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Foodsafe Minnesota Food Manager Certification Course Foodsafe Post Office Box 121 Glenwood, Minnesota 56334 (877) 723-3660 Foodsafe Food Manager Certification Course Book Foodsafe Post Office Box 121 Glenwood, Minnesota 56334 (877) 723-3660 www.foodsafe.homestead.com Written by Todd Appel, Registered Environmental Health Specialist Edited by Timothy John Moran, Certified Instructor Publish by: Foodsafe P.O. Box 121 Glenwood, MN 56334 Copyright 2000 by SAFE Environmental Solutions Copyright 2001, 2005, 2010, 2012, 2014 by Foodsafe All rights reserved including the right of reproduction in whole or in part in any form. Introduction We are pleased that you have chosen to become a Minnesota Certified Food Manager! Not only will this Course and Examination meet the requirements of the Minnesota’s Food Manager Rule, it will also provide you with a solid understanding of food safety principles that you can apply at your establishment. Foodsafe’s Food Manager Certification Course utilizes this customized Coursebook and Approved Examination that are approved by the Minnesota Department of Health and Minnesota Department of Agriculture to meet and exceed the requirements of the Food Manager Certification Rule. This Coursebook has been developed by food safety professionals and industry leaders with extensive knowledge and experience with food safety, regulation, food service operations, and retail operations. The Examination, ServSafe by the National Restaurant Association Educational Foundation or the Certified Professional Food Manager Examination by Prometric, are approved to meet all types of food service operations and jurisdictions in Minnesota. Your success in learning is important to us at Foodsafe. Our Food Manager Certification Course is taught by Todd Appel, Registered Environmental Health Specialist / Certified Instructor, and Timothy Moran, Certified Instructor, who have extensive experience in regulation and teaching to the food service industry. Both instructors have exceeded the highest levels of Certified Instructor Requirements by the National Restaurant Association. Remember, food safety doesn’t stop once you have completed Foodsafe’s Food Manager Certification Course. It has only begun! Training is a process – not an event. It is now your responsibility to take the knowledge you have learned and share it with your coworkers, employees, and staff. 3 Foodsafe’s Food Manager Certification training will give you the necessary information to keep food safe in your establishment. After completion of Foodsafe’s Food Manager Certification Course, you will be able to: Meet and exceed the Demonstration of Knowledge requirements of the Minnesota Food Code. Identify the main types of contamination in food. Prevent the main types of contamination in food. Establish a Sick Employee Policy. Establish Good Employee Personal Hygiene Practice Policies. Establish A HACCP-based food safety program. Reduce the potential for a foodborne outbreak occurring at your establishment. It is now your responsibility to put this information into practice. To do this, you must take what you learned and apply it to your operation by: Implement your own food safety policies and procedures. Provide additional employee training. Provide facilities that encourage food safety. We at Foodsafe want to thank you for your investment of time and resources into your training. We view your training as a critical piece of your success in the food service industry. We are confident that you will benefit greatly by applying what you have learn at your establishment. 4 FDA Model Food Code & Minnesota Food Code Foodsafe’s Food Manager Certification Course, including this customized Coursebook and Approved Examination, is based on the Food and Drug Administration’s (FDA) Model Food Code. FDA Food Code The U. S. Food and Drug Administration (FDA) publishes the Food Code. Local, state, tribal, and federal regulators use the FDA Food Code as a model to develop or update their own food safety rules to be consistent with national food regulatory policy. The Association of Food and Drug Officials reported in June 2005, that 48 of the 56 States and Territories have adopted Food Codes patterned after one of the five versions of the Food Code, beginning with the 1993 edition. Between 1993 and 2001, the Food Code was updated and published every two years by the FDA. With the support of the Conference for Food Protection, the FDA decided to only update the Food Code once every four years. The 2009 Food Code is the first full-edition to publish since the 2005 edition. Minnesota Food Code The Minnesota Food Code, Minnesota Rules Chapter 4626, was based on the 1995 FDA Food Code and adopted throughout Minnesota in 1998. The Minnesota Food Code contains the minimum requirements for the design, installation, construction, operation, and maintenance for all food establishments in Minnesota. These rules are the standards with which Minnesota food establishments must comply in the handling, storing, preparation, and service of food to consumers. Since the FDA Food Code is revised more frequently (every four years) than the Minnesota Food Code (last updated in 1998), there are some discrepancies between the current FDA Food Code requirements and the Minnesota Food Code requirements. Foodsafe’s Course Instructors will explain these discrepancies during the lecture portion of the Certified Food Manager Course. Foodsafe’s Course Instructors will explain these discrepancies during the lecture portion of the Food Manager Certification Course. Our main focus during the course is for all course participants to pass the Certification Examination. The Certification Examination is based on the updated FDA Food Code, thus the FDA Food Code will be the foundation of our course. NOTE: The Minnesota Departments of Health and Agriculture have begun the process to revise the Minnesota Food Code (Minnesota Rules Chapter 4626). The Minnesota Department of Health and Agriculture are considering rule amendments that would bring the Minnesota Food Code up to date and in substantial conformance with the 2013 Food and Drug Administration (FDA) Model Food Code. 5 Chapter 1 Demonstration of Knowledge Foodsafe’s Food Manager Certification Course covers many food safety topics, because individuals working in the food industry must be knowledgeable in many areas. This Coursebook covers the following food safety topics: Biological, Chemical, and Physical Hazards found in our food supply. Time / Temperature Control for Safety (TCS) Foods formally known as Potentially Hazardous Foods (PHF). Food Microbiology (Bacteria, Viruses, Parasites, and Fungus) Employee Health and Hygiene Practices. The Hazard Analysis and Critical Control Point (HACCP) System. Requirements for receiving, storage, and preparation of food. Kitchen Facilities and Plan Review Requirements. Sanitation. Pest Control. Inspection and Enforcement by the Regulatory Authority. Being knowledgeable in these areas not only prevent foodborne illnesses, but it is also the law (per the Minnesota Food Code Law). The Minnesota Food Code requires that the Certified Food Manager and the Person In Charge of the Food Service Establishment must be knowledgeable in food safety and implement that knowledge. Remember, foodborne illness may have fatal consequences which demand food employees exercise extreme care and diligence. What does “Demonstration of Knowledge” mean? · Demonstration of Knowledge The Certified Food Manager and Person In Charge must be able to demonstrate, on request by the Regulatory Authority, knowledge of foodborne disease prevention, requirements of the Minnesota Food Code, and HACCP (Hazard Analysis and Critical Control Point) requirements. What is the definition of “Person in Charge”? · Person in Charge The Person In Charge of the Food Service Establishment is an individual present at a food establishment who is responsible for the operation. There always must be a “Person In Charge” of the establishment whenever the establishment is open to the public. Typically the Person In Charge is also the Certified Food Manager of the Establishment. 6 What knowledge does the Person In Charge / Certified Food Manager have to demonstrate? · · · · · · · · · · · · · · The relationship between the prevention of foodborne illness and personal hygiene. How to prevent the transmission of foodborne illness by a food employee. How to identify the usual symptoms, modes of transmission, incubation periods, and common foods associated with foodborne illness. How maintaining time and temperature prevents foodborne illness. The hazards of consuming raw meat, poultry, eggs, and fish. The required temperatures and times for the cold holding, hot holding, cooling, reheating, and transportation of Time/Temperature Controlled for Safety (TCS) Foods (formally known as Potentially Hazardous Food). The relationship between foodborne illness and control of: cross-contamination, bare hand contact with Ready-To-Eat foods, and hand washing. The correct procedures for cleaning and sanitizing food-contact surfaces. Protection of water, which includes backflow prevention and elimination of cross connections. Identification of poisonous or toxic materials in the food establishment. Implementation of procedures to ensure safe storage, dispensing, use, and disposal of toxic materials and chemicals in according with Minnesota law. Identification of Critical Control Points that may contribute to foodborne illness. How the “Person in Charge” and food employees comply with the HACCP plan. Explanation of the responsibilities, rights, and authorities defined by the Food Code to the food employee, “Person in Charge”, Certified Food Manager, and the Regulatory Authority. What are the specific responsibilities of the Person In Charge / Food Safety Certified Manger? The Certified Food Manager must ensure that: · Food establishment operations are not conducted in a private home. · People unnecessary to the food operation are not allowed in the food preparation areas. · Employees working at the food establishment comply with the Minnesota Food Code. · Employees effectively clean their hands by routinely monitoring hand washing. · Employees visibly observe foods as they are received to determine that they are from approved sources, delivered at the required temperatures, and protected from contamination. · Employees properly cook Time/Temperature Controlled for Safety (TCS) Foods to the required temperatures by daily monitoring of the cooking temperatures. · Employees use proper methods to rapidly cool Time/Temperature Controlled for Safety (TCS) Foods through daily monitoring of food temperatures during cooling. Responsibility of the Person in Charge to Require Reporting by Food Employees The licensee shall require employees to report to the Person in Charge if they have information about their health as it relates to diseases transmissible through food. A food employee shall report to the Person in Charge if they have a symptom caused by illness, infection, or other source that is: · · Associated with diarrhea, vomiting, acute gastrointestinal illness, or jaundice. A boil, infected wound, or other lesion containing pus that is open or draining. The food employee must report to the Person in Charge if they are diagnosed with: Salmonella spp. Shigella spp. Escherichia coli 0157:H7 7 Norovirus Hepatitis A virus The Certified Food Manager / Person in Charge shall: · Exclude (send home) a food employee if ill with vomiting, diarrhea, or jaundice. How long is the employee excluded from the food establishment? The food employee shall remain excluded from the food establishment for at least twenty-four (24) hours after the symptoms resolve. The Certified Food Manager / Person in Charge shall restrict the duties of an employee: The Certified Food Manager / Person in Charge shall restrict a food employee from working with exposed food, clean equipment and clean utensils if they are infected with (but symptom free): Salmonella spp. Shigella spp. Escherichia coli 0157:H7 Norovirus Hepatitis A virus 8 Minnesota Illness Reporting for Foodservice FOOD WORKER RESPONSIBILITIES MANAGER RESPONSIBILITIES You MAY NOT WORK if you have any of the below symptoms. All food employees Exclude symptomatic food employees must report to the Person In Charge if they from the establishment if they are clinically have any of the following symptoms: diagnosed with: Vomiting Salmonella Diarrhea Shigella Jaundice E. coli (yellowing of skin or whites of eyes) Hepatitis A Norovirus If you have been told you have any of the following illness, you must report the illness Restrict non-symptomatic food employees to your manager. All food employees must from working with exposed food, clean report to the Person In Charge if they have equipment, clean utensils, clean linens, and been clinically diagnosed with any of the single service items if they are clinically following: diagnosed with any of the above illnesses. Salmonella Shigella The Person In Charge must also notify the E. coli Regulatory Authority over the establishment Hepatitis A when an employee has been diagnosed with Norovirus any of the above illnesses. Some illnesses that cause diarrhea or Exclude food employees from working with vomiting can be transmitted from food exposed food, clean equipment, clean workers to customers. You may temporarily utensils, clean linens, and single service be given work assignments that do not put items if they have any of the following customers at risk of getting sick. You must symptoms: also report to your manager if you have an Vomiting open, infected wound so precautions can be Diarrhea taken to prevent food contamination. 9 Fact Sheet: Certified Food Manager Everyone in a food service establishment must take the responsibility to practice safe food handling to reduce the risk of a foodborne illness. The Certified Food Manager must be able to identify and take corrective actions to eliminate high risk practices that increase the risk of a foodborne illness. The Minnesota Food Manager Certification Rule requires that there be at least one Certified Food Manager for any food establishment including restaurants, bars, delis and bakeries. The Certified Food Manager must demonstrate knowledge of foodborne illness prevention and is responsible for assuring safe food handling practices. WHAT IS THE RESPONSIBILITY OF THE CERTIFIED FOOD MANAGER? · Being knowledgeable on the relationship between foodborne illness prevention and personal hygiene, control of cross-contamination, and establishment maintenance. The Certified Food Manager must ensure employees are properly washing their hands. · Prevention of foodborne illness by a food employee who has a disease or infectious medical condition. The manager must ensure ill employees are restricted or excluded as required. · The usual symptoms, typical incubation periods, and modes of transmission for the most common foodborne illnesses. · The hazards involved in the consumption of raw or undercooked meat, poultry, eggs, and fish. The Certified Food Manager must ensure employees are properly cooking Time / Temperature Controlled for Safety (TCS) Foods by monitoring cooking temperatures. The Certified Food Manager must ensure proper methods are used to rapidly cool TCS Foods. · The Certified Food Manager must demonstrate knowledge on the required temperatures and times for safe cold holding, hot holding, cooling, cooking, reheating, and transpiration of TCS Foods. · The Certified Food Manager must ensure proper methods are used to clean and sanitize utensils, food contact surfaces, and equipment. · Identifying toxic materials and chemicals found in the food establishment and ensuring these items are properly stored and applied. · Protecting potable water source from backflow and cross connections. ARE YOU READY??? REMEMBER YOU’RE THE CERTIFIED FOOD MANAGER!!! IT’S YOUR RESPONSIBILITY!!!! 