Opening Session of the Consumer Food Safety Education Conference 2014

Opening Session of the Consumer Food Safety Education Conference 2014



well good morning and welcome to the 2014 consumer food safety education conference we're extremely glad that you're all here we also welcome all the individuals who are watching this conference online it is being broadcast live so keep smiling so can I get a show of hands of how many have attended one of the previous food safety education conferences we love repeat business so if you've attended a prior conference you know we pack a lot of programming into a short amount of time and that we're all about providing an experience that will help launch you into new levels of success in your consumer food safety education outreach work I'm very pleased to open this conference on behalf of the board of directors of the partnership for Food Safety education we welcome you to the Washington DC area I'm Stan hazen and I'm the voluntary board chair for the partnership and in my day job I am the director of regulatory affairs for NSF international the NSF mission since nineteen forty four has been the protection of human health and the work of the partnership dovetails very nicely into the work that we do as well and so we're very proud to been involved with this conference since 2006 and we're also delighted to be a sponsor of this conference the partnership food safety education is so much more than just the fight back campaign the partnership is dedicated to making consumer food safety education more collaborative more effective and more visible I encourage you to take advantage of the webinars materials and other resources available to you through the partnership let me encourage you let me encourage you as we kick things off to use the conference app no yes to use the conference app it is easy to use and here's how to download it to your device you are a self select group of the most accomplished and committed heroes in this area of consumer food safety education the reason that we are here this week is to harness the talent the commitment and put to work strategies proven to increase attitudinal and behavioral modification of safe food-handling behaviors you can expect to take home from this conference actionable data tools and improve skills to be even more effective in your work to educate and engage consumers on the preventive health practices of clean separate cook and chill at last conference in Atlanta Georgia in 2010 ninety-four percent of attendees in a survey reported they would be making changes to their practices as a result of the information presented at the conference that's ninety-four percent that's a very significant number and we consider that a huge success and so we're equally optimistic about the outcomes from this conference that you'll take away practices learnings and connections to change the way that you conduct your food safety education outreach we consider this conference to be your tune-up and your battery recharged so let's check in on the aims of this conference they are ambitious and we know you are ready to lead on these challenges yes I'm sorry so we're here to advanced knowledge and practice in support of healthy people 2020 goals to encourage dialogue about proven strategies for consumer behavior change in food safety to support you in developing you as leaders in food safety education and to create memorable opportunities for you to connect and share with others so are you ready to get started are you ready to get started excellent so before we move into the plenary I want to introduce the person who works every day tirelessly to put the fight and fight back that is executive director of the partnership food safety education your very own Shelly Feist okay good I'm coming in outgoing Thank You Stan stands one of the terrific volunteers who not only it was responsible for putting this conference together but also for putting the partnership on track under its new strategic direction to be a catalytic leader in health education and a trusted partner to all of you I have three areas to cover in my short time with you one is we the partnership and this back fighter community we have some goals right and we're going to talk a lot about these goals today conveniently these are important high priority goals that were set by the US Department of Health and Human Services the healthy people 2020 goals that are specific to food safety so these goals are top line one to reduce infections caused by key pathogens transmitted commonly through food and to increase the proportion of consumers who follow key food safety practices and if you go to this great website objectives sub area of healthy people 2020 each of the specific behaviors and the measurements towards those behaviors are are spelled out so I'd encourage you to take a look at that you'll be hearing more about these goals and the efforts to measure progress towards these goals from dr. Patricia Griffin of the CDC and in several breakout sessions during the conference but knowing the importance of making progress in these goals that's what really drives our work at the partnership and that's what motivated us in planning this conference we're going to get kicked off right away with some live polling here because we want to know from you do you feel confident that we will meet these healthy people 2020 food safety goals as a nation by 2020 so you can quite easily participate in this poll on your device you can either use the app you can go to the URL be i ZB 0 / 0 775 and at that URL you'll be able to vote or you can you text so we have some data that demonstrates the need for an increased focus on the consumer behaviors of food thermometer use proper hand-washing and produce handling in particular and at this conference you will have access to some great breakout sessions that address each of these important areas of safe food safe handling behaviors at home my second area to cover at this opening session is to sum up for you who's here today who are the talented leaders in this room that are going to help us get to these goals by 2020 because it's only five years away here's who's with us today Cooperative Extension shout out fifty percent federal government industry nonprofits state and local government and some internationals are with us today so thank you that's that's who's here and needless to say we love you all to meet many people that you have not previously met before at the conference we know from the health and food safety educators we're in touch with that about a quarter of them report reaching more than 500 consumers directly each year and fifty-six percent report that they reach between 50 and 500 people each year so this multiplier effect is extremely important to this decentralized work in food safety education and can be leveraged to meet the healthy people 2020 goals so that's very powerful I want to thank you for making this commitment to work on these common goals and for sticking to it because making progress on these goals requires collaboration and persistence and work overtime so i'm already at my third reason for being up here and that's to thank the many people who helped to make this conference possible first there's you for being willing to take time out from your busy schedules to be with us today we've had a terrific group of volunteers from the federal agencies from industry from consumer groups and academia a truly impressive group how put together this conference the program and our outreach and marketing work so on page eight of your program book you will find a full list of those people in addition the organizations that provide the core operational funding for the partnership this is done by ended by donations from our contributing partners they are listed on the back cover of inside back cover of the of the programming book those people and those organizations are very important I want to recognize Ashley Bell and brittany Sonnier they're both in the room here hi Ashley hi breath that is the partnership staff and so you'll you'll get to know them and many of you may be already know them through our email marketing and our programming and diane henderson and christine garrett for their conference logistics and support have done a great job finally as you know it takes resources to put on a conference like this the following sponsor organizations have made an investment in