Food Safety Risk, Response, and Resources: A School Food Service Action Guide

The goal of Food Safety Risk, Response, and Resources: A School Food Service Action Guide is to provide easy-to-use resources, communication sheets, and fact sheets to assist in reducing the risks of foodborne illness. The key to successfully addressing foodborne illness is communication with members of the school community who are involved with food safety including food and nutrition directors, local health departments, school nurses, district school board members, and parents.

Students and staff consume billions of meals and numerous snacks each year in U.S. schools. The Centers for Disease Control and Prevention (CDC) estimates that 48 million people have a foodborne illness each year. An estimated 3,000 individuals die each year as a result of contracting a foodborne illness.

Between 1998 and 2006, 298 outbreaks have been reported where food was prepared on the school premises. However, the percentage of outbreaks from schools is less than 4% of the total outbreaks nationwide. The reporting data supplied by the states does not distinguish between outbreaks involving school meal programs and those involving food items from other sources such as food bought from home to be used as part of a classroom instruction activity or a social event.

However, over a ten year period, there were 40 outbreaks that were directly attributed to school meal programs (GAO, 2003). The cost in medical expenses, lost income and lawsuits is billions of dollars (Scallan E. and others, 2011). USDA estimates that medical costs and productivity losses due to foodborne illnesses range between $6.5 billion and $34.9 billion annually. Foodborne illnesses affect the health of students and staff, causing symptoms that range from mild discomfort to chronic illness and death. If students or staff became ill with a foodborne illness, they are likely to miss school and students’ full learning potential may not be fulfilled. Preventing foodborne illness and preparing a food-safe school environment for the millions of young people that attend school and consume millions of meals each day is a critical matter of school safety and preparedness.

San Bruno - Restoring a Community

Even before the flames from a September 9, 2010 pipeline explosion, that claimed 8 lives and destroyed 35 homes, were extinguished, it was evident that a highly-coordinated effort would be needed to mitigate the public health threats and environmental damage caused by the ash and debris from the explosion. San Mateo County Environmental Health established a multi-agency team to coordinate resources from across a myriad of State and Federal agencies. The Health Officer issued a Public Health declaration due to concerns that mishandled debris could pose further pose a threat. Efforts to recycle as much as possible helped keep costs down. Without a coordinated debris removal effort, the costs to the homeowners and the City would have been much higher, and it would have taken owners much longer to rebuild and restore their community.

Two days after the explosion, household hazardous waste was collected from the 35 properties. Following this, the County established Right of Entry agreements with each of the property owners, giving full access to the properties with a commitment to return properties to the owners in a state that “a three-year-old could safely walk on.” Before initiating debris removal activities, Environmental Health developed a Health and Safety protocol to allow residents to safely access the area to document losses and salvage personal items. Because this was a difficult time for the community, mental health support was also available. A Debris Removal Operation Center (DROC) was established and operated under incident command protocol. Debris removal began 11 days after the fire. Less than four weeks after debris removal began, the DROC was able to demobilize, with all 35 lots cleared. 58 percent of the 7,891 tons of material removed from the neighborhood was recycled. This operation will also serve as a scalable model that can be used to address debris removal operations in other larger disaster events.

Explaining Environmental Noncompliance

The currently accepted explanation of noncompliant behavior, that it is recalcitrant, inner-drive and inaccessible to interventions, is incomplete and inefficacious; further, that the associated interventions of fear arousal and legal enforcement, while critical to resolve imminent hazards, have been ineffective in producing lasting change. Overemphasis on fear arousal and legal enforcement siphons resources from education and consultation functions, leading to incomplete, enforcement-oriented evaluations, decreased inspector morale and even relapse of compliant conditions due to overuse of fear arousal. This view of noncompliance has become nearly axiomatic, preventing research on system modifications and pushing sanitarians into an enforcement mode. 

Decades of behavioral science (health education) research suggest the need to look at root causes of noncompliance, rather than simply citing the behavior itself1. Examples of this research, e.g  the Health Belief Model and Social Learning Theory, lead to a more comprehensive explanation of noncompliance which incorporates enforcement, education and consultation functions, based on needs of the situation. These concepts can be used both to increase compliance and gain a better understanding, both of the occurrence of noncompliant behavior and of the process required to change behaviors. Few changes are needed in the existing inspection system while the rewards will be higher morale, efficacious site evaluations and, in the long term, better lasting compliance. Expanded public health networking, especially with health educators, is essential to this change, as well as better training and education of sanitarians.                 

Performance evaluation of new onsite wastewater technologies – experiences with recycled media biofilters

A pretreatment system using media derived from the recycled husks of coconuts (100% coir fiber) was evaluated using 20 permanently occupied single-family residences located in the State of Virginia.  Sampling began in the summer of 2009 and continued to the summer of 2011.  Home locations ranged from the mountainous regions of western Virginia to sandy low relief sites on the Eastern Shore of Virginia.  Concentrations of biochemical oxygen demand, total suspended solids, and nitrogen species (TKN, nitrate + nitrite) were measured in system influent and effluent four times (once in each season) for each home.  Total phosphorus was measured from each home’s influent and effluent once during the study.  This paper provides information on the performance of this attached growth treatment system under real world conditions.                         

Rat Hoarder Case

This was one of the most challenging public nuisance complaint cases
I have ever been involved in during my 32 years in the environmental health field.
The Rat Hoarder involved a single woman that lived in a beautiful neighborhood located in Sedona, Arizona. The problem started with two pairs of pet rats (Rattus norvegicus) that she allowed to run free in her house, which were purchased to replace her beloved cat. After eleven months of the rats breeding freely in her house the number of rats grew exponentially and eventually destroyed her once beautiful home and eventually started to escape into the neighborhood. Even with this extensive infestation the Rat Hoarder was still very attached to her rats (she had names for each rat and would kiss each one she picked up). She fought us on ever step of the process even though she was told about the diseases that the rats may carry, or she had to turn off the power to her house because the rats had gnawed through the electrical wiring inside her house, or some of the rats were now starting to become aggressive and bite her.

The public nuisance process took seven (7) months to resolve. To resolve this nuisance we relied on the assistance of the County Attorney’s Office, Arizona Vector Control Department, Sedona Police Department, Sedona Community Development Department, and the National Humane Society. We carefully followed all appropriate enforcement steps available and made sure the Hoarder was given proper due process to prevent the case from being thrown out of court. Both non-judicial and judicial law processes were used in resolving this case, which included:
• Issuance of a notice of violation citing the public nuisance state statute;
• Issuance of a Search Warrant;
• An Administrative Law Hearing; and
• A Superior Court Hearing.

Sedona Animal Control and Coconino County Environmental Health worked together on this case and removed over 900 hundred pet rats from inside her home as well as some that were trapped outside her home. The house had to be completely gutted requiring the replacement of all wall and ceiling boards, insulation, wiring, and plumbing to remove the nesting materials, urine, and feces left from the rats.