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Food and Water Borne Diseases > Final > Flashcards

Final Flashcards

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1
Q

Lead- how?

A

Not naturally occurring
Comes in occupation, environment, waste, water
Kids- paints, canned food, lunch boxes, jewelry, calcium supplements

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2
Q

Lead “elevated” level

A

10ug adults and 5ug kids

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3
Q

Lead hx events

A

Roman Empire & industrialization

1940 Glasgow retardation, regulation began 16c Germany and 17c Massachusetts

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4
Q

Lead in FOOD

A

Processing, pesticides, canning.
Process- gasoline makes it airborne, got into uncovered crops
Pest- lead arsenate still worldwide (coffee Central America) switched to DDT in 1960s because of resistance.
Can- BPA in lining now instead of solder

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5
Q

Lead in WATER

A

Unnatural, r/t infrastructure. Part of EPA SDWA, issue that EPA only protects till property line. Action level first draw after 6 hours sedent, action level <15ppb and actions are:
1) public education (avoid first draw, protect children)
2) water quality parameter (WQP) monitoring
3) source water monitoring & treatment (look for acid causing leaching)
4) corrosion control treatment
DC 2000 crisis & flint 2016 crisis

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6
Q

Lead water crises

A

DC 2000- changed from chlorine to chloramine (lasts longer but not as strong, leached lead from pipes). CDC did investigation and said there was no problem, they took samples from children who had not even been drinking the water and they were covering it up and Mark Edwards blew the whistle. The CDC didn’t retract the report but then noted “limitations of methods” and then same dude was ready for:
Flint 2016- source water had lots of microorganisms (flint river bc Lake Huron too $$) no anticorrosive- leaching and not enough chlorine- biofilm, legionella

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7
Q

Mercury

A

Bioaccumulation from methyl (fish & ayurveda) methylmercury- MeHg. Coal-fires power plants is how Hg gets into wager, then benthic bacteria in water & soil convert to MeHg (sulfate dependent methylcobalamin pathway)-> fish fat. Fetus impaired motor & cognitive skills.
MeHg absorbed into GI with cysteine and this pair looks like methionine and treated as such. Transported in air currents up to Canada. DC is hotspot bc downwind of coal plants. Regulations spots- source control, water, food @ sale, consumer warnings

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8
Q

Arsenic

A

Naturally occurring but also anthropogenic (industry & farming). Colorless, tasteless, odorless, and takes decades to develop disease. Lead arsenate- still worldwide (coffee)
FDA 2016 action level= 100 ppb. Huge in rice products which is what they recommend babies to eat

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9
Q

Arsenic Bangladesh 1980s crisis

A

Switched from biocontaminated surface water to arsenic contaminated groundwater thru tube wells. Lesson here= can be naturally occurring in water unlike lead. They used to grow rice during rainy season but now during the dry season they pump it out with arsenic diesel that’s getting into the rice. Absorbs more effectively because grown in water flood

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10
Q

Outbreak stats

A

Most cases are toxins & chemicals from a HAB
respiratory has more instances but GI affects more ppl, and then out of GI the biggest is crypto
Instances of surface= ground but surface affects more ppl (more common source. Ground isn’t safe either- channels & faults)

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11
Q

Microcystin

A

Cyanobacterial toxin, algal bloom in huge Lake Erie. Regulations hadn’t been in place to protect from toxin so instead EPA published an “advisory”

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12
Q

Ground water rule

A

Oct 2006- purpose= reduce disease causing microorganisms in drinking water. If ground water systems are at risk for feces must take corrective action to reduce potential illness, but still bacteria only!

