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The Food Safety System: Context and Current Status

Since humans began farming, agriculture has evolved rapidly, with pervasive effects on society. An example is the industrialization of food production in the twentieth century, which, among other things, dramatically changed perceptions and behaviors related to food (Hennessy et al., 2003). While this revolution in food production resulted in great benefits to today’s consumers and the ability to feed a growing population, it also resulted in unanticipated foodborne risks. Regulatory agencies responsible for food safety thus are challenged not only to respond to current issues, but also to articulate a vision of food safety that anticipates future risks. This chapter sets the stage for the more detailed assessments, findings, and recommendations that follow by reviewing some of the developments that have contributed to the context for food safety in the United States and by providing an overview of the current U.S. food safety system.

A CHANGING WORLD

The Institute of Medicine (IOM)/National Research Council (NRC) report Ensuring Safe Food: From Production to Consumption (IOM/NRC, 1998) identifies a number of developments with implications for food safety, including (1) emerging pathogens, (2) the trend toward the consumption of more fresh produce, (3) the trend toward eating more meals away from home, and (4) changing demographics, with a greater proportion of the population being immunocompromised or otherwise at increase risk of foodborne illness. These developments continue to be important today, but many others affecting food safety have occurred in the decade since that



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2 The Food Safety System: Context and Current Status S ince humans began farming, agriculture has evolved rapidly, with pervasive effects on society. An example is the industrialization of food production in the twentieth century, which, among other things, dramatically changed perceptions and behaviors related to food (Hennessy et al., 2003). While this revolution in food production resulted in great ben- efits to today’s consumers and the ability to feed a growing population, it also resulted in unanticipated foodborne risks. Regulatory agencies respon- sible for food safety thus are challenged not only to respond to current issues, but also to articulate a vision of food safety that anticipates future risks. This chapter sets the stage for the more detailed assessments, findings, and recommendations that follow by reviewing some of the developments that have contributed to the context for food safety in the United States and by providing an overview of the current U.S. food safety system. A CHANGING WORLD The Institute of Medicine (IOM)/National Research Council (NRC) report Ensuring Safe Food: From Production to Consumption (IOM/NRC, 1998) identifies a number of developments with implications for food safety, including (1) emerging pathogens, (2) the trend toward the consumption of more fresh produce, (3) the trend toward eating more meals away from home, and (4) changing demographics, with a greater proportion of the population being immunocompromised or otherwise at increase risk of foodborne illness. These developments continue to be important today, but many others affecting food safety have occurred in the decade since that 

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 ENHANCING FOOD SAFETY report was published. Together, these developments contribute to the current context for food safety in the United States, which is characterized by a num- ber of features that must inform any assessment of the food safety system. These include changes in the food production landscape, climate change, changing consumer perceptions and behaviors, globalization and increased food importation, the role of labor−management relations and workplace safety, heightened concern about bioterrorism, increased levels of pollution in the environment, and the signing of international trade agreements. Changes in the Food Production Landscape In addition to constant changes in food production and substantial growth in the number of food facilities (the number regulated by the U.S. Food and Drug Administration [FDA] grew by 10 percent between 2003 and 2007 [GAO, 2008a]), the food and agriculture sector has experienced widespread integration and consolidation in recent years. For example, the consolidation of supermarkets has changed the retail grocery landscape in the United States, leading to the dominance of the industry by a small number of large companies. Apart from consequences for the market share of small retailers, the greater dependence of manufacturers on this limited number of retailers for sales volume gives these companies significant lever- age to bargain for lower prices and demand safety standards. The result has been an increased tendency to establish private standards, which has changed the enterprise of food safety (Henson and Humphrey, 2009). For example, large retailers and customers established the Food Safety Leadership Council on Farm Produce Standards to develop standards for the growing and harvesting of fresh produce (FSLC, 2007). Another private effort was the Global Food Safety Initiative, created in 2000 to set common benchmarks for different national and industry food safety programs. Its standards, now used widely around the world, require that the food pro- tection practices of manufacturers of food, including produce, meat, fish, poultry, and ready-to-eat products such as frozen pizza and microwave meals, be audited at regular intervals (GFSI, 2007). Farmers, shippers, and processors in the business of producing leafy greens may participate in the California Leafy Greens Marketing Agreement, a private mechanism oper- ating with oversight from the California Department of Food and Agricul- ture that verifies whether growers are following certain food safety practices (LGMA, 2010). Adoption of these private standards could be seen as an enhancement of food safety; however, private standards can also impose unnecessary burdens if they are not scientifically justified. For example, private standards may result in unnecessarily higher food prices (DeWaal and Plunkett, 2007). Therefore, a close look at such standards is warranted. As an alternative, public standards can be instituted. For example, Tomato

