Good Farmers Market Practices

Good Farmers Market Practices

Manager and Vendor Specific

-Introduce GFMPs (Good Farmers Market Practices) and explain the target audience & intended impactWhile everyone involved with the farmers market (managers, vendors, patrons, literally everyone) are a part of a good food safety culture, this is intended specifically for training managers and vendors of the markets

Good Farmers Market Practices (also called GFMPs) is a new food safety curriculum developed by NC Cooperative Extension including the following elements: Basics of Food Safety, Personnel Health & Hygiene, and Food Sampling. Additional information will be presented to provide an overview of resources focused on basic steps for risk management. Vendors and market managers are encouraged to take advantage of this training to reduce the risk of foodborne illness.

-You may want to read over the CDCs Questions and Answers about Foodborne Illness prior to providing the training (http://www.cdc.gov/foodsafety/facts.html)

REFERENCE #11Food Safety PrinciplesSession OneOverviewFactors contributing to foodborne illnessFood commoditiesWhat bacteria need to growVirusesFood safety culture -Emphasize that the section titled Food Safety Principles applies to everyone involved with the farmers market (managers, vendors, patrons, literally everyone).

-This slide provides an outline for the topics discussed in the Food Safety Principles section of the curriculum.2Food Safety CultureKnow the risks associated with the products or meals producedKnow why managing the risks is importantEffectively manage potential risksToolsMessagesInformationCompelling messages

Powell et al., 2011-Content from Enhancing food safety culture to reduce rates of foodborne illness Powell et al. You will want to read over the paper prior to providing the training.

REFERENCE #23Food Safety CultureSupport for scientifically validated safe food-handling behaviorsFood safety equals behaviorThought and behaviorApplication through management and communicationSaving money happens through food safety cultureFood safety tells a story and is a selling point

Powell et al., 2011Continued-Content from Enhancing food safety culture to reduce rates of foodborne illness Powell et al. You will want to read over the paper prior to providing the training.

REFERENCE #2

4What Is Food Safety?HandlingPreparationStorage

AVOID FOODBORNE ILLNESS-Explain the focus of the curriculum is to decrease the risk of foodborne illness

Food safety focuses on the handling, preparation, and storage of food in ways that reduce the risk of foodborne illness.Examples:Handling: After cutting raw meats, wash hands, cutting board, knife, and countertops with hot, soapy water.Preparation: Ensure that poultry products are cooked to 165 F by measuring the food temperature with a tip-sensitive food thermometer.Storage: Keep hot foods hot and cold foods cold to reduce the growth of microorganisms.5What Are We Dealing With?Preventing contaminationDestroying harmful microorganismsLimiting the growth of harmful microorganisms

-Better define the factors that contribute to decreasing the risk of foodborne illness.

Keep bacteria from entering the food system. Since we cannot see bacteria, preventing contamination, destroying harmful microorganisms, and limiting the growth of harmful microorganisms are the steps to take to reduce the risk of foodborne illness.6Foodborne Illness In The US47.8 Million episodes of foodborne illness127,839 Hospitalizations3,037 Deaths

-in-

Scallan et al., 2011While there are claims that the US enjoys one of the worlds safest food supplies (USDA) people still get sick. In January of 2011, the CDC estimated that each year roughly 1 in 6 Americans or 48 million people gets sick, 128,000 are hospitalized, and 3,000 die of foodborne diseases.

-Content from Foodborne Illness Acquired in the United StatesUnspecified Agents Scallan et al.-Important to read Foodborne illness acquired in the United Statesmajor pathogens Scallan et al.

REFERENCE #3 and #47Major PathogensNorovirusCampylobacterSalmonellaClostridium perfringensStaphylococcusE. coli O157Shigella Listeria monocytogenesHepatitis AGiardia lamblia

-Introduce most common illness-causing pathogens-Give background on each and describe the food products that are usually associated with foodborne illness outbreaks -Read over Pathogen Sheet prior

PathogenBrief Description of SymptomsFoods Associated

REFERENCE #5

8Symptoms Of Foodborne IllnessDiarrhea (may be bloody)Abdominal crampsFeverFatigueLoss of appetiteNauseaDark urineJaundiceMuscle achesHeadachesVomitingChills

Foodborne illnesses can cause symptoms that range from an upset stomach to more serious symptoms, including diarrhea, fever, vomiting, abdominal cramps, and dehydration which can progress in to worse symptoms. Death is a symptom that unfortunately can occur. Most foodborne infections are undiagnosed and unreported.

-Focus on initial symptoms & lack of reporting-Development of worse symptoms-Death is also a symptom9Protecting Real People

22 year-old Stephanie SmithI ask myself every day, Why me? and Why from a hamburger?

Travis Cudney2010 Champion ChildBlind since age 2Complications from a pathogenic E. coli infection-The faces of foodborne illness (both E. coli & HUS syndrome)

-Stephanie: http://www.myfoxtwincities.com/dpp/news/minnesota/stephanie-smith-cargill-ecoli-lawsuit-Read Stephanies Story priorFocus on her good health before & inability to dance afterAlso, comment on her suing Cargill (this could happen to a vendor)

-Travis: http://www.ingersolltimes.com/ArticleDisplay.aspx?e=2797191&archive=true-Read Traviss Story prior

REFERENCE #6 and #7

10Farmers Market OutbreakIn 2000, Escherichia coli O157:H7 linked to produce samples offered at a farmers market in Fort Collins, CO14 People were ill and two elementary school-aged children required dialysis

- Not much information is known about this outbreak. The Health Department does not have any further information than what is presented on the slide.