10 Chapter 2 Foodborne Illness A report, put together by Center for Foodborne Illness Research & Prevention, revealed that food-borne diseases (which most people think stop after giving a short bout of stomach flu) can have long-term effects - especially in youngsters. After a study of five most common food borne illnesses, researchers concluded that these could contribute to complications which could last all throughout a patient’s life. According to the U. S. Centers for Disease Control and Prevention, nearly 76 million people in America fall prey to foodborne illnesses every year. Of these 76 million people, 325,000 are hospitalized and nearly 5,000 die. Almost 50% of these persons are children under the age of 15. In wake of the new findings, authorities are looking to better educate people about foodborne illnesses which are otherwise taken lightly. Good reputation, repeat customers, and profits are important in food service; however, the most important responsibility of a Certified Food Manager is to prepare and serve safe food. To be successful in serving safe food, you need to know what causes a foodborne illness and how to prevent it. Your knowledge of how food becomes contaminated and how to prevent foodborne illness is vital to the success of your job. The Minnesota Food Code requires that every Certified Food Manager is knowledgeable on what causes food borne illnesses and how to prevent them. In addition, the Certified Food Manager must require food employees to report illnesses that could be transmitted through foods. This requires the Certified Food Manager to recognize the symptoms of food borne illnesses and disseminate this knowledge to all food service employees. 11 Fact Sheet: Employee Personal Hygiene IMPORTANCE OF PROPER HYGIENE Employees are the most important link in preventing foodborne illness. Good personal hygiene, including proper and frequent hand washing, is the best way to prevent foodborne illness. RESTRICTED AND EXCLUDED EMPLOYEES Restrict Exclude (Asymptomatic) (Symptomatic) Salmonella Salmonella Shigella Shigella E.coli E.coli Hepatitis A Hepatitis A Norovirus Norovirus Exclude Symptomatic Diarrhea Vomiting Jaundice DIRECT HAND CONTACT Employees must NEVER touch ready-to-eat food items with their bare hands. The use of single-use gloves, deli tissue, and utensil should always be used instead of touching food directly with bare hands. Remember that gloves can become contaminated just like hands - so proper glove use is essential to prevent the contamination of food. Employees should try to limit touching non-ready-to-eat food items (food that will be cooked) whenever possible. The Minnesota Food Code requires employees to “minimize” bare hand and arm contact with food in ready-to-eat form. Proper use of gloves is one way to meet this requirement. HANDWASHING Always make sure hands are washed and dried before starting work, before working with food products, clean equipment, clean utensils, and clean linens. Correct hand washing includes: cleaning the backs of hands, palms, lower arms, between fingers, and under fingernails using warm water (minimum temperature of 100 F) and soap for twenty seconds. CUTS, WOUNDS and SORES Any cuts, wounds, or open sores on the hands and arms must be completely covered by a waterproof bandage. Employees must wear single-use gloves over any bandages on the hands. EMPLOYEE HEALTH POLICY Your establishment must have a written health policy given to all new employees and all current employees annually. The policy should contain the above information. An employee illness log must also be used to document when employees call in sick or are excluded (sent home) from the establishment. Restrict non-symptomatic food employees (no vomiting or diarrhea) when they are clinically diagnosed with Salmonella, Shigella, E. coli, Norovirus, or Hepatitis A. Exclude food employees that have symptoms of vomiting, diarrhea, or jaundice. This protects your customers and limits your liability in the case of a foodborne outbreak. 12 13 Foodborne Illness Three Types of Hazards Associated With Foodborne Illnesses Biological Hazard Bacteria Viruses Parasites Fungi / Molds Chemical Hazards Natural Occurring Toxins Pesticides Additives / Preservatives Toxic Metals Food Service Chemicals Physical Hazards Metal Shavings Shattered Glass Hair Bone Fragments Metal Fragments Three types of Foodborne Illnesses (1) Foodborne Infection: A foodborne infection occurs when a person eats food containing harmful microorganisms (bacteria, viruses, or parasites), which then grow in the intestinal tract and cause illness. Some bacteria, all viruses, and all parasites cause foodborne illness in this manner. The foodborne bacteria that cause infections are Salmonella, Listeria, Campylobacter, and Vibrio. The most common viruses that cause foodborne illness are Hepatitis A and Norovirus. The most common foodborne parasites are: Giardia, Cryptosporidium, Toxoplasmosis, Trichinosis, and Anisakis. Symptoms typically appear in one or two days after consumption of the food item (the microorganisms must multiply in your body before symptoms occur). Foodborne illnesses can cause symptoms that range from an upset stomach to more serious symptoms including diarrhea, fever, vomiting, abdominal cramps, and dehydration. (2) Foodborne Intoxication: When some bacteria grow on food, they produce a toxin (poison). When a person eats this toxin, it is called a foodborne intoxication. Viruses and parasites do not cause foodborne intoxications. The foodborne bacteria that cause intoxication are: Clostridium botulinum, Staph aureus, Clostridium perfringens, and Bacillus cereus. When you eat the food containing the toxin, you may get symptoms usually within one to six hours. Symptoms typically are nausea, vomiting, and diarrhea. (3) Toxin-Mediated Infection: A toxin-mediated infection is when a person eats food containing harmful bacteria. While in the intestinal tract, the bacteria produce toxins that cause illness. Viruses and parasites do not cause a toxin-mediated infection. The foodborne bacteria that cause toxinmediated infection are Shigella and E. coli. Think of this illness as both a foodborne infection and foodborne intoxication combined inside your body. 14 Hazards in Food Food can be contaminated with three types of Hazards. These Hazards are: Biological Hazards, Chemical Hazards, and Physical Hazards. Biological Hazards typical cause most Foodborne illnesses, however all Hazards that contaminate food are important. Biological Hazards Biological Hazards are separated into four different categories: Bacteria, Viruses, Parasites, and Fungi (Mold). Foodborne illnesses occur when we consume these microorganisms that are present on our food. These microorganisms are present on our foods due to: Food obtained from unapproved sources. How food is grown (Soil Contamination). Contamination at the processing plant. Improper cooling. Improper employee hygiene. Improper reheating. Improper cooking. Improper hot and cold holding. Cross Contamination. Control measures to avoid biological contamination include: Purchase food from approved sources. Avoid Cross Contamination. Proper cooking. Proper cooling. Proper reheating. Proper cold and hot holding. Good personal hygiene . Washing foods properly before consumption (washing fruits and vegetables). 15 Depending on an individual’s immune system and the type of Biological Hazard present, it may take many or very few microorganisms to cause illness. Individuals with “normal” immune systems typically can handle some microorganisms being present on the food and still not become sick. The immune system of a healthy person is able to “fight off” many types of microorganisms. If a person has a weakened immune system, they are more prone to become ill if Biological Hazards are present on the food products they consume. These individuals with weakened immune systems are called “High Risk Populations” or “Highly Susceptible Populations”. High Risk Populations / Highly Susceptible Populations The very young (under one year of age). The very old. Immuno-compromised individuals. Whether a person has a “strong” or “weak” immune system, the overall concept we must understand is: People become sick with a Foodborne illness when they consume too many microorganisms that overwhelm the immune system. Thus, all food employees must ensure food has the least amount of microorganisms present as possible to prevent foodborne illnesses. Bacteria Bacteria are single-cell organisms which multiply and increase in number through cell division given the right environmental conditions. Bacteria will grow on specific types of food items which are called Time/Temperature Controlled for Safety (TCS) Food (formally known as Potentially Hazardous Food). Given the proper environmental conditions, Bacteria can double in population every ten to twenty minutes. 16 Bacteria are found everywhere in our environment including the soil, air, water, hair, hands, and food. You cannot see, smell, or taste bacteria on food. Bacteria grow best on food that has high protein content, high moisture content, and a neutral acidity environment. Some bacteria can change into forms known as spores. When a bacterium forms a spore, it can become very resistant to heat and dry conditions. The types of bacteria that form spores (called spore-forming) are Clostridium botulinum (Botulism), Clostridium perfringens, and Bacillus cereus. These types of food in which harmful bacteria can grow are called Time/Temperature Controlled for Safety (TCS) Foods. Products such as dairy, seafood, meat, and poultry can be classified as TCS Foods because they are moist, low in acid, and high in protein. In the recent FDA Food Code, the designation of Potentially Hazardous Food (PHF) changed to Time/Temperature Controlled for Safety (TCS) Food. The reasoning behind this change is that any food can be potentially hazardous if contaminated or handled improperly. The designation of a food being TCS is more in line with what needs to be done to keep the food safe. Foods with these designations must either be time or temperature controlled to keep the food from supporting the rapid growth of pathogenic microorganisms. While this was just changed in the food code and has not caught on nationwide, do not be surprised if in the next year your health inspector uses the acronym TCS instead of PHF. In essence they are different acronyms for the exact same thing. FAT-TOM This is an acronym for Food, Acidity, Time, Temperature, Oxygen, and Moisture. All of these are factors or conditions needed for bacterial growth. Let’s take a closer look at each one. Food When talking about the types of food needed to support rapid bacterial growth, one must look at high protein foods. A high protein food source is essential for bacteria to grow. If a person is to grow, he or she needs to consume a large amount of protein in his or her diet. The same holds true for bacteria. Bacteria grow best on high protein food sources such as dairy, seafood, meat, and poultry. 17 Acidity (pH) Acidity of a food product is measured on a scale from 0 (acidic) to 14 (alkaline). A pH of seven (7) is considered neutral (water). Foods with a pH of around 7 are ideal for bacterial growth. Most animal food products including meat, fish, poultry, eggs, and milk have a pH around 7. Vegetables and pasta products, which have a high pH in their raw state (pH of 7.5 – 9), become ideal for bacterial growth when cooked. A minimum pH of 4.6 or above is required to support bacterial growth. A pH of below 4.6 will inhibit the growth of most bacteria. Most Time/Temperature Controlled for Safety (TCS) Foods are neutral and bacteria love to grow in them! Time Time/Temperature Controlled for Safety (TCS) Foods must not remain in the Temperature Danger Zone (TDZ) of 135 F to 41 F for more than four hours. Anytime a TCS Food is in the Temperature Danger Zone, the bacteria will grow very rapidly. Allowing TCS Foods to be in the Temperature Danger Zone for longer than four hours will result in high levels of bacterial contamination. If you eat the TCS food, the bacteria will your overwhelm your immune system and make you sick. Temperature Bacteria love warm temperatures. Therefore, they grow best between 41F and 135 F. Notice where normal room temperature (70 F) falls within the temperature danger zone? For this reason, you should never cool foods or thaw foods at room temperature. Always place cooling foods and thawing food items in the refrigerator or walkin at or below 41 F. 18 Oxygen Bacteria can be classified into three groups based on the need for oxygen. This is important because bacterial growth problems can occur in a food establishment by the way foods are wrapped or covered. (1) Anaerobic Bacteria are bacteria that can live and grow with little or no oxygen. An example of this type of bacteria is Clostridium botulinum which causes Botulism. Botulism may result in paralysis and death. Examples of food products that have low or no oxygen present are canned foods (especially home canned products), tinfoil-wrapped foods, and in the center of large stockpots of food. (2) Aerobic Bacteria are bacteria that require oxygen to grow. Aerobic bacteria usually cause foods to spoil (i.e. spoiling bacteria). By removing the oxygen in food packaging (vacuumed packing), many manufactures lengthen the shelf life of products (the lack of oxygen in the packaging means no spoiling bacteria can grow). Many people have now purchased a vacuum-packing device at a local discount chain store for this very purpose. Please note that these vacuum packing devices are extremely dangerous. You are creating an environment that allows Clostridium botulinum to grow where it normal would not grow. For this reason, food establishments are not allowed to use such devices. We also highly recommend not using these devices at home. (3) Facultative bacteria are bacteria that can grow with or without oxygen. Examples of these bacteria are Salmonella, Escherichia coli and Staphylococcus aureus (staph). Case In Point … Spokane Woman And Two Children Sickened By Botulism For a Spokane, WA woman and her two children, canning season almost ended in tragedy. Only an emergency delivery by air of the anti-toxin from the Homeland Security storage facility in Seattle has put hope back in this story. The Spokane woman and her two young children were sickened by botulism from improperly canned green beans from a home garden. The woman remains on a ventilator and is slowly recovering. The children suffered milder symptoms. The Spokesman Review newspaper said Epidemiologist Dorothy MacEachern with the Spokane Regional Health District is concerned that people have been responding to difficult economic times by canning more of their food - perhaps improperly. Food safety experts say special precautions must be taken when canning low-acid foods such as green beans and asparagus. 