Reports about pesticides and other contaminants...

Public confidence in the nation’s food supply has been shaken in recent months amid continuing reports of contamination, poisonings and heightened cancer risks.

Questions now linger over the actual health threat posed by problems as varied as harmful bacteria or exposure to pesticide residues in food.

Answers, however, are elusive because many of the food safety issues remain under debate by scientists, health officials, consumer advocates and industry representatives.

Virtually all the major players in this continuing controversy concede that the food supply is safe. Yet, there are many who express reservations about the actual degree of wholesomeness to be found at the nation’s dinner tables.

Federal officials, for instance, acknowledge that food-borne illnesses are increasing. Some of these infections, particularly among those with compromised immune systems, can be fatal.

Put in perspective, however, food-related deaths are minuscule in comparison to the number of fatalities attributed to the nation’s leading killers such as automobile accidents, lung cancer or heart disease.

Even so, the thought that individuals can become seriously ill because of some unseen danger lurking in food has unsettled the public, according to an opinion poll taken earlier this year by a food industry trade group.

Only 23% of those questioned in a national survey conducted in January said they were completely confident that food available in the nation’s supermarkets was safe to eat. The figure dropped to 19% by the end of April, or a month after the Alar in apples controversy as well as the Chilean grape poisoning scare occurred.

“There is more awareness of food safety today,” said Douglas Archer, microbiology director for the U.S. Food and Drug Administration’s Center for Food Safety and Applied Nutrition. “People are more conscious of it and so is the media. . . . Ten to 15 years ago many of these incidents would be overlooked. Today each little (outbreak/poisoning) is brought to the public’s attention.”

Defining the nuances of food safety is complex because the field encompasses so many distinct aspects with each commodity posing different problems.

Often considered the greatest threat to the public are microbiological contaminants, such as bacteria, because of their ability to rapidly cause illness in humans. Another volatile ingredient in the controversy is agriculture’s pesticide usage, considered a more long-term health risk.

Exacerbating the overall problem, however, is the human factor. Namely, poor handling practices that can be found virtually anywhere in the food chain, including farms, meat processing plants, supermarkets, restaurants or in the home.

“Food handling is the thing that has the biggest potential for making people sick in an acute way,” said Dr. Shirley Fannin, associate deputy director of disease control for the Los Angeles County Health Services Department. “Bacteria and parasites that are transferred to humans from improperly handled food gives us more illnesses than we can count.”

Fannin’s view also was echoed by a top California health official familiar with the state’s various contamination incidents.

“You have to recognize that some food is intrinsically contaminated. In fact, no food is sterile,” said Dr. Ben Werner, chief epidemiologist with the California Health Services Department in Berkeley. “There are harmful organisms and human pathogens in food and it behooves the food (preparer) to eliminate them.”

However, consumer advocates argue that more should be done to remove pathogens from food at the manufacturing level and, thus, lower the risk that poor handling practices in the home might lead to illness.

“It is irresponsible to take the position that it is the consumers’ responsibility alone to ensure food safety,” said Ellen Haas, executive director of Public Voice for Food and Health Policy in Washington. “Our changing way of processing food presents hazards that are hidden. . . . Certainly, consumers have a role in protecting their families and proper handling is a component, but only one. The food has to come to market in a safe and wholesome manner.”

Ensuring that health risks from the food supply are minimized falls primarily to the federal government. But responsibility for food safety is divided among several agencies.

The U.S. Department of Agriculture regulates animal byproducts through programs such as its meat inspection service. The U.S. Food and Drug Administration is responsible for all other foods as well as additives. The Environmental Protection Agency determines which farm chemicals are safe to use on crops and what residue levels should be allowed on food after harvest. And the National Marine Fisheries Service oversees the seafood industry through a voluntary inspection program.

Each of these agencies has a different, and sometimes conflicting, approach to regulation. Confusion can be compounded by hundreds of local and state agencies also overseeing the food industry.

“The overriding concern I have is the unwillingness of the federal government to address food safety in a comprehensive fashion,” said Rod Leonard, executive director of the Community Nutrition Institute in Washington. “The contamination issues facing us are due to a lack of a coherent food safety strategy and the splintering of regulatory responsibility. . . . The structure that is suppose to protect us isn’t protecting us anymore and we are losing confidence in it.”

A former high-ranking FDA official also laments the fractured federal approach to food regulation.

“There is no national food policy now,” said Sanford Miller, former director of the FDA’s Center for Food Safety and Applied Nutrition and now dean of the University of Texas graduate school of microbiology. “There has got to be a single agency whose fundamental concerns are food science, food safety and nutrition.”