- Melons are labeled as potentially hazardous due to the large amount of outbreaks that they have been linked to.- Why? Usually due to contamination moving from the porous-outer layer & then receiving inadequate temperature- There were 2 large outbreaks in 1990 & 1991 involving Salmonella in Melons- Melons must be stored at 45oF for no longer than 4 hours11Farmers Market OutbreakIn 2010, Salmonella linked to guacamole, salsa and uncooked tamales at a farmers market in east-central Iowa44 People sick and five hospitalized

-Provide greater background

In the summer of 2010, an estimated 53 cases of Salmonella Newport (nine culture-confirmed) were linked to products sold at two Iowa farmers markets. Through epidemiological interview questionnaires and testing of cases and containers, it was determined that guacamole-based products produced by La Reyna Supermarket & Taqueria were implicated as the source. The restaurant sold guacamole, red and green salsa, along with pork, chicken, and vegetable tamales at the farmers markets. According to Iowa health officials, Linn County Public Health had inspected the restaurant stand at the farmers market on the implicated date. They found that some of the ice used for cooling had melted, increasing the potential risk for temperature abuse of the products. Officials provided factors of contamination such as lack of sanitation techniques, cross-contamination, and improper washing of avocados. Improper holding temperatures were listed as a potential factor for bacterial increase due to the temperature for the day being above 80oF.

REFERENCE #912Farmers Market OutbreakIn 2011, Escherichia coli O157:H7 linked to strawberries sold at multiple farm stands and farmers markets in Oregon12 Females and four males became ill4 Individuals were hospitalized and 2 people suffered kidney failure

- Provide greater information and stress the need to keep animals out of food production areas including fields.

REFERENCE #1013Fruit & Vegetable OutbreaksEscherichia coli O157:H7LettuceUnpasteurized juicesSalmonellaMelonsCryptosporidiumBerriesListeriaCole slawGast et al., 1997

-Emphasize these are only some of the outbreaks and these are common foods sold at farmers markets14Food CommoditiesSeafoodFin fish, shellfish, crabs/crustaceans, etc.Animal meatsBeef, poultry, pork, game, etc.ProduceFruits and vegetables

Grains & nutsCereal, nut meats, etc.EggsProcessed foodsFrozen, fresh, canned, etc.DairyFluid milk, cheese, yogurt, confections, etc.

It is important to know how each food group will be referred to in the curriculum & on the future website for ease understanding the content and knowing where to look for answers to specific commodity questions.15Food Safety Hazard CategoriesPhysicalChemicalBiological

Food safety hazards include physical, chemical, and biological hazards, but this curriculum focuses mainly on biological hazards (bacteria, viruses, and parasites).16Physical HazardsObject or foreign matter in a food itemMay cause illness or injury to a person consuming the productSourcesRaw materialsBadly maintained facilities & equipmentImproper production proceduresPoor employee practicesExamplesBoneMetal flakesStonesGlassWood fragmentsInsects

Physical hazards can pose a problem at any point in the food system. Physical hazards are foreign particles such as glass or metal.17Chemical HazardsToxic substances in a food itemMay cause food to be unsafe to consumeExamples and SourcesPesticidesFertilizersAntibioticsHormonesNitratesLubricantsPaintCleanersSanitizers

Chemical hazards can be naturally present or added during actions such as soil preparation, harvesting, and processing. Chemicals or non-food items should not be placed around food. Chemical hazards include substances such as cleaning solutions and sanitizers.18Biological HazardsMicroorganisms that cause foodborne illnessExamples and SourcesParasitesVirusesBacteria

Biological hazards are the primary target of this food safety curriculum. Biological hazards come mainly from microorganisms including bacteria, viruses and parasites.19Top Five Factors Responsible For Foodborne Illness Outbreaks

Improper hot/cold holding temperatures of potentially hazardous foodImproper cooking temperatures of foodDirty and/or contaminated utensils and equipmentPoor employee health and hygieneFood from unsafe sources

CDC-It is important to note that while each of the factors listed contributes to the risk of foodborne illness, they are not in a specific order.

1. Improper hot and cold holding temperatures of potentially hazardous foods.The purpose of holding potentially hazardous foods at proper temperatures is to minimize the growth of any pathogenic bacteria that may be present in the food. Potentially hazardous foods that are going to be held at cold temperatures must be held at a temperature of 41F or below. Potentially hazardous foods that are going to be held at hot temperatures must be held at a temperature of 135F or above. The temperature range between 41F and 135F is called the danger zone. Food facility operators must take every precaution to minimize the amount of time that potentially hazardous foods spend in the danger zone.

2. Improper Cooking Temperatures of FoodsCooking food to the proper temperatures is extremely important because many raw meats have pathogenic bacteria on them naturally. Once the proper cooking temperature has been achieved, ensure that the food remains at or above that temperature for at least 15 seconds to make sure that most if not all of the bacteria are eliminated.

3. Dirty or Contaminated Utensils and EquipmentWhen utensils or equipment become dirty or contaminated, they can transfer that contamination to the food causing a foodborne illness.

4. Poor Employee Health and HygieneIt is imperative that food workers are in good health while preparing food. A food worker that has been diagnosed with an acute gastrointestinal illness (GI), or is showing symptoms such as diarrhea, or vomiting in conjunction with diarrhea, could potentially contaminate food. It is possible for a food worker to transfer their illness to customers via the food. Even more disconcerting, there is the potential for employees working with large batches of food to spread the illness to numerous people causing an outbreak.

5. Food From Unsafe SourcesAny food that is to be sold, served, given away, or used as an ingredient, must be obtained from an approved source. An approved source is a facility where the food produced, prepared, or processed, meets or exceeds the standards of the responsible regulatory agency. Even when the source you purchase food from is approved, it is still advisable to know exactly how they handle your food before it gets to you.20

High Risk Populations (YOPIs)PregnantImmunocompromised naturallyImmunocompromisedAIDS, chemotherapy, transplants, external stressVery youngUnderdevelopedVery oldDecreased immune function

The high risk population is not only at risk of contracting a foodborne illness but may also suffer more severe symptoms. Young children are at more risk to foodborne diseases because their immune systems are still developing and the protection afforded by the resident gut flora is not as effective as in adults. Children are also more vulnerable to the toxic effects of chemical contaminants in foods. The elderly are more susceptible to foodborne illness than other groups due to the fact that, the natural defenses or ability to fight diseases lessen in old age. A decrease in stomach acid secretion, which is a first line defense against ingested bacteria, compounds the problem. Pregnant woman are naturally more susceptible to being immunocompomised. Due to the weakened immune systems, individuals suffering from cancers and chronic illness such as HIV/AIDS are particularly prone to contracting foodborne illness.21What Bacteria Need To GrowTemperaturepHOrganic acidsOxygenWater activityOther factors:InhibitorsNutrientsCompetition