19 Moisture All bacteria need moisture to grow and reproduce. The amount of water available in food for bacteria to grow is called water activity (Aw). The scale of water activity is measured from 0 (no water) to 1 (100% water). Food must have a water activity of 0.85 or higher to support bacterial growth. TCS foods usually have a water activity level between 0.90 - 0.99. Freezing, drying, or adding salt reduces the amount of available water and slows bacterial growth. There is very little we can do to control most FATTOM conditions, however we can control Time and Temperature. Time / Temperature Control for Safety (TCS) Foods cannot be in the temperature danger zone (41 F to 135) for longer than 4 hours. Bacteria growing on TCS foods in the temperature danger zone for longer than four hours will overwhelm your immune system and cause foodborne illnesses. The FDA has classified the following as TCS Foods even though they do not typically meet the above requirements: Cut Tomatoes Cut Leafy Greens Cut Melons These items MUST be held at or below 41 F under mechanical refrigeration. They MUST NOT be allowed to be in the Temperature Danger Zone for longer than 4 hours. 20 FOODBORNE ILLNESS REVIEW Foodborne Infection: A foodborne infection occurs when a person eats food containing harmful microorganisms (bacteria, viruses, or parasites), which then grow in the intestinal tract and cause illness. Some bacteria, all viruses, and all parasites cause foodborne illness in this manner. The foodborne bacteria that cause infections are Salmonella, Listeria, Campylobacter, and Vibrio. The most common viruses that cause foodborne illness are Hepatitis A and Norovirus. The most common foodborne parasites are Giardia, Cryptosporidium, Toxoplasmosis, Trichinosis, and Anisakis. Symptoms typically appear in 24 to 48 hours after consumption of the contaminated food. Typical symptoms of foodborne infection are diarrhea, fever, vomiting, abdominal cramps, and dehydration. Foodborne Intoxication: When some bacteria grow on food, they will produce a toxin (poison). When a person eats this toxin, it is called a foodborne intoxication. Viruses and parasites do not cause foodborne intoxications. The foodborne bacteria that cause intoxication are Clostridium botulinum, Staph aureus, Clostridium perfringens, and Bacillus cereus. When you eat food containing the toxin, you will get symptoms typically within one to six hours. Symptoms are nausea, vomiting, and diarrhea. Toxin-Mediated Infection: A toxin-mediated infection occurs when a person consumes food containing harmful bacteria. While in the intestinal tract, the bacteria produce toxins that cause illness. Viruses and parasites do not cause a toxinmediated infection. The foodborne bacteria that cause toxin-mediated infections are Shigella and E. coli. Think of this type of foodborne illness as both a foodborne infection and foodborne intoxication combined inside your body. Definition of Foodborne Illness Outbreak: The Center for Disease Control and Prevention (1999) defines a foodborne disease outbreak "as an incident in which two or more persons experience a similar illness after ingestion of a common food and epidemiological analysis implicates the food as the source of the illness." State and local regulatory agencies have established reporting requirements for suspected foodborne illness outbreaks. Check with your Regulatory Authority (Health Inspector) for these criteria. Complaints If you receive a complaint at your food establishment from a customer indicating a possible foodborne illness, the Person In Charge must contact the Regulatory Authority. The consumer should also be encouraged to contact the Regulatory Authority. All suspect food should be saved for testing purposes by the Regulatory Authority. 21 Types of Bacteria Knowing what bacteria are and how they grow can help you control them. Below is a quick review of the common characteristics of bacteria that cause foodborne illness. Temperature: Most bacteria are controlled by keeping food out of the temperature danger zone (41 F – 135 F). TCS foods must not be allowed to be in the temperature danger zone for longer than 4 hours. FDA Temperature Danger Zone Bacterial Growth: If FATTOM conditions are right, bacteria will grow rapidly. Food: Acidity: Time: Temperature: Oxygen: Moisture: High Protein Food Items. pH of 4.6 or above (Scale of 0-14). 4 Hours 41 F to 135 F. Aerobic vs. Anaerobic. Aw of .85 or above (Scale 0 – 1). Spores: Some bacteria may form spores to keep from dying when environmental conditions (typically temperature or moisture) are not optimal for bacterial growth. When environmental conditions improve, the bacteria with revert to its natural form and grow rapidly on the food. In times of stress (such as a very cold or very hot weather that cause food shortages), C. botulinum, like other bacteria species, can produce a spore - a protective structure in which it can survive in a dormant state until conditions improve. How long can it stay in that state? Microbiologists have found dormant bacterial spores that were hundreds of millions of years old. These ancient spores were able to "wake up" and start growing again once environmental conditions were optimal for growth. Toxin production: Some bacteria make toxins on food as they reproduce. People who eat the toxin can become sick (Foodborne Intoxication). Cooking will not destroy these toxins. 22 For each of the following bacteria you must understand: Common Source - Where is the bacteria found? Associated Foods - What foods are commonly linked with the bacteria? Common Symptoms - What are the common symptoms of each illness? Control Measures - What are the most important prevention measures? 23 Bacterial Pathogens Salmonella: Salmonella is a bacterium that causes a diarrheal illness called salmonellosis. The common symptoms of a Salmonella infection are diarrhea, stomach cramps, abdominal pain, and fever. Salmonella bacteria live in the intestines of birds (specifically poultry) and other animals. It can be found in water, food, soil, or surfaces that have been contaminated with the feces of infected humans or animals. People can become infected with Salmonella by: Eating contaminated foods such as undercooked poultry, unpasteurized milk, and undercooked eggs. Eating food contaminated by an infected food handler. Touching contaminated surfaces or objects and then touching their mouth. Not washing hands after using the bathroom room. How to prevent Salmonellosis: Do not eat raw or undercooked eggs, poultry, or unpasteurized milk products. Use pasteurized eggs in recipes that call for raw eggs to be used (Hollandaise Sauce & Caesar Dressing). Prevent cross contamination by separating raw food products from ready-to-eat food products. Properly wash, rinse, and sanitize surfaces that have contacted raw animal products. Properly wash your hands after using the bathroom room. Properly wash your hands after touching raw / undercooked eggs and poultry products. Shigella: Shigella is a bacterium that causes a diarrheal illness called shigellosis. The common symptoms of a Shigella infection are diarrhea (often bloody), abdominal cramps, stomach cramps, and fever. Sometimes people can be infected with Shigella but have no symptoms. These people are commonly referred to as a “carrier” or “asymptomatic carrier”. Shigella is found in the feces of infected people which can contaminate food and surfaces. Common house flies can contaminate food with Shigella bacteria by breeding in infected feces and then landing on food items. People can become infected with Shigella by: Eating food or liquids that were contaminated by the infected person. Touching contaminated surfaces and then touching their mouth. Not washing hands after using the bathroom room. How to prevent Shigellosis: Always wash your hands after using the bathroom and before eating. Never prepare food for other when you are ill (employee exclusion & restriction). Clean and disinfect surfaces with bleach immediately after vomiting or diarrheal accidents. Elimination of house flies. Escherichia coli 0157:H7 (E. coli 0157): E. coli 0157 is one of hundreds of strains of the bacterium E. coli. Most strains of E. coli are harmless and live in the intestines of health humans and animals. The E. coli strain 0157 is a specific strain that lives in the intestines of healthy cattle and other animals (this strain has no effect on the health of the animal – but will make humans very ill). E. coli 0157 produces a powerful toxin that can cause severe illness. Symptoms of E. coli 0157 infection include severe diarrhea (often bloody) and abdominal cramps. Most people infected with E. coli 0157 do not have a fever or vomiting. Feces of infected animals can contaminate food and surfaces. 24 People can become infected with E. coli 0157 by: Eating contaminated hamburger (improper butchering) which has not been cooked to the proper internal temperature of 155 F for 15 seconds. Eating contaminated sprouts and lettuce (improper use of fertilizer or contaminated irrigation water). Touching contaminated surfaces and then touching their mouth. Eating raw shell stock (oysters) that were grown in water contaminated with feces. Not washing hands after using the bathroom. How to prevent E. coli 0157: Properly cook hamburger to a minimum internal cooking temperature of 155 F for 15 seconds. Prevent cross contamination during storage and preparation of raw hamburger. Properly wash your hands after touching raw or undercooked hamburger. Do not consume unpasteurized milk or raw shell stock (oysters). Always wash your hands after using the bathroom room. Listeria: Listeria monocytogenes is a bacterium that causes an illness called Listeriosis. Listeriosis primarily affects people with weakened immune systems (High Risk Populations / Highly Susceptible Populations) such as pregnant women, immune-compromised individuals, and newborns. Symptoms of a Listeria infection include fever, muscle aches, nausea, and diarrhea. Pregnant women that become infected with Listeria may experience a mild, influenza-like illness; however, infections during pregnancy can lead to miscarriage, stillbirth, premature delivery, or infection of the newborn. Listeria is found in soil and water. Animals can carry the bacterium without appearing ill and can contaminate foods of animal origin like meats and dairy products. Listeria has also been found in processed foods that are contaminated after processing such as soft cheeses and cold cuts from the deli counter. Unlike most bacteria, Listeria will grow at refrigeration temperatures (41 F or below) on TCS food items. Thus, it is essential that refrigerated, TCS foods are discarded seven days after opening or preparation. People can become infected with Listeria by: Eating foods contaminated with Listeria. How to prevent Listeria: Only consume pasteurized milk products. Clean and sanitize preparation surfaces prior to use. Label and date all ready-to-eat food products and discard 7 days after opening or preparation. Staphylococcus aureus (S. aureus): S. aureus is a bacterium that is found on the skin (pimples) and hands of infected food employees. S. aureus is most often spread to others by contaminated hands. S. aureus may produce a toxin on TCS foods if that food is temperature abused (left in the temperature danger zone for longer than four hours). People can be infected with S. aureus by: Eating temperature abused TCS food in which S. aureus has grown and produced toxin. Vomiting is a common symptom of this illness (foodborne intoxication). How to prevent S. aureus: Never touch ready-to-eat food with bare hands. Properly wash hands after touching any exposed skin. Employees that have an infected cut or boil must properly wash hands and use disposable gloves. Always ensure TCS foods are not temperature abused. 25 Campylobacter: Campylobacter is a bacterium that causes a diarrheal illness called campylobacteriosis. Campylobacteriosis is one of the most common bacterial foodborne illnesses in the United States. Symptoms of campylobacteriosis include diarrhea, stomach cramps, abdominal pain, and fever which last for approximately one week. Campylobacter lives in the intestines of birds (specifically poultry) and other animals. It can be found in water, food, soil, or surfaces that have been contaminated with the feces of infected humans or animals. People can become infected with Campylobacter by: Eating raw or undercooked poultry. Drinking unpasteurized milk. Touching contaminated surfaces and then touching their mouth. Not washing hands after using the bathroom. How to prevent Campylobacter: Cook all poultry products to 165 F for 15 seconds. Prevent cross contamination by washing hands after contact with raw poultry. Separate raw meats and poultry from ready-to-eat food items during storage, preparation, and serving. Always wash your hands after using the bathroom. Vibrio: Vibrio is a bacterium that causes an illness known as Vibrio-associated gastroenteritis. The Vibrio bacteria lives in brackish (sewage contaminated) saltwater and can contaminate seafood grown in that water. Vibrio causes watery diarrhea often with abdominal cramping, nausea, vomiting, and fever. When an outbreak is traced to an oyster bed, health officials recommend closing the bed until conditions are less favorable for Vibrio. People can become infected with Vibrio by: Eating raw or undercooked shellfish – particularly oysters. How to prevent Vibrio: Only purchase shellfish from approved sources. Do not eat raw or undercooked shellfish – particularly oysters. Properly store and handle raw or undercooked shellfish to prevent cross-contamination. Bacillus cereus: Bacillus cereus is a spore-forming bacterium that is found naturally in soil and vegetation. The toxin that is produced by the bacteria is what makes a person ill - not the bacteria itself (foodborne intoxication). Some toxic spores survive the initial cooking process and are not completed destroyed. Foods prepare or held under improper conditions (improper hot holding, improper cooling, and improper reheating) permit toxinproducing spores to multiply. Bacillus cereus intoxication can cause symptoms such as watery diarrhea, abdominal cramps, nausea, and vomiting. It is characterized by a very short incubation period (1 to 6 hours) and is usually associated with eating fried rice. People become infected with Bacillus by: Eating temperature abused TCS foods. 