WHO/HPP/FNU/93.1 ENGLISH ONLY DISTR.: GENERAL APPLICATION OF THE HAZARD ANALYSIS CRITICAL CONTROL POINT (HACCP) SYSTEM for the IMPROVEMENT OF FOOD SAFETY WHO-Supported Case Studies on Food prepared in Homes, at Street Vending Operations, and in Cottage Industries WORLD HEALTH ORGANIZATION FOOD SAFETY UNIT 1993 Wor1d Hoallh Organization 1993 Tilis document is not a formal publication 01 tlie World Health Ce document n'est pas une publication officielle de l'Organisation Organization (WHO), and all rights are reserved by tlie Organization. mandiale de 13 Sante (OMS) et tous les droits y alhirents sont reserves The document may, however, be freely reviewed, abstracted, repro· par l'Organisation. S'il peut etre commenll!. resume, reproduil ou duced and translated, in part or in whole, but not lor sale nor lor traduil. partiellement au en tolalite, II ne saurail cependant I'elie pour use in conjunction with commercial purposes. I. vente ou a des lim commerciales. The views expressed in documents by named authors are solely the las opinions exprimees dans les documents par des auteurs ciles resl)onsibility of those authors. nommemellt o'engagent que lasdils auteurs. Introduction Foodborne diseases, i.e. illnesses due to contaminated food, are one of the most widespread health problems of the contemporary world, and an important cause of reduced economic productivityl. In addition to human suffering, foodborne, diseases cause substantial economic losses.' These include loss of income, loss of manpower, medical care costs, loss of food, and a decrease in tourism and food export opportunities. Unfortunately, foodborne diseases are increasing in number and frequency allover the world, and in spite of the efforts that are being made the problem is likely to continue to grow if new strategies are not applied. The logical conclusion is that the traditional approaches, for both food control and for prevention of foodborne diseases, are insufficient. This is true even in industrialized countries with a sophisticated and costly formal food safety infrastructure. Therefore, a concerted approach to food safety is needed. The World Health Organization's suggestion for this concerted approach is to combine an effective food safety infrastructure with an adequate educational programme2,3,4. The design of this programme should be based on a combination of two types of information: (a) the information on the sociocultural and economic situation; and (b) the technical information related to food preparation and food habits obtained through the application of the Hazard Analysis Critical Control Point system (HACCP). HACCP is a rational method, relatively new, for the prevention of foodborne diseases. It consists in the identification of hazards associated with any stage of food production, processing or preparation, the assessing of the related risks, and the determination of the operations where control procedures will be effective. Through its Food Safety unit at Geneva and its six Regional Offices, the World Health Organization, convinced of the utility and importance pf HACCP for improving the safety of foods, has been encouraging the development and application of this system in the integrality of the food chain, from production until consumption. In particular, as pointed out above, WHO believes that health education in food safety has to be developed in line with the results obtained through the application of HACCP during the preparation and storage of foods in homes\ food service establishments, cottage industries, and street markets. For this reason, some years ago WHO promoted and financed the practical application of HACCP during the preparation of foods in homes, by street vendors and in cottage industries in selected developing countries. Intensive courses on HACCP were also organized in these countries in order to discuss the results obtained with national experts, and to motivate local teams to continue such studies. Several papers and articles giving the results of the above­ mentioned studies have been published in internationally-renowned journals. 1 The Role of Food Safety in Health and Development. Report of a Joint FAO/WHO Expert Committee on Food Safety. Geneva, World Health Organization 1984 (WHO Technical Report Series, No. 705). 2Integrated Approaches to Health Education in Food Safety. Report of the Task Force Meeting. Geneva, World Health Organization 1991 (WHO/HPP/FOS/90.3). 3Kaferstein FK, Motarjemi Y, Quevedo F. Why Health Education in Food Safety? The rationale for a new approach to food safety. Paper presented at Interregional Seminar on Health Education in Food Safety, Islamabad, Pakistan, 23-27 September 1990. 