It is important to understand that ALL of these factors are important and ALL play into the safety of a food productThis is a list of factors that affect the growth of bacteria and we will look at each factor individually. It is important to understand that all of these factors are important and all play into the safety of a food product. You cannot focus on just one factor because all are important and work together to reduce the risk of foodborne illness.22TemperatureTime and temperature control for bacterial growth

Temperature Danger ZoneHold hot food above 135FHold cold food below 41

Temperature AbuseFoods not heated to a safe temperature or kept at a safe temperature

Bacteria and other microorganisms do not grow well when the temperature of the food is colder than 41 F or hotter than 135 F. The temperatures in between 41 and 135 are in the Danger Zone. Keep potentially hazardous foods out of the Danger Zone! For example, when food is left in the Danger Zone, bacteria can grow fast, and make poisons that can make you and your patrons very sick. Make sure that foods are heated to a safe temperature and kept at a safe temperature.23Temperature AbuseRead the July 11, 2009 infosheet titled Clostridium Perfringens linked cause of illness that sickened many in Myrtle Beach,SC

- Clostridium perfringens may be present in small amounts after cooking and can multiply to dangerous levels in improperly cooled and held food- Improper cooling is suspected as the cause of the outbreak. It is not known how rapidly the food that the caterer prepared was cooled.- Foods that have suffered temperature abuse often lead to Clostridium perfringens poisoning.- Food can be briefly left out to cool, as long as it is refrigerated by the time it reaches 120. Use a thermometer to verify the temperature.

REFERENCE #1124Available OxygenOxygen availability affects bacterial growthAerobic: bacteria require oxygen in order to growAnaerobic: bacteria cannot survive in oxygenOne important cause of food spoilage and spoilage is air and oxygen. Oxygen can provide conditions that enhance the growth of microorganisms. Some bacteria require oxygen for growth (aerobes) while others can grow only in the absence of oxygen (anaerobes). Many bacteria can grow under either condition and are called facultative anaerobes. Molds and most yeast that cause food to spoil require oxygen to grow. They can often be found growing on the surface of foods when air is present. Canned and vacuum packaged foods provide an anaerobic environment. While canning provides a great method for preservation, knowing the correct method and recipe for canning is a must. Improper canning can lead to sickness or even worse, death usually from the growth of the anaerobe Clostridium botulinum.25pHDesignates the level of acidity of a food productpH ranges from 0 to 14Acid: 0 to 7High acid foods have a pH at or below 4.6Slows the rate of bacterial growthDisease-causing bacteria grow best at a pH between 4.6 to 7Alkaline: 7 to 14The acidity of foods has been used for centuries to preserve foods. Acidity plays a primary role in the preservation of fermented foods and combined with other factors such as heat, water activity, and chemical preservatives acts to prevent food deterioration and spoilage. The intensity of acidity of a food is expressed by its pH value. The pH of a food is one of several important factors that determine the survival and growth of microorganisms during processing, storage and distribution. Consequently, food processors are interested in determining the pH of foods and in maintaining pH at certain levels to control microbial growth and prevent product deterioration and spoilage. The pH scale was developed from mathematical calculations based on the dissociation temporary breakdown) of water. These complex calculations allow us to measure pH on a scale that runs from 0 to 14. The values that are less than 7 are acidic, while those greater than 7 are alkaline. A pH value of 7 is neither acid or alkaline and is considered neutral. Pure water has a pH of 7 and is neutral.

(foodsafetysite.com)26Low-Acid Foods

Read the June 15, 2009 infosheet titled 3 in Spokane sicken by Botulism linked to home cannedbeans

- Low acid foods (pH greater than 4.6) such as green beans and asparagus cannot be safely canned using a hot water bath, even if vinegar is used (unless a tested pickling recipe is followed).- Clostridium botulinum spores are common in soil. The spores can be heat activated and turn into cells. The growing cells create a toxin leading to botulism in oxygen-free canned foods.- In February 2009 a Spokane woman and two young children were sickened by botulism from improperly canned green beans from a home garden.- Use a pressure canner and follow a tested recipe to safely preserve beans.

REFERENCE #1227Organic AcidUsed to control the entry & growth of microorganismsUsually added or producedAdd: preservativeProduced: fermentationExamplesAceticPropionicCitricBenzoicAscorbic

The acidity of a food may occur naturally as in citrus fruits, apples, tomatoes and strawberries or it may be produced in foods through microbial fermentation. Selected acid producing bacterial cultures added directly to foods can produce desirable products like yogurt, buttermilk and fermented meat products. Acid may also be added directly to a food; an example is the addition of acetic acid to fish and vegetables, lactic acid to Spanish-type olives and citric acid to beverages.28Water ActivityMeasure of the amount of water not bound to a food and available for bacterial growthWater Activity ranges from 0 to 1Pure water has a water activity of 1Disease causing bacteria grown in foods that have a water activity of 0.85Yeasts & molds can grow on food products that have a water activity as low as 0.75Water in food that is not bound to food molecules can support the growth of bacteria, yeast, and mold. The term water activity refers to this unbound water. Most foods have a water activity above 0.95 and that will provide sufficient moisture to support the growth of bacteria, yeasts, and mold. The amount of available moisture can be reduced to a point that will inhibit the growth of microorganisms.29VirusesSmaller than bacteriaRequire a host to grow and reproduceHuman or animalDo not multiply in foodExamplesHepatitis A virusNorwalk virusRotavirusEffectsTemperatureDisinfectionpHHygiene controlHuman elementHandling