26 How to prevent Bacillus: Keep TCS food out of the temperature danger zone. Properly cool TCS foods (135 F to 70 F within 2 hours and then 70 F to 41 F in an additional 4 hours). Properly hot hold TCS foods (at or above 135 F). TCS food should be rapidly reheated to an internal temperature of 165 F within two hours. Wash fruits and vegetables properly in potable water. Always practice proper personal hygiene. Clostridium perfringens: C. perfringens is a toxin-producing bacteria frequently found in raw meats (beef, pork, poultry, and fish). Some toxic spores survive the initial cooking process and are not completed destroyed. Foods prepare or held under improper conditions (improper hot holding, improper cooling, and improper reheating) permit toxin-producing spores to multiply. Symptoms of C. perfringens are abdominal cramping, gassy pain, and watery diarrhea. Almost all outbreaks are associated with inadequately cooled or reheated meat products such as stews, ground meats, meat pies, and meat gravies. People become infected with C. perfringens by: Eating temperature abuses TCS food – especially inadequately cooled or heated meat products. How to prevent C. perfringens: Serve meat products immediately after cooking to the required internal cooking temperature. Properly cool TCS foods (135 F to 70 F within 2 hours and then 70 F to 41 F in an additional 4 hours). Properly hot hold TCS foods (at or above 135 F). TCS food should be rapidly reheated to an internal temperature of 165 F within two hours. Clostridium botulinum: C. botulinum causes an illness called Botulism. C. botulinum is an anaerobic bacterium (they live and grow in low oxygen environments). Botulism is a life-threatening illness caused by the ingestion of a potent toxin produced during the growth of the C. botulinum bacteria. In the past, botulism was linked primarily to homecanned foods. In recent decades, botulism have been linked to foods such as unrefrigerated homemade salsa, baked potatoes sealed in aluminum foil, honey (the primary cause of botulism in infants), garlic in oil mixtures and traditionally prepared salted and fermented fish. C. botulinum is prevalent in soil and is found most commonly in a spore formation. These spores are found everywhere. While the spores are generally harmless, the danger can occur once the spores begin to grow and produce toxins in anaerobic conditions such as improperly processed (canned) foods. C. botulinum cannot grow below a pH of 4.6, so acidic foods (most fruits, tomatoes, and pickles) can be safely processed in a water bath canner. Foods with a higher pH (most vegetables and meats) must be processed under pressure using a pressure cooker. The pressure cooker will reach high enough temperatures to destroy the C. botulinum spores. Typical symptoms of botulism toxin consumption are double vision, blurred vision, blurred speech, difficulty swallowing, and muscle weakness. These symptoms are caused by the muscle paralysis by the toxin. If botulism is caught in the early stages, the injection of an antitoxin can lessen the severity of the disease by neutralizing any toxin that has not yet bound to nerve endings. People can become infected with C. botulinum by: Consumption of improperly-processed home canned goods. 27 Consumption of temperature abused: Homemade salsa. Baked potatoes sealed in aluminum foil. Garlic in oil mixtures. Traditionally prepared salted and fermented fish. People can prevent C. botulinum by: Use approved heat processes for commercially and home-canned foods (i.e. pressure-can low acid foods such as corn, green beans, meats, and poultry) Discard all swollen, gassy, or spoiled canned foods. Do not taste or eat foods from containers that are leaking, having bulges, or are swollen. Do no not use products that spurt liquid or foam when the container is opened. Refrigerate all leftovers and cooked foods promptly. Never accept or use home-canned food products in a licensed food establishment. No vacuumed packing without an approved HACCP plan in place. Properly storing vacuumed-package food products. Why is honey sold with the warning label, "Do not feed to infants less than one year of age"? Botulism. Bees naturally collect the botulism spores when they gather nectar. The bees then mix the bacteria in with their honey. Most adults have strong enough immune system to handle the contamination; however, babies do not. Honey is the most common cause of infant botulism. Viruses Viruses, specifically Norovirus, are the leading cause of foodborne illnesses. As a manager, you must understand what viruses are and how to prevent them. There are four important concepts to understand about foodborne viruses: Viruses are not alive. Viruses do not multiply in food. Once eaten, viruses infect the cells of the host (you) and cause illness. All foods (not just TCS Foods) can be contaminated with viruses, although some foods are more likely to be contaminated with viruses than others (shellfish). Viral associated foodborne illnesses are typically traced-back to poor personal hygiene of food employees (sick employees continuing to work and lack of hand washing). HIV / AIDS HIV and/or AIDS cannot be transmitted through food. Thus, there is no exclusion or restriction requiment for individuals infected with this virus. Viruses can be transmitted: o Person to Person o Person to Food o Person to Food-Contact Surfaces A food handler can excrete viruses in their feces, urine, and vomit. When food handlers do not wash their hands after going to the bathroom, the employee will spread the virus to employees, food, and food-contact surfaces. 28 When customers get sick from food contaminated with viruses, typically the food was handled by a sick employee. This might be the food service employee, an employee at the food manufacturer plant, or anyone who has the virus and then handles the food such as a wait staff employee. Prevention Exclude Food Employee who has vomiting, diarrhea, or jaundice. Always properly wash hands as required. No bare hand contact with ready-to-eat food. Hepatitis A: Hepatitis A is an infection of the liver caused by the Hepatitis A virus. Some people have very severe symptoms and others have no symptoms at all. If symptoms occur, onset is usually sudden and includes fever, tiredness, loss of appetite, and nausea. Dark urine, light-colored feces, and yellowing of eyes or skin (jaundice) may appear a few days later. Hepatitis A is spread by the virus found in the feces of a person who has Hepatitis A. A person gets infected when the Hepatitis A virus gets into his or her mouth such as eating or drinking contaminated food or beverages (oral / fecal route of transmission). To prevent Hepatitis A infection: The Hepatitis A vaccine is the best way to prevent infection. For healthy persons, the Hepatitis A vaccine may be given to stop the onset of symptoms if the exposed person was infected within the previous two weeks. Careful hand washing after using the bathroom and before preparing food. Hepatitis A is common in foreign countries where drinking water is often contaminated with sewage. Hepatitis A is also common in food products like shell stock (oysters) that are grown in sewage contaminated waters. Other control methods: Sick employees are not allowed to work in the food establishment. No direct hand to food contact with food in Ready-To-Eat form. Noroviruses: Noroviruses are a group of viruses (previously known as Norwalk-like viruses) that can cause gastroenteritis. Gastroenteritis is an inflammation of the stomach and intestines. Norovirus is the leading cause of foodborne illness outbreaks in Minnesota. The infection is often mistakenly referred to as the “stomach flu”. Norovirus is NOT related to the flu (influenza), which is a common respiratory illness caused by the influenza virus. Common symptoms of Norovirus infection are vomiting, diarrhea, and stomach cramping. Symptoms usually begin 24 – 48 hours after ingestion of the virus. Most people recover within 24 – 48 hours after onset. 29 Noroviruses are very contagious. They are found in the stool and vomit of infected people. Noroviruses are transferred to food, water, and surfaces by the hands of infected people. Eating uncooked shellfish harvested from contaminated waters is also a common occurrence. How can people prevent Norovirus Infection? Wash hands with warm, soapy water for 20 seconds after using the bathroom. Clean and disinfect surfaces with bleach immediately after vomiting or diarrheal accidents. Properly cook oysters to 145 F for 15 seconds before consumption. Avoid preparing food for others while you have symptoms and for at least 24 hours after you recover. Close Quarters By Patricia Lynn Henley Health officials are keeping tabs on recent outbreaks of Norovirus, commonly known as the stomach flu. That may sound like a trivial problem, but this group of related viruses can be serious - even fatal. Not something we think of much, it's nonetheless estimated that more than half of all foodborne illnesses are caused by Noroviruses. No stomach flu is pretty, but things get serious when it affects those whose health is already compromised or who coexist in tight living quarters (prisoners or the elderly). In 2006, there were four Norovirus-related deaths in Sonoma County and all involved elderly patients. "It's most dangerous in a skilled nursing facility, because the people there tend to have underlying diseases that get hit hard by Norovirus," says Leigh Hall, deputy health officer for Sonoma County. Last week, San Quentin prison was closed to all visitors because some 500 inmates came down with Norovirus symptoms. Outbreaks are currently being monitored throughout the greater San Francisco Bay Area. This is such an everyday malady, second only in frequency to the common cold, that medical officials generally don't test for the virus unless a large group of people fall ill. Parasites Foodborne infections caused by parasites are not very common as compared to bacterial and viral foodborne infections. Although these infections are not very common, it is still important to understand parasites so these infections can be prevented. Characteristics of Parasites Growth: Parasites do not grow in food. Parasites only grow in a host (you). Transfer: Consumption of food contaminated with a parasite will cause an infection. Many animals (cows, chickens, pigs, fish, and wild game animals) can become infected with parasites. Parasites can also be found in the feces of animals and people. 30 Contamination: Parasites can contaminate both food and water. Parasites can also contaminate water used to irrigate produce. Common Foodborne Illness Parasites Anisakis Anisakis is a marine parasitic worm which is most commonly found in fresh water and wild salmon. It is also common in certain small salt water fish, such as herrings and sardines. Eating seafood infected with Anisakis could cause Anisakiasis. This is a parasitic infection of the gastrointestinal tract caused by the consumption of raw or undercooked seafood. Prevention of Anisakis: Cook all seafood to a minimum internal temperature of 145 F for 15 seconds. Seafood consumed raw or undercooked (sushi) must be froze at - 4 F for 7 days. Trichinosis: Trichinosis is caused by eating raw or undercooked pork and wild game (bear) products infected with the Trichinella larvae. The initial symptoms of a Trichinosis infection are nausea, diarrhea, vomiting, fatigue, fever, and abdominal discomfort. Headache, fever, chills, and muscle pain follow the initial symptoms. Prevention of Trichinosis: Cook whole pork products to a minimum internal temperature of 145 F for 15 seconds. Cook ground pork products to a minimum internal temperature of 155 F for 15 seconds. Cook wild game animal (bear) products to a minimum internal temperature of 165 F for 15 seconds. Cook all meats products prior to being fed to pigs or other wild animals. Clean and sanitize meat grinders after preparing ground meats. Curing, drying, smoking, or microwaving meats do not consistently kill the worms. Giardia: Giardia is a parasite that causes a diarrheal illness called giardiasis. Symptoms of giardiasis include diarrhea, gas, stomach cramps, nausea, loss of appetite, and weight loss. Onset of symptoms typically occurs within one to two weeks after consumption of the contaminated food or beverages. Giardia can be found in water, food, soil, or surfaces that have been contaminated with the feces of infected humans or animals. Prevention of Giardia: Do not drink untreated water from lakes, rivers, streams, ponds, or unsafe water supplies. Wash and/or peel fruit and vegetables before consumption in potable water. Wash your hands with warm soapy water for 20 seconds: o After using the bathroom room. o After changing diapers. o After touching animals. o Before eating. o Before preparing foods. 31 Cryptosporidium: Cryptosporidium is a parasite that causes diarrheal illness called cryptosporidiosis (“Crypto”). Symptoms of “Crypto” include watery diarrhea, vomiting, stomach cramps, loss of appetite, weight loss, and a slight fever. Symptoms may go in cycles in which you may seem to get better for a few days and then feel worse again before the illness ends. “Crypto” can be found in water, food, soil, or surfaces that have been contaminated with the feces of infected humans or animals. Prevention of “Crypto”: Do not drink untreated water from lakes, rivers, streams, ponds, or unsafe water supplies. Wash and/or peel fruit and vegetables before consumption in potable water. Clean and disinfect surfaces immediately after vomiting or diarrheal accidents. Wash your hands with warm soapy water for 20 seconds: o After using the bathroom room. o After changing diapers. o After touching animals. o Before eating. o Before preparing foods. Fungi Fungi are pathogens that sometimes make people sick. Mostly, these pathogens just spoil food. They can be found in the air, soil, plants, water, and some foods Mold: Molds share some basic characteristics: Effects: Molds spoil food and sometimes cause illness. Toxins: Some molds can produce toxins called aflatoxins. Growth: Molds will grow under in almost any environment. Mold grows especially well in acidic foods with little moisture (jams and jellies). Temperature: Cooler or freezer temperatures will slow mold growth; however, these lower temperatures will not kill the mold on food. Prevention: Discard all moldy food, unless the mold is a natural part of the product (cheese such as Brie, Camembert, and Gorgonzola). The FDA recommends cutting away a minimum of one inch around moldy areas of hard cheese. 