UNSAFE AT ANY MEAL? : In 1993, Americans came face to face with the hazards of the national food supply. It was the year of eating dangerously.

For generations, Americans were led to believe that the United States had the world’s safest food supply. Secure in the knowledge that federal inspectors and the food industry would stand guard over the fields, processing plants and slaughter houses from which our food comes, we believed that there was little risk of anything harmful appearing on our plates, save for the occasional unrefrigerated potato salad at a summer picnic.

But in 1993 reality hit: A series of food poisonings--from strange-sounding bacteria, viruses and chemicals--converged to change the way America thinks about food. And the message from both government and industry in response to these crises was surprising, but clear: Food preparation has become a game of chance, and individual consumers alone are responsible for ensuring that the food on their dinner table is safe to eat.

At hearings and debates throughout the year, government and industry experts conceded that the system has grown too large, too complex and too intricate for any official or private enterprise to guarantee purity. There is no ever-watchful system to swoop in and make everything right when food contamination is exposed. And as resources are spread exceptionally thin, federal inspection programs continue to fall further behind modern production methods or don’t exist at all.

What’s more, food-borne bacteria continue to evolve into new, more infectious strains, with serious and sometimes fatal consequences.

Last year, for instance, began on a dismal note. Within the first few weeks of 1993, our confidence in the food supply was shattered by a little-known bacteria called E. coli O157:H7, which had taken hold in the seemingly innocuous hamburger. Contaminated ground meat served at Jack-in-the-Box and purchased from U.S. and Australian suppliers was making people sick up and down the Pacific Coast. Hundreds became seriously ill and several children died.

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The symbolism of hamburgers as poison prompted public demand that something be done. The new Clinton Administration sent a Presidential envoy to Washington state in search of causes. But 12 months later, federal officials are no closer to knowing the origins of the contaminated meat than they were in January of 1993. All subsequent investigations have ended without answering the critical question of exactly where the system first failed. More important, no one is reassuring the public that similar, and more severe, episodes can be prevented in the future.

It’s a predictable cycle. Instead of working quickly to find and eliminate the sources of food contamination--and so, reassuring the public--government and industry officials react hastily to each new crisis. Health advisories are released, recommended cooking temperatures are raised, toll-free help lines are established and inspection crackdowns are launched. Underlying it all is the common refrain, from government and industry, that Americans should now transform their kitchens into the sanitary equivalent of a hospital operating room. But soon thereafter, both the industry and consumers drift back into normal, sometimes dangerous, habits.

But last year, anxiety over food safety seemed to take hold. The E. coli outbreak was but one incident undermining the country’s Norman Rockwell confidence in the wholesomeness of American food. Only 13% of those surveyed in 1993 by a food industry trade group expressed “complete confidence” that the food sold in supermarkets is safe to eat. Still, only 38% said they rely on themselves to ensure that their food is safe, with the remainder looking to others such as government, food companies and consumer advocates to do the job.

Precautions long forgotten, or never learned, are only gradually being adopted in many homes and restaurants as the cost of food-borne illness--in terms of medical attention, lost wages and reduced productivity--soars to $4.3 billion annually, according to one recent estimate from the U.S. Department of Agriculture.

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There is little way of knowing the actual financial cost of food-related illness, because the nation’s medical system is equipped to monitor only the most severe outbreaks, such as January’s E. coli O157:H7 contamination. But even in these cases, no one really knows the extent of the problem because the most current statistics amount to guess work. In the E. coli outbreak, officials can only estimate that 600 or more people were affected.

The Centers for Disease Control and Prevention places the number of all food-borne illnesses in this country at 6.5 million a year, with a corresponding 9,000 deaths. However, some high-ranking health officials say the CDC figure is only a fraction, as little as 1/10th, of the actual number of cases that occur. And knowledgeable sources say that virtually everyone in the country gets at least a mild case of food poisoning each year. The number of those most susceptible to food-borne illnesses--or the list of potential victims--is also increasing as Americans live longer and the percentage of the population at acute risk due to disease or infections increases.

What’s frustrating is that the sources of food-borne illness are frequently foods that we take for granted and are a part of daily life--not exotica. Besides ground meat, some of the recent vehicles of contamination include: hot dogs, chicken, eggs, oysters, fish, milk, cantaloupe, soft cheeses and delicatessen foods. And virtually any food can cause disease if improperly stored or prepared, or if handled by someone infected with, for example, hepatitis or shigellosis.