At present, Miller said, only 20% of the FDA’s budget is allocated to food-related activities while the bulk is devoted to medical or pharmacological issues. The agency is also underfunded by Congress and unable to conduct as much residue or microbiological testing of food as is often demanded by consumer groups or the public, Miller said.

The USDA also has been criticized for its food safety efforts and has been charged with being too close to the industry it regulates. However, the department’s original charter calls for the agency to “promote” agriculture. In interpreting its mission, USDA has often weighed the industry’s financial well-being as well as any public health concerns.

Whether a single federal food agency or larger safety budget would reduce the number of food-related illnesses is unknown. In fact, the federal government is having a difficult time determining even how many people become sick as a result of contaminated food.

Charting food-borne illnesses is the responsibility of the Centers for Disease Control in Atlanta. But successfully investigating contamination incidents is extremely difficult, partially because an illness can develop days after a contaminated food is eaten. By then, few traces of the adulterated item are available for health officials to determine what went wrong.

For instance, in 1987, the CDC reported that there were 50,916 reported cases of salmonellosis in this country, said William C. Levine, medical epidemiologist. However, the actual number of salmonella infections was significantly understated, he said. The total could have been as high as 5 million, or 100 times more than were brought to the attention of health officials.

The disparity exists because only in severe cases do people usually seek medical treatment for the flu-like symptoms normally associated with bacterial infections. Compounding the situation is that physicians often fail to diagnose the various food-borne diseases. Further, some states are lax in detailing or even reporting outbreaks.

20 Million Cases

Without hard data, some have estimated that more than 20 million cases of food-borne illness occur annually in this country. Others familiar with epidemiology, or the study of diseases in the population, state that virtually everyone falls ill at least once a year to bacteria, viruses, parasites or toxins that may be present in food.

There are several groups, though, who face a particularly high risk from pathogens because their immune systems are weakened and unable to fight off the infections. Among these are infants, pregnant women, the elderly and those with underlying illnesses such as cancer or AIDS.

In fact, the USDA recently issued an advisory stating that the elderly, especially those who live alone and prepare their own food, are at significant risk of infections because of possible food handling mistakes due to declining skills and diminished sensory awareness.

The overall risk to the public from food-borne illnesses can be seen by the wide range of items implicated as the source of outbreaks in recent months. Some of these include eggs, hot dogs, oysters, mushrooms, garlic oil, shellfish, ground beef, cheese, milk and grains.

Fruit and vegetables have also been implicated because of pesticide residues. Farm chemicals, in fact, have come under unprecedented criticism in the past year.

Nor is cancer the only potential threat from pesticides. Harmful levels of the chemicals in both processed and fresh foods have also caused a series of poisonings.

Despite the number of troubling developments in the food supply, there is no cause for alarm or a fear of feeding, health officials say. Much of the contamination associated with food can be negated with proper handling, storage and cooking practices. And knowing where the major problems exist is important in reducing the risk of illness especially because most of the potential hazards cannot be seen, smelled nor felt.

RAW MEATS

Of all the animal byproducts, raw meats--whether poultry, beef, pork or others species--need to be handled with extreme care. Health officials have advised consumers to treat each uncooked piece of meat as if it were contaminated because some of it is, in fact, infected.

For instance, as much as 40% of the nation’s uncooked chickens, according to federal estimates, contain salmonella bacteria, the leading cause of food contamination in this country.

Poultry production methods, such as sloppy evisceration, are to blame for the high contamination rate. Compounding the matter is that birds are pooled along the production line, thus bringing salmonella-infected chickens in contact with otherwise clean birds. Industry observers also say that even the feed fed to broilers and fryers may contain small amounts of salmonella, making the contaminant a permanent part of the growth cycle.

In addition to the problem with salmonella, a CDC study identified undercooked chicken as one of the leading causes of Listeriosis, a severe, but still relatively rare, infection.

Beef is also a candidate to host salmonella and other bacteria. However, the number of salmonellosis outbreaks related to beef is fewer than those linked to poultry. But there are other problems. A USDA survey conducted in 1987 found that 5% of the randomly selected beef tested contained Listeria monocytogenes, a harmful bacteria. Despite the findings, the agency emphasized that no cases of Listeriosis have yet been associated with beef.

There is also the matter of growth hormones, or anabolic steroids, used on American cattle. Despite critics’ claim to the contrary, government officials and industry scientists say the compounds are safe at current levels.

