World Food Safety Day is celebrated every year on 7 June to raise awareness and inspire actions that aid in the prevention, detection, and control of risks associated with foodborne diseases. The focus of this year’s observance is the theme, “Food Safety: Prepare for the Unexpected,” which underscores the essentiality of being ready to handle any food safety incidents that may arise, regardless of their severity.
In our previously published article—“How Murphy’s Law Can Help Prevent Disease Outbreaks”—we proposed how embracing the principle of “Anything that can go wrong will go wrong” can significantly improve preparedness for potential disease outbreaks on board; an approach that is particularly relevant to ensuring food safety.
What is a Food Safety Incident?
A food safety incident refers to a situation where there is a potential or confirmed health hazard associated with eating a particular food item: this includes drinks, ice, and any other ingredient utilized entirely or partially for human consumption. Incidents can range from mild cases of food poisoning, which may go unreported to a vessel’s medical staff or designated officer, to large-scale events that receive media coverage, such as the recent suspected norovirus outbreak aboard the P&O Cruises’ Ventura.
The opportunity for the contamination of food exists at any point in the supply chain, from “farm to fork”. Foodborne illnesses can be the result of human error, poor personal hygiene practices, insufficient managerial supervision, or inadequate company procedures. Additionally, factors outside a vessel’s control, like the purchase of adulterated food or the supply of produce irrigated with polluted water, may also contribute to food contamination.
To prevent subsequent health issues from arising, it is essential that vessel owners, operators, and ship management companies implement and enforce stringent food safety practices on their ships. The presence of harmful bacteria, viruses, or parasites in food can lead to illness, with over 200 known diseases attributable to the consumption of unsafe food. When adequate safeguards are not in place, vulnerabilities in a company’s supply chain can have serious, sometimes fatal, consequences for the end consumer.
The Four Main Types of Food Contamination
Food contamination occurs when food, whether in its raw state or as a ready-to-eat (RTE) product, contains a harmful or unwanted substance that poses a potential risk to the person consuming it. The significance of this issue should not be underestimated: it represents a global public health problem, with an estimated 10% of the world’s population suffering from a foodborne illness every year.
Numerous studies have shown the primary causes of foodborne illness outbreaks are due to unsanitary conditions, inadequate hygiene practices by food handlers, and a limited knowledge and attitude towards food safety. The most common factors contributing to these outbreaks are the improper management of perishable food items that become unsafe to consume when not maintained at the correct temperatures, food employees working when infected with a communicable disease, and the use of contaminated raw ingredients.
Food can become contaminated through four primary avenues. Each of these categories poses a risk of contaminating food. The main types of food contamination are:
- Biological Contamination: Biological contamination, also known as microbial contamination, is the most common cause of food poisoning. It occurs when food becomes contaminated with harmful pathogens such as bacteria, viruses, parasites, or fungi. This can happen in one of two ways: directly or via cross-contamination. Direct contamination is when pathogens already present within the food proliferate to levels considered hazardous, whereas cross-contamination involves the transfer of pathogens from external sources into food (e.g., via the hands of a food employee).
- Chemical Contamination: There are two different types of chemical contamination, natural and artificial. The first denotes the presence of chemicals that exist naturally in food, such as toxins found in certain species of fish. Artificial contamination refers to food coming into contact with a chemical which is not a natural by-product of food. It encompasses a range of chemicals, including those employed in cleaning and sanitizing processes, as well as various agricultural substances like fertilizers and pesticides. The effects of chemical food poisoning on human health are serious and can vary widely, from minor cases of gastroenteritis to life-threatening conditions affecting the liver, kidneys, and nervous system.
- Physical Contamination: Physical contamination is the presence of any foreign object in food such as glass, metal, plastic, jewelry, fingernails, or human hair. These items not only pose a risk of injury and chocking, but may be vectors for additional biological contaminants. The likelihood of food being contaminated with foreign objects increases with certain behaviors including ineffective pest control measures, the use of damaged or improper utensils during food preparation or service, and storing food outside of designated areas on board.