this conference and in you because they are also committed to making progress on healthy people 2020 and they support your role in that our conference sponsors are the American Meat Institute foundation Ecolab the fmi foundation the grocery Manufacturers Association the Illinois Institute of Technology Institute for food safety and health NSF international the produce Marketing Association and Walmart so please join me in a round of applause to thank these times so before we introduce our welcome our first speaker i want to bring out the poll results i think that has to be done by the crew in the back here they're going to bring up the results what you all have to say about how you feel about our collective progress on healthy people 2020 goals all right well overall optimistic forty percent say yes twenty-seven percent say no we'll work on those people and thirty-two percent are not sure but that's very interesting isn't it I'm was very interested in what you all thought about that thank you alright we'll go back to my slide for I am very happy today to introduce our first speaker who represents the nation's health protection agency the centers for disease control and prevention which saves lives and protects people from health threats the CDC tackles big problems and as you know they've been in the news a lot lately we're very pleased to welcome dr. Patricia Griffin to open this conference dr. Griffin received her doctor of medicine degree from the University of Pennsylvania School of Medicine trained in internal medicine at the hospital of the University of Pennsylvania in gastroenterology at Brigham and Women's Hospital in Boston and in mucosal immunology at the University of Pennsylvania and in epidemiology at the CDC dr. Griffin is chief of the interrac diseases epidemiology branch the branch conducts surveillance for illness caused by enteric bacteria throughout the United States tracks changes in incidents determines risk factors for illness and investigates outbreaks she'll talk about some of these branch programs including the foodborne diseases active surveillance network food net the foodborne disease outbreak surveillance system and the human epidemiology arm of the National and hi microbial resistance monitoring system for enteric bacteria the branch also provides consultation to other countries dr. Griffin has authored a co-authored over 200 journal articles book chapters and other publications and she holds an adjunct appointment in the Emory University Rollins School of Public Health please join me in welcoming dr. Patricia Griffin Thank You Shelley and good morning I understand that that survey I was holding my arm down because I wanted to say I'd been at the last meeting because I worked hard with Chris Prue and making the agenda for the meeting in twenty ten at CDC but I had to be somewhere else so it's especially nice that I get to come actually to this meeting so we will start and see if I can work this thing food safety is one of CDC's designated public health winnable battles because it's one of those issues in which our director things we can make significant progress in a short period of time and affect the lives of many people CDC is a non regulatory agency we track human illness and for us to be effective we need to work very closely with the regulatory agencies FDA and USDA who regulate food and food animals CDC provides the vital link for improving the safety of food by linking practices on farms in production plans and in kitchens to ill people I'll talk today about some of CDC's rolls these include providing data and analyses to guide policy advancing technology for faster better control and prevention and detecting investigating and stopping outbreaks and I'll give you some examples of these so for example food net is our food borne diseases active surveillance network it covers 48 million people in 10 sites some are whole states and some are parts of states food net provider for the food safety progress report that we issue every spring with data from the previous year and if you look down the arrows and the faces you'll see that we had last year an increase in campylobacter illness and an increase in vibrio illnesses others had no change those were ecoli o157 Listeria Salmonella and yersinia little targets that are hard to see and be hard for me to use this pointer to get at them show our healthy people 2020 goals some of those that Shelly mentioned and the writing on the right is a reminder that we just track lab confirmed infections but for many of our pathogens there are 25 or 30 more illnesses estimated to occur for everyone that's lab confirmed and that's certainly true for cantle dr e coli o157 and salmonella food that also provides data that allowed us to estimate the annual number of foodborne illnesses caused by noon pathogens and that includes both lab confirmed and not lab confirmed and we estimated nine million illnesses 56,000 hospitalizations and 1300 deaths now if anybody having trouble hearing me raise your hand if you're having any trouble and if it happens during the talk stand up and shout at me another of our surveillance systems is foodborne disease outbreak reporting and you can see from this graph that CDC has been doing this since 1973 and you can also see that the color is changed and with that the average annual number of outbreaks reported change and this is due to improvements in the surveillance system from dark blue to light blue we went from a paper-based system to electronic and when we turned green that's when we improved our definitions of a foodborne outbreak so we get about 800 outbreak reports a year and they tell us a lot about what are the foods that people that are making people sick where are they eating them what are the problems that causes those outbreaks this outbreak data has allowed us to make our first comprehensive attribution estimates that we published last year we estimated the percentage of foodborne illnesses caused by known pathogens do to each food category you can see the first set of bars shows in light blue that we estimate forty six percent of illnesses were associated with eating produce and going down to the next set we estimated that twenty nine percent of deaths were associated with eating meat and poultry pulse net is our national molecular subtyping network for foodborne disease surveillance it connects cases of the illness nationwide to quickly identify outbreaks including many that would otherwise not be detected so public health laboratories analyze the bacterial DNA from ill patients for example a Salmonella that that made somebody sick is sent to the public health laboratory they they grind it up and look at the DNA and they get these pulsed-field gel electrophoresis patterns that they send over the internet to the national database at cdc and they are teams search for similar pfge patterns and when a clusters identified they report it to the epidemiologists who look for a common source and you can see here each row look at the redbox each row is a pfg pattern of one isolate from one person and there's a cluster of four rows in which the those barcodes look the same and that suggests that even though those people may be scattered across the country they may have gotten sick from a common source so pulse net is helping us in detecting investigating and responding to multi-state outbreaks and you can see from the bar graph that multi-state outbreaks are being detected more frequently every year over a hundred in the most recent five-year period we looked at along with this the meeting number of illnesses per multistate outbreak is decreasing it peaked at 69 in the 1990s mates many of you probably remember getting a lot of notices about these big outbreaks well now we have more outbreaks but they're smaller the average number is 35 in the 2000s and that's because we're detecting these outbreaks faster and that's coupled with rapid Public Health Action to get contaminated products off the market so we've identified 22 new food vehicles in multi-state Salmonella outbreaks since 2006 no I'm not going to read you this entire list but you you'll be familiar with many of them they were they were all reported in the media and on CDC's website and we continue to identify new products every year and that's part of our role to just be on the lookout to not expect the expect it's been looking for the unusual the cookie dough's the things that