ready-to-eat foods cannot be handled with bare hands, requiring use of serving utensils or gloved hands. Because saliva can contain pathogens, employees should not be allowed to eat, drink, smoke, or chew gum or tobacco when preparing or serving food or cleaning work areas or equipment. Managers need to conduct daily inspections of all employees to ensure that proper sanitation practices are being followed.

Accident Prevention

A foodservice operation should have an accident prevention program that seeks to elim-inate all accidents, not just those resulting in personal injury. Accidents are expensive and can result in increased insurance premiums, lost productivity, wasted time, overtime expenses, work-ers' compensation claims, potential lawsuits, and human suffering. Accidents can also result in a fine or legal action if provisions of the Occupational Safety and Health Act (OSHA) are violated. Many aspects of safety are related to construction and maintenance of the structure and equipment. For example, floors and wiring should be in good repair, and adequate lighting should be provided in work areas, corridors, and outside the facility. Exits should be clearly marked, nonslip flooring materials used, and all equipment supplied with necessary safety de-vices. Also, fire extinguishers of the appropriate type should be readily available throughout the foodservice facility. The basic traffic flow should be designed to avoid collisions.

biosecurity

A number of organizations have developed food biosecurity guidelines for foodservice operations. The National Restaurant Association (NRA Education Foundation, 2014) encour-ages foodservice managers to have a food defense program that addresses points in the operation where food is at risk for tampering. The FDA Center for Food Safety and Applied Nutrition developed food security preventive measures guidance for food processors and retailers (see www.foodsafety.gov). The guidance documents, based on the acronym A.L.E.R.T., identifies measures that can be taken by foodservice operators to minimize the risk of food being subjected to tampering or criminal or terrorist actions as Assure products received are from safe sources, Look (monitor) the security of productions in the operation, Employees know who should or should not be in the area, Report and keep information related to food defense accessible and Threat, and identify what you will do and who you will contact if there is suspicious activity.

sanitation

A properly designed foodservice facility is basic to maintain a high standard of sanitation. The first requirement for a sanitary design is cleanability, which means the facility has been arranged so that it can be cleaned easily. Equipment and fixtures should be arranged and designed to comply with sanitation standards, and trash and garbage isolated to avoid contaminating food and attracting pests. For a facility to be clean is not enough; it must also be sanitary. Although the two words are often used synonymously, clean means free of physical soil and organic matter (Fraser & Pascal, 2010). These objects may look clean on the surface but may harbor disease agents or harmful chemicals. Sanitary means "the application of cumulative heat or chemicals on cleaned food contact surfaces that, when evaluated for efficacy, is sufficient to yield a reduction of 5 logs, which is equal to a 99.999% reduction, of representative disease microorganisms of pub-lic health importance" (Food Code, 2013). Cleaning and sanitizing are both issues of concern in the maintenance of foodservice facilities and equipment, and together they form the basis for good housekeeping in foodservice operations. Any surface (counters, utensils, equipment) in a foodservice operation that touches food must be cleaned, rinsed, sanitized, and allowed to air dry.

food safety programs

A well-designed food safety program monitors all food production activities for errors in handling and eliminates those errors. Critical control points (CCPs) must be identified, standard operating procedure put in place, and a Hazard Analysis Critical Control Point (HACCP) model selected. Although the FDA publishes the Food Code as a guideline for food safety practices, indi-vidual health departments set the sanitation policies and procedures for their jurisdiction.

pre rec

According to the ISU HACCP Information Center, the basis of a strong HACCP program is having the necessary prerequisite programs in place. Those prerequisite programs include: • Sanitation standard operating procedures • Quality management • Employee education and training • Personal hygiene • Safe food-handling and storage practices • Temperature monitoring • Specifications and suppliers • Food recalls and disaster plans • Equipment monitoring and calibration • Preventative maintenance programs • Integrated pest management

control points

After determining the critical control points, methods have to be established to avoid break-downs in those problematic areas. Monitoring must be in place to make sure the controls are work-ing successfully. Detailed recordkeeping, such as temperature checks, also is part of the HACCP, as is verification of cleanliness (e.g., conducting laboratory tests for bacteria). The HACCP pro-gram requires a lot of recordkeeping, which may present challenges for small operations. HACCP implementation does not eliminate the risk of foodborne illness. Contamination problems may be reduced, but the possibility of mishandling food remains real throughout the food chain. By charting the flow of food through the operation, points can be identified where con-tamination or growth of microorganisms can occur. Often similar food items (like cold meat sandwiches or cream soups) can be grouped together under one HACCP plan as they will fol-low the same flow through the operation and have the same CCPs. Implementation of HACCP

employee safety programs

Although many aspects of safety are concerned with construction and design of facilities, safe practices of employees are also a critical element in a safety program. Ergonomics is another factor of work safety. Ergonomics examines how workers interact with their work environment, including equipment, the workstation, and climate; it influences such factors as lighting and foot-wear, which in turn influence safety. Recommendations such as storing heaviest items on middle shelves to reduce back strain are an example of an ergonomic employee safety recommendation. Equipment manufacturers have developed equipment with built-in features such as safety valves on pressure steamers and guards on slicing and chopping machines (DOL Officially Declares, 1991). The Department of Labor went one step further and issued regulations to officially prohibit 16-and 17-year-olds from using power-driven food slicers in restaurants, especially quick-service operations. OSHA requires special "lock out tag out" practices and procedures to prevent employee injury from unexpected start-up of electrical equipment during service and maintenance.

Employee safety

An accident is frequently defined as an event that is unexpected or the cause of which was unforeseen, resulting in injury, loss, or damage. An accident is also an unplanned event that interrupts an activity or function. Although they may or may not be the result of negligence, many accidents can be prevented. Safety is every employer's responsibility. Accidents do not just happen—something causes them, and the majority are controllable (Somerville, 1992). Ac-cording to Goetsch (2010), the most common causes of workplace accidents are overexertion (employees working beyond their physical limits), impact accidents (employee being struck by or against an object), and falls. Filiaggi and Courtney (2003) indicated that the most common injuries in restaurants were sprain/strains (34%), cuts/punctures (18%), burns (10%), bruises (10%), fractures (7%), and all other types of injuries (21%). Schweitzer (2010) encouraged inclusion of the following major components in a best-practices foodservice safety program:

choking

Approximately 60% of all choking incidents occur in restaurants (Herlong, 1991). Prior to 1974, when the Heimlich maneuver was introduced, about 20,000 choking fatalities occurred each year; currently about 2,000 to 3,000 occur. Laws on first-aid training requirements vary by state. Some states require only that restaurants post Heimlich maneuver instructional diagrams where all employees can see them, but others require formal training for foodservice employees as well as posting of instructions. The National Restaurant Association, the American Red Cross, and the Heimlich Institute all provide charts and instructional materials on the Heimlich maneuver.

step

At each step in the flow of food through operation, risk, which is a chance that a condi-tion in foodservice will lead to a hazard, can occur (Spears, 1999). A hazard is considered an unacceptable contamination. As risks are determined, managers need to identify critical control points, defined as a step or procedure in a foodservice process at which control can be applied and a food safety hazard can be prevented, eliminated, or reduced to acceptable levels. The ob-jective is to identify the points during the production process where food is most likely to be contaminated (Dulen, 1998). Having a HACCP program in place is required by federal agencies, accrediting bodies, or local health departments for many foodservice operations. The USDA (2005), the National Restaurant Association (2004), the Institute of Child Nutrition (2002), and the Iowa State Uni-versity (ISU) HACCP Information Center (www.extension.iastate.edu/foodsafety/HACCP) have developed manuals and materials to help foodservice managers develop HACCP plans and pro-cedures for their foodservice operations.

bacteria

Bacteria are microscopic, unicellular organisms of varying size and shape, includ-ing spherical, rod, and spiral. According to the CDC, the most commonly recognized foodborne infections are those caused by the bacteria Campylobacter, Nontyphoidal Salmonella, Staphylo-coccus aureus, and Escherichia coli O157:H7 (information from www.cdc.gov, 2010). Although requirements for growth vary among different types of bacteria, all bacterial cells pass through various phases (McSwane, Rue, Linton, & Williams, 2004). When the multi-plication of bacteria is steady, the number of cells produced over a certain period of time can be plotted.