Viruses are the smallest of the foodborne microbial contaminants. Most experts believe that viruses are the most common cause of foodborne illness in the U.S. Unlike bacteria, viruses cannot multiply outside of their specific host - human, animal, or plant. Although inert in the environment, viruses transmitted by food are quite hardy and remain infectious while stored in the refrigerator or the freezer. Therefore, maintaining foods at proper temperatures does not reduce the presence of viral agents. Viruses can also withstand the low pH of the stomach and the harsh detergent conditions of the upper small intestine.30Norovirus

Read August 8, 2008 infosheet titled Chips transmit illness at wedding reception in Rochester,MN

- Norovirus was the real wedding crasher at this gathering.- More than 20 people who attended a Rochester wedding reception on August 1 got sick after eating tortilla chips contaminated with norovirus, possibly from vomit or fecal matter.- Almost 40% of Norovirus outbreaks are linked to food service settings - Norovirus is spread largely through food contaminated by vomit or fecal matter, or through close contact with infected people

REFERENCE #1331What Specific Foods Cause Illness?What people thought:1: Chicken2: Meats3: Ground meats4: Fin fish5: Shellfish

Environics, 2005What actual causes illness:1: Produce2: Poultry3: Beef4: Eggs5: Seafood

CDC, 200932Why is this important to farmers markets? Produce is the number one food product seen sold by vendors- Also, reinforce that produce is not exempt from causing foodborne illnessWhat Foods Cause Illness?ANY FOOD can cause foodborne illnessFoods classified as potentially hazardous have a greater possibility of supporting the growth of harmful bacteria and causing illness

Since any food is capable of causing illness, it is important to focus on reducing the risk of foodborne illness no matter what food product you are selling. Disease causing bacteria can multiply rapidly in potentially hazardous foods if temperature controls are not used or are inadequate. Potentially hazardous foods include foods of animal origin that are raw or heat-treated, a food of plant origin that is heat-treated or consists of raw seed sprouts, cut melons, and garlic-in-oil mixtures that have not been properly acidified to prevent the growth of pathogenic bacteria. 33Potentially Hazardous FoodsAllow for rapid progression & growth of pathogensExamples

These products must be kept at proper temperaturesDairy productsMeatPoultryGame animalsSeafoodEggsLeafy greensSliced melonsRaw sproutsCut tomatoesTofuGarlic-in-oil mixtures

Here are some examples of potentially hazardous foods, these food products must be stored at safe temperatures.34Potentially Hazardous FoodsPotentially hazardous food characteristicsHigh in protein or carbohydrateLow acid

Potentially hazardous foods are usually high in protein or carbohydrate and/or low acid foods. For example, eggs and animal meats are high in protein and most canned vegetables and meats are low acid foods.35Low Acid FoodsAny food with:pH greater than 4.6Water activity greater than 0.85Examples:Red meatSeafoodPoultryMilkFresh vegetables

It is mostly important to know if a food is low-acid especially if you are canning it. Canned low-acid food recipes must be tested and registered with the FDA. Please take the Acidified Foods GMP School to help you think through safety concerns of your low-acid food products.36Ready-To-Eat FoodsFoods that do not need any further processing or cooking for safetyExamples:SaladFruitsVegetablesBaked goodsNutsSpicesFermented sausageDeli meatsReady to eat foods are foods that do not need any further processing or cooking for safety. Some examples are salad, fruits, vegetables, baked goods, nuts, spices, fermented sausage, and deli meats.37Legal Requirements For Specific FoodsKnow requirements to legally sell foodsMore importantly:

Know food safety precautionsLabelingCertificationsClasses (i.e.: GAPs, Acidified Foods School)If you are going to sell a food product, you must know the legal requirements that you must satisfy in order to sell your product. Even more importantly, you need to know the safety precautions to take to reduce the risk of foodborne microorganisms entering and growing in your product. If you need more information on safety or legal requirements for the food products that you are selling, contact your county extension agent.38LabelingCurrent labeling regulations:All food products in package form must conform to required label information Product nameNet weightIngredient listingManufacturer/distributor name and addressNutrition information

Some food product labels may also be required to have product coding and other statements related to product storageStress extension can help with labels, contact county extension agent39

Acidified Foods Better Process Control School Processing acidified foodsCertified supervisorAdequate pH, time, and temperature What is an acidified food?A food, usually a vegetable, which is preserved by an acid, such as vinegarWhy?Processes for rendering the product safeInhibit the presence of dangerous microorganismsExample: Clostridium botulinumWhen?2+ times per year in North Carolina

http://www.ncagr.gov/fooddrug/food/homebiz.htm

Check out:After talking about the safety and legal requirements of canned foods, stress the need of vendors to take the Acidified Foods Better Process Control School.

-Send them on to the NC entrepreneurial website listed below40Say Something

Read the April 10, 2010 infosheet titled Oops It happened again: messy diaper changing can lead toillnesses

Even though people witnessed Britney Spears changing her baby, they did not speak up. As part of a good food safety culture, everyone needs to be involved. If you witness a risky practice, say something because the risky practices could make you or someone else sick.

- In 2006, Britney Spears was spotted changing her baby atop a restaurant table in Los Angeles.- Norovirus, Shigella, and Salmonella can be passed through poop to food and cause illnesses.

REFERENCE #1441Team Commitment

Read the June 21, 2007 infosheet titled E. coli O157 Outbreak may have been caused by goat slaughter in kitchen; Death linked to E. coli O157 complications in North Carolina restaurantoutbreak

- The restaurants owners didnt know what was going on inside the establishment which is not the sign of a good food safety culture. Everyone who has access to the food production and food products should be accountable for their food safety behavior.-North Carolina E. coli outbreak caused by a goat.-Know whats going on with everyone involved

REFERENCE #1542QuestionsFood Safety Principles

Questions on food safety principles or any other part of the curriculum.

43Personnel Health & HygieneSession TwoTraining programCommunicationSupervisionProper handwashing techniquesSanitizers & One-use glovesOpen woundsRestroom useClothing and cleanliness

-Emphasize that the section titled Personnel Health & Hygiene applies mainly to food handlers and vendors.