you might not expect the dog food that's making people sick here are some of our web postings from 2013 we post reports as the outbreaks occurring not after its over we let you know what's going on and the media gets very interested in these reports these are some of the media reports just from 2014 and you can see on the in the middle right salmonella in 10 states linked to bean sprouts I'll talk a bit more about that one multistate outbreaks have major impact many require a national level response because people are scattered throughout the country they often reveal important gaps in the food safety system that result in system-wide improvements and there are major implications for food safety policy in government and industry so I now want to turn to some of our food safety challenges and I chose to talk about six and the first two are pathogens salmonella and norovirus so this graph shows the fall and rise of reported Salmonella infections for almost a hundred years and you can see in the white and that's that's Salmonella typhi it's a severe disease and it decreased partly because we separated human feces from food and water because this organism is carried only in the intestines of people animals don't carry it so that when we achieved that we reduce those illnesses almost to nothing and almost all of our cases now are imported from other countries but look what happened in the mid 50's the yellow shows the increase in non typhoid ille salmonella those organisms are carried in all of our food animals and those illnesses increase partly because agriculture became industrialized non-title salmonella infection is usually diarrhea with fever and abdominal pain incubation period is up to 48 hours and people are sick for about a week with a pretty bad diarrhea but five percent of disease is invasive meaning bacteria are in the blood or unusually sterile sites like the lining of the brain or in the bones and as you can imagine this is a severe disease and it's most common in infants and in the elderly so this shows more recent incidents of Salmonella infections that we've been tracking in food net since 1996 that green line is quite disappointing considering our healthy people goal in 2010 we became less aggressive in 2020 but we're still not meeting that goal and remembered many more illnesses occur than are reported so we have a lot of work to do on salmonella norovirus is estimated to be the number one cause of foodborne illness in the United States it causes vomiting with diarrhea and people are usually ill for about two days it's the most common source of food borne the most common source of foodborne norovirus outbreaks is foods that are eaten raw often contaminated by ill ill food handler and you educators know this problem that a survey of ill restaurant workers down that one in five reported working while sick with diarrhea and vomiting that's pretty sad trying to work while they're still sick but it's because they want to get paid so it's a difficult problem and it causes a lot of illnesses I'll now talk about antibiotic resistance last year CDC issued the antibiotic threats reports the first time a report like this was written for the United States and it provided data on 18 resistant threats now two of them are transmitted commonly by food and also have animal reservoirs and those are Salmonella that's resistant to ceftriaxone or ciprofloxacin or five or more classes of antibiotics and campylobacter resistant to ciprofloxacin or as if through meissen and as many of you know who've been sick or whose kids have been sick cipro is a pretty commonly used drug and we don't want things to be resistant to it ceftriaxone is also a really important drug it's given intravenously for severe infections and you really don't want bacteria to be resistant to it I'll talk a bit more about this is not advancing and if the batteries ran out oh there it is okay just it was just slow fell asleep is anybody else asleep beside this lives okay so I'll talk a bit more about salmonella resistant to ceftriaxone but first I think it is the batteries want to remind you that the use of antibiotics is the single most important factor leading to antibiotic resistance around the world we just have to hit it several times now to get it going and let's talk about antibiotics and food animals a large proportion of antibiotics sold in the United States are used in food animals they are FDA approved to treat disease to prevent infection and to promote growth most have been used to promote growth not for Animal Health this purpose is no longer allowed in the EU countries and a year ago fda issued guidance in tended to voluntarily phase-out use for promoting growth by 2017 so we're looking to see what happens in that area all right this is a complicated slide I said I'd tell you that ceftriaxone the message is simple and clear I probably take longer to try to fix it so I'll just push it a couple times and you'll put up with me so is it the message here is really clear the bottom line is that everything is going up and let me just lead you through this the title ceftriaxone resistance among Salmonella serotype Heidelberg it's a type of Salmonella and we're looking at humans chickens retail chicken and retail ground turkey and if you look in the far left the yellow bar shows that from humans only three percent of isolates were resistant to ceftriaxone in 1996 and if you look in the far right you'll see that fifteen percent of those salmonella strains are now resistant to ceftriaxone at the same time all the other lines are going up the other lines are chickens retail chicken and retail ground turkey there's a couple times when those lines touch the base line and I wouldn't put too much credence on that because each of the the dots numbers are very small we have very small numbers of isolates that we're testing so we're looking at general overall trends so now I'll talk about some foods and start with poultry poultry is the food most commonly implicated in foodborne disease outbreaks in the past decade poultry has been responsible for about a quarter of outbreak associated illnesses hospitalizations and deaths this graph shows the percentage of retail meat samples yielding campylobacter and about forty six percent of retail chicken is contaminated with campylobacter and by retail chicken what I mean is the chicken that you would buy in your grocery store these are just packages of chicken that investigators pick up from stores in food net sites and a few other sites and you can see that that they're very little campylobacter in ground turkey ground beef and pork chops so then let's look at the same graph for salmonella and that shows twelve percent of retail chicken and ground turkey yield salmonella but very few ground beef or pork chop samples yielded salmonella we had a multistate outbreak of Salmonella serotype heidelberg infections from chicken that lasted over a year and a half and just end it last summer 634 people were sickened in 29 states and thirty-eight percent were hospitalized the outbreak strain was found on chicken from three slaughter and processing facilities of the same producer on breasts wings and whole birds improvements were clearly needed at many points the forms in the processing plants in the warehouse store that roasted whole birds and then rican Taman ated them food handlers and restaurants and consumers a lot of education is needed here about handling chicken because of the contamination that we're dealing with I want to talk about produce this is the same slide I showed you earlier that top bar shows that we estimate forty six percent of the illnesses are due to consumption of produce and I'll give you one example but to give the example I have to talk a little bit about Listeria it's a very rare illness and it tends not to hit healthy people it hits people in certain risk groups the elderly get bloodstream infection or meningitis persons with immuno compromising conditions also get the severe illness pregnant women get a flu-like illness but then they have a miscarriage or stillbirth and the newborns gets a severe illness so you may remember our listeria outbreak from cantaloupe in 2011 it made a lot of news because it was the largest ever outbreak of listeriosis 147 people or sickened 33 died and there was one missing miscarried rapid identification of the food source using pulse net and Listeria initiative questionnaires we estimate