4Abdussa1am, M, Kaferstein F. Food Safety in Primary Health Care. World health forum (in press), Geneva, World Health Organization. ( ii) The purpose of this document is to still further disseminate the principal articles and papers published with WHO support, bringing them together in one volume. Particular attention is given to the experimental studies performed in Peru, the Dominican Republic and Pakistan. The support of the German Agency for Technical Cooperation (GTZ) and the Industry Council for Development (ICD) is specially acknowledged, particularly with regard to the research work undertaken in Pakistan. We would also like to express our thanks to the editors of the journals in which the papers were originally published for their permission to reproduce them in this document. 293 Reprinted from Journal of Food Protection, Vol. 51, No.4, Pages 293-302 (Apri/1988) Copyrighl© International AsSOCiation of Milk, Food and Environmental Sanitarians Hazard Analyses of Foods Prepared by Inhabitants Along the Peruvian Amazon River SILVIA MICHANIE1, FRANK L. BRYANz·, NELLY MENDOZA FERNANDEZ, MAGDA MOSCOSO VIZCARRAJ, DORA TABOADA p.3, OBDUUA NAVARROS.3, AURORA BRAVO ALONS03, AND UTA SANTILLAN M.4 Veterinary Public Health Program. Pan American Zoonoses Center (CEPANZO), Pan American Health Organization. Casilla Correo 3092 (I()()())Buenos Aires. Argentina (Received for publication July 22, 1986) ABSTRACf control measures and criteria; (d) monitoring of each critical control point, and (e) implementation of appropriate and Hazard analyses of food preparation practices were conducted immediate corrective action whenever the criteria are not in two households in Indiana (a settlement along the Peruvian met. Hazards relate to contamination of foods by microor­ Amazon River). in a household in a cluster of about a half dozen ganisms and to their survival during processing and multipli­ houses up river. and in three households in Belen (a district near cation during storage. A critical control point is an operation Iquitos), Peru. These analyses consisted of watching all steps of the (location, practice, procedure, or process) that if not under operation, recording temperatures throughout all these steps, and control could lead to unacceptable contamination, survival or collecting samples of food and testing them for common foodbome pathogens and indicator organisms. Foods prepared included rice, growth of undesirable microorganisms. Monitoring is the plantains, yuca, dry fish, fresh fish, beef, and chicken. During checking that the process or handling procedure at the critical cooking, foods attained temperatures of at least 93.3"C; they control points is properly carried out. usually boiled. Such time-temperature exposure would kill vegeta­ This approach is applicable to evaluate food safety in tive forms of foodbome pathogenic bacteria, but not heat-resistant homes as well as food processing and foodservice spores. When cooked foods were leftover, they were kept either on establishments (16). Furthermore. a FAO/WHO Expert tables or on the unheated stoves or grills on which they were Committee on Food Safety recommended that the HACCP cooked. During this interval, at the prevailing ambient temperature approach be used in homes in developing countries to get a and high humidity of the jungle region, conditions were such that greater insight into hazards associated with food preparation considerable microbial growth could occur. Time of exposure, and applicable preventive measures (7). however, limited counts to the 105-1 06 level. In the evening, foods The feasibility of using this approach in households was were only mildly reheated, if reheated at all, so temperatures were not attained in the center regions of the food that would have killed tested in Peru because of the country's diverse geographic microorganisms that had multiplied during the holding period. and climatic conditions and the different cultural groups that Hence, the primary critical control point is holding between live there. A determining factor for these diversities and cooking and serving. but cooking and reheating are critical control differences is the Andes mountain chain which creates three points also. natural regions: the coastal, the mountains and the jungle. Hazard analyses reported here were conducted in households The hazard analysis critical control point (HACCP) along the Peruvian A!OOZon. Food-preparation hazards in approach consists of (a) determination of hazards and assess­ households in the other regions were described in two related ment of their severity. and the risks they pose; (b) identifica­ papers. tion of critical control points required to prevent or control significant hazards; (c) establishment of preventive and MATERIALS AND METHODS Description ofthe region, population and diet 'Veterinary Public Health Program