The illness most commonly associated with pork is trichinosis, but this parasitic infection has been in decline since the 1950s, according to the FDA. The cause of the problem is Trichinella spiralis, a nematode worm. Improved livestock practices in the pork industry have dramatically reduced the number of hogs infected with trichinea to less than of 0.1%. Exotic game meats, which have become increasingly popular at some specialized restaurants, are also known to be infected with trichinea.

PROCESSED MEATS

Some of the more surprising incidents of food-borne illness have occurred as a result of processed, or partially cooked, meats. The most recent was a episode in which a Listeriosis infection was traced to contaminated turkey hot dogs. The incident marked the first time any such illness was associated with a fully-cooked meat product, which are purportedly free of any such problems.

As a result, the USDA has announced tighter controls for the processed meat industry, including recalls of any products found to contain the Listeria pathogen. Previously, producers were not required to recall their products if USDA analyses detected the Listeria in the meat. Rather, they were encouraged to solve the problem on their own before any such punitive action was initiated.

Partially cooked meat patties were also linked to a string of hemorrhagic Escherichia coli illnesses in the Minneapolis area in 1988. Health officials believe that the preformed hamburgers were improperly reheated and thus the cooking did not destroy the bacteria present.

Increased Cases of E. Coli

FDA officials have also said that there is an increasing number of E. coli cases being reported in the Northwestern United States. Again, improperly cooked ground beef is believed to be the cause. E. coli is a severe infection and can cause extended periods of bloody diarrhea.

The problems illustrated by the Listeriosis and E. Coli episodes demonstrates why health officials are concerned over the increasing availability of supermarket convenience foods, such as fully and partially cooked entrees.

If mishandled anywhere along the production line, then these items present an ideal environment for the growth of bacteria. Further, proper refrigeration is not adequate protection against contamination in some cases because a number of harmful microorganisms can survive in refrigeration. Yersenia and Listeria are two such bacteria considered to be cold-resistant.

The risk presented by this new category of food has prompted a supermarket trade group to begin educating retailers about the contamination threat.

“Most of these products--chilled and ready-to-eat--add a (contamination) risk. . . . They are easily abused by temperature changes,” said John Farquhar, vice president of science and technology for the Food Marketing Institute in Washington. “The idea is to reduce the new risks we have gotten into in the past three or four years (with such convenience products).”

EGGS

One of the nation’s largest recent outbreaks was caused by the presence of Salmonella enteriditis in eggs. The episode began in the Northeastern United States but has since spread to other areas.

What has troubled health officials in this incidence is that the eggs apparently become contaminated even before a shell is formed, or in the bird’s ova duct.

“It has been known for years that eggs could be contaminated with salmonella,” said California’s Werner. “But the problem in the Northeast was a new wrinkle. The egg not only could get infected from the flock’s environment, but also from the mother hen through a trans-ovarian transmission.”

Although FDA representatives said that the incidence of S. enteriditis infections has declined over the winter, the agency expects the rate to increase as we enter the warm weather months, a season that provides improved conditions for the pathogen’s growth.

“To properly cook eggs is a warning we have made all along,” said Los Angeles County’s Fannin. “Raw eggs, in particular, are a source of salmonella. It is a given.”

FISH AND SHELLFISH

The controversy surrounding the seafood industry is that only a fraction of the fish sold in this country is inspected by the government on any regular basis. There is a federal study under way that will ultimately recommend an expanded and improved inspection program for the industry. The leading industry trade group, the National Fisheries Institute, was instrumental in calling for a new system.

But various contamination incidents have also encouraged federal and state governments to look more closely at fishery products.

“In other areas of the food chain you are talking about tightening federal oversight here you are talking about an absence of oversight; no mandatory inspection,” said Haas of Public Voice.

One of the more surprising developments occurred earlier this year when the FDA’s Seattle office found anisakis worms in 109 out of the 110 samples of salmon tested. The parasite, if consumed, can invade the intestinal lining.

“We knew from previous examinations that there were parasites in Pacific Ocean salmon, but we didn’t know they were that extensive,” said James A. Davis of the FDA.

Fish are also likely to absorb any industrial pollutants that may be present in their habitat. The federal government has made an effort to combat this problem by closing to fishermen areas where chemical pollutants are known to be concentrated. However, critics maintain that not enough testing is conducted to fully monitor fish for these environmental toxins.

Problems with shellfish have gotten to the stage where virtually all health officials recommend against eating them undercooked or raw. Oysters have been a particular problem and those harvested from the Gulf of Mexico are thought responsible for an increased number of Vibrio vulnificus illnesses in the past few years. The infection can be serious as it often causes blood poisoning, particularly in those individuals with kidney problems.