prevented about 36 illnesses and seven deaths and you can see that the patients were scattered throughout the country in 28 states the environmental assessment found that the processing facility was the most likely source of contamination alper extremes were found on cantaloupes and on surfaces at the facility and deficiencies include that the melons were not cooled after harvest the equipment was designed and used improperly and sanitation was inadequate so here there's a lot of room for education at the farm and processing level this is just one slide on one other produce outbreak and I'm mentioning it because it's going on right now it's a multistate outbreak of serotype and two rigidus infections linked mung bean sprouts in our last posting on November 24th 68 people were sickened in 10 states and twenty-six percent were hospitalized but look for an update from CDC this week on this outbreak so our last challenge I'll discuss is raw dairy products we did an analysis of outbreaks due to non pasteurized dairy products from 1993 through 2006 we found 56 milk outbreaks and eighty-two percent of them were associated with raw milk and compared with pasteurized milk outbreaks raw milk outbreaks had an eleven times higher hospitalization rate probably because all of them were caused by bacteria now the estimated risk of an outbreak is about a hundred fifty times higher per pound for raw than for pasteurized dairy product this bar graph shows the actual average annual number of outbreaks due to raw milk you can see the first bars are for a longer period 19 you three through 2006 we got a few per year and the orange bars show total outbreaks the white bars show those outbreaks that were caused by campylobacter so most of the outbreaks are caused by campylobacter but look at the later periods 07 209 we saw a marked increase in the average number of outbreaks and 2010 through 2012 it increased further so clearly this this is a big and difficult area for food safety education you're saying more and more of these outbreaks so I now want to talk about some successes that inspire and guide us first Vibrio vulnificus foodborne Vibrio vulnificus infection is a rare disease but about fifty percent of patients die patients develop fever sepsis and skin lesions people who get the disease tend to have high risk conditions um mainly liver disease alcoholism and diabetes and raw oysters are the most important source so so back in the 90s California decided to attack this problem by requiring warning signs in restaurants and they continue to have illnesses and the black bars showed the deaths then they required that the warnings be in English and Spanish and we may have seen a decline it looks like a decline in illnesses but then they weren't satisfied with that and they required that raw Gulf Coast oysters harvested in the warm months be treated so that this organism is not detectable and since then since 2003 they've had no vulnificus illnesses from raw oysters pretty pretty effective intervention ecoli o157 has also seen some success just to remind you about this illness it starts by ingesting the organism and then you develop non bloody diarrhea and abdominal cramps that often becomes quickly bloody and tends to resolve in about a week but some people develop hemolytic uremic syndrome and that's more likely in young children and that's anemia with fragments of red blood cells low platelet count and kidney failure its a severe disease and it's exciting that we've seen such a big decline in these infections we think it started after a big 1993 fast-food hamburger outbreak prompted the Department of Agriculture to declare this organism to be an adulterant in ground beef and that followed big overhaul in our meat inspection system and while this was all going on we were finding more and more outbreaks that was resulting in a lot of publicity and a lot of ground beef recalls in 2002 we had a really big ground beef recall and after that many companies began testing all lots of beef trim for o157 and in fact this decline that we see is paralleled by a decline in the percentage of ground beef that's positive for o157 so final success is Listeria back in the 1980s we had a very high incidence of Listeria infections per million population again it's a rare disease but we were up at around seven or eight per million people but look what's happened since then if we add on the line of ready-to-eat meats positive the decline that we see in listeria has paralleled the decline in the percent of processed meat that's positive for Listeria monocytogenes and we think this is because during this period of the decline we found many Listeria outbreaks we identified hot dogs and deli turkey needs this problem and the department of agriculture and industry made many changes to make these meats safer so we've talked about the high-risk groups for Listeria and CDC on our website has these posters including what foods are risky we think that deli meats and hot dogs are now less risky but we're concerned about produce such as raw sprouts raw milk soft cheese and smoked seafood as risk factors so we've made significant progress in reducing foodborne illness I've talked about Listeria and e.coli 157 we also had some early success with campylobacter and in fact for all of these organisms the successes were mostly in the late 90s and early 2000s and as a result of the decreases in 2010 alone we estimate that over 500,000 illnesses were averted and about a hundred million was saved in direct medical savings so I've talked about seedy seeds roll about food safety challenges and about successes that inspire and guide us and I want to end with a quote from the director-general of wh 0 that next year wh 0 will dedicate world health day to food safety to catalyze government and public action to put measures in place that will improve the safety and food from farms factories street vendors and kitchens so thank you for your attention thank you dr. Griffin while fifty percent of poultry is contaminated with campylobacter and 12% with salmonella it's quite serious we need to pay a lot of attention to that and a lot of it comes from safe food handling practices that are at the heart of preventing illness as a result of these contaminated products however I'd like to now introduce our next speaker dr. Lynn frewer professor frewer is chair of food and society at newcastle university a public research university located in newcastle upon tyne in northeast England a good friend of Harry Potter's I think previously she was professor of food and society at vagon University in the Netherlands and head of consumer science at the Institute of Food Research at Norwich in the UK dr. Freud's research interests focus on understanding and measuring societal and individual responses to risks and benefits associated with food health sustainability and safety methodological innovation regarding the application of systematic reviews in the social science and agri-food governance and associated policy issues including policy translation of scientific results and foresight dr. Pryor has had extensive involvement in EU and nationally funded projects primarily in the area of social science and the agri-food sector she has published more than 165 refereed journal articles and edited five books she has also been involved in national and european research funding and strategy committees please join me in welcoming dr. Lynn früher well first of all thank you to the organizers for asking me to talk to you today it's lovely to be in Washington now I have to say this is the first conference I've been to where I've wanted to go to every session all of the parallel sessions everything is so fascinating so so I'm hopefully going to follow up on a lot of the the things that are being presented today this amazing conference so I was asked to talk to you about supporting consumers facilitating behavior that reduces risky behaviors before I go into the into the into the talk I'd like to say following up on your excellent presentation I'm certainly from a European perspective beginning to pick up conflicting policy issues for example policy relating to food security and sustainability and some of the behaviors that are appearing in people's homes so the drive to keep foods for longer and perhaps store them inappropriately seems to be while supporting sustainability conflicting with people's promotion of health in relation