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  • Alan Frischer, MD, MPH

Food Safety

We all need to eat. Most of us assume that the food we buy is safe. Is this assumption correct? Well…no.


Lost productivity and medical expenses resulting from unsafe food worldwide cost about $110 billion every year. Unsafe food might contain harmful bacteria, viruses, parasites or chemicals, leading to some 200 different diseases, ranging from diarrhea to cancer. According to the CDC, roughly one in six Americans fall ill from foodborne disease each year, and children under five are especially susceptible. Diseases causing diarrhea are by far the most common.


Common bacterial food pathogens result in symptoms including fever, headache, nausea, vomiting, abdominal pain, and diarrhea. Salmonella can be found in eggs, poultry and other animal products. Campylobacter is mainly seen in raw milk, raw or uncooked poultry and contaminated drinking water. E. coli is associated with unpasteurized milk, undercooked meat and fresh fruit and vegetables. Listeria is found in unpasteurized dairy products and various ready-to-eat foods, and can grow even at refrigerator temperatures. It can lead to miscarriages, or death of newborn babies, and this is why it is important for pregnant women to avoid unpasteurized products.


Food contaminated with viruses is often from infected food handlers. Norovirus symptoms include nausea, vomiting, diarrhea and abdominal pain. It has been seen on cruise ships. It can be spread through very small particles of feces or vomit from an infected person, or from direct contact. Hepatitis A can cause liver disease and spreads through raw or undercooked seafood, or contaminated raw products.


Parasites are transmitted through food, contaminated water, or person-to-person contact. They can live in soil and contaminate fresh produce. In the United States, the most common foodborne parasites are strains of protozoa, which include Cryptosporidium, Giardia, Cyclosporine and Toxoplasma. These protozoa can be found in undercooked fish, crab and mollusks, undercooked meat, raw watercress, and raw vegetables that were exposed to human or animal feces. Food service workers can be a source. Typical symptoms of foodborne parasites include diarrhea and other gastrointestinal symptoms.

Chemicals can contaminate food and water, and result in a wide range of health problems. Some of these chemicals are natural, and others are manufactured. One well-known example is BPA, found in plastic water bottles. It is released into the water when the bottles are opened and exposed to heat. BPA has been linked to various reproductive issues. Based on hundreds of studies, the Food and Drug Administration (FDA) has said that BPA is safe at the very low levels that occur in some foods, but continues to monitor the research.


How can we help to ensure that our food is safe to eat?

  • Clean: Wash hands and working surfaces frequently. Wash for 20 seconds with soap and water before, during, and after preparing food, and before eating. Wash utensils, cutting boards, and countertops with hot, soapy water. Unless the packaging clearly states “pre-washed,” rinse fresh fruits and vegetables well.

  • Separate: Be careful to not cross contaminate certain foods. Use separate cutting boards and plates for raw meat, poultry, and seafood. When shopping, and in the refrigerator, keep raw meat, poultry, seafood, and their juices, away from other foods.

  • Cook: Food is safely cooked when the internal temperature is high enough to kill germs that can cause illness. Use a food thermometer, as checking the color or texture is not good enough.

  • Chill: Once food is properly handled and cooked, it needs to be properly stored. Bacteria can multiply rapidly. As a rule, never leave perishable food out for more than two hours, or one hour if the temperature is above 90 degrees. Keep this rule in mind when bringing home “doggy bags”! Make sure that the refrigerator temperature is 40 degrees or below. Thaw frozen food in the refrigerator, in cold water, or in the microwave. Don’t thaw foods on the counter, because bacteria can quickly multiply in the parts that reach room temperature.


When shopping, avoid cans that are bulging or jars that have cracks or loose lids. Always check expiration dates, and discard foods when they expire. Once fruit and vegetables are cut, refrigerate them. Remember that potlucks are legendary for causing food poisoning, because foods often sit out too long.


Be cautious, be safe, and bon appetit!

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