HomeMy WebLinkAboutBoard of Health April 2 20131
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WHATCOM COUNTY COUNCIL
Board of Health
April 2, 2013
CALL TO ORDER
Council Chair Kathy Kershner called the meeting to order at 10:30 a.m. in the
Council Chambers, 311 Grand Avenue, Bellingham, Washington.
ROLL CALL
(10:33:31 AM)
Present: Barbara Brenner, Sam Crawford, Ken Mann, Bill Knutzen, Kathy Kershner,
Carl Weimer and Pete Kremen.
Absent: None.
1. FOOD SAFETY AND FOOD CODE UPDATE
Greg Stern, Health Department, stated this discussion precedes a request to revise
the County Code on food safety. They will talk about the creation and implementation of
food safety regulations.
Food borne diseases come from many sources. It's important to know the risks and
how to prepare food at home. When going out to eat, people depend on others to take
necessary food safety measures. The Health Department helps food establishments know
the risks from food and reduce those risks. In commercial settings, an outbreak can impact
many people. Things can spread quickly. The Health Department provides food safety
training. There are sporadic cases of food borne illnesses. He described how an outbreak
can occur.
From 2009 to 2011, there were two or three dozen outbreaks in the state per year.
Almost half were associated with restaurants. Eight percent were from catered events, and
19 percent were from other commercial food products. In 2010 in Washington State, there
were 37 outbreaks and more than 300 associated cases. The regulations are products of
collaboration with food scientists, federal and state regulators, and the industry. Regular
dialog in the industry produces code changes to be effective in protecting public health and
are also fair and reasonable for the food businesses.
There are many activities in the local food regulation program, including meeting
with new businesses to identify problems before there are fines. The Department also
receives complaints, works with business owners, and applies enforcement actions.
Tom Kunesh, Health Department, stated the County has a public interest and
expectation to provide food safety inspection in the community. The program is effective if
they can keep the interests of the operator in mind. They must see a benefit to themselves
as business people. Inspection staff are trained. It's a technical matter to enforce a food
code and understand risks of illness. The staff go through about 40 hours of Food and Drug
Administration (FDA) training, mostly online. They also conduct 25 joint inspections with an
experienced inspector. That process takes about two months. Once trained, inspectors are
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standardized to a federal program. They must understand the technical aspects of food
safety and also have certain detective skills to get an idea of what's happening when they're
not there. They focus on prevention. They focus on things that are more likely to cause
illness.
Inspectors work to maintain a good rapport with the operators. It's in the
businesses' best interest to operate a safe establishment. They conduct periodic inspections
and maintain open lines of communication. They try to focus on establishments that do
more complex food handling, such as full service restaurants. They work with
establishments on the specific steps they take while preparing food. They investigate
complaints, issue permits, and respond to incidents. He described recent situations in the
community in which the department staff worked with operators. Before dictating solutions,
the inspection staff must find out the concerns and interests of the owner /operator.
As an enforcement agency, they may occasionally not be as successful as they like
with their efforts to get compliance. There are over 1,100 permanent food establishments
in the county, and staff conduct over 1,100 inspections. They issue about 700 permits for
temporary establishments, such as fairs, festivals, and farmer's markets, each year. They
conduct over 200 inspections of those establishments every year. In 2012, staff reviewed
about 350 plans for new establishments, remodels, or changes of ownership. When the
economy struggles, they are even more busy because the owner turnover is higher. In
2012, there were over 240 individual complaints.
The State Board of Health recently adopted a revised food code. The Washington
code is an amended version of the FDA model food code. Both levels have had stakeholder
review. Whatcom County currently adopted the State retail food code by reference in the
County Code. They did an economic impact analysis. The changes may have an impact on
business. In most cases, the costs are defined as minor. The Health Department is
committed to finding low- or no -cost solutions.
A few changes are unique to Washington State. The biggest change is that cut
tomatoes and cut leafy greens must be refrigerated for safety. Evidence shows
contamination is happening at the producer level, but lack of refrigeration along the chain of
distribution can make the problem worse.
There have been changes in the foods that require temperature control for safety.
There are restrictions in the current code about mixing large quantities of eggs together.
The food code revision, at the request of the industry and changes to the FDA code, allows
fresh eggs to be used in larger batches if they're cooked right away. The holding
temperature for hot foods is reduced. There are new provisions for wild mushroom source
identification that give operators more options for obtaining wild harvested mushrooms.
The new requirements allow folks to buy direct from pickers rather than going through
wholesale distributors. This allows restaurants to offer local delicacies.
A new provision establishes a distance from a work station to a hand washing sink in
a restaurant. In new construction, make sure hand washing sinks are appropriately located.