Anaerobic

Bacteria differ in their need for oxygen for growth. Aerobic bacteria need oxygen to grow; anaerobic bacteria reproduce without oxygen. Multiplication of bacteria is affected by available moisture in food. The amount of water available to support bacterial growth is termed water activity (Aw). Bacteria need a water activity higher than 0.85 to grow (McSwane et al., 2004). Water becomes less available through the pres-ence of solutes such as salt and sugar, through freezing, or through dehydration. Various inhibitors have a pronounced effect on bacterial multiplication and death. According to Longrée and Armbruster (1996), inhibitors may be integral in the food, developed during pro-cessing as a product of the microorganism's metabolism, or added purposely by the processor. The benzoic acid in cranberries and lysozyme in egg whites, for example, are natural inhibitors of these foods. Alcohol produced in the growth and fermentation of yeast, in fruit juices, or in the produc-tion of wine is an example of an inhibitory substance that may accumulate and become toxic. Some bacteria produce toxins in food as they grow and die. The toxin often cannot be de-stroyed by heating or freezing and can cause illness or death.

natural toxins

Biological contamination can occur from the microorganisms themselves or by the toxins produced from these microorganisms. Fish, shellfish, and mushroom toxins are examples. These toxins cannot be killed by freezing, cooking, or curing; thus, they are passed on to the humans consuming them. Fish toxins include histamine, ciguatoxin, saxioxin, bretoxin, and domoic acid.

campylobacter

Campylobacter jejuni was a well-known pathogen in veterinary medicine before it was considered a human pathogen. It is now recognized as one of the most common causes of gastroenteritis in humans, termed Campylobacteriosis or Campylobacter enteritis. A pathogen of cattle, sheep, pigs, and poultry, it is present in the flesh of these food animals and thus may be introduced into the food supply. It is particularly common in poultry; the FDA cites survey estimates that 20-100% of raw poultry is infected with C. jejuni (see Bad Bug Book at www.fda.gov). Properly cooking food and preventing cross contamination between raw and cooked foods are recommended preventative practices.

high acid foods

Chemical contamination can occur when high-acid foods are prepared or stored in metal-lined containers. Poisoning may result if brass or copper, galvanized, or gray enamelware containers are used. Fruit juices should never be stored in enamelware coated with lead glaze or tin milk cans. Cases of poisoning have been recorded that are attributed to use of improper metal utensils. Sauerkraut, to-matoes, fruit gelatins, lemonade, and fruit punches have been implicated in metal poisonings. Toxic metals also have been implicated in food poisoning cases. Copper may become poison-ous when it is in prolonged contact with acid foods or carbonated beverages. The vending industry voluntarily discontinued all point-of-sale carbonation systems that do not completely guard against the possibility of backflow into copper water lines (backflow may dissolve the copper). Also, food such as meat placed directly on cadmium-plated refrigerator shelves may be rendered poisonous.

chemical contamination

Chemical contamination occurs when substances such as chemicals, toxic metals, or sanitizers are introduced into a food product (NRA Education Foundation, 2014). The following are exam-ples of chemical contamination that can occur in a foodservice operation: • Contamination of food with foodservice chemicals, such as pesticides, detergents, and sanitizers • Use of excessive quantities of additives, preservatives, and spices • Acidic action of foods with metal-lined containers • Contamination of food with toxic metals Pesticides are chemicals that kill or discourage the growth of pests, which are defined as organisms that cause damage to food, making it inedible, unappealing, or unsafe (Chaisson, Petersen, & Douglass, 1991). Pesticides typically are applied to crops growing in the field but also may be applied after harvest to prevent insect or mold infestation during transport or stor-age. Much research is being conducted on ways to reduce reliance on applied pesticides.

receiving complaints

Cheney (1993) suggested the fol-lowing steps for receiving a complaint: • Obtain all the pertinent information including the names and addresses of all party mem-bers, the employee who served the meal, the date and time of the customer's visit, and the suspect meal. • Remain concerned and polite, but do not admit liability or offer to pay medical bills. • Never suggest symptoms, but let the complainant tell his or her own story. • Record the time that the symptoms started, which will help in identifying the disease and determining the foodservice operation's responsibility. • If possible, try to get a food history of all the meals and snacks eaten before and after the person ate the suspect meal. • Never offer medical advice; gather information but do not interpret symptoms. All foodservice operations should have a crisis management plan in place for handling food safety complaints. Figure 8-12 details steps for developing a crisis plan.

Citations

Citations are issued by an OSHA area director upon review of the compliance officer's in-spection report if standards or rules have been violated. Several kinds of violations are possible, which may involve fines or legal action if the violation is sufficiently serious. Many hospitals will have an Occupational Safety Officer, or Department of Occupational Safety that consists of several individuals, who works with managers in all departments to en-sure compliance with OSHA and other health and safety regulations. Foodservice accidents and health inspections are monitored by this individual.

clostridium botulinum

Clostridium botulinum produces a toxin that affects the nervous system and is extremely dangerous. The disease, botulism, is the food intoxication caused by this bacte-ria. Improved food processing techniques have led to greatly reduced incidence of botulism, al-though inadequately processed home-canned foods are still frequently associated with botulism. Meats, fish, and low-acid vegetables have been found to support toxin formation and growth. Precautions for avoiding botulism include procuring foods from safe sources, rejecting home-canned products and low-acid products, destroying canned goods with defects such as swells or leaks, storing foods under recommended conditions, and using appropriate methods for thawing frozen foods. In addition to improperly processed products, other suspicious foods include smoked, vacuum-packed fish; garlic products packed in oil; grilled onions; baked potatoes; turkey loaf; and stew. Sous vide products offer a potential risk because they are vacuum packaged. Soil-grown vegetables, particularly potatoes, can be prime carriers of this toxin.

clostridium

Clostridium perfringens is a common inhabitant of the intestinal tract of healthy animals and human beings and occurs in soil, sewage, water, and dust and causes the illness Clostridium perfringens gastroenteritis. The infected food has invariably been held at room temperature or refrigerated in a large mass at the inappropriate temperature for several hours. Meats, poultry, meat mixtures, and gravies are frequently implicated. Overnight roasting of meat has been a contributing factor in some cases because of the low temperatures often used. Prevention of C. perfringens multiplication can be achieved by refrigerating foods at 40°F or below or holding them at 145°F or higher. In addition, rapid cooling of cooked foods is an im-portant practice.

Cold Chain Management

Cold chain management, temperature control throughout the supply chain delivery pro-cess, has become increasingly important in the foodservice industry. The focus is on maintaining a temperature-controlled environment throughout the distribution and storage stages of a food product. Cold chain management would involve, for example, tracking the temperature of meat from the time it was initially processed at a meat packing plant through storage and transportation until it reached the foodservice operator to ensure that the temperature of the product was maintained at acceptable levels throughout the supply chain stages. This often involves use of refrigerated or frozen trucks, insulated containers, temperature data logger devices, and closely monitored conditioned storage units in warehouses.

safety and health act

Congress passed the Occupational Safety and Health Act in 1970. The purpose of the act is "to assure, so far as possible, every working man and woman in the Nation safe and healthful work-ing conditions, and to preserve our human resources." OSHA allows a compliance officer to enter a facility to determine adherence to standards and to determine if the workplace is free of recognized hazards. During an OSHA inspection, some of the specific conditions for which the compliance officer will be searching include the following: • Accessibility of fire extinguishers and their readiness for use • Guards on floor openings, balcony storage areas, and receiving docks • Adequate handrails on stairs • Properly maintained ladders • Proper guards and electrical grounding for foodservice equipment • Lighted passageways, clear of obstructions • Readily available first-aid supplies and instructions • Proper use of extension cords • Compliance with OSHA posting and record keeping requirements

Contamination

Contamination is the presence of harmful substances in food. Contamination can occur naturally or be caused by humans or the environment. Contamination of food typically is categorized as biological, physical, or chemical. The extent of contamination of some foods may be difficult to determine from their appearance, odor, and taste; in other foods, mold, discolored or altered appearance, off-odors, or off-flavors are obvious signs of contamination.

customer controls

Control of contamination from customers is more difficult, but various as-pects of facility design or policies and procedures can assist in this arena. Sneeze guards on a service counter or salad bar can help reduce the spread of bacteria as can isolation procedures for a patient hospitalized with a highly communicable disease. Maintaining the safety of food served to customers from salad bars can be challenging. Customers often spill food around or in other containers. Observations have been reported of poor sanitation practices such as customers using fingers to pick up items or to dip into the salad dressing to taste it or returning with an already eaten from plate for refills. Sneeze guards are provided with salad bars to help reduce the chance of contamination; however, depending on the configuration of the salad bar, customers may place heads under the sneeze guards to better see and choose items.

cross contam

Cross-contamination can occur in production and service when improper food-handling practices are used. Cross-contamination can occur from the following actions: • Using a cutting board to cut raw meats and then not cleaning and sanitizing it properly before using that same cutting board to cut produce • Handling raw meat or poultry and then not washing hands appropriately before handling ready-to-eat products

