Pre-cut lettuce is suspected cause of food poisoning outbreak

http://www.washingtonpost.com/wp-dyn/content/article/2010/05/17/AR2010051703033.html?hpid=sec-health

Pre-cut lettuce is suspected cause of food poisoning outbreak


By Lyndsey Layton
Washington Post Staff Writer
Tuesday, May 18, 2010

It's convenient and popular, a healthy option for harried shoppers. But bagged lettuce suspected of causing a multi-state outbreak of E. coli illness raises new questions about whether pre-cut produce is riskier than whole vegetables.

The outbreak, which involves romaine lettuce cut up and distributed in bags to 23 states and the District, is the latest in a string of recent food poisoning cases involving pre-shredded leafy greens.

Twenty-three people in four states have been sickened since March 1, with another seven probable cases, according to the Centers for Disease Control and Prevention. Of the confirmed cases, a dozen people were hospitalized and three developed a life-threatening type of kidney failure. No deaths have been reported.

The romaine in question was not sold directly to consumers in the produce section but was used by food service companies and supermarkets in salad bars and "grab and go" meals. Several of the victims were students at colleges in Michigan, Ohio and New York who apparently ate the infected lettuce in dining halls.

It is difficult to judge whether pre-cut produce has been linked to more outbreaks than whole vegetables because state and federal health officials don't always specify whether the leafy greens associated with an outbreak were bagged or whole. But several multi-state outbreaks involving pre-cut produce in the last five years have raised concerns, most notably the 2006 outbreak of E. coli O157:H7 associated with Dole bagged spinach that sickened 238 people and caused five deaths.

James Gorny, senior adviser for produce safety at the Food and Drug Administration, said bagged greens represent a disproportionate number of recalls, chiefly because they're easier to identify than whole produce. "When you buy a whole head of lettuce, you have no idea what the brand name is, or who the grower is," Gorny said. "So tracing it back is that much harder."
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But, he said, pre-cut produce is not inherently riskier than whole vegetables.

Others disagree.

"I've been avoiding bagged lettuce for years," said Michael Doyle, a nationally known microbiologist who directs the Center for Food Safety at the University of Georgia. "I've been concerned about this for some time."

Most processors of fresh-cut produce remove the outer leaves and core the heads of lettuce in the field, where cutting utensils can come into contact with soil and spread contamination from the dirt to the crop, Doyle said. In farming areas, especially in a region near cattle farms, it is not unusual to find E. coli in the soil.

In a study published last year in the Journal of Food Protection, Doyle and several colleagues contaminated coring devices with soil that contained E. coli O157:H7 -- the most common E. coli strain associated with human illness -- and showed how the bacteria spread from the coring equipment to heads of lettuce. Washing the cored lettuce with a chlorine spray, a standard step, did not kill enough of the bacteria, the researchers found.

"In a processing plant, you'd have to have walls and clean floors," Doyle said. "But here, they're starting it right out in the dirt. It's a very hazardous practice."

Once the bacteria attach to a lettuce leaf, "it's very difficult to remove them," said Robert Gravani, a microbiologist at Cornell University. "We certainly want to increase our consumption of fresh fruits and vegetables, but we really have to address some of these issues."

Caroline Smith DeWaal, food safety director at the Center for Science in the Public Interest, said cross-contamination is another danger. "The process of harvesting lettuce, chopping it or tearing it, washing and putting it in a bag is a process similar to mixing ground beef," she said. "You're taking lettuce that could be grown in different areas and batching it together. So if you've got one infected field, you're mixing it with lettuce that would otherwise be uninfected, and now the whole batch is contaminated."

Fresh-cut produce began in the food service industry in the 1980s and then migrated to retail shelves to meet growing consumer demand for a fast, healthful product that required no more preparation than slicing open the bag. According to Nielson Co. ratings, pre-cut salad mix was the top-selling fruit or vegetable between January 2009 and January 2010, outselling heads of lettuce by more than 2 to 1.

"As long as it's treated with respect and handled properly, consumers should feel as confident in the safety of fresh-cut leafy greens as they do in whole-head forms," said Julia Stewart of the Produce Marketing Association.

The current outbreak is drawing special attention because the romaine lettuce was contaminated with E. coli O145, a strain that is primarily found in cattle and wildlife feces and has never before been linked to a food-borne illness, according to the CDC.

Patricia M. Griffin, chief of CDC's Enteric Diseases Epidemiology branch, said it is likely that E. coli O145 has caused previous food poisonings but has gone undetected because only about 5 percent of clinical laboratories are able to detect it. "The fact that we found it now doesn't mean it wasn't there before," she said. "The ability to look for the organism in ill people and in outbreaks and food has been increasing. We're gradually finding more of these organisms."