to food safety so there are lots of errors where I think we need to do a little bit more research to try and understand these changes as policy changes how does this affect people so thinking about risky behavior this might mean not adopting say food preparation practices it might also mean reducing the nutritional quality of the diet empathy in response to perceived food rose we're seeing a new I don't think it's an APA listed disorder of orthorexia which means that some people are excluding certain foods or eating foods which they perceive to be risky which might actually compromise their nutritional status and the other issue which I'm going to raise is the rejection of potentially beneficial food innovations which might also reduce people's risk in the home and perhaps you can come back to that later we have the classical risk analysis framework I'm sure all of you are familiar with this of interest this particular meeting is the risk communication and stakeholder involvement in part of this and what I'd like to highlight of course also following on from the previous talk is the interactive exchange of information and opinions and increasingly this is not just about how to communicate with particular stakeholder groups it's about gathering data about outbreaks about people being sick so we get a better understanding of not only the path of foodborne illness but also how effectively interventions are working I'm coming from the UK where there seems to be considerable pressure on the health services which has resulted in reduced reporting of foodborne illness but at the same time a suspicion that in some areas there's an increase in in in illness so using the social media big data to analyze trends in an illness might also help us understand how effective risk communication is you're all familiar with risk perception that risk perception drives people's attitudes and the people react to risks in a way which may not necessary carolee be predictable from technical risk estimates so involuntary risks over which people have no control are more threatening than one people choose to take in the error of food safety one might think about the headlines associated with contamination from a restaurant compared to the incidence of from headlines associated with food and produced inside the home catastrophic risks concern people most I'll come back to the issue of crisis communication later on and unnatural or technological risks are much more threatening than natural ones so that's like a shopping list of why it's difficult to communicate to consumers about taking self protective measures people perceive that they themselves have control over exposure to foodborne illness in the home often people aren't affected in large numbers although that's not always the case but the chronic incidence is one that people don't tend to think about and of course foodborne illness is largely perceived to be natural so therefore less threatening and coming back to some of the the slides presented by our previous speaker concerns about animal welfare about natural production systems may may also conflict with the emergence of some of these foodborne illness issues I was quite fascinated by the the slides on raw milk where it is clear that this represents a real threat but nonetheless one people perhaps either choose to take or filter out of their behaviors because it's seen as having a reflecting a food choice or consumption pattern with far bigger advantages now I'm not sure because I haven't seen the data in the you us whether this relates primarily to free-range animal welfare organic standards or simply the quality of the food that's produced but something has to be done so we know that people underestimate the risks of food poisoning contracted in the home and there are also risks associated with habitual food preparation practices we know from European data that the percentage of people that would use a meat thermometer is a tiny fraction of those actually preparing meat less than five percent so developing communication messages which promote these kinds of technological innovations is rather difficult because people haven't traditionally used these kinds of technologies in domestic food preparation practices and the other thing I'd like to raise is that we have substantive evidence that people do not isolate food safety behaviors from other food safety behaviors I'm originally a psychologist we know that the people that way people think about food risks tends to be cognitively interlinked so on one hand people have a lot of knowledge about food safety which they simply don't activate so personally I doubt that always giving them more information is going to result in them applying this information when they're preparing food the second thing we know is that knowledge about food safety is linked to their knowledge about nutrition and pulling up one set of pieces of information can can link or trigger a whole set of other associations so if you take a food skur dioxins in the environment we find that that also triggers information about how people prepare and think about food safety risks so just isolating nutrition from food safety from other types of food risk information may not necessarily always produce the best behavioral response and of course trust getting it wrong i'm from europe this was a terrible event that the issue was not just about the loss of life it was about blame and cult ability so Germany blamed the Spanish and the Spanish cucumber producers who then tested their own facilities found no evidence of e.coli and the culprit was these brain sprouts being produced in Germany the cost in terms of the socio-economic impact on producers in Spain was immense that was part of it the other part was the decline in trust in the German authorities why were they trying to put the blame on producers in another country if they weren't trying to promote their own vested interest now I have no idea if this is what they were thinking but this was the interpretation so communication getting it wrong trust and culpability the perceived protection of economic interests it's going to be extraordinarily important to also take this into account if you're a regulator or an industry when you're trying to get risk communication and food safety issues right so a quick summary this is a paper and press the result of a systematic review of everything that's been published which met a certain stone about food safety and consumer and citizen risk perceptions and what this means for communication there are some pretty established guidelines experts rely on technical risk assessment they tend to communicate using scientific argumentation which does not take account of socio-economic impacts but these clearly important what if for example people are eating risky foods in the home because they can't afford to buy products and throw it away in theory experts balance risk against benefits but again it's not always clear how socio-economic benefits or even technical benefits are assessed if we come back to the the classical wh 0 FAO risk analysis framework the public of course have to use their risk perceptions to make judgments about risk and we all do this when we're crossing the road we make some kind of probabilistic assessment and when we cross the road at a crossing we're trusting the driver of the car heading towards us to stop we use a heuristic to decide whether a behavior is safety or not people require risk communication to take account of their concerns as well as technical risk estimates and emotional or affective responses are important people get very emotional if some groups and the population are affected particularly children particularly that the vulnerable and these are the messages which people tend to pick up from the social media but everybody is at risk and everybody is preparing food or at least involved with people that do this let's go back a long time the kind of images associated with BSE this is where a lot of emotion resulted in a lot of restructuring mobley we have a lot of issues still in Europe about traceability labeling for animal welfare and trust a more recently horse gate which was presented as a food safety issue although there's no reason why by heat horses can't be consumed by humans they are in some European countries but which as a consequence of being promoted as a food safety issue in the media meant that many commercial