Other nations, with wildly different degrees of sanitation, are also playing a greater role in the American food supply, a trend that will continue with the advent of expanding free trade. Even today, for instance, a single hamburger patty may contain meat from hundreds of animals raised in different countries under varying degrees of regulation.

Despite inadequate government regulation and an inattentive medical system, food industry representatives and their counterparts in government frequently claim that America has the safest food supply in the world. But the sweeping statement is rarely substantiated. Does the United States have fewer per capita food poisonings than Canada? Denmark? Norway? New Zealand? Japan? If officials don’t know the extent of food-borne illness in this country, how can anyone correctly claim we have the safest food system in the world?

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Congress frequently enters the debate, and over the years numerous bills have been introduced to improve food safety regulations. But the legislation often stalls over power struggles that pit those who represent agriculture and its many related interests against representatives of urban consumers.

And there is a lot of turf for Congress to battle over: 12 federal agencies with a total annual budget of $1 billion have at least some responsibility for regulating the nation’s food supply, according to the Government Accounting Office, the investigative arm of Congress. The fractured jurisdictions have led to duplication of efforts, lack of inter-agency communication, wasted resources and questionable effectiveness, the GAO found.

The Clinton Administration, under its “Reinventing Government” initiative, has proposed combining all the far-flung food safety programs into a single agency.

But such a proposal would require radical surgery: portions of the USDA, the FDA, the Commerce Department’s National Marine Fisheries Service, the Federal Trade Commission, the Treasury Department’s Bureau of Alcohol, Tobacco and Firearms, and others would have to be combined into a super food-safety agency. The plan has received lukewarm support in Congress, and it remains to be seen how such a dramatic reorganization could be forged.

In the meantime, several major food safety issues remain pressing.

Seafood

The regulation of seafood is one of the best examples of federal inefficiency in food safety oversight.

The USDA inspects virtually every cow, hog or chicken carcass that is slaughtered for human consumption. Inspectors are present each moment a slaughter plant or meat processing facility is in operation. Despite the intensive $500-million operation, the meat inspection program is riddled with problems. And the situation with seafood is even more uncertain. The FDA normally inspects seafood plants once every three to five years and is hampered by a limited annual budget of about $44 million for its Office of Seafood. The agency has attempted to increase the frequency of its visits but, at best, is inspecting fish and shellfish producers once a year.

Nowhere are the seafood industry’s problems greater than with molluskan shellfish. A federal risk assessment study found that one out of every 1,000 servings of raw oysters, clams or mussels causes illness, some fatal. For chicken, the risk assessment is about one illness for every 25,000 servings. The rate for all seafood, with raw molluskan shellfish included, is one illness per 250,000 servings.

Effective this week, an ad hoc group of state, federal and industry officials known as the Interstate Shellfish Sanitation Conference will implement stricter regulations on the nation’s shellfish plants. In preparation for the changes in 1993, joint state and FDA reviews of 163 facilities found 43% of the plants had “critical” deficiencies. Beginning in 1994, any such problem would require closing the plant till corrective measures were taken. But penalties have little bite if inspections are infrequent or nonexistent, as they are at present.

Other shortcomings detected during the joint state-FDA review included discovery that one major producing state, Mississippi, did not adequately fund its required shellfish inspection efforts. And another state, Texas, did not prosecute those arrested for harvesting shellfish from illegal (contaminated) waters.

Faced with the FDA’s leadership vacuum and despite limited resources, California has been in the forefront of shellfish regulation. California was the first state to require retail outlets--supermarkets and restaurants--to provide warning labels or signs whenever Gulf of Mexico oysters are sold. The Gulf oysters have been linked to numerous cases of Vibrio vulnificus , a severe infection with a high fatality rate. Florida and Louisiana have also subsequently instituted some form of warning system for high-risk individuals.

Selective warnings may not be enough. California’s Health Services Department recently issued a report that said the risk from eating raw shellfish is so high, and can be so severe, that it is considering the unprecedented step of alerting the public that “ All persons avoid the consumption of raw shellfish.” (Emphasis theirs.) Such a statement, if forthcoming, would do incredible damage to the seafood industry and would be the first demonstration of an official lack of confidence in a popular food.

Indeed, shellfish interests are vulnerable: Earlier this year, a Northern California man received a $1 million settlement from five companies that took part in shipping Gulf oysters to the state. After consuming the shellfish raw, the man developed a severe Vibrio infection that resulted in $50,000 in hospital costs and permanent muscular, bone and tissue damage.