Cyclospora cayetanensis 2

Cyclospora cayetanensis is a microscopic parasite composed of a sin-gle cell. Cyclospora infection often is found in people who live or travel in developing countries and consume contaminated water or fresh produce washed in contaminated water. Time between becoming infected and showing symptoms usually is a week or longer.

hygiene

Employee personal hygiene and good food-handling practices are basics of a food safety program in a foodservice facility. One major risk is that unsani-tary employees can contaminate, or infect by bacteria, food products in production and service (Beasley, 1993). When interviewing prospective employees, managers should note their per-sonal grooming habits and appearance. Employees who practice poor hygiene at home and at work can be the cause of outbreaks of foodborne illnesses. Foodservice managers, therefore, should emphasize the importance of food safety and sanitation to employees before hiring and then after hiring, when an educational process should begin.

cross contamination

Food safety during storage of food is another area of concern for the foodservice manager. Proper storage temperatures were discussed in Chapter 5. Proper storage practices should pre-vent cross-contamination, the transfer of microorganisms from one food product to another, by storing raw meat, poultry, and fish separate from cooked and ready-to-eat foods. Raw poul-try should go on the lowest shelves. Raw ground meat should be placed on shelves above raw chicken but under raw whole meats and fish. Raw meats should be placed above raw poultry and raw ground meat but under cooked and ready-to-eat foods. Ready-to-eat foods and cooked food items should be placed on upper shelves above any raw meat, fish, or poultry. Wrapping food correctly can reduce risk of cross-contamination in the storage units. Foods placed into storage should be labeled and dated, rotated to facilitate use of oldest product first, stored in shelving that is at least six inches off the floor, and held at the proper temperature. Food items should be stored in durable, leakproof containers that are intended for food use. Food should never be stored in empty chemical containers or in plastic garbage bags. Chemicals need to be stored separately from food products.

bacteria 2

Figure 8-3 shows a typical bacterial growth curve. The growth curve typically is divided into four phases as follows: • Lag phase—initial stage where, although bacterial cells exist, little to no growth occurs • Log phase—a period of rapid growth in a relatively short period of time • Stationary phase—the rate of growth is slowed and eventually stops as bacterial cells be-gin to die • Death phase—bacterial cells die more rapidly, new cells are created due to lack of nutri-ents and the excess waste the cells create Food is the most important condition needed for bacterial growth (McSwane et al., 2004). Foods high in protein or carbohydrate are the most supportive of bacterial growth.

flies

Flies are a greater menace to human health than cockroaches. They transmit foodborne illnesses because they feed on human and animal wastes and garbage. Flies enter the facility primarily through outside doors or other external openings. Control can be facilitated by having tight-fitting and self-closing doors, closed windows, and good screening. Screened or closed storage for garbage is also important. Control, however, should be handled by a licensed PCO. Fruit flies are small, flying insects usually congregating around food. They typically breed in warm, moist areas such as floor drains. A licensed PCO can help with their control (NRA Edu-cation Foundation, 2014).

allergy

Food irradiation is classified as a food additive and is regulated by the FDA. It controls microbes responsible for foodborne illness and extends the shelf life of refrigerated foods, such as fresh fruits and vegetables, by delaying ripening. It also extends the shelf life of stored foods like spices and dried herbs. A food allergy is the body's immune system reaction to certain foods. Symptoms of an allergic reaction include itching or swelling in or around the mouth, face, and scalp; tightening in the throat; wheezing or shortness of breath; hives; abdominal cramps, vomiting or diarrhea; loss of consciousness; and even death. (NRA Education Foundation, 2014). Food allergens are primarily protein in nature. Some of the most common food allergens include peanuts and tree-nuts, milk and dairy products, eggs, shellfish, wheat, and soy. According to physicians at the Mayo Clinic (www.mayoclinic.com) food allergies affect 6 to 8% of young children and about 4% of adults. Labeling of foods with these allergens, having waitstaff be able to describe ingre-dients, and avoiding cross-contamination in food production areas will help reduce the chance of allergic reactions by customers.

food safety in storing

Food safety starts in the receiving area of a food-service operation. Deliveries should be made in off-peak hours to allow sufficient time to inspect deliveries carefully. Both the temperature and condition of packaging should be inspected at deliv-ery. Food safety criteria to check in receiving include (NRA Education Foundation, 2006, 2010): • Meat. 41°F or below; bright red color; firm, nonslimy texture; no odor; intact and clean packaging • Poultry. 41°F or below; no discoloration; firm; no odor; frozen or packed in crushed, self-draining ice • Fish. 41°F or below; bright red gills and bright shiny skin; firm flesh; mild ocean or sea-weed smell; bright, clear full eyes; frozen or packed in crushed, self-draining ice • Shellfish. Live on ice or at temperature of 45°F or below; shucked at internal temperature of 45°F or below; mild ocean or seaweed smell; unbroken shells; closed shells if alive; shellstock identification tags (packer's name, address, and certification number) on con-tainer (manager must date when the last shellfish was served and then keep tags on file for 90 days from date) • Shell eggs. Temperature of 45°F or below; no odor; clean and unbroken shells • Liquid, frozen, dried eggs. Must be pasteurized and have a USDA inspection mark • Dairy. Temperature of 41°F or below; milk must be pasteurized and comply with FDA Grade A standards; cheese with typical flavor, texture, and uniform color • Canned goods. Can and seal in good condition (no swollen ends, leaks, dents) • Dry goods. Intact packaging (no holes, tears, punctures, water stains) • Produce. Temperature of 41°F or below for fresh cut greens, melons, tomatoes, or other processed produce

approved source pg 234

Food should be purchased from approved, reputable suppliers. Foodservice managers should visit and inspect the vendor's facilities to assure they are using Good Manufacturing Practices (GMP) or Good Agricultural Practices (GAP).

preservatives

Foodservice chemicals, including detergents, polishes, caustics, and cleaning and drying agents, are poisonous to humans and should never come in contact with food. Labels should be read carefully for directions on how to use and store these products under safe conditions away from food. Preservatives used to preserve the flavor, safety, and consistency of foods have been linked to food contamination. Additives, which are used to enhance appearance and/or flavor of products, also can become a chemical contaminate if used in excess or if given to someone with a sensitivity or allergy to the product. Several preservatives and food additives, when used in excessive amounts, have caused illness. Nitrites, for example, are preservatives used by the meat industry to prevent growth of cer-tain harmful bacteria and as a flavor enhancer (NRA Educational Foundation, 2004). Scientists have established a link between cancer and nitrites when meat containing them is overbrowned or burned. As a result, the meat industry has decreased levels of nitrites in meats.

bacillus cereus

Foodservice managers are beginning to be concerned about the B. cereus toxin, which is found in soil and, therefore, gets into many foods once thought to be safe (NRA Educa-tional Foundation, 2014). B. cereus bacteria are found in grains, rice, flour, spices, starch, and in dry mix products such as those used for soups, gravies, and puddings and can cause Bacillus ce-reus gastroenteritis. Time and temperature are very important in preventing rapid increase in the vegetative bacteria and development of spores. Foods should not be held at room temperature for any period of time, but should be held hot or quickly chilled to at least 40°F.

risk management

Foodservice operators are encouraged to implement an operations risk management (ORM) process to prioritize the preventive measures that are most likely to have the greatest im-pact on reducing the risk of food security problems. USDA's Food & Nutrition Service released Biosecurity Checklist for School Foodservice Programs: Developing a Biosecurity Management Plan (2004) to assist school foodservice directors with their food biosecurity planning. The As-sociation of Nutrition & Foodservice Professionals (www.anfponline.org) offers the following suggestions for food protection: • Awareness—be alert to unusual activity in and around your operation • Procurement—use reputable suppliers and inspect deliveries carefully • Access—control access to foodservice operation • Personnel Management—screen applicants carefully and document, post, and enforce employee schedules • Monitoring—observe employees and customers and check less used areas • Planning—have detailed response plans in place that include call lists • Education—educate employees on the role they need to play in helping monitor and report unusual occurrences

fungi

Fungi includes single and multicellular organisms such as molds, yeasts, and mushrooms. Molds are larger than bacteria and more complex in structure. In general, they grow on a wide range of substrates—moist or dry, acid or nonacid, high or low in salt or sugar. Molds also grow over a wide range of temperatures, although the optimum temperature is between 77°F and 86°F. Because mold growth may appear as highly colored, cottony, powdery, or fuzzy tufts and patches, it is probably the most common type of spoilage that can be identified by the naked eye. Some food products, such as Gorgonzola and blue cheese, have mold as a natural component of the product. Yeasts are not known to cause foodborne illnesses, but they may cause spoilage of sugar-containing foods. They are unicellular plants that play an important role in the food in-dustry, particularly in the fermentation or leavening of beer, wine, and bread. Yeasts can induce undesirable reactions, however, resulting in a sour or vinegary taste. Mushrooms are a type of fungi. Many forms are safe to eat. Some are toxic and can cause foodborne illness if eaten (discussed in the next section).