32 Biological Toxins Biological toxins are naturally occurring toxins that can occur in foods. The most common biological toxins are: Scombroid Toxin – causes Scombroid poisoning (Histamine poisoning). Ciguatera Toxin – causes Ciguatera poisoning. Mushroom Toxins. Scombroid Toxins: Scombroid poisoning is also known as histamine poisoning. This illness is caused by eating high levels of histamine in scombroid (Tuna Fish) and other species of fish (mahi-mahi and amberjack). When the fish are time-temperature abused, histidine in the flesh of the fish is converted to histamine. This biological conversion occurs at temperatures above 60 F. The histamine cannot be destroyed by freezing, cooking, smoking, or curing. To prevent Scombroid poisoning, always purchase fish from an approved and reputable supplier (a supplier that will not temperature abuse the fish). Ciguatera Toxin: Ciguatoxin is found in certain marine algae. The toxin builds up in larger fish as they consume smaller fish that have eaten the toxic algae. Ciguatoxin cannot be destroyed by cooking or freezing the fish. To prevent Ciguatoxin, always purchase fish from an approved and reputable suppler (a supplier that will not fish the algaebloom areas of the ocean). Mushroom Toxins: Foodborne illnesses linked with mushrooms are almost always caused by eating toxic, wild mushrooms collected by amateur hunters. Symptoms depend on the type and amount of toxic mushroom consumed. Only purchase mushrooms from approved, reputable suppliers. Regulations on Wild Mushroom Sales The Minnesota Department of Agriculture (MDA) has specific regulations for individuals who harvest and wish to sell wild mushrooms. To learn more about becoming an MDA approved source, or to inquire about an MDA license, call the MDA Dairy and Food Inspection Division at (651) 201-6027. 33 Chemical Contamination Chemical Contamination If not properly handled, chemical substances can contaminate food, equipment, single service items, linens, and food preparation areas. Most reported chemical contamination is associated with substances such as naturally occurring toxins, additives, preservatives, pesticides, toxic metals, and toxic cleaning products. Typically, symptoms of chemical food poisoning occur very rapidly (within seconds) upon ingesting the chemical. Initial symptoms may include vomiting, skin rash, hives, and difficult breathing. It is important to always store chemicals away from food, food contact surfaces, single service items, and clean linens to avoid chemical contamination. Food Additives and Preservatives Additives and preservatives are agents that enhance the flavor of foods or keep them fresh longer. Many people are sensitive or allergic to food preservatives (such as sulfites) that are sometimes added to food. An example of a food preservative is Fruit Fresh. Certain populations are also sensitive to food additives such as MSG (monosodium glutamate). If your establishment utilizes an additive such as MSG, you must clearly LABEL the food products on the menu. No establishment is allowed to use a chemical preservative to preserve food items. 34 Pesticides Pesticides or insecticides are used in food service operations to kill insects and rodents. Pest Control Officers (PCOs) are licensed professionals that work with your establishment to solve difficult pest control problems. Application of pesticides at a food service establishment should only be conducted by the Pest Control Officer. Chemical contamination of food due to pesticides is usually a result of carelessness, mislabeling, or poor housekeeping procedures. Keep all pesticides separate from food and other cleaning supplies. Pesticides are often confused with cleaning and sanitizing chemicals by employees that do not properly read chemical labels. Pesticides should only be used as a last resort and only be applied by the Pest Control Officer. Toxic Metals Toxic metals such as copper, brass, cadmium, lead, and zinc can be a source of chemical contamination. For example, if acidic foods (foods that have a pH of 6.0 or lower) are stored in galvanized food containers, zinc can leach into the food. Equipment that has baked-on enamel should not be used in the establishment (i.e. roasters). Over time, the enamel wears-off and chips leaving the underlining metal exposed which can leach into the food. Cleaning Products Improper storage and use of cleaning agents, sanitizers, and other substances can result in chemical contamination of food. Always store cleaning agents away from food, food contact surfaces, single service items, and clean linens. Ensure all chemical spray bottles are PROPERLY LABELED with the contents. Never mix two chemicals together in a food establishment. For example, many establishments mix soap and bleach together. This action is against OSHA guidelines and must be avoided. OSHA requires employers to keep Material Safety Data Sheets (MSDS) available for use by all employees for every chemical present in the food establishment. MSDS sheets should be stored in a three-ring binder and kept in the employee work area. MSDS sheets contain first-aid information in case of accidental exposure. MSDS sheet are typically included in the shipment of chemicals purchases by the case. If you only purchase chemicals by the bottle, you can call the company (look for the phone number on the chemical container) and request a MSDS sheet. Many MSDS sheets are also available on-line at the website http://www.ehso.com/msds.php 35 Physical Contamination Physical Contamination Physical contamination is caused by foreign materials unintentionally introduced into food or naturally occurring objects (bones in fish). Physical contamination in food may cause: Cuts to the mouth or throat. Damage to the intestine. Damage to teeth or gums. The main types of physical hazards in food include: Glass – from broken light bulbs or glass containers. Metal Fragments – from worn utensils or staples used in packaging. Wood – from wood pallets at the processing plant. Plastic – from gloves used at the processing plant or worn utensils. Stones – from stones picked-up during harvesting of crops. 36 Preventing Foodborne Illnesses in Your Establishment The top three causes of foodborne illness in Minnesota are: 1. Sick employees working and poor personal hygiene. 2. Time and Temperature abuse of Time/Temperature Control for Safety (TCS) Foods. 3. Cross Contamination. Training employees in good hygienic practices is vital for food safety at your establishment. The Person in Charge must ensure all employees know and follow good hygiene practices. Employee Health Food employees must never work when they have symptoms of a foodborne illness. The Minnesota Food Code mandates reporting, restriction, exclusion, and documentation (sick employee log) by the Person In Charge. Workers who have cuts, abrasions, or burns may continue to work if they cover the wound with a water-resistant bandage and then use plastic gloves. Personal Hygiene Practicing good personal hygiene is extremely important. All food workers should arrive at work clean. Activities such as eating, drinking from open beverage containers, and tobacco use in any form is not permitted in kitchen areas. The Minnesota Food Code allows employees to drink from a closed beverage container; however, please check with your Regulatory Authority before allowing this practice. All food employees who prepare food and dishwashers must properly restrain their hair to prevent contamination of food and clean equipment. There must be something physical on the head to act as a hair restraint. This can include wearing a hat or hair net. Beard restraints are also required to properly restrain facial hair. Remember, you do not want your customer to find a hair in their food! It is bad for business! 37 Employee Personal Hygiene Importance of Proper Hygiene Employees are the most important link in preventing foodborne illness. Good personal hygiene, including proper and frequent hand washing, is the best way to prevent foodborne illness. Restricted and Excluded Employees Employees who are ill with vomiting or diarrhea must be excluded (sent home) from the establishment and must remain home for at least 24 hours after recovery per FDA Food Code. Per FDA Food Code, asymptomatic food employees must be restricted from working with exposed food, clean equipment, utensils, linens, and single-service items who has been clinically diagnosed with Salmonella Hepatitis A Shigella Norovirus E. coli 0157:H7 Notification by the Person In Charge to the Regulatory Authority must also occur whenever a food worker has been clinically diagnosed with any of the above illness. Handwashing Always make sure hands are washed and thoroughly dried before starting work, between tasks, and before working with food products, equipment, utensils, and linens. Correct hand washing includes cleaning the backs of hands, palms, forearms, between fingers, and under the fingernails using hot water (100 F) and soap Cuts, Wounds, and Sores Any cuts, wounds, or open sores on the hands and must be completely covered by a waterproof bandage. Wear single-use gloves or finger cots over any bandages on the hands and fingers. Hair Restraints Employees are required to wear hair restraints such as hair nets, hats, scarves, or beard nets that are effective in keeping their hair in control. Employees such as counter staff, hostesses, wait staff, and bartenders may not be required to wear hair restraints if they present a minimal risk of contaminating exposed food, clean equipment, utensils, and unwrapped single service items. Proper Work Clothing Employees must wear clean outer garments. It is recommended that aprons, chef jackets, or smocks be worn over street clothing to prevent contamination. Keep spare personal clothing and other personal items away from food handling and storage areas. Employers must provide adequate storage areas for employee's personal belongings. If employees routinely change clothing at the establishment, a room or area must be designated and used for that purpose. Such changing areas must be separate from food, clean equipment, single-service items, and linen. 38 Handwashing Sinks All food establishments must provide hand washing sinks for workers to frequently wash their hands. Hand washing sinks must be kept accessible at all times. Hand washing sinks must only be used for hand washing. Provide soap, paper towels, and a waste container at all hand washing stations. Hand washing sinks must have hot (100 F minimum) and cold running water under pressure. Special Notes on Hand Washing: Always wash your hands for a minimum of 20 seconds. Always use hot water for proper hand washing (minimum temperature of 100 F). Always dry your hands using a single use paper towel. Never use a cloth towel (common towel) or apron. Turn off the faucet using the paper towel to ensure you do not recontaminate your hands. When using the bathroom room, wash your hands in the restroom and re-wash your hands upon entering the kitchen. Your hands become recontaminated when you touch the door knob on the way out of the bathroom! WASHING YOUR HANDS IS THE SINGLE MOST IMPORTANT ACTION YOU CAN TAKE TO PREVENT THE SPREAD OF A FOODBORNE ILLNESS! Employees can be a significant source of harmful microorganisms. Proper hand washing and not going to work sick are the two most important actions employees can take to prevent foodborne illness. 39 When To Wash Hands Before starting to work with food, utensils, or equipment. During food preparation, as needed. When switching between raw foods and ready-to-eat foods. After handling soiled utensils and equipment. After coughing, sneezing, using a tissue, or using tobacco products. After eating and drinking. After touching bare human body parts. After handling animals. Between changes of gloves. 1. Roll up sleeves and wet hands with warm water. After using the bathroom. Wash hands at the hand washing sink in the bathroom and then re-wash hands in the kitchen area. 2. Using soap, work-up a soapy lather that covers hands and forearms. Correct Way to Wash Hands Before washing your hands, remember to remove any jewelry (except wedding band). Wash your hands in designated hand washing only. Do not wash your hands in utensil, food preparation, or service sinks. 3. Rub hands together for at least 20 seconds. Make sure to wash palms, back of hands, between fingers, and forearms. 4. If needed, use a fingernail brush to clean under the fingernails and between fingers. 5. Rinse hands and forearms in warm water. Keep fingertips pointed down while rinsing. 6. Dry hands with single-use paper towels. Turn off the faucet with paper towels to prevent re-contamination of hands. 40 Hand Sanitizers & Single-Use Gloves Hand sanitizers and single-use gloves are not substitutes for hand washing. Only after proper hand washing has been completed, should hand sanitizers or gloves be used. If used correctly, both can provide additional food protection. If used incorrectly, gloves and hand sanitizers can become another source of food contamination. Hand Sanitizers Hand sanitizers are not intended to replace soap in the hand washing process. They are not effective in removing dirt or other organic materials. If used after proper hand washing, they can reduce the number of bacteria and viruses that may remain on your hands. The use of hand sanitizers is not required by the Minnesota Food Code. Single-Use Gloves Although single-use gloves can provide additional food protection, they are only effective if placed on properly washed hands and changed at appropriate times during the food operation. The Minnesota Food Code requires that employees limit direct hand contact with food - wearing gloves is one way to meet this requirement. Singleuse gloves must be worn anytime an employee has a boil, infected wound, or other lesion on their hand (after application of a water-resistant bandage). When Single-Use Gloves Are Used: Wash hands thoroughly before and after wearing gloves. Wash hands between changes of gloves. Change gloves between handling raw foods and ready-to-eat foods. Discard gloves when torn, contaminated, or removed for any reason. Change gloves when interruptions occur in the food operation. Change gloves frequently. Never reuse gloves under any circumstances. Employees wear gloves must change the gloves at least every 4 hours (assuming no contamination of the gloves has occurred). Disposable gloves are being used in food establishments to ensure safe handling of food items and to eliminate food contamination and food-borne illnesses. By following the above guidelines, you can be certain that the disposable gloves are being used properly and they accomplish the function of ensuring better food safety. Note About Wearing Jewelry: The wearing of jewelry should be limited to plain banded rings only. Employees preparing food should not wear necklaces, bracelets, earrings, or other types of jewelry. 