-This slide provides an outline for the topics discussed in the Personnel Health & Hygiene section of the curriculum.

44V: Vendor SpecificM: Manager specificCoding System -- Responsibility-Explain the mixture of curriculum intended for vendors and mangers-Good accountability is a part of a good food safety culture

45Top Five Factors Responsible For Foodborne Illness Outbreaks

Improper hot/cold holding temperatures of potentially hazardous foodImproper cooking temperatures of foodDirty and/or contaminated utensils and equipmentPoor employee health and hygieneFood from unsafe sources

CDC-It is important to note that while each of the factors listed contributes to the risk of foodborne illness, they are not in a specific order.

1. Improper hot and cold holding temperatures of potentially hazardous foods.The purpose of holding potentially hazardous foods at proper temperatures is to minimize the growth of any pathogenic bacteria that may be present in the food. Potentially hazardous foods that are going to be held at cold temperatures must be held at a temperature of 41F or below. Potentially hazardous foods that are going to be held at hot temperatures must be held at a temperature of 135F or above. The temperature range between 41F and 135F is called the danger zone. Food facility operators must take every precaution to minimize the amount of time that potentially hazardous foods spend in the danger zone.

2. Improper Cooking Temperatures of FoodsCooking food to the proper temperatures is extremely important because many raw meats have pathogenic bacteria on them naturally. Once the proper cooking temperature has been achieved, ensure that the food remains at or above that temperature for at least 15 seconds to make sure that most if not all of the bacteria are eliminated.

3. Dirty or Contaminated Utensils and EquipmentWhen utensils or equipment become dirty or contaminated, they can transfer that contamination to the food causing a foodborne illness.

4. Poor Employee Health and HygieneIt is imperative that food workers are in good health while preparing food. A food worker that has been diagnosed with an acute gastrointestinal illness (GI), or is showing symptoms such as diarrhea, or vomiting in conjunction with diarrhea, could potentially contaminate food. It is possible for a food worker to transfer their illness to customers via the food. Even more disconcerting, there is the potential for employees working with large batches of food to spread the illness to numerous people causing an outbreak.

5. Food From Unsafe SourcesAny food that is to be sold, served, given away, or used as an ingredient, must be obtained from an approved source. An approved source is a facility where the food produced, prepared, or processed, meets or exceeds the standards of the responsible regulatory agency. Even when the source you purchase food from is approved, it is still advisable to know exactly how they handle your food before it gets to you.46Training ProgramUnderstand food safety cultureResponsibilityConsequence of action OR no actionReason, understand, protect

Powell et al., 2011As part of a good food safety culture, everyone should be trained on good food safety behaviors and risk reduction practices. The process of developing a good food safety culture involves everyone understanding their role and responsibility in reducing the risk of foodborne illnesses. Reinforce the consequences of action or no action. Everyone needs to be able to reason, understand, and protect others from getting sick.

REFERENCE #247CommunicationEffectively manage potential risksToolsMessagesInformationCompelling messagesFood safety equals behaviorThought and behaviorApplication through management and communication

Powell et al., 2011The method of communicating food safety with those who are a part of the farmers market needs to be catered to the needs of the market. Use effective tools, messages, and information with compelling messages. Since food safety is behavior based, behaviors should be reinforced through effective management and communication.

REFERENCE #248Restroom FacilitiesRestrooms with handwashing facilities should be available within 200 feet of the marketGeneral considerationsAccessibility needsChildrenHandicapped personsMIt is a best practice to have restrooms with handwashing facilities available in a location where people will use them. If the facilities are too far away from that market location then most people will not visit the facilities. A handwashing station should be available in the restroom because hand sanitizer does not kill viruses so it should not be used in place of handwashing. Also, considerations should be made to ensure that everyone has access to the handwashing stations that are available.49Restroom FacilitiesRestroom not to be used for storage of food, equipment, or suppliesClean toilet facilitiesToilet rooms separated from other areasToilet paper provided in a permanently installed dispenser at each toiletHandwashing facilitiesNear toilet roomsM- Reinforce basic concepts necessary for a restroom.- It is important to have the restroom accessible and even more important to keep the handwashing facilities stocked and available50Handwashing StationsFDA recommends handwashing facilities are convenient Within 25 ft of the booth or tableVendors who sample are encourages to have one in their boothUnobstructedConvenient

M- It is important to have handwashing stations be readily available for vendors so they have a greater chance of washing their hands.51Handwashing StationsHands-free (PVC pipes)Six-component method5 Gallon cooler with free-flow spigot (clean & sanitary)Constant flowTwo-handed washingSoapClean waterPaper towelsCatch basin for wastewaterTrash receptacle

M

- It may be best to have a setup of handwashing stations and make recommendations on methods for the market or vendors to make their own.52Handwashing StationsSinks should be of appropriate height & clearly markedHandwashing signsEnglish as well as in other languages when customers & employees may not speak primarily English

M

- Further recommendations53Effective HandwashingCorrect technique for handwashingBest way to prevent the spread of diseaseWash hands with soapBetween fingersUnder finger nailsRinse hands with running waterDry hands with one-use paper towelHand sanitizersNot a replacement to handwashingSupplement

- It may be best to demonstrate handwashing during the training.- Do not assume that people know how to wash their hands.- This slide should not be brushed over.54Importance Of Handwashing

Read the October 26, 2011 infosheet titled Server with Hepatitis A at Cheddars Casual Cafe results in thousands ofvaccinations

- An estimated 7,700 diners may have been exposed to Hepatitis A in Texas.- Servers while not traditionally thought as food handlers are often involved with scooping beverage ice and salad prep.- Handwashing can reduce the chance of passing on Hepatitis A to patrons. Keep poop off your hands.