Retrofits aren't required.
(I1: 05:23 AM)
Knutzen asked if chanterelle mushrooms growing in cow manure are a problem.
Kunesh stated a picker would have to provide that information on location of harvest to a
retailer. They are trying to make sources of wild foods more like sources of fresh produce,
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which has an easy path to the restaurant. They must balance that with restricting types of
species that can be harvested to those that don't commonly have toxic lookalikes.
Stern stated the main concern with wild mushrooms is picking toadstools instead.
Misidentification is a bigger concern. Manure issues can be addressed with cooking
temperatures.
Knutzen asked about interpreters on the County's on -call list. Kunesh stated they
used to have several interpreters, but now they have access to the AT &T interpreter service.
Kershner asked if the public can look up the deficiencies of a specific establishment.
Kunesh stated they can't do that online, but all records are public records. The staff have
talked about adding that capability to the website.
Stern stated many counties post inspection reports. Whatcom County decided to
create the silver platter award instead. There is a system in place to ensure safety without
publicizing problems. It doesn't advance public safety.
Kershner asked if the State code change effective May 1 will automatically happen in
Whatcom County, without Council action. Stern stated they just adopt the State codes.
Some of the language is obsolete, so changes are mostly for housekeeping. They will bring
something forward for Council action.
Brenner asked if cabbage is a problem similar to leafy greens. Kunesh stated the
opportunity for contamination in an open head is greater than with a solid head, like an
iceberg or cabbage. Contamination happens at the field or grower level. Once leaves are
cut, bacteria can anchor and grow. The concern is low with a whole head.
Brenner asked if they can say the same thing with celery or other vegetables.
Kunesh stated they haven't seen epidemiology as risky as cut tomatoes and leafy greens.
Brenner asked if the situation is the same with melons. Kunesh stated whole melons
don't need refrigeration, but cut melons do. That change was made to the code previously.
Kremen stated Whatcom County has one of the more robust food safety programs in
the state. However, they can sometimes go overboard. There is a happy medium in terms
of protecting the public and deciding what's cost effective. The department should keep
that in mind. He asked if they are talking about cut vegetables in commercial
establishments and not home use. Stern stated precautions for commercial regulations are
based on evidence from microbiology and epidemiology. If not using precautions, there
may be sporadic problems at home. There won't be huge outbreaks because the problem
will be limited to the home. However, food safety recommendations apply. People balance
the risk they take knowingly with the benefit they get from taste and nutrition. They don't
want restaurants making that choice for consumers who assume they're getting a safe
product. It is more stringent at home, but the same principles apply.
Kremen stated the general public doesn't know that there is a significant loss in the
nutrient value of produce once it's cut. No one would engage in the practice of cutting and
not refrigerating lettuce because it would go bad. He asked if the public is better served by
buying bags of cut greens knowing it's been washed, or buying the same greens at home
and not washing the greens. Stern stated those are two different risks. He doesn't know
which risk is higher. They've had several outbreaks of bad spinach and cut greens. Cut
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vegetables are convenient, but they are at a higher risk of contamination. Public education
and personal accountability is a factor at home.
Kunesh stated that regarding the relative risk of home preparation versus prepared
vegetables, many outbreaks are from commercial bagged products, which aren't necessarily
safer. The reason they're involved in outbreaks has more to do with volume. Statistics
show that outbreaks associated with tomato and lettuce are prevalent. Staff will make sure
operators have options that don't cost money, to comply with the new code provisions. The
code allows short -term storage without refrigeration, as long as the product is used soon.
Tools will help an operator comply without costing money.
Kremen stated he read several articles from several media that say a person isn't
supposed to refrigerate tomatoes because they lose taste. Kunesh stated tomatoes will
ripen naturally if left out. They'll be sweeter if left on the vine. Refrigeration retards sugar
production, so the quality concern is with refrigerated tomatoes. From a code standpoint,
they don't need to be refrigerated until they're cut. From a practical quality standpoint,
most restaurants don't cut them until they're immediately needed.
Kershner asked if local farms, community supported agriculture (CSA) programs, and
farmers market vendors will not have to keep their cut produce at 41 degrees. Kunesh
stated State law dictates that a County or City cannot require a permit of someone who is
growing and selling their produce, unless the produce is processed. Most vendors at the
farmers markets aren't going to process the foods. Those who do process have licenses
from the State Department of Agriculture. The FDA is working with growers and others to
implement refrigeration throughout the food chain. It's a collaborative effort. County code
deals strictly with retail food establishments and people directly selling food to the
consumer. The revision won't regulate anyone who isn't already regulated.