41 Case In Point … Gloves Alone Aren't Enough for Food Safety by Laurel Curran According studies published in the Journal of Food Protection, gloves have become a symbol of food safety. However, glove use can inspire a false sense of security. The studies indicated that even gloves used properly in food preparation cannot by themselves adequately protect against food contamination. Gloves may actually pose a number of unforeseen risks because the confidence they provide may encourage risky behavior. The authors suggest that even the best gloves are no substitute for proper hand washing. They explain that the warm and moist environment inside every glove is an ideal environment for microbial proliferation. Bacteria can travel though the tiniest holes or tears produced when wearing gloves for an extend period of time. Long fingernails or rings greatly increase the likelihood of glove puncture. This is a double threat because nails and jewelry tend to harbor higher concentrations of harmful bacteria than bare hands. The longer gloves are worn, the more likely their effectiveness as a barrier will be breached. Numerous studies recommend that food employees change their gloves every hour to guard against possible unseen punctures. Although the "loss of integrity" in gloves can lead to contamination of foods, studies indicate that the improper use of gloves is more likely to cause problems than glove leakage. The authors note that studies in the United Kingdom have concluded that compared to bare hands, gloved hands can contribute as much - if not more - bacteria to foods. Thus gloves themselves, can be a cause of contamination if not used properly. According to the studies, the most important food safety precaution may be proper hand washing when wearing gloves. Employees must properly wash their hands before putting gloves on and after taking them off. Gloves are but one of many barriers recommended by the authors to prevent foodborne illness. Other barriers include use of utensils, tongs, deli papers, and appropriate hand washing. The studies acknowledge, gloves tend to be one of the easiest food-safety methods to regulate. Employers can easily check to see how many gloves have been used. "Glove use is easily observed to verify hygiene compliance, unlike assessing hand washing frequency and thoroughness," the study concludes. The study also notes that most glove studies have focused on transfer of bacteria, but the ability of gloves to prevent infection from enteric viruses, such as norovirus, has not been well studied. 42 Chapter 3 HAZARD ANALYSIS CRITICAL CONTROL POINT HACCP for Food Service Establishments The Hazard Analysis Critical Control Point (HACCP) system is a seven-step process that is used to develop a “food process based”- food safety plan. The HACCP process identifies critical control points and aids in the development of food safety control measures. What is a Critical Control Point (CCP)? The "CCP" in HACCP stands for critical control point. A CCP is defined as a procedure where a food safety hazard can be prevented, eliminated, or reduced. Points in the food preparation process that are typically CCP’s include: cooking, cooling, reheating, and hot holding. CCP’s must be measurable and monitored. (Step One) HAZARD ANALYSIS: The first step in the HACCP system is to identify Time/Temperature Control for Safety (TCS) Foods on your menu and develop a “flow of food” for these items. A “flow of food” is every step food goes through at your establishment from receiving to discarding left-overs. Example Flow of Food 1. Receive food product. 7. Cool food using ice bath. 2. Cold hold food (Store in walk-in cooler). 8. Cold hold food (put in walk-in after cooling). 3. Prepare food. 9. Reheat food (reheat in oven). 4. Cook food in oven. 10. Serve reheated food on daily buffet. 5. Hot hold food on steam table. 11. Throw remaining food after buffet is done. 6. Serve the food by customer request. 43 (Step Two) IDENTIFY CRITICAL CONTROL POINTS (CCP’s): For this section, you need to locate which steps in the flow of food that a food safety hazard can be reduced or eliminated. These are the steps or points within the process where a food safety hazard can be prevented, eliminated, or reduced. Cooking, cooling, reheating, and hot holding are all examples of Critical Control Points. (Step Three) SET UP STANDARDS FOR CCP’S: This third step establishes critical limits or standards at each CCP to keep food from becoming contaminated. The main question to be asked at this point is what “level” or “limit” must be met to ensure food safety. The standards must be measurable and specific. For example, all reheated foods must be reheated rapidly on a stove to an internal temperature of 165 F for at least 15 seconds. (Step Four) SET UP MONITORING PROCEDURES: In this step, you are checking to see if the standards (set up in step three) are being met for each CCP. How often do you need to do the monitoring? The following are typical monitoring procedures: Check cooking temperatures Monitor cooling at the end of the during the start & end of shift. second and sixth hour Hot holding temperatures are Monitor reheating at the end monitored every two hours. of the second hour. (Step Five) ESTABLISH CORRECTIVE ACTIONS: If a standard is not being met, what should you do? This step requires you to establish a corrective action for each CCP to be conducted if your critical limit is not being met. Corrective actions should be implemented immediately. The corrective action procedures developed should be documented on the recipe or flow chart. 44 (Step Six) SET UP RECORD KEEPING SYSTEMS: You must document every step of the HACCP system. This helps you to identify problems which can be corrected quickly. The record system should be simple and easy to use (blank forms or clip boards near work areas). If records are easy to use, the employees are less likely to dry lab (recording information without actually measuring food temperatures). (Step Seven) VERIFY THE SYSTEM IS WORKING: The final step of HACCP is to verify the system is working. Once procedures and critical control points are in place, you must evaluate the flow of food to make sure your decisions were correct. Verification of the HACCP system includes: reviewing that the appropriate CCPs have been identified, the CCPs are effectively monitored, and the appropriate corrective actions are established. Staff and managers should be involved in this step to discuss any changes if needed. The HACCP system must be updated when menus and/or recipes change. Hazard Analysis Critical Control Point What is HACCP? Hazard Analysis Critical Control Point (HACCP) is a seven-step process to develop a food process based food safety plan. The HACCP process identifies Critical Control Points and aids in the development of safety control measures. What are the seven steps in HACCP? 1. 2. 3. 4. Conduct hazard analysis. Identify critical control points (CCPs). Establish critical limits for each CCP. Establish monitoring for control points. 5. Establish corrective actions. 6. Establish effective record keeping systems. 7. Establish procedures to verify HACCP. What are the typical Critical Control Points (CCPs) in a food establishment? Reheating Food Items Cooling Food Items Cooking Food Items Hot Holding Food Items 45 Chapter 4 Purchasing, Receiving and Storing Approved Sources All foods used in a food service establishment must be obtained from an approved source. No home prepared or home-canned food is allowed. Remember home-canned food is a major source of Botulism, thus they are never allowed to be brought into a licensed food establishment. Inspecting Food Items All food received in a food service establishment must be inspected for contamination. It is important that your supplier delivers your goods at a time when all products can be adequately inspected. When receiving food, employees must inspect for possible contamination (biological, chemical or physical). The food was delivered in a delivery truck. No signs of mud, dirt, oil, or other types of contamination. Delivery truck was properly cleaned between shipments. Food items are received at the required temperature. Refrigerated Foods must be received at or below 41 F. Shell eggs must be received at or below 45 F or lower and stored at 45 F or lower. Milk must be received at or below 45 F. The milk must be stored at or below 41 F. Frozen Foods must be received at or below 0 F (Frozen Hard). Hot Foods must be received at or above 135 F. Packaging material and containers must be in sound condition. Reject the shipment if packages have been damaged, patched, or taped shut. Reject the shipment if there are signs of cross-contamination. Reject any frozen product that has large ice crystals (a sign of thawed an re-freezing) 46 Thermometers Temperature control is a very important aspect of food safety. Every establishment must have an accurate thermometer in an easily accessible location. There are several different types of thermometers available to monitor temperatures. The different types of thermometers Types of Thermometers Available Thermal couple Digital thermometer Metal stem thermometer Time Temperature Indicator (TTI) Infrared Thermometer depend on ease of use and cost. Thermometers: Never use a glass or mercury-filled thermometer. They can break easily. The thermometer stem should be made of stainless steel. Thermometers must be able to measure temperatures from 0 F to 220 F. Thermometers must be regularly checked (weekly) for accuracy (+/- 2 F). Thermometers must be cleaned and sanitized after each use. Calibrate the thermometers by: Ice Point Method 50% Ice & 50% Water Calibrate to 32 F Boiling Point Method Boiling Water Calibrate to 212 F 47 Receiving Foods Meat (Beef and Pork) All meat products must be purchased from an approved source. All products must be inspected by a federal (USDA) or state regulatory agency and bear an inspection stamp. Ensure all meat products are properly inspected prior to accepting the food shipment. Reject any shipment with damaged or soiled packaging. Check the internal temperature of all meat products. Refrigerated meats must be received at or below 41 F. Frozen meats must be received at or below 0 F. Reject any meat products that do not meet these temperature requirements. Reject any meat products with an off odor. Poultry Poultry must be purchased from an approved source. All poultry products must be inspected by a federal (USDA) or state regulatory agency and bear a circular inspection stamp. Check all packaging of poultry shipments for damage or signs of temperature abuse. Refrigerated poultry must be received at or below 41 F. Frozen poultry must be received at or below 0 F. Reject any poultry shipment that does not meet these temperature requirements. Reject any poultry products that have a yellowish or greenish color. Seafood Seafood must be purchased from an approved source. All seafood products must be inspected by a federal (USDA) or state regulatory agency. Seafood must be received at or below 41 F (refrigerated) or 0 F (frozen). Fresh fish has bright skin with gills that are moist and red. The eyes are clear and bulging. Molluscan shellfish must be purchased from approved supplier who follows the National Shellfish Sanitation Program Manual of Operation. Identification tags must be dated on receipt and held for 90 days. Live Molluscan shellfish must be alive upon delivered and should not have a strong “fishy” odor. Live shell-stock may be received at a temperature of 45 F or below. 48 Milk and Dairy Products All dairy products must be purchased from an approved source. All dairy products must be inspected by a federal (USDA) or state regulatory agency. All milk and dairy products used in a food establishment must be pasteurized and Grade A. Milk and dairy products must be received at or below 45 F and then cooled and stored at or below 41 F. All milk and dairy products should be received well within their expiration dates. Individual fluid creamers (half & half) must be stored at or below 41 F, unless the product has been ultrapasteurized. Ultra-pasteurized products will bear the mark “UHT” which stands for ultrahigh temperature. Eggs Eggs must be purchased from an approved source. All egg products must be inspected by a federal (USDA) or state regulatory agency. Eggs must be received at or below 45 F and stored at or below 45 F. Liquid, frozen, or dried egg products must be pasteurized. If raw egg products are indicated in a recipe, pasteurized egg products must be used. A shell egg stamped with a “P” indicates the egg has been pasteurized in the shell. Fruits and Vegetables Fruits and vegetables having blemished spots may be accepted if the quality is not affected. There is no federal or state regulatory authority that inspects fruits and vegetables (except wild mushrooms). All produce must be thoroughly washed in potable water to remove possible soil residue that could cause biological contamination (Listeria). Use of pesticides in farming is another reason to thoroughly wash produce prior to use. Receiving and Storage of Processed Food Items Frozen Foods Ice used as a cooling medium must be made from drinkable water (potable). This ice must not be reused. Any signs of frozen foods being thawed and refrozen must be immediately rejected. An indication that frozen food was thawed and refrozen is the presence of large ice crystal formation. Frozen foods must be received and stored at or below 0 F. Frozen foods must not be thawed and then re-frozen. Frozen foods must not be thawed at room temperature (see preparation chapter). 