HACCP PLAN

In November 1992, NACMCF defined seven widely accepted principles to consider when developing a HACCP plan: • Principle 1: Conduct a hazard analysis. • Principle 2: Determine the critical control points. • Principle 3: Establish critical limits. • Principle 4: Establish monitoring procedures. • Principle 5: Establish corrective actions. • Principle 6: Establish verification procedures. • Principle 7: Establish recordkeeping and documentation procedures.

Hazards

In comparison with many industrial jobs, those in hospitality are relatively safe occupations. Bureau of Labor Statistics data (www.bls.gov) found that the number of nonfatal occupational injuries at leisure and hospitality places in 2012 was 3.9 per 100 full-time employees, which was a decline from 8.4 in 1990 and was equal to the average for all industries. A foodservice facility, however, has many potential hazards; minor injuries from cuts and burns are common, and more serious injuries occur all too frequently. The quantity of hot foods handled, type of equipment used, weight and size of products lifted and moved, potential for spills, and the frequently frenetic pace of a foodservice operation require that safety conscious-ness be a high priority. Accident prevention must be a priority for foodservice managers because accidents may involve injury or even death of employees or customers.

1980

In the 1980s, a number of food-related illnesses, allergic in type, were traced to sulfites used on fresh fruits and vegetables, shrimp, dried fruit, and wine. For packaged foods, if sulfites are used, proper labeling now is required. Foodservice operators now use lemon juice or citric acid for preserving color in fresh produce as the FDA prohibits the use of sulfites on raw fruits and vegetables that are to be served or sold to customers. One foodborne illness that remains in question is that which can result from the use of too much monosodium glutamate (MSG), a food additive that serves as a flavor enhancer. Because it is often heavily used in Chinese and Japanese foods, apparent reactions to MSG have been called the "Chinese Restaurant Syndrome." MSG also is very high in sodium. Most of the symp-toms after ingestion are subjective. They include a feeling of tightening of the face and neck skin, tingling sensations, dizziness, and headache. MSG apparently affects only persons with sensitivity to MSG (Cody & Kunkel, 2002). Federal law requires that MSG be listed on the label of any product to which it is added.

IPM

Integrated pest management (IPM) is an alternate approach being used in agriculture to control pests; it is also a program in foodservice operations to prevent pests from entering an operation or to eliminate them if they do enter. In agriculture, IPM incorporates the latest ag-ricultural technologies and biological controls, including pest predators and pest diseases, to decrease the amount of pesticide used. The USDA and FDA are responsible for monitoring the food supply to ensure that residue levels are within tolerance limits. In a foodservice operation, IPM involves preventing pests' access to the operation; elim-inating sources of food, water, and nesting places for pests within an operation; and working with a licensed Pest Control Operator (PCO) to eliminate pests if they do enter the operation. The most common pests in a foodservice operation are cockroaches, rodents (mice, rats), flies, and fruit flies. Cockroaches live and breed in moist, warm, dark places, so often they are only seen by the signs they leave behind, such as a strong oily smell, droppings that look like grains of pepper, and/or capsule-shaped egg cases. Rodents, too, are often not seen, as they tend to live in holes in quiet places. Signs of rodent infestation include signs of gnawing, shiny black drop-pings, tracks on dusty surfaces, and nesting materials.

listeria

Listeria monocytogenes is the bacterium responsible for listeriosis and is widely distributed in nature. It has been isolated from feces of healthy human carriers and sheep, cattle, and poultry. It has been detected in cow's milk and has been isolated from un-washed leafy vegetables and fruit and soil. Also, the bacterium has been found in dairy and meat processing factories with some degree of frequency. Unlike other bacteria, it grows in cool, moist environments. Listeriosis disease has been linked to consumption of contaminated delicatessen food, milk, soft cheeses (like Mexican-style feta, Brie, Camembert, and blue-veined cheeses), and undercooked chicken. Preventive measures include discarding outdated products, cooking foods to the recommended internal temperature, preventing cross contamination be-tween raw and cooked foods, and avoiding unpasteurized milk.

Equipment

Maintenance of equipment and facilities is important. The safety of surroundings often is related to cleaning and maintenance practices. Two examples are spills that are not cleaned up properly, which may cause people to fall, and grease buildup in the hoods over the production equipment, which is a major cause of fires in foodservice operations.

employee

Management commitment (managers model safe behaviors, show concern and investigate employee injuries, modify work environment as needed to make it safer) • Employee involvement (employees attend safety meetings, view posted safety information, follow safe practices) • Communication (communication of required safety behaviors/practices and suggestion boxes and meetings as ways to share safety concerns) • Education and training (orientation to safety, on-the-job training for safe behaviors) • Injury reporting and treatment (forms and process for reporting injuries, mechanism for reviewing injury reports and implementing corrective action as needed) Return to work policies (detailing process/procedures for clearance to return to work) • Safety program (employee involvement, policies/procedures detailed, training) • Safety audits and inspection (conduct routine, formal inspections of operation to assure safe working environment; audit corrective action completion)

thermometer 2

Many foodservice operations have supplemented the use of thermometers with a disposable product called T-Sticks. T-Sticks are multipurpose sensor sticks used to monitor food tempera-tures and the temperature in the dishwasher's final rinse section. They help promote food safety in restaurants and other foodservice operations. They are relatively inexpensive, and employees who might not take the time to track down a thermometer find them easy to use. T-Stick 140 Plus is used for monitoring food temperatures on hot lines or steam tables; food must be held at 140°F or higher to stop growth of harmful bacteria. It turns green at 142°F to 144°F for a margin of safety. T-Stick 160 monitors the cooking temperature of hamburger, ground meat, fish, pork, and eggs and verifies temperatures in the final rinse section of the dishwashing machine. It turns black if the temperature reaches 160°F. An illustration of how to use the T-Stick 160 for cooking hamburgers is shown in Figure 8-10. T-Sticks also are used to check the final rinse temperature in a dishmachine by attaching the T-Stick to a plate and sending it through the dishmachine. The Iowa HACCP Web site (www.extension.iastate.edu/foodsafety/HACCP) contains a variety of resources to help a foodservice manager develop a HACCP program. Included is a case study detailing the process in a school, SOPs, forms for monitoring temperatures, and em-ployee training materials.

customer safety

Many of the factors discussed for employee safety also apply to customer safety. A crack in the sidewalk, an exit door that does not open, grease on the dining room floor, or a cup of hot coffee that is dropped can cause customers to have serious accidents that end in litigation. Customer safety is the responsibility of the foodservice manager and employees. Employees should be trained on steps to take in case of customer injury. A foodservice operation always should have a complete first-aid kit. Some states also have laws specifying the supplies that must be included in this kit. OSHA requires that a restaurant either have a kit equipped according to the advice of a company physician or have physical or telephone access to community emergency services. Ideally, a foodservice operation should have present at all times an employee who is trained and certified in first aid, including how to administer the Heimlich maneuver, how to give cardiopulmonary resuscitation (CPR), and how to identify potential allergic reactions.

time and temp

Many of the foodborne illness outbreaks are caused by in-adequate cooking and improper holding of food (see www.cdc.gov). Minimum, maximum, and optimum temperatures vary for the various pathogenic microorganisms; in general, however, they flourish at temperatures between 41°F and 135°F (Figure 8-7). This temperature range is commonly called the temperature danger zone because bacteria multiply rapidly within it. The Food Code (2013) indicates that TCS foods, termed time/temperature control for safety (TCS) food, should be cooled within 2 hours from 135°F to 70°F; and within 6 hours from 135°F to 41°F or less (www.fda.gov). Safe temperatures, then, as applied to TCS food, are those of 41°F and below and 135°F and above.

ciguatoxin

Many species of marine algae contain tox-ins. The toxins enter fish and shellfish that consume the algae or smaller fish who have con-sumed the algae and are passed on to humans who consume the fish. Ciguatera fish poisoning occurs with the consumption of Ciguatoxin and is found in predatory tropical reef fish such as barracuda, grouper, jacks, and snapper who eat smaller fish who have consumed the algae toxin. Saxitoxin, which causes paralytic shellfish poisoning; brevetoxin, which causes neurotoxic shellfish poisoning; and domoic acid, which causes amnesic shellfish poisoning, can be in shell-fish (clams, mussels, oysters, scallops) from contaminated waters (NRA Education Foundation, 2014). These toxins are passed on to humans when infected fish is consumed. None of these fish toxins are destroyed by cooking or freezing, thus purchasing seafood from approved, reputable suppliers is critical to help prevent illness.