brands here we see findus various large-scale companies having to engage in a full-scale food safety recall on the basis of something which wasn't actually a food scare now I'm a vegetarian I wouldn't eat any of these things so I I have a kind of excuse here but again the consequences of not quite understanding how consumers respond to some of these issues resulted in some very odd communication on the internet and the need for agencies concerned primarily with food safety having to address a non food safety issue so fraud and standards is in X or ibly entwined with some of these communication issues horse gates a food chain the beef chain where absolute absolutely rigorous standards are expected to be applied the public concern certainly in Europe now focuses on illegal economic gain that somehow food chains and standards are being tampered with particularly aligned with criminal activity and although the issue in a technical way is not focused on food safety from the possibility of some veterinary drug residues in the food chain the public concern is again intermingling the safety issues with these broader issues of criminality fraud and traceability so this is important and again is something which needs to be addressed as a risk communication issue so I'm going to finish with the systematic review and just report what we seem to know and what we don't seem to know what we found was first of all that certain food issues were much more interesting to researchers Andres purse sponsors than others in terms of risk communication for research so if you like there are some orphan foodborne illnesses which simply hadn't been the topic of systemic risk communication research cap for some reason calob actor has been researched a lot ecoli a moderate amount and some of these much more shall we say not marginal but threatening and emerging risk related diseases simply haven't been considered what we also found was that pattern of research typically followed the occurrence of a crisis or a policy concern so all you research funders thur it's perhaps a good idea to try and anticipate emerging foodborne issues and put the risk communication money there before they've emerged rather than follow on after the crisis has occurred three broad themes relevant to the development of best practice and risk benefit communication the characteristics of the target population the contents of the information and the characteristic the information sources or perhaps that's not so surprising but the gaps that were identified there's a need to consider the difference between communications under acute or chronic conditions and if we're thinking about emerging disease risk then the emerging issues are likely to first meet the public in the context of something that's very acute I think people behave very differently to risks which might be described as chronic which are ongoing and they also tend habituate to the information so something like this terrier or campylobacter when you first start communicating people are very interested but as for any communication message the impact of that message tends to drop off as time goes on now we've been doing some research but we're essentially using emotion as a carrier to try and get people to reinvestigate their knowledge about some of these chronic illnesses and it works for a while if you have pictures of people vomiting it tends to get people to think about some of these food risk issues that people quickly habituate to that as well it lasts you know a few months so again I would argue that we need to undertake analysis of the long-term impacts of communication interventions and not just the short term ones and understand why people are engaging in benefit perceptions sorry in particular behaviors which means looking at their benefit perceptions as well as their risk perceptions again I was engaged by the ROI raw oyster argument which to me implies people are getting a lot of hedonic pleasure out of consuming something which is clearly risky narvaez it's horrible all those warning science and restaurants but people are still engaging that behave because they like easting eating oysters so that's the driver if we think about a cute risks they may be difficult to predict so pre-planning is also difficult what type of hazzard will occur when who will be affected so here there needs to be clear guidelines on the the process of communication and they need to be generic because we don't know who when and why is going to be affected with chronic risks we had more information regarding the impact of the risk who is affected and it's more feasible to tailor messages according to people's perceptions and perceptions within target groups associated with worth risk and benefit the needs of those most affected we need to understand risky behaviors in the home you might need ethnographic methods to understand what people are doing rather than what they say they're doing because often there's an enormous mismatch between those things and in terms of people's current behaviors and habits so build risk communication about what people are doing but also understand what it is that is easy for them to change because telling them to use a meat thermometer might not be the easiest behavior and it also might be the one which they find most difficult so targeting communications the perceptions and needs of at-risk groups we need to understand their perceptions because they may be very different to the rest of the population and I'd like to introduce as well this idea of instrumental introduction of food risks which have resulted in unintended consequences here people start to become distrustful because a particular food risk is introduced to meet some other public health goal or to reduce prices or to deliver something that's beneficial in a crisis we need also to communicate about mitigation measures through the entire food chain about what's being done to reduce the risk again and again and again in Europe we see that food chain actors are not reporting a food risk until clearly people are affected until perhaps people have died it could be a month or two months after there was knowledge that risk was in the food chain so why is that happening and despite policy measures being introduced to reduce that the rapid alert systems that problem is still there so communication about mitigation measures and related research activities is needed to reassure consumers and also in short trust is reinstated and also because the food chain is very broad it's very long it's very complex we talk about food webs communication about uncertainties risk uncertainties and what is being done to reduce these is needed in real time and that would be true of any food scare and that needs not only to reach the consumer at home it also needs to exploit social media and it also needs to reach all of those actors in the food chain those are responsibility for food preparation in restaurants in in other environments where food is being prepared so sometimes I think a lot of effort on consumer education is good but certainly in my part of the world we also need to communicate with those other people with responsibility for consumer protection from food risk and of course deliberate contamination we need to communicate about enforcement and identification of fraudulent or deliberate introduction of foodborne illnesses into the food chain and also understand that consumers may lose something from not consuming a particular food or switching to alternatives so again why are people doing what they do don't just tell them that what they're doing is wrong but try and understand what's motivating them to engage in a particular course of action I've seen some really interesting breakout groups on the role of the social media I don't understand what's going on and have no idea how you can measure the impact of social medias I'm going to learn from you guys about how to measure this so big data geography demographic groups identify emerging food risk issues I'd like to just point out that the social media is not inclusive in the UK population there are 65 million people those active on Twitter 15 million people the ones that aren't active are probably the ones who are most vulnerable the most excluded so again a plea don't rely on just the social media as a risk communication tool even though we've got our smartphones and it is hot and sexy and and yeah it's it's one tall among