More recently, Louisiana oysters shipped to 14 other states in November caused gastroenteritis--diarrhea, vomiting, nausea, abdominal cramps and fever--in at least 23 different settings and caused as many as 180 illnesses, according to the CDC. Because the oysters were identified as being from two different harvest beds--Grand Pass and Cabbage Reef--three states were able to recall the suspect shellfish. The FDA, on the other hand, only issued an advisory that consumers should not consume any oysters--raw or cooked--from the Grand Pass and Cabbage Reefs areas that were harvested before Nov. 16. But only supermarket or restaurant personnel would have access to tagging or labels that would identify the implicated oysters, and rarely is this information shared with the consumer.

Ironically, the FDA does not have legal authority of its own to order recalls. The agency must persuade companies to voluntarily comply with requests to remove product, or it must secure a court order sanctioning a recall.

Hot Dogs

In July, The Times commissioned laboratory tests to determine whether hot dogs were free of harmful bacteria. Twenty percent of the major brands analyzed where found to have Listeria monocytogenes , a pathogen that not only can cause flu-like symptoms but also serious illness in high-risk individuals, such as children and pregnant women. Hot dogs are classified by the federal government as a fully cooked product--similar to ham, roast beef and salami--and should be safe to eat right out of the package. Yet, the discovery of Listeria indicates a sanitation failure somewhere in the processing or packaging of the hot dogs. As a result, undercooking the contaminated hot dogs could cause illness.

In the aftermath of The Times findings, the USDA’s Food Safety and Inspection Service, which operates the meat and poultry inspection program, analyzed hot dogs from four of the five plants that were responsible for the contaminated products. All samples taken by the USDA were found to be free of Listeria, according to a department spokeswoman in Washington. Subsequently, Food Safety and Inspection Service personnel returned to random monitoring for the presence of Listeria in cooked meats.

However, the fifth producer whose product contained Listeria in The Times testing--Wilson Foods of Oklahoma City--did not receive a special follow-up visit by the USDA. And just two weeks ago the company was required to recall 40,000 pounds of its Wilson Jumbo Franks because the products were “undercooked,” a condition that could lead to the growth of Listeria and other harmful organisms.

The Listeria risk extends to other fully cooked foods, particularly take-out items such as delicatessen meats, salads and entrees.

Pesticide Residues

The definitive study on the controversy over pesticide residues was scheduled for release in 1993. Many thought the National Academy of Sciences’ National Research Council report would settle the uncertainty surrounding possible harmful effects on children from pesticide residues. The anticipated public reaction was expected to prompt a call for extreme cutbacks in the use of pesticides; the Clinton administration even announced a plan to work toward pesticide reduction just before the findings were released.

Yet, when the long-awaited report, “Pesticides in the Diets of Infants and Children,” appeared, it in essence called for more studies on the matter.

The strongest language the NRC used in the report wasn’t very strong at all: “Although the data were weak, the committee estimated that for some children (farm chemical residues in food) could be sufficiently high to produce symptoms of acute organophosphate pesticide poisoning.”

Produce industry representatives insist that the benefits of a diet high in fruits and vegetables far outweighs the theoretical risk from any pesticide residues in food, and that pesticide use is slightly subsiding.

But the National Agriculture Chemicals Assn. reported that there were $6.05 billion in agriculture chemical sales in 1992, an increase of 5.6% over the previous year. Given the low rate of inflation, this increase likely indicates that more pesticides are being used in this country, not less.

Also during 1992, the FDA residue monitoring program discovered that 35% of the food sampled contained at least some pesticide residues, though illegal amounts were found on only about 1% of the domestically produced foods; the violation rate for imported foods was 3% of those items analyzed.

Eggs

Initially, Salmonella enteritidis cases linked to eggs were clustered in the Northeastern United States. But since 1985, the incidents have appeared in other parts of the country as well. In the past seven years, the CDC reports 15,162 confirmed cases of S. enteritidis , 1,734 hospitalizations and 53 deaths.

Scientists believe the S. enteritidis is present in the yolk while the egg is still being formed in the hen’s ovaduct. The contaminant is also believed to be isolated within a few major egg-producing flocks in this country.