Norovirus pg 229

Norovirus is a viral illness caused by poor personal hygiene among infected food handlers (NRA Educational Foundation, 2014). Because it is a virus, it does not reproduce in food but remains active until the food is eaten. It is very contagious and consuming even a small amount can make someone ill. It has been identified as the cause of several incidents of foodborne illness on cruise ships, sometimes causing the early return of the ship to port. The Norovirus (formerly known as the Norwalk virus) is rapidly increasing as a health threat. Out-breaks have occurred through water contaminated with sewage, raw shellfish harvested from polluted growing areas, and feces of infected food handlers who have not scrubbed their hands after using the toilet and transferred the virus to ready-to-eat foods. The CDC estimates that Norovirus and similar viruses account for more than half of all foodborne outbreaks of gastro-enteritis (information from www.cdc.gov, 2014). 24- 48 hr, 1-3 day illness, source is human

fire safety

More fires start in foodservice than in any other kind of business operation (NRA Educational Foundation, 1992). Oxygen, fuel, and heat are required to start and sustain a fire; most fires start with the mishandling of fuel and heat. Suppressing a fire typically focuses on reducing or elimi-nating oxygen or the source of the fuel for the fire (Goetsch, 2010). Managers must check their operations regularly and must establish procedures for han-dling any hazards that could start fires. Hot oil in fryers can burst into flames at its flammable limit of between 425°F and 500°F and be the source of a fire, or it can increase the severity of a fire that is started another way. Also, oil in ventilation systems and on walls, equipment, and other surfaces is highly flammable. Hoods over ranges and filters that are not cleaned regularly provide an ideal environment for a grease fire (Bendall, 1992). A good solution for high-volume restaurants is the extractor ventilator, which is a series of baffles on the hood to extract grease through a centrifugal action. Some have an automatic wash-down feature to clean the inside of the hood with detergent and hot water at scheduled times. Tests have shown that some of these ventilators can remove more than 90% of the grease from the air.

Human error

Most accidents are the result of human error. Employees may lift heavy loads incorrectly, leave spills on the floor, walk across freshly mopped floors, fail to use safety devices on food-service equipment, block passageways, or fail to clean greasy filters regularly. Many other un-safe practices can be added to this list. Obviously, then, training is an important part of a safety program. Employees should be taught to prevent accidents by learning to recognize and avoid or correct hazardous conditions. The first day on the job is the best time to start educating a new employee about safety procedures and equipment handling (Spertzel, 1992b).

complaints

No foodservice manager is immune to outbreaks of foodborne illness (Cheney, 1993). A cook might fail to heat up the grill to the correct temperature, a refrigerator might break down, em-ployees might forget to wash their hands before cutting meat or produce, and a supplier might deliver a contaminated product. Customers who believe their health has been harmed by food eaten in the foodservice establishment have a right to take the manager to court (NRA Educa-tional Foundation, 1995). The customer might have a legitimate grievance, and managing this crisis correctly could be difficult. When someone complains of foodborne illness, it is best practice to have that person com-plete a complaint report similar to the one shown in Figure 8-11. This will ensure that the right questions are asked even if the business is hectic at the time.

salmonella

Nontyphoidal Salmonella frequently has been associated with foodborne illnesses and causes salmonellosis. The bacterium does not release toxins into the food in which it multi-plies; rather, the ingested cells continue to multiply in the intestinal tract of the victim, causing illness. The primary source of Nontyphoidal Salmonella is the intestinal tract of carrier animals. A carrier appears to be well and shows no symptoms or signs of illness but harbors causative or-ganisms. Various insects and pets may be reservoirs of Nontyphoidal Salmonella. Food animals are important reservoirs, especially hogs, chickens, turkeys, and ducks. The disease salmonello-sis is spread largely by contaminated food and is believed to be one of the major communicable diseases in the United States. A number of raw and processed foods have been found to carry Nontyphoidal Salmonella, especially raw meat, poultry, shellfish, processed meats, egg products, and dried milk. Meat mix-tures, dressings, gravies, puddings, and cream-filled pastries are among the menu items frequently indicated in salmonellosis. Food handlers and poor sanitation practices are often associated with outbreaks. Care must be exercised in production, storage, and service to ensure that food is not held for long periods at warm temperatures, cooled slowly, or cut on contaminated surfaces. Another form of salmonella is Salmonella typhi, which causes typhoid fever. This organ-ism lives in the intestinal tract and bloodstream of humans who have typhoid fever. It is passed to others when poor handwashing is not practiced by infected individuals. It is most commonly transferred on ready-to-eat food items.

safety training

Obviously, safety training must have major emphasis in both initial and in-service employee training. Many resource materials on safety and accident prevention are available, such as those of the National Safety Council and the American Red Cross. Also, personnel from state and local fire prevention agencies are often available as speakers. The National Restaurant Association (www.restaurant.org) has published a variety of workplace safety training materials and mini-posters to help foodservice managers continually improve the safety in their operation. The Institute of Child Nutrition (ICN) (www.nfsmi.org) also has posters and training materials available for foodservice managers to use to train employees.

prions

One of the newest foodborne disease concerns is a group of organisms termed prions (PROteinaceous INfectious particle). According to Cody and Kunkel (2002), prion proteins are small glycosylated protein molecules found in brain cell membranes. Prion diseases, often termed transmissible spongiform encephalopathy (TSE), are infectious diseases of the brain that can occur in both animals and humans. The disease is termed bovine spongiform encephalopathy (BSE) (mad cow disease) in cattle, scrapie in sheep, chronic wasting disease in deer and elk, and Creutzfeld Jakob disease (CJD) or Gerstmann Sträussler syndrome (GSS) in humans. Prions are extremely resistant to heat; heating to 100°C often does not inactivate them. Prion diseases are transmissible between species. The period of time between infection and appearance of clinical symptoms can be years. The disease course in humans includes behavioral changes, ataxia, progressive dementia, and death (Cody & Kunkel, 2002).

SOP

One of the prerequisite programs is documentation of Standard Operating Procedures (SOPs). SOPs are written, step-by-step instructions for routine tasks. SOP checklists and sam-ples can be found at the online ISU HACCP Information Center. An example of an SOP for handwashing is included in Figure 8-8. In a HACCP program, temperatures must be monitored and recorded. Placing deep containers of hot foods, especially soups and stocks, in refrigeration units is one of the most often-cited cases of food safety risk. Not only does hot food not reach recommended safe temperatures within the specified time frame, but the heat from the containers can raise the temperatures in refrigerators. Hot foods should be put into shallow pans before refrigeration to speed the cooling. Blast chillers can help reduce very quickly the temperature of these foods. Results of study on cooling confirm these recommendations. Olds and Sneed (2005) found that a 3-gallon pot of chili placed in a walk-in refrigerator took more than 24 hours to cool from 135°F to 70°F (Olds & Sneed, 2005). When hot chili was placed in a 2-inch pan in the walk-in refrig-erator, it cooled from 135°F to 70°F in 7 hours. A 2-inch pan of chili cooled in a blast chiller dropped from 135°F to 70°F in less than 2 hours.

parasites

Parasites are living organisms that need a host to survive. They include Trichinae, Anisakis simplex, Cryptosporidium parvum, Giardia duodenalis or G. lamblia, and Cyclospora cayetanensis.

pathogens

Pathogens can be categorized as bacteria, viruses, parasites, fungi, and natural toxins. They are found everywhere that temperature, moisture, and substrate favor life and growth. Some spe-cies are valuable and useful in preserving food, producing alcohol, or developing special flavors if they are specially cultured and used under controlled conditions. Other microbial activity, however, can be a primary cause of foodborne illness or intoxication. Foodborne microorganisms need the right conditions to grow. FAT TOM is an acronym used to identify the ideal conditions for foodborne microorganism growth (NRA Education Foundation, 2014): • F is for Food: specifically carbohydrates and proteins • A is for Acidity: a pH of 4.6 to 7.5 is ideal T is for Temperature: growth is best between 41°F and 135°F (5°C and 57°C) • T is for Time: food should be in the temperature danger zone for limited amounts of time • O is for Oxygen: some need oxygen, others do not • M is for Moisture: water activity (Aw) of 0.85 or higher is ideal for growth

