A particular headline I saw online one Saturday this spring announced a countdown of “The 10 biggest food recalls in American history.”

I read it, and you can find it here: http://bit.ly/consultcorner0615. I found, one thing they have in common — they are all based on microbial contamination, with the exception of the Hallmark recall that was based on the potential for Mad Cow disease.

That is a lot of product recalled, and potentially a lot of people who were prevented from getting sick or even dying, right? Well when you read the recalls most of the products had already been consumed, so the people were either sick or had already died.

You might ask me why I am talking about this. Well, as I mentioned above, it is a Saturday, and I needed a break from reviewing audits for some of our clients.

So, consider that, when you look at audit requirements from all of the big retailers, they seldom if ever actually audit for food-safety issues. Instead, they go after basic sanitation. While the sanitation checks are important, they don’t get to the real issue of food safety. What ends up happening is that in order to pass the audit, the company spends time and resources focusing on such things as organization charts, broken-glass programs and allergens.

The hysteria about allergens is amazing. In her article “Food Allergy Deaths: Less Common Than You Think”, Meredith Broussard notes the Centers for Disease Control and Prevention (CDC) doesn’t even publish data on how many people die from food allergens because it is so low (http://bit.ly/consultcorner06152). The last time the CDC reported the data was in 2005, when 11 people died from food allergies. More people died from injuries suffered in lawnmower accidents.

The amazing thing is the food industry spends a huge number of resources to deal with allergens, and yet the risk of someone dying from an allergic reaction is very small. In properly labeled product, it is almost nonexistent. It is truly a labeling issue, not a food safety issue. Yet almost every third-party audit I have seen, the establishment gets beaten up about allergens.

The one thing I don’t see is the third-party auditors saying anything about E. coli, Listeria, Hepatitis or other pathogens. They are worried about how far the Dumpster is from the establishment, or whether the light bulbs were checked at least daily for breakage. It is amazing to me that as an industry we pump so many resources into passing third-party audits, only to end up with food-safety issues. Doesn’t it make more sense to put our resources into preventing food-safety issues in the first place?

That got me to thinking, how many people actually die from foodborne illnesses every year? What is the actual number, not just the “estimates” used by almost everyone.

I decided to dig into the CDC Wonder database (Underlying Cause of Death, 1999-2013 Results) to find out how many people actually died in 2012 from food-related diseases. The system isn’t easy to use but I have listed some numbers in the sidebar and chart on page 30. Please note these are the numbers as reported on death certificates, not an estimated number.

A couple of things about this data jumped out at me. The first was that whenever I see a CDC study about food, it doesn’t actually use these numbers. The CDC uses an estimated number of illnesses. That makes me wonder why they don’t include the actual number of people who died due to the disease. Maybe the numbers are not sensational enough?

The second thing I noticed is, according to the database, one person died of an allergic reaction to food in 2012. By comparison, 23 people died of lack of food, 43 were legally executed and 46 died from lack of food and water because of self-neglect. Thirty-five people died from a reaction to food, anaphylactic shock or another adverse reaction that was identified as a contributing factor.

One person dying is too many, I fully agree; however, I encourage you to look at the numbers yourself. Afterward, ask yourself, is our approach to food safety and the use of resources to make sure we produce safe food the right approach? Are you focusing on the right areas? How can you, and we as an industry, do better?

One of the statistics that the CDC doesn’t point out? You have a much better chance of catching a disease that will kill you while at the hospital than at the restaurant.

My advice is that when you perform your hazard analysis, think about these numbers, what are your hazards and how do they match up to what actually causes death?

The next step is to look at what is really a regulatory requirement, and what is actually other consumer protection, and then allocate your resources to do the most good. You don’t want to pump resources into programs that have no return and short yourself in critical areas; finding out you have LM in your facility after you recall product for LM contamination is much more expensive that catching it before the product leaves!
 

2012 Underlying Cause of Death, as reported to CDC

Please note these are not the number of people that get sick; these are numbers of people who died and were grouped by their listed underlying cause of death. The numbers are not broken out by food specifically but are the total number identified as having died from the causative agent, not how they contracted the causative agent — they may have gotten the Salmonella from a turtle, for example. The numbers in parentheses indicate the number of people who died who had the applicable causative agent listed as a contributing factor in the death. These numbers include those who died and had it listed as the underlying cause of death.