many and I was recently talking to a colleague from Birmingham is an expert on social media most people are who they say they are but but there are also people falsifying identities and that might be industry actors or all sorts of people playing games with statistics related to foodborne illness but we just don't know so some care finally with social media another warning we're finding that the kind of social media that I'm familiar with are so unfashionable with my students they just laugh at me if I say Twitter there are other other forms which people who are in the know really really like to use as soon as social media is institutionalized by universities or perhaps government departments it becomes less hot so the real news is being broken on tinder someone tell me what interests you can told you in the coffee break really because this one's beyond me but the people that know are telling me this is the case so again we need to look at the social processes which is driving how these messages conveyed and who is being affected so some principles of risk communication risk-benefit communication variability and uncertainty these need to be communicated together with risk management and regulatory priorities what preventative measures are being taken by food chain actors not just by consumers and actions to prepare to improve future preparedness when as soon as a risk is identified and this is what we're not doing in Europe we need to get the information out by whatever means are available social media traditional media and we also need to say what we don't know if there are gaps in knowledge be honest about the uncertainties for many people this is difficult because how do you explain that actually you're not in control but to make sure that people trust and also protect themselves it's important so when new identification mitigation of prevention measures being put into a place these two may need to be put into the public domain and I would still argue that we were not perfect at communicating in a crisis were far better than when BSE happened in 1996 which was perceived as repressing the truth about a food risk but again what's being done how agencies communicate and coordinate their communications uncertainty how to get information to vulnerable populations who may be the most difficult to reach particularly in a crisis the location of risk in different food chains that needs to be conveyed as well as the geographical location of the risk and I just want to point out but in a real crisis for example a nuclear reactor goes up there might be all sorts of risk communication issues including that related to foodborne illness that needs to be conveyed quickly but you won't have the internet because there'll be no electricity so again contingency measures to make sure that we're not relying purely on modern technology so thank you any questions or comments first of all I've been asked to introduce myself my name is Brian Bedard I'm the executive director of the grocery Manufacturers science and education foundation and if you're wondering what I'm doing and how I'm involved with the partnership just I didn't realize I was doing so much with the partnership I'm a veterinary epidemiologist and I've been with the foundation now for about a year and we have a lot of complementary programs I'm also on the board of directors of the partnership and very pleased to be here this is the first conference I've been at and very excited to be involved with with the partnership I've been involved in food safety and the agribusiness for many many years and one things we've learned is that that the consumers of the future is where we have to focus our efforts to drive this food safety agenda and the partnership we know is doing an outstanding job in that effort and we're very pleased to be able to partner with them and I'd also like to thank the keynote speakers today I think they've done an excellent job at laying the groundwork aircraft to get started and what they've offered us today I think blends very well with with the program that allows us to dive a little bit deeper into some of the elements that they've talked about today and I'd like to highlight just a few of the takeaways that i got from their their presentations in terms of of the need for more data big data and the ability to analyze that data in much more powerful ways and we see the CDC and other agencies doing that in terms of how they're analyzing data we see them becoming more and more sophisticated new technologies and better I think better analysis of the data that then allows us either through the work we're doing in the partnership and industry to really target interventions so they really drive towards resolving the issues that are that are affecting us on a day-to-day basis the mention about antibiotic residues those of you that happened to have read the international new york times today that's front and center article about about the global risks of antibiotic resistance particularly what's happening in India it's quite shocking those of you that have time to have a look at that article I would encourage you to do so and and this dr. firs presentation I think leads right into that I mean one of the things that we've learned and I've heard several times say that if you you lead with the science you'll lose with the science and it's an issue about dealing with consumers and how they behave in their behaviors and that's something we're all learning in terms of what is going to drive food safety yes there are better technologies there better processing technologies there are better ways to train and teach people by the end of the day what we need to get at is people's behavior let me give you a little personal example I lived in China for 12 years and raised three children there so we were very my wife and I were very diligent about what they were fed we had an organic farm with greenhouses the three boys we raised we're working on the farm so they knew about the risks of food safety they only drank imported milk and happening to be a veterinarian and not a vegetarian I where the meat was coming from so that it was safe so we were being very very careful yep I come home one day in the early in the afternoon there's two of my boys on the street corner buying meat sticks from a local vendors street vendor and eating them as fast as they could he's cutting it up on an old piece of wood and and I said what are you doing boys his daddy but it tastes so good and it's so cheap and those are the risky behaviors that that consumers are getting involved in and from dr. Ferrer's presentation you can see that that there are there's a lot of work yet to be done in that way in terms of driving this into what we're doing it in the in the companies we work with for example food safety culture is becoming front and center and that whole food safety I believe they expanded beyond that to consumers and well beyond so without any further ado I'd like to open the floor up to any questions you may have for our keynote speakers I'm sure there are plenty we have about 10 minutes before the break so please if there any questions please raise your hand and anybody can help me to identify who the questioners are there is a microphone available are there any questions first of all I like I'm Christine brown university of california at davis i want to repeat i know what we all feel these are excellent presentations and a grand way to begin our program i'm wondering dr. Griffin are we focusing even too narrowly when we look at antibiotic resistance and look at at animal agriculture do we have any data on how frequent it is for humans who have a particular prescription antibiotic who stopped because they stop taking their antibiotic before the 10 days or whatever because they are now feeling better you know I concur that that we're focusing here on foodborne illness but are we should we broaden our view for other health communications to direct some of these issues that are arising so yes thank you for broadening the topic I focus just on pathogens that are transmitted commonly by food in the antibiotic threats report that CDC published last year the major focus is on bacteria that are not carried by animals that tend to be resistant because they've become resistant in a hospital environment or in other environments due to the overuse of antibiotics in human medicine so that certainly is a major major