REFERENCE #1655Wash HandsBefore starting workAfter any absence from booth (example: breaks)After restroom useAfter smoking, eating, or drinkingAfter touching an open sore, boil, or cutAfter handling fresh produceAfter taking out the trashAfter any activity that may have caused contaminationIt is important to ask yourself, should I wash my hands? If you have the time or can make the time, wash your hands. It will help keep you and others from getting sick. It is a good idea to have more than one person working at each stand so there is more time for handwashing to be a priority.56One-Use GlovesGloves are capable of spreading germsNot a substitute for handwashingHelpful for avoiding bare-hand contact with foodMust be used for single task & discardedDamagedSoiledInterrupted taskNon-latex glovesAllergiesV- Make sure to emphasize that gloves are NOT a substitution for handwashing but can be a supplementation to handwashing if there are restraints that do not allow for ease in handwashing.- Reinforce that handwashing is the best practice.57Open WoundsDo not handle food if you have a sore that contains pus or that is infected.Cover affected area with a bandage, a finger cot, and then a single-use glove.

V- This is a good example of when gloves would act as a supplementation to handwashing.

58Money HandlingNot as big of a problem as expectedScience supportedPatron opinion may demand otherwise

V- Money has not been scientifically proven as a foodborne pathogen vehicle but patrons may have a certain perception of money handling and then touching food products.- Suggest that vendors use this as something to communicate with patrons. Maybe have signs around the market as part of the good food safety culture.59Handling Ready-To-Eat FoodsEnsure no food handlers are illPromote effective handwashing by food handlersAvoid bare hand contact with ready-to-eat foodsGlovesTongsSpoonsHand papersExamplesCooked foodsRaw produceBaked goodsDried sausageCanned foodsBeveragesV- This slide is used to reinforce some of the basic principles of personnel health and hygiene especially in regards to handling of ready-to-eat foods.60Ready-To-Eat Foods

Read the June 24, 2010 infosheet titled Salmonellosis transferred bydelicatessenworkers

- Staff member had been in contact with infected chickens.- Food handlers can transmit Salmonella in their poop without knowing; you dont have to be ill to pass it on.- Wash hands with soap after handling birds, baby chicks or reptiles and after contact with pet feces.

REFERENCE #1761Clothing CleanlinessClothing can be a source of contaminationAppropriate hair restraintClean clothingJewelryV- Clothing can be a factor in pathogen transfer so encourage those in attendance of the market to not wear the same clothing that they where on their farm to the market.- Jewelry can be a source of physical contamination. Be aware of all items that are in the food serving and selling area of the market.62VendorsSickSTAY HOMEStorage of vendor drinkAway from sellable food itemsVWorkers can carry microbial pathogens on their skin, in their hair, on their hands, and in their digestive systems or respiratory tracts. Unless workers understand and follow basic food protection principles, they may unintentionally contaminate fresh produce and fresh-cut produce, food contact surfaces, water supplies, or other workers, and thereby, create the opportunity to transmit foodborne illness. Basic food protection practices related to worker health and hygiene fall into two categories, disease control and cleanliness.63Keep The Sick At Home

Read the October 30, 2008 infosheet titled Stay home if you aresick

You might not be comfortable discussing "private" matters like diarrhea, and vomit but for the spread of disease to be prevented, illnesses and symptoms must be discussed with those involved. If you are sick stay home.

- In 2006, a line cook at a Michigan restaurant who showed up to work ill and vomited in a kitchen waste basket was linked to a norovirus outbreak that made 364 patrons ill.

REFERENCE #1864QuestionsPersonnel Health & Hygiene

Questions on personnel health and hygiene or any other part of the curriculum.

65SamplingSession ThreePreparationStorageClean & sanitaryChemicalsTransportation

-Emphasize that the section titled Sampling applies mostly to vendors and their interactions with patrons but should be encouraged by the manager.

-This slide provides an outline for the topics discussed in the Food Safety Principles section of the curriculum.

66Top Five Factors Responsible For Foodborne Illness Outbreaks

Improper hot/cold holding temperatures of potentially hazardous foodImproper cooking temperatures of foodDirty and/or contaminated utensils and equipmentPoor employee health and hygieneFood from unsafe sources

CDC-It is important to note that while each of the factors listed contributes to the risk of foodborne illness, they are not in a specific order.

1. Improper hot and cold holding temperatures of potentially hazardous foods.The purpose of holding potentially hazardous foods at proper temperatures is to minimize the growth of any pathogenic bacteria that may be present in the food. Potentially hazardous foods that are going to be held at cold temperatures must be held at a temperature of 41F or below. Potentially hazardous foods that are going to be held at hot temperatures must be held at a temperature of 135F or above. The temperature range between 41F and 135F is called the danger zone. Food facility operators must take every precaution to minimize the amount of time that potentially hazardous foods spend in the danger zone.

2. Improper Cooking Temperatures of FoodsCooking food to the proper temperatures is extremely important because many raw meats have pathogenic bacteria on them naturally. Once the proper cooking temperature has been achieved, ensure that the food remains at or above that temperature for at least 15 seconds to make sure that most if not all of the bacteria are eliminated.

3. Dirty or Contaminated Utensils and EquipmentWhen utensils or equipment become dirty or contaminated, they can transfer that contamination to the food causing a foodborne illness.

4. Poor Employee Health and HygieneIt is imperative that food workers are in good health while preparing food. A food worker that has been diagnosed with an acute gastrointestinal illness (GI), or is showing symptoms such as diarrhea, or vomiting in conjunction with diarrhea, could potentially contaminate food. It is possible for a food worker to transfer their illness to customers via the food. Even more disconcerting, there is the potential for employees working with large batches of food to spread the illness to numerous people causing an outbreak.

5. Food From Unsafe SourcesAny food that is to be sold, served, given away, or used as an ingredient, must be obtained from an approved source. An approved source is a facility where the food produced, prepared, or processed, meets or exceeds the standards of the responsible regulatory agency. Even when the source you purchase food from is approved, it is still advisable to know exactly how they handle your food before it gets to you.67V: Vendor SpecificM: Manager specificCoding System -- Responsibility-Explain the mixture of curriculum intended for vendors and mangers-Good accountability is a part of a good food safety culture

68PreparationProper cooking temperatures for foodThawingHeating/coolingClean & sanitize utensils and equipmentPrevent cross-contaminationFood preparerPatrons handsLimit handling

V- Read through slide with emphasis on need to think food safe while preparing.