Stern stated the cottage food industry used to have to meet the requirements of
food establishments. The new regulation of cottage food would be low risk products made
in small lots and sold to the public. Those are regulated by the Department of Agriculture,
not by the County. It's a way to allow those businesses to operate, and still assure food
safety.
Brenner asked if picked spinach leaves are considered whole, not cut. Kunesh stated
that according to guidance from the State Department of Health, field cut spinach does not
require refrigeration. If only the stem is cut one time, it's not regulated. If the spinach is
washed and cut a few more times, it becomes a regulated processing operation.
Brenner asked if it's okay to chop lettuce and put it in the refrigerator at 41 degrees.
Kunesh stated the outbreaks in cut leafy greens are salmonella and e -coli. It won't multiply
if refrigerated, and it may remain below the level of contamination.
Mann stated they are doing a great job. Food safety is a successful program in the
entire country. Outbreaks are rare. He's glad they work with businesses to maintain a
cooperative relationship. Stern stated their goal is to find a balance when working with
operators. They're not interested in suppressing businesses.
Weimer asked if there are special precautions for salad bars, such as those in
grocery stores, where people without food handling permits are handling the food. Kunesh
stated most are already refrigerated. It won't require any changes, as long as there is a
functioning refrigerated salad bar. There are practical solutions such as serving smaller
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servings more frequently and offering tongs and utensils. Someone could inadvertently
contaminate a salad bar. It's a risk that the operator and consumer accept.
Kremen stated an example of how the County went overboard was at the Rome
Grange, which cooked thousands of breakfasts using eggs in cartons. About eight years
ago, they were no longer allowed to use raw eggs for anything. They were forced to
purchase the pasteurized eggs that were much more expensive. That was a prime example
of overkill. Kunesh stated that requirement has been modified. It's will be okay to use
fresh eggs as long as they are cooked within 30 minutes from breaking. In 2005, the State
diverged from the federal example. The new regulation is a response to the needs of the
industry.
Stern stated one in 10,000 eggs has salmonella in the egg. In a very large food
service venue that goes through 1,000 eggs per day, one contaminated egg can expose
them all. This is the risk assessment.
Kershner asked if there is evidence that the human population hasn't been exposed
to enough germs, and can no longer fight off viruses and bacteria. Stern stated humans are
exposed to a lot of bacteria and viruses, and are challenged all the time. Humans don't get
sick from a lot of exposures because the immune system protects from sickness. This
argument happens about vaccines, too. There's no science to support the claim that
vaccinations cause weakened immune systems. There may be concerns regarding allergies
and childhood exposure to certain environmental antigens. In general, it's not good to be
exposed to viruses and bacteria that can cause illness and death. There are plenty of
opportunities to stimulate the immune system.
Kremen stated an example of that is people who live in Mexico who have built up
their immunities and don't get sick from the water. He believes the United States life
expectancy is less here than in Mexico. Given the sanitary conditions there compared to the
United States, they aren't having any more problems than in the United States. Stern
stated they are having problems. He isn't seeing the infant and elderly mortality rates from
diarrheal diseases. The things they are trying to protect against include the e -coli that
causes death or chronic kidney disease, for example. Certain disease can cause chronic,
lifelong problems. They have changed regulations, which may seem like overkill, to prevent
those risks. It involves epidemiology and identifying the vulnerable populations. A good
question is whether public health efforts create more problems. It's a question they should
address.
Kunesh stated food, water, and milk are much safer than they were a hundred years
ago. Continue to make sure the food supply remains safe. There are questions about
protecting and developing the immune system, but don't go back to the time when diarrhea
and dysentery were the leading causes of death.
Brenner stated some regulations have become less stringent because they've found
that the less stringent regulations work just fine. The information she read was very
balanced.
Kremen stated a recent study of salt indicated that there was a higher mortality rate
in those that had a reduced, restricted salt intake. He's perplexed by that study. Stern
stated he would look at the study. It's important to look at all the studies together and
their methodology. They must also look at the populations vulnerable to salt, the impact of
salt intake on the population in general. Staff can talk about healthy diets and the role of
salt, sugar, and fat in promoting the use of unhealthy and less nutritious foods.
Board of Health, 4/2/2013, Page 5
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ADJOURN
The meeting adjourned at 11:56 a.m.
The Council approved these minutes on April 23, 2013.
ATTEST:
WHATCOM COUNTY COUNCIL
WHATCOM COUNTY, WASHINGTON
Please contact the Council Office to obtain an
official, signed copy:
360- 676 -6690 or council@�.o.w hatcom .wa.us
Board of Health, 4/2/2013, Page 6