49 Refrigerated Foods All refrigerated foods must be received and stored at or below 41 F (see exemptions above). A thermometer must be placed in the warmest part of the refrigerator. Always store raw meats below ready-to-eat foods to eliminate cross-contamination. Store raw meat in order of their cooking temperature to prevent cross contamination (see table below). Fresh fish should be stored in the refrigerator in well drained ice. Do not overload refrigerator units. Air must circulate around the products to keep them at 41 F. Do not line shelves in the refrigerator with foil. This prevents air circulation. All refrigerated TCS foods that are Ready-To-Eat (i.e. prepared salads) must be labeled and dated with the date of preparation or opening. Proper Storage of Raw Food Items These foods must be discarded seven days after preparation or opening “Swim - Walk - Fl due to the risk of Listeria contamination. Modified Atmosphere Packaging and Sous Vide Products Modified-Atmosphere Packaging (MAP) is the removal of oxygen from a food. This anaerobic atmosphere (without oxygen) creates an environment for botulism to grow. Thus, MAP foods must be received and stored at or below 41 F. Sous vide foods are vacuumed packed (without oxygen) and then partially or fully cooked. These items must be treated the same as MAP foods. Due to the risk of Botulism, your establishment may not perform any type of modified-atmosphere packing without a HACCP Plan in place and pre-approval by the Regulatory Authority. Canned and Dry Food Items Due to the risk of Botulism, all canned and vacuum-packed foods must be thoroughly inspected when received for leakage, broken seals, and dents. These are signs of Botulism contamination. 50 Both ends of the canned product should be checked for swells (concaved bottom or top of cans). Always practice FIFO. FIFO stands for “First In First Out”. This will ensure all old products are used prior to newly delivered food items. Always store food items in the original packaging or container. If you must transfer food items to a new container, ensure the container is clearly labeled and dated. Always store food items off the floor (a minimum of six inches is required). Toxic Item Storage To prevent possible contamination, poisonous and toxic items must be stored below Food Equipment Utensils Single Service Items Clean linens A solid partition may also be used to physically separate chemicals. Clearly label chemicals transferred to spray bottles. Ensure a corresponding MSDS sheet is available for each chemical used at your establishment. Never mix two chemicals together. The most preferred location for toxic items is a locked cabinet away from food. 51 Receiving Food Products from an “Approved Supplier” The Person In Charge must ensure that inspections are conducted during food deliveries. Inspections are conducted to ensure intact packaging, signs of temperature abuse, and other types of contamination (insects / rodents). Boxes/Cartons/Containers Inspect all delivers to ensure packages are intact and not leaking. Inspect all delivers to ensure container are not broken, crushed, torn, or damaged. Inspect food products for signs of contamination by rodents, insects, or birds. If any of these problems are identified, reject the product. Canned Products When receiving canned products, always inspect the containers for the following issues: Dents on the top rim, bottom rim, or side seam. Swollen or bulging cans. Rusted cans with pitted surfaces. If cans have any of the above problems, reject the product. Shell Stock When receiving fresh shell stock (i.e. oysters), you must keep the Shell Stock Identification Tags for 90 days. Shell stock must be delivered at or below 41 F. First In First Out When receiving food items, ensure you are practicing product rotation. Such rotation is commonly called First In First Out (FIFO). This practice ensures the older food is used prior to any newly delivered food. 52 Chapter 5 Preparing and Serving Food TCS foods are at high risk of bacterial growth / contamination during preparation. During preparation, foods typically pass through the temperature danger zone (41 F to 135 F) several times. In addition, cross contamination is possible during preparation from other foods and food contact surfaces (cutting boards, hands, utensils, etc.). Thus, it is essential to prevent TCS foods from spending more than four hours in the temperature danger zone and to prevent cross contamination at all times. Time and Temperature Control Bacteria grow very rapidly on TCS foods when they are in the temperature danger zone (41 to 135 F). Employees must understand this concept and use time and temperature to control bacterial growth at all times. Using an accurate thermometer, employees must monitor temperatures during cooking, hot holding, serving, cooling, and reheating. At a minimum, temperatures should be monitored as indicated below: Check cooking temperatures periodically during your shift or per batch. Hot holding temperatures should be monitored every two hours. Cooling temperatures should be monitored at the end of the second and sixth hour (Two Stage Cooling Method). Cooling temperatures should be monitored at the end of the fourth hour. (One Stage Cooling Method). Monitor reheating temperatures at the end of the second hour. Monitor refrigeration temperatures of all units once per shift. Food Preparation Avoiding cross contamination is very important during the preparation process. Raw products must be kept separate from cooked products / ready-to-eat products. Food contact surfaces that have touched raw foods must be washed, rinsed, and sanitized before a cooked food touches the same surface. 53 Cross Contamination Contaminated or uncooked raw foods may cause harmful microorganisms to be passed to safe foods and cause a foodborne illness. This is called cross contamination. For example, storing raw meats above Ready-To-Eat foods in the refrigerator may result in a cross contamination. Cross contamination also occurs when food contact surfaces (such as cutting boards) are not kept cleaned and sanitized. Dirty hands can also be a great way for cross contamination to occur. Separate: Don't Cross Contaminate Cross contamination is how bacteria spread from one food product to another. This is especially true for raw meat, poultry, and seafood. Food employees must keep these foods and their juices away from Ready-To-Eat foods. Here's how you can fight cross-contamination: Separate raw meat, poultry, and seafood from other foods in the walk-in cooler or refrigerator. If possible, use one cutting board for raw meat products and another for salads and other foods which are Ready-To-Eat. Always wash, rinse, and sanitize cutting boards, knives, and utensils after they come in contact with raw meat, poultry, and seafood. In-use food contact surfaces (i.e. utensils and cutting boards) must be washed, rinsed, and sanitized once every four hours. Never place cooked foods on a plate which previously held raw meat products. Always wash your hands between contacting raw foods and Ready-To-Eat food. Thawing Food Thaw foods only by these four methods. NEVER THAW AT ROOM TEMPERATURE! 1. The most preferred thawing method is in a refrigerator at 41 F or below. Place raw meats on the lowest shelf possible (never above Ready-To-Eat foods) to avoid cross-contamination. 2. Thaw under running cold water (70 F or lower). 3. Thaw as part of the cooking process (placing a frozen hamburger patty on a hot grill). 4. Thaw in a microwave. Use this method only if food will be immediately moved to other cooking equipment or immediately finished cooking in the microwave. 54 Cooking Food Most menu items have a specific time and temperature requirement for cooking. To check proper cooking temperatures, insert the thermometer in several different areas of the food item (especially the thickest part). Monitoring the internal temperature of the product is the ONLY WAY to make sure food has been cooked properly. Always cook foods using the proper equipment. Never use unapproved equipment for cooking foods (crock pots or steam tables). Unapproved equipment typically does not cook the food fast enough or hot enough (required minimum initial cooking temperature). Food employees should: Cook foods higher than the minimum internal cooking temperatures unless the quality will deteriorate. Measure food temperatures using a calibrated thermometer. Never “guess” at the temperature. Avoid overloading ovens or other cooking equipment. Cooking Temperatures (temperatures and times specified are minimum): Raw whole red meats, eggs, and fish must be cooked to an internal temperature of 145 F for 15 seconds. Ground beef and ground pork must be cooked to an internal temperature of 155 F for 15 seconds. Poultry and all stuffed foods must be cooked to an internal temperature of 165 F for 15 seconds. Rare roast beef (prime rib) must be cooked to an internal temperature of 130 F for 112 minutes. 55 Microwave Cooking Foods prepared in a microwave must be cooked to an internal temperature of 165 F. The product must be covered and rotated / stirred during the cooking process. After cooking, allow the covered product to stand for two minutes prior to serving. Hot Holding Food All hot holding equipment must be able to maintain a temperature of 135 F or above. Never use holding equipment for reheating foods. Holding equipment heats too slowly to be effective and leaves TCS Foods in the Temperature Danger Zone for too long. Crock pots are not to be used in the food establishment. These have been implicated in several foodborne outbreaks because they were not able to hold or cook foods to proper temperatures. Hot holding devices provide irregular heat, thus a food thermometer must be used to ensure the food is maintained at the proper temperatures. Monitor hot holding temperatures every two hours. Customer Self-Service Self-Service operations such as cafeterias, salad bars, and buffets are popular but pose certain food safety challenges. Foods in these establishments are handled by many people making it difficult to maintain proper holding and serving temperatures. Since customers serve themselves, contamination of the food products may easily occur. Food employees at these establishments should always attempt to serve the food in a way that minimizes contamination. Self-service customers should be monitored to ensure they utilize clean dishes and utensils when returning to the buffet (coffee cups and glasses do not need to be replaced when refilled). Signs should be posted to remind customers to use a clean plate for each trip. 56 Other Buffet Requirements: Reduce contamination to exposed foods by placing an easy-to-clean, properly constructed, food guard (sneeze guard) between the customer and the food. Provide enough serving utensils for each food presented. To avoid cross-contamination, each utensil should be used for only one food item. Replace serving utensils at least every four hours. Monitor temperatures of food every two hours. Keep cold foods cold and hot foods hot. Cooling Food TCS foods must be cooled from 135 F to 70 F within two hours and then 70 F to 41 F in an additional four hours. This is known as the “two-stage” cooling process. If “one-stage” cooling process is used, the food must be cooled from 135 F to 41 F in 4 hours or less. Proper Methods of Cooling: Divide foods into smaller portions. Use shallow pans: Maximum product depth of 2 inches for thick foods (i.e. chili). Maximum product depth of 3 inches for thin foods (broth). Use the ice bath method. Place the food container in ice and stir the food frequently. Ensure to monitor the cooling temperatures. Use a cooling paddle that is available at your local restaurant supply store on Internet. Reheating Food Reheating cooked foods must be done rapidly. All food must be reheated to 165 F within two hours. If using a microwave oven, food must be reheated to 165 F and allowed to stand covered for two minutes. Remember to use food preparation equipment to reheat food. Do not use steam tables, heat lamps, or other food holding equipment to reheat food. These types of equipment are not designed for this use. 57 Chapter 6 Physical Facilities Facilities If your establishment is planning new construction or remodeling, you must obtain prior approval from the Regulatory Authority. The Regulatory Authority will conduct a plan review of the proposed construction or remodeling to ensure the establishment can be easily cleaned, maintained, and meet the requirements of the Minnesota Food Code. The Regulatory Authority may also review the ventilation and plumbing systems since these systems impact food safety. Walls and Ceilings All wall and ceiling surfaces in a food establishment must be in good repair and maintained in a sanitary condition. All surfaces must be sealed, smooth, and nonabsorbent. The walls and ceilings should also be a light color. This allows light to be distributed which will make soil, dirt, and other types of contamination easy to be seen and cleaned. Floors All floors must be smooth and properly constructed with approved materials. Approved flooring materials include: sealed concrete, terrazzo, quarry tile, and durable grades of linoleum. Carpet is only allowed in the dining areas. All kitchen and storage areas must have approved flooring that promotes easy cleaning. Coving (a sealed edge between the floor and wall) and floor drains are also required to make floors easily cleanable. Lighting Bright lighting must be provided so that dirt, soil, and other types of contamination can be easily seen. Light bulbs located in food preparation and storage areas must be shatter proof. You can shatter proof light bulbs by providing a shield or buying Teflon-coated bulbs. Heat lamps must have covers. 58 Ventilation Ventilation is required in food establishments to remove smoke, odors, moisture, and other obnoxious odors. Ventilation systems are also required to return 80% fresh air to the food establishment. The filters in the hood must be easy to take out and cleaned frequently (usually at least once a week). Plumbing Potable water (drinkable water) must be handled in a sanitary manner. Nonpotable water can cause many different types of illnesses when consumed or used in food service establishments. Non-potable water may only be used for air conditioning and fire suppression. If a plumbing failure occurs in a food establishment, the safety of food, cleanliness of utensils and equipment, and the personal hygiene of employees cannot be ensured. Thus, the food service establishment must stop all operations until the water service can be restored. Cross-connection A cross connection is defined as the mixing of a known quality of water with an unknown quality of water. A cross-connection occurs when non-potable water (or water of unknown quality) contaminates potable water supplies (water of a known quality). All non-potable water supplies must remain separate and labeled in a food service establishment. Back Siphonage Back siphonage may occur when the pressure in the potable water supply drops below that of non-potable water sources. To prevent back siphonage, use an air gap or backflow (back siphonage) preventer. A backflow or back siphonage prevention device installed on a water supply system must meet the American Society of Sanitary Engineers standards for construction, installation, and maintenance for the specific application of the type of device. An air gap is an open, vertical space between potable water and any possible source of contamination. The potable water must pass through open space prior to disposal into the source of contamination. 