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13
Q

RECREATION

A

Untreated all bugs are equal but treated it’s all crypto. Swimming pools ppl don’t seek treatment for diarrhea they keep swimming. Crypto so danj bc low infectious dose & high titer in diarrhea= one incident can affect everyone. Diarrhea disperses w/o notice. Action- immun, toddlers, and I’ll avoid swimming (6 pleas). Operators educate. Comes from dog poop too. Can either shock chlorinate the pool or some pools are using 1 micron filters

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14
Q

Emerging infections program EIP- FoodNet

A

Owned by CDC- main part is foodnet, hears back from CDC, USDA, FDA, and has 10 sites in different states. Surveils 15% area, tracks:
1) new & emerging
2) frequency & severity
3) trends
4) specific foods
Might be 6-23 days from eating food to case confirmed. It’s active not passive meaning it reaches out to labs. Tracks all big bacteria but NOT NORO. eFORS= electronic food outb syst. If one state outbreak they may consult but let them handle it, once it’s multi state it becomes outbreak net

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15
Q

OutbreakNet

A

“The national network of public health officials coordinated by CDC that investigates enteric disease outbreaks” and coordinates among states, leads studies (ID & how) then take info to FDA/USDA and start recalling stuff. Tell public, tell docs how to treat, prevent. Can’t point fingers too soon bc it’s millions of dollars

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16
Q

PulseNet

A

“The national subtyping network for foodborne disease surveillance coordinated by CDC” outbreak detection with sero & subtyping

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17
Q

Pulsed-field gel electrophoresis

A

The fingerprint, you have to already have it to know it. It’s all approximate, this is what was historically used, but hard to actually get & harvest sample from pt

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18
Q

Whole genome sequencing

A

Uses computer algorithms & looks at whole thing so better

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19
Q

Peter Pan peanut butter 2006

A

47 states, strain Tennessee. PulseNet was like woah lots more salmonella then outbreaknet was like ok where is it coming from and it took weeks to figure out it was PB. 4000 products, 360 companies. Pigeons in plant, untrained workers, tried to resell recalled containers

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20
Q

Spinach 2006

A

O157:H7 it’s constant from California Salinas valley
Wisconsin first thought livestock at state fair but then questionnaires found it was spinach. About 10 days to confirm spinach & recall bags, 15 to find “smoking bag” sad bc a 2yo boy died. 50% hospitalized, 17% got HUS (more than usual because this type of shiga tox very virulent) came from wild pigs shitting on the lettuce. they told the industry to change and it hasn’t really changed. should be using clean water, keeping away animals, giving bathrooms to workers, decontaminating before mixing, keeping it all cold

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21
Q

Seed sprouts

A

Over 30 outbreaks of salmo & ecoli since 1995. Even 2018 is was jimmy johns. eaten raw, high moisture, penetrate inside, hard to treat in a way that doesn’t kill a sprout but could do chlorine & heat

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22
Q

Turkey X disease

A

Started with turkey X in 1961- they stop eating & growing, get lifeless, die. Interviewed ppl who made the food and learned that it was moldy. So there are spores in the soil and then mold grows on food after harvest. Aflatoxin is fluorescent, heat stable, lethal at high dose and liver Ca at low dose. Stunts growth bad in central america that’s why theyre short. peanuts, wheat, rice, corn, oats. There is a small level allowed in food because it would be too $$$ if we took it all out but Valencia brand has 0 aflatoxin.

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23
Q

Food testing & regulation acts

A

1906 Food & Drug Act
1938 Food Drug & Cosmetic act
1960 Amendment-
Dietary Supplement & Health Act of 1994 (DSHEA)

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24
Q

Nitrates & nitrites

A

Eclipse cafeteria had sodium nitrate instead of salt and 11 blue men came to the hospital. 5 other housemates did same thing with mislabeled bucket. Nitrate is a good botulism blocker. Ascorbic acid (vitamin C) blocks carcinogenic ability of nitrates. Spam has a ton of them, turns meat red.

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25
Q

GU poison squad

A

Harvey Washington Wiley fed med students common additives to see if they hurt. Candy colorings had lead in them.

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26
Q

Acrylamide

A

The use for it is water treatments, etc. Pins & needles to testes & nervous system- loss of balance, slurred speech, sweating. 6 in 10,000 Ca risk. Processed foods have a TON of them in them (esp kettle chips & McDs fries!!) lots of chips & tortilla products, the higher the temp the way more that forms. Formula= potato starch + asparagine + sugar (“the mallard reaction”) Trying to get rid of it raises the price of food.