Oysters are not alone. The FDA’s Davis and his colleagues found that 30% of all processed and cooked crab and shrimp tested from Seattle area plants contained Listeria monocytogenes. Once again, the agency has emphasized that no Listeriosis cases have been linked to cooked seafood, but concede an infection is possible.

“There are seafood processing plants where cooked and raw product are in the same room (risking cross-contamination),” said FDA’s Archer. “The industry’s crab (cooking) plants range from very modern to some that are primitive.”

PESTICIDES

Certainly, the farm chemical controversy is the year’s most heated food issue. The Natural Resources Defense Council, in a February report, claimed that children were at greater risk of cancer from pesticide residues on produce than adults. Although the use of Alar on apples was the focus of much of the subsequent media coverage, the NRDC is also urging the EPA to reduce the amount of seven other farm chemicals allowed on produce also shown to be a hazard to children.

Just last week, Uniroyal Chemical Co. announced it would no longer manufacture Alar--a growth enhancer for apples--because of concerns about its carcinogenicity.

The NRDC claims that the federal government’s own data indicates that more than 60 farm chemicals approved for use in this country are also known carcinogens.

“We are not calling for a ban on all pesticides overnight. That is not reasonable,” said Jennifer Curtis, a NRDC research associate in San Francisco. “But we do want a phase out of carcinogenic pesticides used on food over the course of 10 years.”

Rep. Henry Waxman (D-Los Angeles) is sponsoring legislation that would lower the amount of farm chemicals on fruit and vegetables that can be considered acceptable. And last week, Assemblyman Lloyd G. Connelly (D-Sacramento) introduced a bill that would require the state to consider children’s susceptibility to pesticide residues in setting allowable levels for the chemicals in food.

“Pesticides are clearly the most dangerous thing in the food supply,” said Sidney Wolfe, director of Public Citizen’s Health Research Group. “There is a very long list of pesticides that are clearly shown to cause cancer. Why are they still around and why does EPA take so long to get rid of them?”

Produce industry representatives, however, maintain that the health risk from the legal use of pesticides is negligible for both children and adults.

“If farm chemicals are used in accordance with the laws and regulations that exist, then the residues that result do not represent a safety hazard to consumers,” said John McClung with the Center for Produce Quality in Alexandria, Va. “And the determination about what is safe should not be made by the produce industry or advocacy groups, but by toxicologists, food technologists and chemists.”

Federal and state tests of produce find that as much as 50% of the fruit and vegetables analyzed contain no detectable amounts of chemicals. These same surveys indicate that only about 1% of the produce tested contains illegal pesticide residues.

“There are more acute hazards that the FDA is spending time on than Alar on apples,” said Joe Madden, assistant director for microbiology with the Center for Food Safety and Applied Nutrition. “There are more life-threatening food safety issues than looking at things like just pesticide residues.”

Beyond the cancer question, though, is the harmful exposure to pesticides by farm workers or others.

The state of California reported that 1,507 people were exposed to potentially toxic concentrations of pesticides in 1987. Of these, 777 incidents occurred during agricultural applications of the chemicals. The others were results of contact with the compounds either during urban pest-control efforts, shipping, manufacturing or related activities.

One such case occurred in Orange County last year when at least five people experienced seizures after eating frozen taquitos that contained endrin, a banned pesticide.

Health officials determined that the highly toxic chemical was present in the tortillas, not the meat filling. But an investigation yielded no traces of the chemical at either the manufacturing site nor at the store. Officials speculated that the incident was sabotage.

In commenting on the case, the CDC stated that endrin, though banned in the United States since 1984, is still used in other countries. The compound has been responsible for more than 1,200 illnesses and 45 deaths in countries other than the United States.

The taquito poisoning episode demonstrates what critics of pesticide regulations have claimed could happen, however. Namely, compounds banned in this country are still being used by other nations that export food to the United States. Occasionally, these pesticides may turn up in the food sold here.

RAW MILK

For almost a quarter century, state and local health officials have argued with Alta-Dena Dairy over the safety of the firm’s raw certified milk. Throughout the dispute, there have been numerous recalls of the product because laboratory tests indicated the presence of salmonella bacteria.

The certified raw milk is no longer sold under the Alta-Dena label. Instead, the unpasteurized products are distributed by Stueve’s Natural.

As a result of a recent lawsuit, an Alameda County Superior Court judge ruled that the dairy must place a warning label on all its raw milk cartons. The cautionary statement warns high-risk groups, such as those with weakened immune systems, that “dangerous bacteria” may be present.

Officials for Stueve’s said they would appeal the judge’s warning label decision, if necessary, all the way to the U.S. Supreme Court and would continue producing the certified raw milk.