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 THE FOOD SAFETY SYSTEM: CONTEXT AND CURRENT STATUS Good Agricultural Practices for tomato farms and Tomato Best Manage- ment Practices for tomato packinghouses are the first mandatory produce safety programs in the United States (Florida Department of Agriculture and Consumer Services, 2007). Climate Change Climate change is doubly relevant to the food enterprise: not only may climate change affect food yields, but food production may contribute to climate change by releasing a substantial amount of greenhouse gases, such as carbon monoxide and nitrogen monoxide (Stern, 2007). Stern (2007), among others, has highlighted serious concerns regarding the effects of climate change on future food security, especially for populations in low- income countries that are already at risk of food insecurity. Climate change can affect food systems directly, by affecting crop production (e.g., because of changes in rainfall or warmer or cooler tem- peratures), or indirectly, by changing markets, food prices, and the supply chain infrastructure—although the relative importance of climate change for food security and safety is expected to differ among regions (Gregory et al., 2005). A recent Food and Agriculture Organization paper, Climate Change: Implications for Food Safety (FAO, 2008), identifies the potential impacts of anticipated changes in climate on food safety and its control at all stages of the food chain. The specific food safety issues cited are increased range and incidence of common bacterial foodborne diseases, zoonotic diseases, mycotoxin contamination, biotoxins in fishery products, and environmental contaminants with significance for the food chain. To raise awareness and facilitate international cooperation, the paper also highlights the substantial uncertainty on the effects of climate change and the need for adequate attention to food safety to ensure effective manage- ment of the problem. Changing Consumer Perceptions and Behaviors With an increasingly global food market, consumer expectations and behaviors with regard to food have changed dramatically over the past hundred years. Consumers have grown to expect a wide variety of foods, including exotic and out-of-season foods. As a result, the consumption of fresh fruits and vegetables has increased (IOM/NRC, 1998) and is expected to continue to do so: per capita fruit consumption is predicted to grow in the United States by 5−8 percent by 2020, with a smaller increase predicted for vegetables (Lin, 2004). Additionally, consumers are spending more money on food away from home, which accounted for 48.5 percent of total food dollars, or approximately $565 billion, in 2008 (ERS, 2010).

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 ENHANCING FOOD SAFETY At the same time, consumer perceptions and behaviors with respect to food safety have also changed significantly. Consumer knowledge about foodborne pathogens, high-risk foods, vulnerable populations, and safe food-handling practices has increased in recent years, although this knowl- edge is sometimes wrong or incomplete (FSIS, 2002). Recent foodborne illness outbreaks have further increased consumer awareness about food safety; in fact, a majority of consumers believe foodborne illnesses are a serious or very serious worry (FSIS, 2002; Hart Research Associates/Public Opinion Strategies, 2009). Further, recent polls indicate a lack of confidence in the ability of the FDA to protect consumers against food-related threats (Hart Research Associates/Public Opinion Strategies, 2009). While food producers, processors, and retailers have the primary respon- sibility for the safety of the food they produce, food preparers also play an important role in preventing foodborne illness. Accordingly, several groups have developed educational messages aimed at teaching safe food-handling behaviors to consumers and other food preparers. The Clean, Separate, Cook, Chill approach, for example, is focused primarily on consumers in the home. However, this initiative has proven to be largely ineffective (Anderson et al., 2004). Several studies have found that, although self-reported use of safe food-handling practices has increased, consumers and other food pre- parers do not always follow these practices (Redmond and Griffith, 2003; Howells et al., 2008; Abbot et al., 2009). Further, the International Food Information Council Foundation found that many consumers fail to use some important food safety practices; for example, just 50 and 25 percent of consumers, respectively, use a different or freshly cleaned cutting board for each type of food and check the doneness of meat and poultry items with a food thermometer (IFICF, 2009). Several factors have been identified as affecting the adoption of safe food-handling practices, including attitudes, lack of motivation, sociodemographic factors, and cultural beliefs (Medeiros et al., 2004; Patil et al., 2005; Pilling et al., 2008). In addition, the media often promote poor food-handling practices during on-air cooking demon- strations and frequently give misinformation on the subject (Mathiasen et al., 2004). The decline of home economics classes in schools, coupled with the increasing trend to eat out, further contributes to the lack of food safety knowledge. In addition, few medical providers diagnose and report food- borne illness, and fewer yet discuss safe food-handling practices with their patients (Wong et al., 2004; Henao et al., 2005). Globalization and Increased Food Importation The expansion and liberalization of international trade in recent decades have resulted in an increase in food imports. By 2005, the volume of imported medical supplies and food had increased seven-fold over that in 1994, and