problem but because we were focusing on foodborne illness i focused on on that particular part of it so thank you for broadening that are there any other questions over here hello I'm Joan Hague Rafael Baker I'm the food safety specialist for SDSU south coast state university extension I've just this past few months I've served on the raw milk working group for South Dakota it has not been Pleasant I can tell you but and there is nothing you can say or do anybody that can bring that you can bring to the table when you're working with policy that can really get this group to change their mind I mean you have data you have all kinds of information you can bring human interest stories and there is nothing you can do so or that we found that we could do so if you have anything that you can help in that area I mean I think this is a good idea where you bring in you know the CDC and the data together and the same panel with with communicating risk but it was just I mean it I don't know what I could have done and what anybody could have done that were signed to sitting at that table so any ideas you can share would be great well I was hoping you would come up with ideas and tell us what 22 I agree with you that I mean we we have to try to acknowledge people's concerns and the reason that they're choosing raw milk I would hope that we begin to get enough of those stories from people who are believers in the benefits of many aspects of a healthy diet and in incorrectly I think throw raw milk into that box and then suffer the consequences for themselves or their children i'm hoping to get more of those stories we have those stories on our website and you're right I'm not that they have helped that much but perhaps a real speaker a leader in one of those groups who who suffered could help us but winds going to give us the answer all perhaps not it did occur to me i'm not sure if there's a an analysis of why people are choosing the raw milk which is pulling up the values that they're applying to their decision-making there must be something associated with that particular purchase which outweighs the perceptions of risk in the decision-making that they're doing i'm kind of thinking this is tied up with a whole raft of other value systems so naturalness organic production I'm not sure well also they politically they would use that it is their right to make that decision and and I and I can agree with them I guess on that so it came down to it everybody had to leave some skin at the table and a secretary of egg for South Dakota ran the session I mean we had several sessions and we all communicate very well together I mean I think I made some good friends but what we came down to on one of the things that we will that they have to have if they're raw milk producer is education and so SDSU extension will be developing that and and I think we're probably one of the first days that's going down that route and I I'm kind of concerned on the even what will happen with that you know what well I think that now we're risk free and so we have to really be careful how we develop that piece of education for the producers is something that that I'm looking at thank you very much we have two more questions over here go ahead sure so dr. frewer I am intrigued by this notion of I think he called it orthorexia is that correct yeah and if you could expand a bit about expand a bit on that it seems to me that the whole gluten free movement is sort of an exam of that and if you could talk a bit about what we understand as unrealistic optimism the idea that bad things happen to other people and that's a reason that people may engage in risky practices like eating oysters or drinking raw milk so if you could talk about those two things a bit um i'll start with the orthorexia i believe it's not yet formally been diagnosed as a medical condition a psychiatric condition by the APA but there's increasing evidence that people are restricting their diets in a healthy or what's perceived to be a healthy direction in a way which is actually result in malnutrition and and health problems so excluding and this also perhaps speaks to there are the Royal Mail kitchen excluding anything that's not produced in a particular way which isn't raw perhaps incorporate some of the more extreme versions of diets in the anti-shah diet is the one which I or the Paleolithic diet they're there to that I've come across the one that seems as you've mentioned there is the the one that seems to be taking over at the moment is avoiding gluten because in some way gluten is perceived to be unhealthy which it is if you have celiac disease obviously but but for normal people I'm not quite getting why why that perception has arisen and I suspect again it's linked up with a whole set of other values related to processing resulted to associated with carbohydrate intake all sorts of things which come together to promote what are actually likely to be unhealthy dietary practices the most extreme form is is when people simply won't eat outside of the home because they don't perceive that the food is being produced in a healthy natural way which aligns with the set of rules that somebody has produced with Russian companies whether that's really associate with foodborne illness on not sure but again I have something right raw milk it is aligned without that set of values now I do think we need to look at entire value systems rather than trying to isolate particular leaves because that's affecting how people behave in live their lives optimistic bias I was actually going to bring this into the breakout session that I'm also doing so I I'm going to steal my own thunder here but many people perceive that a lot of this information is directed towards others who engage in risky behaviors who often have higher perceptions of personal control over risk and perceive themselves to be more knowledgeable than an average member of society and we see it with all sorts of risk-taking behaviors in the past we observed it with smoking behaviors people think risk message is about smoking are directed towards individuals who smoke far more than they do as individuals sexual activity all sorts of things and I still think this is a major barrier to people taking notice of risk communication about foodborne illness that the messages are perceived to be directed towards very vulnerable individuals or very ignorant individuals and people simply don't attend those messages there are various interventions which have been utilized to overcome those optimistic biases but again I think speaking to the long term rather than the short term people very rapidly psychologically adopt and go back to doing what they always did so a big gap in our research basis understanding the long-term impact of all of these information interventions I've been advised that we have I apologize we don't have any more time for more questions but perhaps if you have I'm gonna allow this one question the last question I'm watching for the bullwhip though hi powerful nonverbals please Lynn Paul Montana State University Extension actually that was a great segue into my question and that is when you look at risk communication we're looking at ways in which to devise the message for behavior change but I was thinking about wet perhaps we need to look at those persistent messages that people take all that people have held on for decades and one example of that is the potato salad in the summer okay now I hear it all the time I still hear it all the time so why has that persisted long-term so if we can understand that perhaps we can understand as you said the what I want to say oh the the effectiveness of that message long term do you see what my point is yeah I absolutely agree and very quickly people sometimes take on board messages which they like and they're embedded in their cognition and they're very very difficult to change or shift and as new information comes to light people just disregard it because it is cognitively difficult process that information and also they like to do what they've always done it makes them feel comfortable so you're right we need to examine that yeah so we need to start with the unsafe practices of potato salad in the summer and just go from there yes a good start thank you thank you so please join me once again in thanking the keynote speakers for getting us off to a great start you

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