PPE

Personal Protective Equipment (PPE) items are used to help protect the foodservice worker from injury or illness. Examples of PPE use include: wearing protective glasses and rubber gloves when deliming the dishmachine to protect the eyes and hands from harsh chemicals; using stain-less steel mesh gloves when cleaning the slicer to prevent cuts; or wearing asbestos arm guards when working over a hot grill. PPE and special cleaning materials must be used when cleaning up spills of blood or other body fluids. Most organizations will have a procedure and special chemicals to use for cleaning up such spills. The process involves wearing protective gloves, using chemicals such as isolyzers and disinfectants, and following specific time and process guidelines.

physical contamination

Physical contamination occurs when particles that are not supposed to be in a food product are accidentally introduced into that product (National Restaurant Association [NRA] Educational Foundation, 2014). Chips of glass or metal from broken glasses or enamelware dishes are obviously dangerous. Metal curls from a worn-out can opener can fall into the food when the can is being opened. Other physical contaminants would include staples from cartons, fingernails or hair, dirt, bones, jewelry, or fruit pits. Dangers caused by physical contaminants may result from tampering incidents, particularly with soft-packed food items. Food items delivered to the food-service operation should be rejected if evidence of tampering is seen.

food safety in purchasing

Possibilities for contamination of food before it is purchased include contaminated equipment, infected pests and animals, untreated sewage, un-safe water, and soil, as shown in Figure 8-5. After purchase, possibilities of contamination ex-ist in storage, preparation, and service of food. Following human consumption, illness occurs. Figure 8-6 illustrates the possible transmission routes from infected persons through respira-tory tract discharges, open sores, cuts, and boils, or through hands soiled with feces into food being prepared. The consumed food then completes the transmission to other persons. The USDA's Economic Research Service (www.ers.usda.gov) reports that imports are very common in the American diet. In 2013, nearly $105 billon in food was imported into the United States. Nearly 70% of all the fish and shellfish consumed in the United States in 2012 were imported, as were 35% of fruits and nuts, 20% of vegetables, and 10% of red meat. Im-ported foods, particularly produce, have been linked to a growing number of foodborne illness outbreaks. Foodservice operators can avoid potentially contaminated food items by using repu-table producers and suppliers, who should comply with growing and transportation standards set by the Produce Marketing Association.

facilities

Proper cleaning of food production and service surfaces and equip-ment is an important component of any food safety program. The Food Code (2009) stipulates that room temperature food contact surfaces used in the preparation of TCS foods need to be cleaned at least every 4 hours.

food safety in production

Safety of the food supply during production and service needs to focus on food products and how they are handled. Also of importance are the hygiene and practices of employee and cleanliness of facilities and equipment.

Safety Sanitation of Maintenance

Safety, sanitation, and maintenance are critical in a foodservice operation. As a future foodservice manager, you will be responsible for ensuring the safety of your employees and customers. An important component of this safety will be the sanitation and maintenance of your equipment and facility. In this chapter, we will discuss the safety, sanitation, and maintenance subsystem of the foodservice system model. Emphasis will be placed on food safety and techniques that you as a manager can implement to help ensure food safety in your operation. Concepts such as risk management and solid waste management also will be discussed.

functional subsystem

Safety, sanitation, and maintenance is the last major functional subsystem in the foodservice system, and it permeates all other subsystems (Figure 8-1). Ensuring safety in a foodservice operation is a major responsibility of the manager of that operation. This responsibility includes the safety of employees and guests of that operation and the safety of the food served. Risk management activities often focus on safety issues.

histamine

Scombroid poisoning occurs when persons consume scombroid and related species of fish (tuna, mackerel, mahi mahi) that have been time/temperature abused and bacteria on the fish have produced high levels of histamine. This histamine is a toxin that causes allergic reactions such as headache, burning in throat and mouth, reddening of the face and neck, and sweating.

factors

Several factors will affect the cleaning process. • Type and condition of dirt—certain types of dirt require special cleaning methods • Water hardness—cleaning is more difficult with hard water as the minerals in the water react with the cleaning detergent and decrease its effectiveness • Water temperature—hot water aids in dissolving detergent and loosening dirt • Surface to be cleaned—some surfaces require special cleaning supplies and techniques • Agitation or pressure—additional pressure may be needed to remove dirt • Length of treatment—longer exposure to detergent makes cleaning easier Cleaners are chemicals that are used remove food, dirt, and other deposits. Four types of cleaners are commonly found in foodservice operations (NRA Education Foundation, 2013): • Detergents—used to remove dirt from surfaces (floors, walls, counters, equipment) • Abrasive cleaners—contain abrasive agent(s) to help more difficult to remove dirt • Degreasers—used to remove grease from surfaces (ovens, grills, hoods) • Delimers—used to remove mineral deposits (dishmachines, steam wells)

Cyclospora cayetanensis

Several parasites are found in feces of contaminated individuals or contaminated water, including Cyclospora cayetanensis, Cryptosporidium parvum, and Giardia duodenalis (G. lamblia or G. intestinalis). These para-sites sometimes are transmitted when improperly treated water is used to irrigate produce and that produce is not washed properly before eating. Infected individuals also can transmit the parasite to others, if proper handwashing practices are not used.

shigella

Shigella spp. is a bacteria that causes the foodborne illness, shigellosis, sometimes called bacillary dysentery. It is an infection that occurs 1 to 7 days after the ingestion of the bacteria. Humans are the prime reservoir for Shigella. Carriers excrete Shigella in their feces and transmit the bacteria to the food if they do not wash their hands properly. Flies also are thought to carry the bacteria. Foods involved are raw produce and moist-prepared foods, such as potato, tuna, turkey, and macaroni salads that have been handled with bare hands during preparation. Shigellosis can be prevented if employees wash their hands after using the toilet, if food is rap-idly cooled, and if flies are controlled.

Food borne infections

Some bacteria produce toxins in food as they grow and die. The toxin often cannot be de-stroyed by heating or freezing and can cause illness or death. Foodborne infections are caused by the activity of large numbers of pathogenic bacterial cells carried by the food into the gastrointestinal system of the victim and causing illness. Food-borne intoxications are caused by toxins formed in the food prior to consumption. Consump-tion of the toxins causes the illness. The symptoms from ingesting toxin-containing food may occur within as short a period of time as 2 hours. The incubation period of an infection, however, is usually longer than that of an intoxication. Tables 8-1 and 8-2 summarize information about various pathogenic bacteria that can cause foodborne illness or intoxication. Symptoms of each are frequently severe and commonly include nausea, cramping, vomiting, and diarrhea.

food borne pathogens

The CDC is expanding its prevention efforts to focus on heading off new foodborne pathogens, specific causes of diseases such as bacteria or viruses that can be spread globally by foods tainted with low-level contamination. The CDC has developed the PulseNet system, which will help public health experts determine whether the illnesses are from the same strain or from a common exposure source. PulseNet is a national network of public health laboratories that per-form a "fingerprinting" on bacteria that may be foodborne. PulseNet provides an early warning system for outbreaks of foodborne disease by having bacteria "fingerprinting" data on a central CDC computer that is linked to state and local health departments (see www.cdc.gov/pulsenet).

Staph

Staphylococcus aureus, a bacterium commonly referred to as staph or S. aureus, is the principal causative agent in the foodborne illness, Staphylococcal gastroenteri-tis. The staph bacteria can produce a toxin when allowed to grow in large numbers. Staphylo-coccal intoxication is a fairly frequent cause of foodborne illness, with foods high in protein the usual culprits. Cream pies, custards, meat sauces, gravies, and meat salad are among the prod-ucts most likely to be involved in foodborne intoxication. The appearance, flavor, or odor of the affected food items are not noticeably altered. Temperatures must be carefully controlled to pre-vent multiplication of staphylococci in food. The organism multiplies even under refrigeration if temperatures are not sufficiently low or if the cooling process does not proceed rapidly enough.

thichinae

Trichinosis is a foodborne disease that affects the muscles of the body and is caused by the Trichinae parasite. Anyone who eats undercooked meat from infected animals can de-velop trichinosis. Although once common in pork and pork products, improved livestock pro-duction practices of using controlled feed rather than allowing pigs to eat garbage has nearly eliminated its existence in pork products. Wild animal meat is the primary sources of trichinella. This disease is preventable, however, if food is cooked to a proper end-point temperature. The USDA Food Safety and Inspection Service recommend that pork be cooked to an end tempera-ture of 160°F.

food safety

The Centers for Disease Control and Prevention (CDC) warns that the mishandling of food has caused many foodborne outbreaks in the foodservice segment of the industry where food is prepared and served to the public. Food protection began in the early 1900s when the U.S. Public Health Service (PHS) studied the role of milk in the spread of disease. Model codes were developed to help state and local governments start and maintain effective programs for the prevention of foodborne illnesses. The Food and Drug Administration (FDA), Food Safety and Inspection Service (FSIS), and CDC jointly published the Food Code (2013) (see www.fda.gov). It is a reference document for regulatory agencies responsible for overseeing food safety in retail outlets such as restaurants, grocery stores, and institutions (nursing homes, hospitals, schools, childcare centers, etc.). It may be adopted and used by agencies at all levels of government that are responsible for managing food safety risks. The model Food Code provisions are designed to be consistent with federal food laws and regulations and are written for ease of legal adoption at all levels of government. Since publication of the first version of the Food Code in 1997, important progress has been made in efforts to monitor and prevent foodborne diseases and ensure that consumers are provided the safest possible foods.