The FDA, which has repeatedly urged growers to improve produce safety, is crafting what will be the first federal regulations for growing, harvesting and processing fresh produce, Gorny said. The proposed rules are scheduled to be published next year, he said.

In addition, a bill pending in Congress would give the FDA broad new authority to regulate the safety of produce and other foods.

"The FDA needs much more authority to set standards on the farm, and that's contained in the legislation that's been passed by the House and is currently being considered in the Senate, Smith DeWaal said. "The FDA needs to do a much better job at inspecting plants that process and bag lettuce, and it needs to provide better guidance to lettuce producers so they know how to avoid these problems."

You never know who's handled your produce

http://seattletimes.nwsource.com/html/foodwine/2011894157_foodhandling18.html

You never know who's handled your produce

By Landon Hall

The Orange County Register


Prof. Carl Winter, director of the FoodSafe Program at UC Davis, heard about the new study linking certain kinds of pesticides with an increased risk of attention-deficit/hyperactivity disorder in children, and he became quite concerned. Not so much about the study itself, but the possibility that parents might now be less likely to serve fruits and vegetables to their kids.

"The most important thing consumers can do is eat fruits and vegetables," he said. "There's not, at this stage, the evidence that this causes ADHD. There seems to be a correlation, but not a cause-and-effect relationship. We need to take these things seriously, but at the same time we don't want to unnecessarily scare consumers into avoiding fruits and vegetables."

The bigger danger, Winter says, is from bacteria that could cause illness. Contamination can happen anywhere along the food-supply chain, and such illnesses cost the U.S. an estimated $152 billion a year in health-care costs.

That's why it's important for people to wash their fruits and veggies. About.com has rounded up a list of tips from various sources, including the CDC. Here are a few:

• Rinse the produce under running water, but only when you're ready to prepare it. Foods have natural coatings, and washing them off could make them spoil faster.

• Wash hands thoroughly before preparing foods, and keep countertops clean.

• Wash foods even if they have a skin you plan to peel away, like carrots and cucumbers.

• Remove the outer leaves of lettuce and cabbage, then wash the rest.

• Don't bother with the expensive sprays and rinses. They're a waste of money.

"No matter what food you have, you don't know who touched it before you got it, and for that reason you should do what you can to take care of it," Winter said.

Parents can also reduce their chances of exposure to chemicals by buying only organic produce.

The study, published in the Journal of the American Academy of Pediatrics, analyzed urine samples from 1,139 children age 8 to 15. Nearly 95 percent of the kids had at least one chemical byproduct (called metabolites) of a class of pesticides called organophosphates in their systems. There are about 40 organophosphates in use in the U.S. One of them, malathion, was used widely in California in the 1980s to eradicate the Mediterranean fruit fly, which posed a controversial problem for then-Gov. Jerry Brown.

Researchers found that kids with the highest levels of malathion metabolite in their urine were associated with a 55 percent higher risk of having ADHD. About 10 percent of the children in the study pool had the disorder, slightly above the national average.

The study speculates that most of the children got exposure to the pesticides from residue on foods. It notes that a 2008 report showed 28 percent of frozen blueberries, 25 percent of strawberries, and 20 percent of celery contained one type of organophosphate.

The Battle Over Taxing Soda

http://www.nytimes.com/2010/05/19/business/economy/19leonhardt.html?src=busln

The Battle Over Taxing Soda

The classic way for lobbyists to defend their client’s interest is to insist that they are not actually defending their client’s interest. Really, they say, they are just looking out for ordinary Americans.

Tobacco lobbyists spent years fighting regulation by claiming to be defending individual freedom, not the profits of tobacco companies. Detroit’s lobbyists did much the same to push back against seat belt and pollution laws. Wall Street has spent months opposing the financial regulation bill in the name of families and small businesses.

The latest example comes from Coca-Cola, PepsiCo and the rest of the soda industry, which is trying to defeat a soda tax now before the District of Columbia Council. The industry has succeeded recently in beating back similar taxes in New York and Philadelphia, and in keeping one out of the federal health overhaul bill. But the Washington Council seems to be seriously considering a penny-per-ounce tax on nondiet sodas, energy drinks and artificial juices. Council members are set to vote on the issue next week.

This soda debate is probably going to be around for some time. Cities and counties, desperate to find money to pay for schools and roads, are starting to see a soda tax as a way to raise revenue. The tax also appears to be one of the most promising ways to attack obesity, given the huge role sugary drinks play in the epidemic.