69ThawingImproperly thawed food can support the growth of bacteriaSafe methods of thawing are:In the refrigerator (best way)During cookingIn the microwave oven followed by cookingUnder cold, running water

V- Encourage proper thawing method before transporting the food or even at the market.70Proper Thawing

Read March 24, 2008 infosheet titled Keeping poop off the plate during a holidaymeal

- Holiday turkey meals have been linked to outbreaks of Salmonella and Campylobacter.- Following steps to safely thaw, prepare, and cook your bird can reduce the risk of making people ill.

REFERENCE #1971Cooking TemperaturesFood ItemMinimum TemperaturePoultry including ground chicken and turkey165oFStuffing, stuffed foods, and casseroles165oFGround meats and eggs155oFPork, beef, veal, lamb, and fish145oFCommercially processed foods135oFCooked plant foods135oFReview cooking temperatures.Reinforce the notion of each vendor having a tip-sensitive thermometer and USING IT.72Cooking Temperatures

Read March 26, 2010 infosheet titled Raw and steamed oysters linked to recent norovirusoutbreaks

- Since December 2009 three oyster-linked outbreaks resulting in over 300 illnesses have been reported in the U.S.- Ensure that you buy oysters from licensed, reputable suppliers.- Ask your suppliers about their food safety practices and harvesting sites.- Tell patrons that steaming is not always an effective cooking step for oysters; steamed is not a safe alternative to raw.

REFERENCE #2073Tools & UtensilsEquipment, cutting board, knife, and utensils Easy to cleanGood conditionFree of cracksSmoothStored & coveredProtect from contamination during transit to market & when not in useV- Read through slide with emphasis on need to think food safe while preparing.74Cutting BoardPlace on sanitized food-contact surfaceReservoir for contaminationDo not useSame cutting board for raw foods & ready-to-eat foodsWood cutting boardsTable surfacesUsePolypropylene materialsVCutting boards should be sanitized because they can act as a source of cross-contamination.Think through the process of using, cleaning, and sanitizing the cutting board.75Food Contact SurfacesCleanSoap & water SanitizeAir dry before useWipingSingle-use paper towels recommendedWiping cloths Must be sanitizedStore in sanitizing solutionCheck concentrationV- This slide should encourage the process of cleaning and sanitizing with either single-use paper towels or a wiping cloth.76SanitizersWash hands & all equipment with soapy waterRemove debrisSanitizing solution1 Tablespoon bleach + 1 gallon of waterSanitize all food-contact surfaceDo not assume that more is betterSanitizers exposed to air lose concentration over time, while spray bottles hold concentration for extended periodsStore chemicals away from food

V- With the recommendation of having a sanitizer available at the market, go over the process of making and maintaining the sanitizer.77Sanitation

Read May 5, 2010 food safety infosheet titled Tragic story of a childs death linked to E. coli O157:H7 outbreak atWashingtondaycare

- Source of outbreak is still unknown; hygiene, cross-contamination and food all potential factors- 4-year-old Ronan Wilsons symptoms included vomit and feces red with blood, lungs filling with liquid and brain swelling- 13 cases of E. coli O157:H7 were confirmed with some individuals showing no symptoms- Practice good hygiene, especially food handlers who also care for children (including handwashing after handling diapers).

REFERENCE #2178ProtectionKeep food items at least 6 inches above the groundCover samples to protectTents & roofsInsectsDustOther contaminantsPrevent patrons from touching samplesOther than the one they takeChildren samplingToothpicks are helpful but not error-freeSticking one in each sample, as time permits, can help discourage reuseVEncourage protection measures.While they may add on an extra expenditure, they will reduce the risk of foodborne illness.79Sampling Hazardous FoodsSample small amounts & replenish frequentlyTime and temperature control for bacterial growthCook all potentially hazardous foods at approved temperatures for the required durationDiscard after 2 hours out of refrigerationUse an accurate thermometer

Temperature Danger ZoneHold hot food above 135FHold cold food below 41

VReinforce the danger zone.Encourage the vendors to make food safety a priority and market it along with the great quality of their food.80Fresh-Cut ProduceKeep fresh-cut produce chilledFresh-cut produce should be prepared fresh every morningNever mix freshly cut produce with oldAvoid dropping and mishandling fresh-cut produceIt will become damaged easilyVFresh-cut fruits and vegetables are fresh fruits and vegetables for human consumption that have been minimally processed and altered in form by one of the following methods: peeling, slicing, chopping, shredding, coring, or trimming. These processes can be carried out with or without washing, prior to being packaged for use by the consumer. It is important to keep fresh-cut produce chilled. To help reduce the risk of foodborne microorganisms, fresh-cut produce should be prepared fresh every morning of the farmers market. Use a first-in, first-out method so as to not mix the new produce with the old produce. To help prevent damage, avoid dropping and mishandling fresh-cut produce. 81Signs Of SpoilageMushinessSoftnessBad odorLight brown or tan spotsIndicator of deep decayGrey moldReddish brown spots on lettuceMechanical damageBruisesRupturesV-Here is a list of signs of spoilage for produce82Cross-ContaminationKeep raw and prepared food separateClean & sanitize thoroughly after handling uncooked foodsHandsCutting boardsCountersKnivesOther utensilsHands should be washed before handling any food and between handling different food itemsVCross-contamination is the physical movement or transfer of harmful bacteria from one person, object or place to another. Preventing cross-contamination is a key factor in preventing foodborne illness. Good food safety practice that aim to reduce the risk of cross-contamination include keeping raw food and prepared food separate. Clean and sanitize all surfaces such as cutting boards and counters between raw and ready-to-eat food preparation. Use different utensils such as knives, tongs and lifters for raw and ready-to-eat foods, if cleaning and sanitizing between use isnt practical. Wash and dry hands after handling raw food items. Hands contaminated with meat juices can be great vehicles for cross-contamination.83Avoid Cross-Contamination

Read the October 19, 2009 Infosheet titled Five students ill from outbreak linked to Campylobacter at school inUK

- Environmental health officers focus on cross-contamination practices of food handlers.- Infections often are a result of cross-contamination, cooking to unsafe temperatures or contact with animals; Campylobacter is not often passed person-to person.- Clean and sanitize all surfaces (cutting boards, counters) between raw and ready-to-eat food preparation.- Use different utensils such as knives, tongs and lifters for raw and ready-to-eat foods, if cleaning and sanitizing between use isnt practical.