HACCP

The Hazard Analysis Critical Control Point (HACCP) concept refers to a model developed initially for quality control in the food processing industry, with special emphasis on microbial control. Critical control points are those steps in production processing in which loss of control would result in an unacceptable safety risk. HACCP is a preventive approach to quality control, identifying potential dangers for corrective action. The HACCP program was developed in 1971 for the National Aeronautics and Space Ad-ministration (NASA) to be sure food fed to astronauts in outer space is absolutely safe. The system had to ensure zero defects in handling food during processing. It had to correct errors before they happened rather than sample finished products to identify those with high levels of contamination (Dulen, 1998).

national fire association

The National Fire Protection Association has identified ABC classes of fire, which are described in Figure 8-2 along with the types of extinguishers for each. The foodservice manager should know the differences among the extinguishers and purchase the proper kind. The local fire department usually is willing to demonstrate extinguishers. In addition to fire extinguishers, heat and smoke detection devices and some form of fire protection, such as dry/wet chemicals, should be installed over cooking equipment. Water mist operates from the building's water sprinkler, which has an unlimited supply of water, and is effective in suffocating most types of fires. Dry/wet chemicals in containers are piped to outlet nozzles above each piece of equipment; once the chemicals are discharged, they have to be replaced immediately to provide continuing fire protection. In many states, a state fire marshal has responsibility for approving the design and construction of buildings from a safety and fire protection standpoint.

reduce violence

The Occupational Safety & Health Administration (www.osha.gov) offers several sugges-tions to help reduce workplace violence: • Establish a zero tolerance policy toward workplace violence against or by employees • Provide workplace safety education to all employees including how to recognize work-place violence, what to do if they experience or witness violence, how to diffuse poten-tially violent situations, and how to protect themselves • Provide security for the workplace through deploying security personnel, installing sur-veillance cameras, restricting access to outsiders, and so on • Provide drop safes to limit the amount of cash on hand • Use a buddy system for potentially dangerous situations, at night, and so on

violence types

The University of Iowa Injury Prevention Research Center (2001) categorized workplace violence into the following four types: • Criminal intent. The perpetrator has no legitimate linkage to the business and its employ-ees; commits the violence as part of a crime such as a robbery • Customer/client. The perpetrator has a legitimate relationship with the business and be-comes violent while being served • Worker-on-worker. The perpetrator is an employee or former employee of the business and attacks or threatens another employee or former employee • Personal relationship. The perpetrator usually is not an employee of the business but has a personal relationship with an employee They reported that the majority of workplace homicides were a result of criminal intent; the majority of healthcare incidents of workplace violence were because of customer/client violence.

thermometer pg 240

The bimetallic stemmed thermometer is the most commonly used thermometer. It has a dimple on the stem indicating the length of thermometer that needs to be inserted in a food prod-uct to get an accurate temperature reading. The accuracy of the stemmed thermometer must be checked and recalibrated as needed on a regular basis. The easiest way to calibrate it is to place the thermometer in a glass of ice water for at least 30 seconds. If the thermometer is not reading 32°F, the calibration nut under the indicator head should be held with a wrench and the indicator head rotated until it reads the correct temperature.

anisakis simplex

The current popularity of raw seafood dishes, like sushi, sashimi, and ceviche, and undercooked fin fish has introduced a new source of tapeworm and roundworm infestation. Anisakis, a form of round worm, can be particularly devastating because the parasite attaches itself to the wall of the digestive organs and requires surgery to dislodge it. Consumption of the Anisakis parasite results in an illness termed anisakiasis. The Anisakis parasite is destroyed by cooking or freezing. The Food Code (2013) indicates that fish that is not to be cooked thor-oughly must be frozen to -31°F and stored at -4°F or below for 24 hours, frozen to -31°F or below, and stored for 15 hours or frozen to -4°F or below and stored for 168 hours (7 days). In addition, the foodservice operator must keep a record of the process on file for 90 days.

pH

The degree of a food's acidity or alkalinity, expressed as pH value, also affects bacterial growth. The pH value represents the hydrogen ion concentration and is expressed on a scale from 0 to 14, with 7 expressing neutrality. Values below 7 indicate acidity; those above 7 indi-cate basic or alkaline materials. Bacteria vary widely in their reaction to pH. Although some are quite tolerant to acid, they generally grow best at a pH near neutral, so acid is frequently used in food preservation to suppress bacterial multiplication. Multiplication of the organisms causing food infections and foodborne illnesses are supported in slightly acidic, neutral, and slightly alkaline food materials (Longrée & Armbruster, 1996). The pH of some common foods is listed in Figure 8-4. Microorganisms have specific temperature requirements for growth. At its optimum tem-perature, a cell multiplies and grows most rapidly, but a cell will also grow within the minimum and maximum temperatures around its optimum. Foods that require time and temperature control because they are capable of supporting growth of pathogenic microorganisms or toxin formation are termed Time/Temperature Control for Safety Food (TCS) (Food Code, 2013). TCS foods typically contain protein and moisture, have a neutral or slightly acidic pH, and require time and temperature controls to prevent growth of microorganisms. TCS foods include products such as milk and dairy products, meat, poultry, pork, lamb, fish and shellfish, eggs, raw sprouts, baked potatoes, tofu, and sliced melons.

Food code

The model Food Code is neither federal law nor federal regulation. Rather, it represents the FDA's best advice for a uniform system of regulation to ensure that food is safe and properly protected. Each state, county, and city health department has the option to adopt all or part of the code, thus food safety regulations often vary in different health department jurisdictions. Food safety information included in this chapter will reflect recommendations in Food Code (2013). Those using this text should check with their local health department to determine specific regulations for local foodservice operations. Without question, public awareness has made consumers more cautious about the handling of food at home (Featsent, 1998). Nationwide recalls of meat and produce items have created increased customer awareness and scrutiny of the food supply. Foodservice managers must eliminate any perception of food safety risk in their operations.

HACCP 2

The original HACCP model was modified for use in foodservice operations by Bobeng and David (1978) to include not only microbiological but also nutritive and sensory quality. They applied the model to quality control of entrée production in conventional, cook-chill, and cook-freeze hospital foodservice operations. HACCP models were developed during three phases: selection of control points, using flow diagrams; identification of critical control points; and establishment of monitors for control. In 1988, the National Advisory Committee on Microbiological Criteria for Foods (NACMCF) was formed to provide guidance and recommendations to the Secretary of Agri-culture and the Secretary of Health and Human Services regarding the microbiological safety of foods. The NACMCF, an advisory committee chartered under the U.S. Department of Agriculture, includes participants from the USDA (Food Safety and Inspection Service), the Department of Health and Human Services (U.S. Food and Drug Administration and the Centers for Disease Control and Prevention), the Department of Commerce (National Marine Fisheries Service), the Department of Defense (Office of the Army Surgeon General), academia, industry, and state employees. In November 1992,