“It’s wrong for the government to stand idle in the face of an epidemic of obesity that’s hurting the quality of life and the health of our residents,” says Mary Cheh, the Council member who has proposed the tax, “when we have policy choices in front of us that can materially affect the problem.”

The soda industry, of course, is fighting back with newspaper and radio advertisements, among other things. It says a tax would most hurt “hard-working, low- and middle-income families, elderly residents and those living on fixed incomes” and would destroy jobs. Ellen Valentino, an industry official, recently told The Washington Post that companies would spend “whatever it takes” to make their case.

•

The argument for a soda tax is the same as the argument for a tax on tobacco, pollution or, for that matter, banks that take big, expensive risks. When an activity imposes costs on society, economists have long said that the activity should be taxed. Doing so accomplishes two goals: it discourages the activity, and it raises money to help pay society’s costs.

In the case of soda, those costs come in the form of medical bills for diabetes, heart disease and other side effects of obesity. We’re all paying these bills, via Medicare, Medicaid and private insurance premiums. Obesity has become a significant cause of our swelling long-term budget deficit.

And soda is a huge reason the country is so much more obese. The typical American consumes almost three times as many calories from sugary drinks as in the late 1970s. This increase accounts for about half the total per-capita rise in calorie consumption over the same period. Remember, many of these drinks have zero nutritional benefit — unlike meat, cheese or juice.

As Kelly Brownell, a Yale researcher, says, the link between obesity and soda is scientifically stronger than the link between obesity and any other type of food or beverage.

We’re drinking more soda for several reasons. Above all, the inflation-adjusted price has fallen 34 percent since the late 1970s, largely because it can be manufactured more cheaply than in the past. Meanwhile, the average real cost of fruits and vegetables has risen more than 30 percent, according to the Bureau of Labor Statistics.

Coincidentally, Ms. Cheh’s proposed tax would roughly reverse the drop in the price of soda over the last three decades, at least for the popular 12-pack of cans. An extra penny per ounce on a 12-pack would add $1.44 — or about 30 percent — to the current typical $4.75 price. (The tax rate would be lower for single-serve bottles and higher for bulk purchases.)

Most of the revenue would then be used to improve the miserable quality of many school lunches in Washington. One blog, Better D.C. School Food, has taken to documenting these lunches, with a series of photographs of bland bread, processed cheese and reconstituted beef.

So what about Coke’s and Pepsi’s arguments against the tax?

They are certainly right that less soda consumption could cost the soda industry some jobs. But it would eliminate jobs from the overall economy only if people put the money they had been spending on soda into their savings accounts. That’s highly unlikely. Instead, people will probably spend more on other food and drinks or, say, go to the movies more often — and create jobs in those industries.

The argument that the tax will hurt the poor is a little more serious. The average American now drinks almost a gallon of sweetened beverages each week. If the tax passes, any Washington resident who continued to do so would have to pay about $1.20 each week in soda taxes.

Yet even that number overstates the cost, because the tax would surely affect how much soda many people drank. One of the lessons of the recent rise in cigarette taxes is that big price changes can lead to big behavior changes, even with an addictive product like tobacco. Teenagers, the biggest soda drinkers of all, are especially price sensitive. People who cut their soda drinking from a gallon a week to merely three-quarters of a gallon — that’s still 96 ounces, more than twice the consumption level of the late 1970s — would be spending no more on soda than they are now.

I suspect that some Washington Council members, in the face of opposition from the soda makers and distributors, may be tempted to support a weakened version of the tax. One option would simply be to extend the normal 6 percent sales tax to sweetened beverages. Like food, they are currently exempt.

But here’s the problem with that idea: small tax changes don’t always change behavior, as a recent study by the RAND Corporation found. So a small soda tax could actually have a worse impact on some families’ budgets than a substantial one — by raising the price of soda without affecting consumption. No wonder the American Heart Association supports the penny-per-ounce proposal.

Such a tax would certainly raise the cost of living for some heavy soda drinkers, just as cigarette taxes have stretched the budgets of some smokers and mandatory seat belts have added costs to car production. But consider the benefits from those other public health initiatives. They have vastly outweighed the costs.

Someday, we will probably look back on our gallon-a-week soda habit the way we now look back on allowing children to ride without seat belts or listening to doctors who endorsed Camel cigarettes. We will wonder what we were thinking.

Coke and Pepsi, unfortunately, seem willing to do whatever it takes to delay that day.

E-mail: leonhardt@nytimes.com