Introduction In early 1986, the New York City Department of Consumer Affairs began to examine the prevalence of foodborne illness caused by meat and poultry contamination. As the entire production cycle was explored, it became clear: Procedures at every stage need to be improved. From the raising of animals on bacteria-laden feed to improper handling of meat and poultry in the kitchen, the cycle of contamination continues. While the high rate of reported foodborne illness in New York City quarter of the national total is most likely a result of better public health surveillance than the rest of the country, the pervasiveness of foodborne disease is unacceptable. - one Millions of Americans are affected each year by food poisoning from meat and poultry. Yet too few know the full extent of the problem, or that the bacteria which causes food poisoning does not necessarily affect the look, smell, or feel of the product. Many studies on meat and poultry production, inspections, handling, and consumption as they contribute to foodborne illness have been conducted. This report examines that research which has preceded it to create an overview of this "silent public health hazard." The human and economic costs of foodborne illness, the pathogens, the cycle of contamination, the roles of responsible parties, reasons for change in the system, and specific recommendations are set forth in this report. ABSTRACT: An estimated 6.5 million cases of foodborne illness occur in the United States each year, at least half of which result from contaminated meat and poultry. Scientists at the Centers for Disease Control (CDC) believe these figures are conservative, and estimate that two bacteria (Salmonella and Campylobacter) alone may be responsible for up to eight million cases of food poisoning. According to the most recent national annual summary data available, 50% of the cases reported to the CDC originated in New York State. Half of those cases were reported by New York City. Thus, the City reported one-quarter of the cases in the nation. National estimates of foodborne illness costs range from one to ten billion dollars a year in lost wages and hospital expenses. Although foodborne illness from meat and poultry contamination costs consumers billions, the USDA will spend only $2.4 million in pathogen control research in 1986. The USDA's current meat and poultry inspection program has not been substantially modified since its inception in 1906. The USDA -- responsible for assuring the wholesomeness of meat and poultry produced in this nation -- has never incorporated microbiological standards in its inspection programs for raw meat and poultry. Standards would limit the amount of foodborne illness-causing bacteria acceptable on meat and poultry. These bacteria, also known as pathogens, are not the same organisms that cause food to spoil and are not superficially detectable by inspectors and consumers. Meat and poultry regulatory policy from feed to refrigeration is weak or not enforced. Refrigeration of transportation vehicles is not required, although specific temperatures of the cargo must be maintained. Practices resulting in food poisoning include the use of spoiling meat in both animal feed and luncheon meats, and the use of unsanitary equipment during processing. - The United States Department of Agriculture (USDA) estimates that 37% of the chickens produced in this country are contaminated with Salmonella. A study by the USDA Agriculture Research Service indicates that approximately 30% of the chickens produced may also be contaminated with Campylobacter. The USDA allows the use of chlorine to sanitize chicken and red meat, although the chemical is more frequently used on chicken. While such substances are effective in reducing the number of pathogens on the product, scientists are still exploring the risks posed by the use of the chemical. The USDA also allows the industry to use flavor enhancers, such as monomonium glutamate, in order to put back the flavor "sanitizers" may take out. - Federal efforts to reduce the incidence of foodborne illness have been aimed at educating consumers. The results of these efforts have been shown to be largely ineffective. In a 1974 Gallup poll, results indicated that 74% of the women surveyed did not know that Salmonella is a bacteria which may cause food poisoning; 66% did not know how to minimize the spread of pathogens within the home; and 39% were certain that raw meat and poultry on the market are inspected for Salmonella, when in fact they are not. Common pathogens known to cause food poisoning are Salmonella, Campylobacter, Staphylococcus aureus (S.aureus), Clostridium perfringens (C.perfringens), and Escherichia coli (E.coli). Bacteria, such as Salmonella and Campylobacter, include hundreds of different strains, all having specific names (e.g., S.dublin, C. jejuni). Chapter One THE HUMAN AND ECONOMIC COSTS OF FOODBORNE DISEASE Summary While only estimates on the actual number of cases are available, it is clear that food poisoning is a major public health problem. It is estimated that at least 6.5 million consumers will be afflicted by a foodborne illness in 1986. Scientists at the Centers for Disease Control (CDC) state that contaminated meat and poultry are implicated in at least half of the foodborne illness cases in the United States. In order to assure that meat and poultry products are safe from contamination, dramatic changes in meat and poultry production and greater budget allocations for public health programs are necessary. In justifying expenditures for such programs, policy makers weigh costs and benefits to the public. Foodborne illness costs taxpayers and industry billions of dollars annually, yet little is being done to root out the problem. This section will explore why dramatic policy change is not occurring in Washington, and why consumers remain largely unaware of the personal expense in health, time, and money resulting from foodborne illness. Introducing programs aimed at reducing bacteria on meat and poultry has been difficult to justify because the United States does not have a surveillance system which uniformly records the incidence of foodborne illness. State health departments do not always provide reliable figures on foodborne outbreaks, partly because minor incidences are often not reported, and only Salmonella bacteria is given surveillance attention by all fifty states. This passive surveillance system makes it difficult to calculate the real number of cases, which would justify greater expenditures for foodborne illness prevention programs. Human Costs Public health officials and the federal government state that millions of Americans suffer from food poisoning every year. The USDA acknowledges that there are at least a total of two million individual cases of foodborne illness annually, but concedes that the Department has not conducted a thorough investigation. The CDC -- the federal agency mandated to study and report on conditions affecting public health believes that the number of food poisoning cases caused by meat and poultry alone is higher than three million. A yet-unpublished comprehensive study recently completed by the Carter Center at Emory University (Closing the Gap) estimates that 6.5 million people are afflicted by foodborne illness and |