Spoilage

The safety of food can be impacted by both spoilage and contamination. Spoilage denotes unfitness for human consumption due to chemical or biological causes. Longrée and Armbruster (1996) identified the following criteria for assuring foods are fit to eat: • The desired stage of development or maturity of the food • Freedom from pollution at any stage in production and subsequent handling • Freedom from objectionable chemical and physical changes resulting from action of food enzymes; activity of microbes, insects, and rodents; invasion of parasites; and damage from pressure, freezing, heating, or drying Freedom from microorganisms and parasites causing foodborne illnesses

bioterrorism

The terrorist attacks in the United States on September 11, 2001 prompted legislation and changes in operational practice to better protect the U.S. food supply. Congress passed and President Bush signed into law on June 12, 2002 the Public Health Security and Bioterrorism Preparedness and Response Act of 2002 (the Bioterrorism Act). Title III of the act focuses on protecting the safety and security of the food supply. Bioterrorism is the intentional use of biological agents or germs to cause illness. A U.S. Department of Homeland Security was formed as part of the Homeland Security Act of 2002 in part to help reduce the vulnerability of the United States to terrorist attacks. The nation's food and water were identified as potential targets for terrorist attacks. In September 2005, the Department of Homeland Security (DHS), U.S. Department of Agriculture, Food and Drug Administration, and the Federal Bureau of Investigation (FBI) be-gan collaborations with private industry and the states in a joint initiative termed the Strategic Partnership Program Agroterrorism (SPPA) Initiative, which is designed to protect the nation's food supply.

operational practices

The ultimate goal of a foodservice manager is to assure that a safe food product is served to customers to protect them from foodborne illness. The role of the foodservice manager is to take responsibility for purchasing, producing, and serving safe food to customers and for training employees on a continual basis. Control of the safety of food must focus on the food itself; the people involved in handling food, either as employees or customers; and the facilities and equipment. The legal fees, medical claims, lost wages, and loss of business associated with foodborne illness can be overwhelming (NRA Educational Foundation, 2004).

mushrooms

There are four categories of mushroom toxins: protoplasmic poisons (amanitin, gyromitrin, orellanine), neurotoxins (ibotenic acid, muscimol, psilocybin), gastrointestinal irri-tants, and disulfiram-like toxins. These toxins are produced naturally by a variety of types of mush-rooms. The toxins cannot be destroyed by cooking or freezing and depending on the type of toxin can cause gastrointestinal distress, neurological impairment, organ failure, and even death. Poison-ing by mushroom toxins most often occurs when eating mushrooms found growing in the wild.

E coli

There currently are four classes of enterovirulent Escherichia coli or E. coli: enterotoxigenic E. coli, enteropathogenic E. coli, enterohemorrhagic E. coli O157:H7, and en-teroinvasive E. coli. The most common is E. coli O157:H7, which is a shiga toxin-producing form that causes Hemorrhagic colitis. E. coli O157:H7 most often has been transmitted by eat-ing raw or undercooked ground beef, and has caused serious illness and death. This bacterium is found in the intestinal tract of cattle and is transferred to the surface of meat during the slaugh-tering process. The bacteria on the surface of cuts such as steaks and roasts are killed when these pieces of meat are grilled or roasted (McCarthy, 1993). Grinding meat, however, transfers the bacteria from the surface to the inside of the product, making E. coli more difficult to kill prompting recommendations by the U.S. Department of Agriculture (USDA) (www.usda.gov) that hamburgers and ground meat mixtures be cooked to at least 160°F. Several national recalls have occurred related to ground beef found to be contaminated with E. coli O157:H7.

PPE 2

Those working in healthcare facilities who may enter patient or resident rooms will need to be familiar with use of transmission precautions and need for PPE when entering rooms of those with droplet, airborne, or contact transmitted illnesses. Depending on the illness, employees entering the room may be required to wear protective gowns, gloves, and/or masks. In some cases food may need to be served on disposable dishes and trays that can be disposed of in the room to prevent the potential of transmission of disease. Healthcare facilities will have charts identifying the precaution needed.

biological contamination

Thousands of species of microorganisms have been identified. Many are harmless, but others, termed pathogens, are harmful and can cause illness or death. Biological contamination occurs when harmful microorganisms contaminate food and cause foodborne illness. Today, foodborne illnesses are recognized as a major health problem in the United States. The CDC estimates that 48 million people get sick, 128,000 are hospitalized, and 3,000 die of foodborne disease in the United States each year (information from www.cdc.gov, 2014). According to the CDC, more than half of all reported foodborne outbreaks were caused by mis-handling food in commercial and onsite foodservices where ready-to-eat (RTE) food is prepared and served to the public. According to economists of the Economic Research Service (ERS) (see www.ers.usda.gov), the most costly foodborne bacterial pathogens are Salmonella, Toxo-plasma gondii, Listeria monoytogenes, Norovirus, and Campylobacter. The ERS estimates the economic costs of medical care, productivity losses, and premature death from these five patho-gens is nearly $14 billion a year (www.ers.usda.gov).

thermal death time

Various types of bacteria respond differently to temperature. In general, spores of microorganisms are more heat resistant than vegetative mature cells, which are dormant and asexual. Some bacteria form spores inside the wall of their cells when they mature. Spores are more resistant to high heat, low humidity, and other adverse conditions than are vegetative bacterial cells. They may remain dormant for long periods of time and germinate when conditions are favorable into new, sensitive, vegetative cells. The heat resistance of microorganisms is their thermal death time, or the time required at a specified temperature to kill a specified number of vegetative cells or spores under specific conditions. Thermal death depends on the age of the organism, temperature to which it is ex-posed, length of time for which heat is applied, presence of moisture, and nature of the medium. Thus, time and temperature are important in preserving microbiological quality in foods. Time also is a critical component in bacterial growth as a single cell can generate more than a million new cells in a few hours' time. Bacteria need about 4 hours to produce enough cells to cause illness.

vibrio vulnifcus

Vibrio parahaemolyticus and Vibrio vulnificus are bacteria that grow in seawater and can contaminate shellfish such as oysters, clams, and crabs. Both bacteria can cause Vibrio gastroenteritis. Vibrio vulnificus can cause septicemia in diabe-tes. Illness, which results in diarrhea, nausea, vomiting, fever, and chills, occurs when infected shellfish are eaten raw; both bacteria are killed when shellfish is cooked.

viruses

Viruses are small pathogens that are not a complete cell. They multiply in the living cells of the host but not in cooked food. They are capable of causing diseases in plants, animals, and humans. Viruses can be carried in food and water, but they multiply only in the living cell. They are easily transferred between people and between food and people. In many respects, viruses resemble bacteria in that the right temperature, nutrients, moisture, and pH are neces-sary for effective growth and reproduction. Examples of human diseases caused by viruses are influenza, poliomyelitis, chickenpox, and hepatitis, some of which have been associated with foodborne outbreaks. Many viruses are inactivated by high temperatures (149°F-212°F) and by refrigeration. Information about viruses that cause foodborne illness is included in Table 8.3.

Workplace violence

Workplace violence is defined by the National Institute for Occupational Safety and Health (NIOSH) as violent acts directed toward persons at work or on duty (www.cdc.gov/niosh). Workplace violence includes verbal or written threats, threatening body language, physical as-saults, or aggravated assaults. According to the U.S. Occupational Safety & Health Adminis-tration (OSHA) website (www.osha.gov), more than 2 million workers in the United States are victims of workplace violence each year. The likelihood of workplace violence is increased in organizations such as restaurants and similar foodservice operations that work with the public, have an exchange of money taking place in the organization, and deliver service.

yersini enterocolitica

Yersiniosis, the illness caused by Yersinia enterocolitica and Yersinia pseudotuberculosis, is characterized by fever and abdominal pain, often mimicking an appendicitis. The exact cause of the contamination is not known but the organisms are commonly found in soil and water. It is more common in Northern European and Scandinavian countries and Japan than in the United States.

Classes of fires pg 219

class A- wood, paper cloth, cardboard, plastics, in a trash can, in drapes or cloth class b- flammable gas like propane or butane and flammable liquids like gas, oil, and paint. fire in butane cooking torch class c- electrical, motors, switches, cords, fire in toaster class d- combustible metals like K, NA, AL, MG, fires during construction work with metals class k- cooking oil and greases such as animal or veg fat, fire in deep fryer or on grill

control 2

programs is responsible for making thermometers more sophisticated than they have ever been. The same thermometer often was used for finding out the temperature in a refrigerator or an oven, and results were seldom analyzed. Currently, thermometers are becoming very special-ized; for example, some models are designed for ovens, deep fat fryers, and coffee. All TCS foods should be prepared according to specific HACCP guidelines. The minimum number of thermometers needed in a foodservice operation are the bimetallic stemmed or digital pocket test, refrigerator/freezer/dry storage, hot holding, and meat thermometers shown in Figure 8-9. The third one, called the HACCP Manager, is an electronic device for recording and transmitting temperature, time, and location for any food preparation process that requires accurate record-keeping; a downloading feature allows the user to graph and chart data to review and analyze for corrective action or required recordkeeping. A newer option is infrared thermometers. These thermometers are not inserted into food; rather they use infrared technology to measure the tem-perature of the food on the surface.