Salmonella infection or foodborne intoxication due to any Salmonella species other than S. typhi and S. paratyphi

-Salmonella enteritis:                                                       11 (17)
-Salmonella septicemia:                                                  28 (36)
-Salmonella localized infection:                                          2 (4)
-Salmonella infection, unspecified:                                  3 (18)

Shigellosis, unspecified:                                                       2 (4)

Enterohemorrhagic Escherichia coli infection:                 1 (1)

Other intestinal Escherichia coli infections:                       4 (9)
(Escherichia coli enteritis NOS)

Campylobacterenteritis:                                                        4 (5)

Enterocolitis due to Clostridium difficile:          7,739 (12,565)
(Foodborne intoxication by Clostridium difficile Pseudomembranous colitis)
* Note that Clostridium difficile is fecal to oral route, typically in health-care setting.

Other specified bacterial intestinal infections:            98 (136)

Bacterial intestinal infection, unspecified:                    20 (29)
(Bacterial enteritis NOS)

Botulism:                                                                                 1 (1)
(Classical foodborne intoxication due to Clostridium botulinum)

Cryptosporidiosis:                                                                 2 (6)

Listerial meningitis and meningoencephalitis:           25 (29)

Listerial septicemia:                                                         10 (12)

Other forms of listeriosis:                                                     1 (1)

Listeriosis, unspecified:                                                     8 (20)

Staphylococcal infection, unspecified:                  472 (3,189)

Streptococcal infection, unspecified:                     148 (1,021)

Bacterial infection, unspecified:                              575 (5,084)
(Bacteremia NOS)

Creutzfeldt-Jakob disease – CJD:                             338 (357)

Hepatitis A without hepatic coma:                                  23 (77)
Acute hepatitis B without delta-agent with hepatic coma: 15 (15)

Acute hepatitis B without delta-agent
and without hepatic coma:                                       429 (1,415)

Acute hepatitis E:                                                                   2 (2)
Other specified acute viral hepatitis:                                  2 (5)

Acute viral hepatitis, unspecified:                                90 (150)

Chronic viral hepatitis B without delta-agent:         137 (334)

Chronic viral hepatitis C:                                    7,292 (18,593)

Other chronic viral hepatitis:                                                1 (2)

Chronic viral hepatitis, unspecified:                              14 (26)

Unspecified viral hepatitis hepatic with coma:                 1 (1)

Unspecified viral hepatitis without hepatic coma:    56 (109)

Lack of food:                                                                      23 (42)

Legal execution:                                                               43 (43)

Penicillins:                                                                              1 (6)
(Antibiotics)

Pneumonitis due to food and vomit:              17,892 (57,694)
Includes: Aspiration pneumonia (due to): NOS, food (regurgitated), gastric secretions, milk, vomit

Insufficient intake of food and water due to self-neglect: 46 (2,163)

Inhalation and ingestion of
food causing obstruction of respiratory tract:                1,138 (1,833)
(Caused by food itself, not foreign object)

Inhalation and ingestion of other objects
causing obstruction of respiratory tract:                       3,183 (16,392)
(Includes coins, toys, etc., i.e. not directly related to food)

Foreign body in respiratory tract                              0 (15,388)
(asphyxia due to foreign body choked on: food (regurgitated), phlegm, inhalation of liquid or vomitus NOS)

Allergic and dietetic gastroenteritis and colitis:               1 (1)
(Food hypersensitivity gastroenteritis or colitis)

Anaphylactic shock due to adverse food reaction        0 (18)

Other adverse food reactions, not elsewhere classified 0 (17)
Excludes bacterial foodborne intoxications, dermatitis due to food, dermatitis due to food in contact with the skin.

Asphyxia:                                                                  223 (17,981)
(Exclude foreign body in respiratory tract)

You can find the database at http://wonder.cdc.gov/ucd-icd10.html, and the explanation of the codes, i.e. what is supposed to be reported, at: http://apps.who.int/classifications/icd10/browse/2015/en#/A04.7