59 For example, the discharge line of a water softener must be elevated above the floor drain so the water must pass through air before contacting the sanitary sewer. The air gap must be at least one inch or twice the diameter of the discharge line. An air gap is the only reliable method to prevent back siphonage. Sewage All sewage and contaminated water (i.e. mop water) must be disposed of in a sanitary sewage system. The sanitary sewage system must meet state or local requirements. Any problem with the sanitary sewer is a serious health concern. If your sewer system backs-up or does not work properly, stop food service activities and contact the health department. Garbage and Refuse · Keep the garbage and refuse storage areas clean. · Use sturdy, insect, and rodent proof containers. · Do not store garbage in paper bags or cardboard boxes. · Store all garbage and refuse in covered containers. Keep the dumpster’s lids closed. · Routinely clean and sanitize the garbage and refuse containers. Separate Facilities and Dressing Rooms Due to possible contamination from employees’ personal items, provide lockers or closets for employees to change into uniforms and work clothes as well as to store their personal items. Rooms used as living or sleeping quarters may not be used for food service operations. There cannot be a direct opening between the living area and the food service establishment. Toilet Rooms and Hand Washing Facilities · Toilet rooms must be fully enclosed. · Use tight fitting and self-closing doors on all toilet rooms. · The doors to the toilet rooms must always remain closed (except during cleaning). · Hot and cold running water must be provided at all hand washing sinks. · Provide an adequate supply of soap and paper towels at all employee hand washing sinks. · A hand washing sign is recommended at the hand wash station to remind employees to wash their hands. · Provide a waste container for the dispose of paper waste. 60 · Provide an additional covered waste receptacle in all toilet rooms (sanitary napkins). · Do not use cloth towels to dry hands. These are referred to as “common towel” and can transmit many types of illnesses. Always use single use paper towels to dry hands. Equipment Equipment must be designed and constructed utilizing safe materials which are non-corrosive, nonabsorbent, smooth, easily cleanable, and durable. Equipment must meet applicable standards of NSF (National Sanitation Foundation) or equivalent. Do not use domestic equipment in a food establishment. · Materials used to construct equipment must not transmit any odor, color, or taste to food. · Wood used for cutting boards must be made from hard maple or equivalent wood. · Plastic must be made of materials that are resistant to scratching, scoring, and chipping. · Food contact surfaces must be clean, smooth, free of breaks, and promote easy cleaning. · Food contact surfaces must be wash, rinse, and sanitized at least every four hours. · All lubricants must be food-grade if they come into contact with food contact surfaces. · Sinks and drainboards must be self draining. · Non-Food contact surfaces must be smooth, washable, and easy to clean. · Non-Food contact surfaces must be cleaned once every 24 hours. Table and Floor Mounted Equipment · Table mounted equipment must be sealed to the table or elevated on 4 inch legs. · Floor mounted equipment must be sealed to the floor or elevated on 6 inch legs. 61 Chapter 7 Cleaning and Sanitizing What is Sanitizing? Sanitizing is a process that reduces the number of harmful microorganisms to acceptable levels. Safe sanitizing can be accomplished using either hot water or chemicals, after proper washing and rinsing. Manual Cleaning and Sanitizing Equipment and utensils that cannot be cleaned in an automatic dishwasher may be cleaned and sanitized by hand. Large sinks with at least three compartments and attached drainboards are required. Manual cleaning and sanitizing must be done in five separate steps. 1. Scrape and sort items to be cleaned and sanitized on the drainboard. 2. Wash items in hot, soapy water. The temperature of the wash solution should be maintained at 110 F. 3. Rinse items in clean, hot water. Rinsing removes the detergent. Minimum water temp should be 120 F. 4. There are two ways to sanitize items (see following page). 5. Air Dry on the drain board – never towel dry cleaned and sanitized items. 62 Option One: Sanitize items with an approved chemical sanitizer in water temperature of 75 F. Chlorine at a concentration of 50 – 100 ppm with a contact time of 30 – 60 seconds. Iodine at a concentration of 12.5 - 25 ppm, with a contact time of 30 – 60 seconds. Quaternary Ammonia at a concentration of 200 ppm, with a contact time of 30 – 60 seconds. Use a test strip to monitor the proper concentration of the chemical sanitizer. Option Two: Sanitize items in 171 F hot water for 30 seconds. An approved heating device must be used to properly heat water to the required sanitizing temperature of 171 F. A complete immersion for 30-60 seconds is required. Use a calibrated thermometer to ensure water temperature of 171 F. Caution is essential due to the temperature of the water. Mechanical Cleaning and Sanitizing Dishwashing machines are generally better than manual washing for cleaning and sanitizing utensils and equipment. Mechanical dishwashers use either hot water or chemicals to properly sanitize items. Operate the dishwasher in accordance with the instructions on the machine’s data plate. Use a thermometer installed on the manifold to verify correct hot water temperatures on Hot Water Sanitizing Dishwashers. Use test strips to measure the chemical sanitizer concentration on Chemical Sanitizing Dishwashers. Chemical Sanitizing Dishwasher Other basics on mechanical dishwashers: · The temperature of the wash water must not be less than 120 F. · In Chemical Sanitizing Dishwashers, the sanitizer must be automatically dispensed in the proper strength (same concentration listed above). · Correct chemical contact time must be followed. · In Hot Water Sanitizing Dishwashers, the minimum hot water rinse temperature is 180 F. · Rinse water must not be above 194 F. At this temperature, the rinse water turns to steam and does not properly sanitize. · Hot Water Sanitizing Dishwasher Both chemical sanitizing units and hot water sanitizing units should be located under a ventilation hood to remove heat and moisture. 63 Storage of Equipment and Tableware Store cleaned and sanitized items at least 6 inches off the floor. Ensure all items are protected from contamination. Always air-dry items before putting them away - never towel dry. Store cleaned and sanitized items upside-down (inverted) in a self-draining position. Store items in a manner that does not allow workers to contact the food contact surfaces (handles on utensils must be pointed towards the worker or consumer). Do not store food, equipment, utensils, or single service items in bathrooms or other areas with possible contaminants (over head sewer pipes, under stairs, in garbage rooms, etc.). Do not store food, equipment, utensils, or single service items on absorbent cloth towels. Pre-set tableware must be protected from contamination (wrap the tableware in clean napkins). Stationary Equipment This equipment is designed to be cleaned and sanitized by running a detergent solution through the unit followed by a hot water rinse and a chemical sanitizing solution. Examples of clean in place equipment are: soft serve ice cream and frozen yogurt dispensers. Always follow the manufacturer's instructions for proper cleaning and sanitizing. Wiping Cloths Cloths used for cleaning equipment, utensils, and food contact surfaces should not be used for any other purpose. When using wiping cloths for food spills, the cloths must be rinsed frequently in a sanitizing solution. The sanitizing solution should be kept fresh – change every two hours or more often as required. These cloths must be kept in a sanitizing solution when not in use. Frequency of Cleaning and Sanitizing All equipment, utensils, and food-contact surfaces must be cleaned and sanitized after each use. In-use utensils and food contact surfaces must be cleaned and sanitized once every four hours. Maintaining Sanitary Facilities Floors and Walls Facilities must be cleaned regularly. Establish cleaning schedules for all parts of your food service establishment. Make sure that everyone knows when to clean it and how to clean it! 64 Cleaning Equipment Maintain and store cleaning tools such as brooms, mops, vacuum cleaners, and similar equipment in a way that does not contaminate food, utensils, equipment, or linens. Keep them neatly stored in an easy-to-reach area. Service Sinks (Mop Sinks): Store mops with mop heads off the floor for proper air drying. Provide at least one utility sink or curbed cleaning sink to be used for cleaning mops. Discard of all mop water in the service sink – never on the ground surface. Do not use service sinks for dishwashing or hand washing. Pest Control Insects and rodents are serious hazards to a food service operation. Pests damage food, supplies, and facilities. Insects and rodents pose a great threat in causing foodborne illnesses. A regular cleaning and sanitation program is your first line of defense against pests. The best way to keep pests out of the food establishment is to ensure they cannot get in. Ensure walls and floors are in good condition. All outside doors must be tightly seal when shut and equipped with self-closing devices. All windows, doors, air ducts, and other openings to the outside must have screens. Store food supplies properly (six inches off the floor in suitable containers). All surfaces in the food establishment should be cleaned regularly. All food debris and garbage must be removed from the establishment frequently. These actions will reduce the food supply for pests. A reliable and licensed Pest Control Officer (PCO) can be utilized to develop an ongoing pest control program called a Intergraded Pest Management System (IPMS). This program stresses prevention, sanitary establishments, repairs, pesticides, and traps. Roaches Roaches transmit the bacteria Salmonella. Roaches can be found in any place that has food and water available. Droppings (small pepper flakes) indicate roaches are present. 65 House Flies Flies transmit the bacteria Shigella. Flies eat by vomiting on food which dissolves into a substance the flies can consume. This process leaves behind the Shigella bacteria. Elimination of flies in a food establishment should be a top priority. Use screens on doors and windows to prevent the entry of these pests. Air curtains are also an effective means to combat entry of flies into the establishment. Rats and Mice Rats and mice are good climbers and can squeeze through small openings. A rat can squeeze through a hole the size of a quarter. A mouse can fit through a hole the size of a dime! There are several ways to control mice, rats, and other vermin. These include traps, repellents, sprays, glue boards, and poison. Poisons and pesticides can be as deadly to people as to rodents. Pesticides should only be used as a last resort and only a licensed and bonded Pest Control Officer should apply them. stations are covered and locked. 66 Always insure bait Chapter 8 Federal, State and Local Rules and Regulations The goal of Government regulation in the food industry is to promote and protect the public’s health. Federal, State, and Local entities regulate the food industry from planting to consumption. This regulation is an attempt to decreasing foodborne illnesses. Federal Regulators Food and Drug Administration (FDA) - This agency acts as a resource for state and local agencies. This agency also publishes a document called the Model Food Code, which the Minnesota Food Code is based. The Model Food Code is revised and republished every four years. United States Department of Agriculture (USDA) - USDA’s main goal is to improve food production to cure poverty, hunger, and malnutrition. In order to safeguard and ensure safe food, the USDA offers and conducts inspections and grading services. The USDA inspects meats, meat products, poultry, eggs, and dairy products. This organization also regulates pesticide use in the agriculture industry. Center for Disease Control (CDC) - The CDC is responsible for preventing and controlling disease and to respond to public health emergencies. Foodborne outbreaks are also monitored and by the CDC. Environmental Protection Agency - EPA’s main focus is to protect and preserve the environmental resources of today and for future generations. Occupational Safety and Health Act - OSHA works to provide employees with safe working conditions. OSHA’s goal is to have safe and hazard free working environments which include providing safe equipment and safe job procedures and policies. State and Local Regulators State and local health regulators are often called Environmental Health Specialists or Health Inspectors. Often these regulators have the greatest impact on you and your establishment. The Environmental Health Specialists monitors the condition of an establishment to determine if the establishments meet the standards of the Minnesota Food Code. Food Safety Inspections When the Environmental Health Specialist / Regulatory Authority arrives at your establishment do not panic. They are there to ASSIST you in providing safe food to the public and protect the overall public health. A food safety inspection should be conducted by a Environmental Health Specialist at least once per year (this varies from jurisdiction to jurisdiction and risk level of the establishment). The Environmental Health Specialist evaluates food preparation practices, employee health and hygiene practices, equipment, sanitation practices, and physical facilities. Be professional and courteous to the inspector – remember they are there to help you and your establishment! You must provide any records if requested by the Regulatory Authority. A written inspection report will be reviewed and a signature requested. Ensure you obtain a copy of the inspection report for your reference. Correct any problem as soon as possible and respond back to the Environmental Health Specialists. Foodborne Outbreaks What do you do if a Foodborne outbreak occurs at your establishment? First, stop serving food! This is the only way to limit the foodborne outbreak. Secondly, contact your Regulatory Authority. He or she will advise you on what to do. Ensure you do not dispose of any food items, especially the food in question (suspect food items are often tested). Above all else, cooperate with the Environmental Health Specialist! They are there to help you resolve the situation as quickly and quietly as possible.