REFERENCE #2284StorageDecrease handlingCross-contaminationFood-grade containersGarbage bags are not food-gradeTreated with mold-inhibiting compoundsReuse of grocery bagsMay have contamination by food previously storedCoverageTemperatureThermometer

VWhile storing food prior to travelling to market or at the farmers market, try to limit the amount of handling a food product receives. This will help reduce the risk of cross-contamination. Also, use food-grade containers to store food products. While garbage bags may seem like a good method for transporting a large quantity of food, they are treated with mold inhibitors and therefore are not food grade. Think about what was previously stored in bags, boxes, and crates before reusing them because they may be contaminated. It is a good idea to cover foods to retain moisture and prevent them from picking up odors from other foods as well as protect them from pests. Use a thermometer to measure temperature. For example, thermometers can be used to measure the inside temperature of a cooler or a food product.85IceMade from potable waterCold packsMore economicalFood will not become wet or softIce used for keeping food cold should not be served for human consumptionVIce has important food safety considerations. Use clean, non-breakable utensils to handle ice, such as tongs or an ice scoop. Avoid touching ice with dirty hands or glasses. Store ice only in clean containers that are safe for storing food. It may be more economical to use cold packs as opposed to ice and cold packs will prevent food for becoming overly wet or soft. The ice that is used to keep foo products cold should not be served or sold for human consumption.86TransportationEnsure vehicles and packaging are clean & sanitaryDirty vehicles can be a source of cross-contaminationReuse of containersHelp your patronsRefrigerate productsProvide inexpensive coolers & ice-packs for purchaseVWhile a lot of energy is used to focus on the on-farm food safety and at the farmers market food safety, transportation is an important factor that must be carried out safely. Ensure the vehicle you use to bring food to market are clean and sanitary. Dirty vehicles can be a source of cross-contamination. This includes the containers or packaging that you are transporting your food in to the market, it should be clean and sanitary. Also, help your patrons transport foods safely home by encouraging them to get refrigerated products refrigerated quickly. Vendors and or market managers may want to have inexpensive coolers and ice-packs available for purchase to aid in patrons safely transporting food home.87Waste ContainersEnsure waste is disposed of properly and placed directly into a waste containerKeep waste containers covered, and empty them oftenIf you are providing food samples, you should also provide a waste container for patrons to place their used sampling containers or utensils

VWaste containers should be available throughout the market for everyone to use. Waste containers should be covered and emptied often. It is recommended that each vendor supplying samples provide a small garbage can for patrons to place their used sampling containers or utensils.88Patrons Eating SamplesBest practice is to limit patrons touching samples as well as food productsCommunicate the riskMarket food safetyEveryone is responsible for a good food safety culture and that includes patrons. As part of your food safety considerations and decisions toward best practices, think through patrons handling and sampling your food.89Potential RisksKnow risks associated with food samplesKnow how to prevent risksPlan corrective actionsCorrect a failure in controllingVIt is important to understand the potential risks associated with the foods that you are selling and sampling. For example, if you are serving samples of your cantaloupe at the farmers market, make sure to provide adequate temperature control such as a cooler or ice to keep the temperature at/or below 41oF. Knowing the risks and potential risky practices are important to understand especially for the specific products you are selling so you can. Help protect the farmers market sector by making positive food safety behavior changes. 90QuestionsSampling

Questions on sampling or any other part of the curriculum. 91

South C arolina health o cials ha ve det ermined that bact eria c ommonl y link ed t o improper c ooling and reheating of food wa s the lik el y cause of an il lness that sick ened o ver 30 att endees of a political e vent in May at the M yrtle Beach Convention Cent er.

S.C. Depar tment of H ealth and Environmental Control o cials con rmed Clostridium peringens lik el y caused the outbreak link ed t o a meal ser ved a fter an e vent honoring U .S . R ep. H enr y Brown.

Improper c ooling is suspect ed a s the cause of the outbreak. I t is not known how rapidl y the food that the cat erer prepared wa s c ooled.

The menu of barbecue pork, coleslaw , bak ed beans, rol ls and desser t wa s repor tedl y prepared 15 miles away f rom the e vent and por tions w ere wa s reheat ed on sit e.

Many of the a ect ed su ered f rom diarrhea and low er ga stroint estinal issues.

Foods that ha ve su ered t emperature abuse oft en lead t o Clostridium peringens poisoning

`` Sometimes food doesn t get c ool enough, quick enough. That s

when bact eria multiplies to food poisoning type levels

Adam M yrick, SC Depar tment of H ealth and Environmental Control

Fo od can be br iefly left o ut to cool, as long as it is refr igerated by the time it reaches 120 . Use a therm ometer to verify the tem perature.

Fo od coo ls faster when uncovered, an d should be cooled in a d ish no more than 2 inch es deep or less than 1-gallon/6-inches-in-d iameter pot .

Be carefu l to not cross-contam inate while co oling ; food can be co vered after it reaches 55 F.

Cool food s afe ly

WH AT Y OU C AN DO

CL OSTR I DI UM PE R F R I N GE NS L I KE LY CAU SE OF I L L N ESS THAT S I CKEN E D

MANY I N MYRTL E BE ACH , SC .

F O O D S A F E T Y I N F O S H E E T J U L Y 1 1 , 2 0 0 9

Clostridium perfringens may be present in small amounts

after cooking and can multiply to danger ous levels in

impr operly cooled and held food

For mor e information contact Ben Chapman, bchapman@ncsu.edu or Doug Powell, dpowell@ksu.edu

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