Despite almost a decade of scientific knowledge about the relationship between S. enteritidis and eggs, the federal government has yet to require egg manufacturers to place any kind of handling or cooking guidelines on egg cartons. The directions would parallel those for other raw animal foods, including the need for constant refrigeration. But to this day, a consumer can easily find supermarkets that display eggs at room temperature, an environment that would allow for the exponential growth of any harmful bacteria that may be present.

The CDC recently reported that at least three outbreaks of S. enteritidis linked to eggs occurred in California in 1993. In Los Angeles County, the source of the illnesses were egg-based dishes (omelets, scrambled eggs or egg salad) served at a single restaurant. Another episode, in San Diego County, was attributed to hollandaise sauce prepared with raw egg yolks by a restaurant. The third incident was home-made mayonnaise from raw eggs that was used on sandwiches. (Commercial mayonnaise includes only pasteurized eggs.) All the implicated eggs were traced to a single farm.

The CDC recommends that all hospital, nursing home and commercial kitchens use only pasteurized eggs products.

Meat and Poultry

The year began and ended with questions about the credibility of the nation’s meat and poultry inspection program. Critics contend that the “USDA Inspected” symbol on meats is little more than a cosmetic seal and does not address whether potentially harmful bacteria may be present.

The hamburger contamination scandal exposed several serious flaws in the USDA’s meat inspection program. For instance, 50-year-old methods--sight, smell and touch--are being used by federal inspectors to determine the wholesomeness of meat and poultry. But the bacteria that was present in the tainted hamburgers-- E. coli 0157:H7--and other pathogens are detectable only through chemical analyses.

Two high-ranking USDA officials--one a holdover from the Bush Administration, the other a new appointee--have resigned, in part because of Clinton Administration dissatisfaction with progress in improving the Food Safety and Inspection Service’s capabilities.

Even so, USDA Secretary Mike Espy claims that more has been done to improve his department’s food safety programs in the last 12 months than in the previous 12 years. The major accomplishments cited by Espy include:

* Increasing the number of federal meat inspectors by 200 to an inspection work force of 9,000.

* Special, unannounced inspections of 90 meat plants, resulting in the temporary closure of 30 for sanitation violations.

* Appointing a special USDA liaison to work with the CDC on future E. coli 0157:H7 outbreaks.

* Introducing safe handling and cooking instructions on raw meat and poultry packages. However, the proposal, the USDA’s first attempt to mandate the labels, was blocked in court late last year. The department is now proceeding with a second regulation, which also may be challenged by food industry groups opposed to the idea.

Even with all this activity, a review of Espy’s first year in office by a coalition of consumer groups said the changes made by the new administration have not been substantive and placed part of the blame on institutional inertia and industry influence.

The Safe Food Coalition--which includes Consumers Union, Public Voice for Food and Health Policy and the Center for Science in the Public Interest--found fault with the USDA’s inability to develop rapid tests for detection of harmful bacteria on carcasses, failure to get Congressional approval to require that all slaughter and processing plants maintain records on the carcass sources so that the origins of future contaminated meat shipments could be determined, and for not enforcing the USDA’s own rule requiring that carcasses with fecal contamination be trimmed, condemned or converted into a fully cooked product.

Finally, government officials and industry representatives are excoriated by consumer advocates for saying that the ultimate responsibility for food safety rests with the public. The statement seems to be an abdication of liability for producing a safe product. Whether this is fair public policy, given the amount of federal and state funds spent on food regulations, will be debated for years to come. But never has it been more true that consumers should be especially careful of what they eat. And we eat, the government estimates, 275 billion meals a year.

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These are not foods that necessarily should be avoided. But health risks are frequently found in foods that are a part of everyday eating, and cautious consumers should be aware. See “What’s Left for Dinner” below.

1. Pork: Trichinosis may still a problem; E. coli suspected in ground pork.

2. Parsley: Eighteen percent of samples tested by FDA showed illegal levels of pesticide residues.

3. Hamburger: Beef patties caused hundreds of illnesses in 1993.

4. Strawberries: Pesticide residues (though in allowable levels) found on 77% of samples tested by FDA.

5. Chicken: Between 66% and 100% of domestic raw product contains Salmonella bacteria.

6. Eggs: Raw and undercooked linked to nationwide outbreak of Salmonella enteritidis .

7. Fish: Government regulations are minimal. See story.

8. Raw Oysters: One out of every 1,000 servings causes illness.

9. Cut Cantaloupe: Bacteria on outer skin can contaminate flesh if left

unrefrigerated.