- Allergenic Contamination: Allergenic contamination is when a food that triggers an allergic reaction inadvertently comes into contact with another food item. While all foods have the potential to cause an allergic response, certain foods are recognized as being more likely to do so. A food allergy is when the body’s immune system perceives a typically innocuous food item as a threat and reacts adversely. This results in an immunological response that may manifest as minor symptoms such as a rash, or escalate to more serious medical conditions, including respiratory distress or anaphylaxis. For an individual with a food allergy, ingesting even just a small quantity of allergenic food can trigger a life-threatening reaction, which is why vessels must have strict processes in place to prevent such cross-contamination.
Is Food Contamination a Problem in the Maritime Industry?
The scarcity of real-time data makes it difficult to evaluate the true impact of food contamination within the maritime industry. Research into this issue has been predominantly focused on the cruise sector; very little information exists on the consequences of improper food safety and the frequency of associated gastrointestinal diseases in other maritime verticals, such as commercial shipping and yachting.
It is widely acknowledged that cruise ships experience outbreaks of acute gastroenteritis (AGE) attributed to bacteria and viruses—particularly noroviruses—present in contaminated food and water. While it must be recognized that not all reported AGE outbreaks can be traced back to the consumption of food, it is frequently implicated as a source of transmission.
The immediate data accessible to the general public is limited to cruise vessels sailing in U.S. waters, which does not reflect the true incidence of gastrointestinal illness. Additionally, information regarding AGE case numbers are only published on the CDC’s Vessel Sanitation Program website if specific criteria is fulfilled, such as when 3% or more of passengers or crew report symptoms during a voyage. Moreover, neither local health authorities nor cruise lines typically conduct detailed investigations into the origins of each individual AGE case reported, thus, the actual consequences of improper food safety on board are unknown.
Being Prepared for the Unexpected
It is reasonable to conclude that maritime vessels are as susceptible to food safety incidents as any similar land-based operation. They face the same difficulties encountered by food establishments ashore, with some additional challenges unique to the maritime environment. For example, seafarer contracts typically require crew members to work 10 hours a day, for stretches of 9 to 10 months without a break. Under such strenuous circumstances, it’s unrealistic to expect they can always operate to the best of their ability.
When mistakes happen, the impact of food contamination on ships is not only confined to its origin; it can potentially compromise the health of individuals and communities across the globe. Being prepared for the unexpected requires maritime companies to make the unexpected part of their plan. While the primary goal of a food safety management system is to prevent the contamination of food, food safety does not exist in isolation. A multifaceted approach that incorporates all aspects of public health is required—if a vessel’s water supply is contaminated with E. coli, then food safety on board is also compromised.
The implementation of robust public health procedures, in conjunction with Outbreak Prevention & Response Plans (OPRPs), is a good starting point. Nonetheless, for company processes to be truly effective, they must be communicated, acknowledged, trained, and importantly, put into practice. If proper hygiene behaviors are not integrated into the daily routines of crew, don’t expect them to suddenly adapt the correct habits when case numbers of acute gastroenteritis on board increase.
The risk of a food safety incident on board will always exist: it’s an organization’s preparedness for such events that defines its success in preventing them. By developing robust public health cultures that champion effective food safety procedures, crew training programs, and continuous improvement initiatives, maritime companies can ensure food items are safe for consumption, and be better prepared for when things don’t go to plan.
Ultimately, perhaps the greatest challenge for public health vis-à-vis food safety within the maritime industry, is achieving acceptance that the consequences of improper controls are serious. While scientifically there’s some truth in the statement, “If I can’t see it, it doesn’t exist”, not everything is observable to the naked eye. Where public health is concerned, the pathogens that cause illness can only be viewed through a microscope. If the dangers these “invisible threats” pose could be better understood, perhaps the benefits of implementing a strong public health culture would be more appreciated throughout the maritime industry?
Echoing the words of Nelson Mandela, “One cannot be prepared for something while secretly believing it will not happen.”