27
Q

Metabolism Heterocyclic Amines

A

L-phenylalanine + Creatine= Heterocyclic Amines, flames searing meat trap juices inside and then reaction occurs esp sausage casing has a ton bc at least patty some juices flow out. PhlP (aminomethylPHenyLimidazoPyridine) is the most abundant HCA and then that can make cancer like wherever it wants. The paradox- we cook food to kill bacteria & denature protein but in the course of doing that we produce byproducts. Also wow red meat is calssified as an official carcinogen and technically all mammals so that means pork too. Stomach, pancreas, colon.

28
Q

Food and drug act

A

prohibit addled/misadverts food.

29
Q

Food drug & cosmetic act

A

ppl have to demonstrate FDA compliance, set pesticide, color additive, & cosmetic LIMITS. Ppl died drinking Elixir Sulfanilamide.
1960 Amendment- now need premarket approval and carcinogenics not allowed.
FQPA requires “reasonable certainty of no harm” previously there were other standards- risk/benny for fresh produce- Delaney Clause
EPA establishes tolerances of allowable levels of pesticides

30
Q

Delaney paradox

A

Zero risk for processed foods so residue was “safe” on fresh food but not allowed on a processed food

31
Q

Dietary supplement and health act

A

1994 (DSHEA): “d’shay”- so drugs are easy for the FDA to regulate obvs because that’s their thing but to regulate a supplement they have to prove harm instead of prove benefit and I think big tobacco has an interest in limiting their power so u kno how that goes.
Food fraud- olive oil, milk, honey, saffron, seafood

32
Q

Animal Feeding Operations (AFOs)

A

agricultural operations where animals are kept and raised in confined situations. AFOs congregate animals, feed, manure and urine, dead animals,
and production operations on a small land area. Feed is brought to the animals rather than the animals grazing or otherwise seeking feed in pastures, fields, or on rangeland.
​-animals are confined for at least 45 days in a 12-month period (bc beef cattle are often taken to places where they are grass fed for finishing)
​-there’s no grass or other vegetation in the confinement area during the normal growing season

33
Q

Concentrated Animal Feeding Operations (CAFOs)

A

AFOs that meet certain EPA criteria. CAFOs make up approximately 15 percent of total AFOs.
alternative- deep straw beds & socialization for better life and it goes to scale.

34
Q

What might cause problems in animal feed?

A

(1) bacteria= infections, (2) abx= abx resistant infections, (3) prions= vCJD, (4) arsenicals= cancer, (5) mycotoxins= cancer, (6) dioxins= cancer (7) fats bc accumulated dioxins & PCBs

35
Q

Prions

A

A prion is a misfolded protein- its not a living entitiy its an aberrant protein and it can go to the brain and make it have holes, spongelike. its not replicating but it changes other proteins where they become wrong folded as well!
​transmissible spongiform encephalopathies (TSEs)
​BSE= bovine spongiform encephalopathies
​variant Creutzfeldt-Jakob Disease- (vCJD)- untreatable & fatal, same prion strain as BSE. youll also ​see it as “chronic wasting disease” in news todays. you have to eat the brain so it was happening ​that they were being fed brain & spinal cord, definitely do NOT put the cows walking crooked in ​there

36
Q

Comprehensive Nutrient Management Plans (CNMPs)

A

CWA 2002 revision- NMP required to get a CAFO permit. This plan must include provisions for handling chemicals and dead animals (have to be able to bury them), for soil testing and safe manure spreading, and for diverting clean water away from the farm (good or bad idea?). Manure must be analyzed annually for its nutrient content and soil must be tested for phosphorus levels (a nutrient that can cause HABs).
Whats missing?? Microbes monitoring! The abx!

37
Q

CAFO odor emissions

A

smells, poops, & corpses
gas ammonia & hydrogen sulfide but its complicated with 160 compounds
hard to make regulations for smell because you do you measure?? but medical effect decreased Forced Expiratory Volume (FEV1) intense alveolar inflammation in the lower airways of healthy subjects and that’s just acute exposure not chronic, which is what the workers have. the economy suffers because no tourism, no businesses, no houses sold, even electric bills because windows are closed.

38
Q

Antibiotic resistance

A

since they came around in 1940s. Administered at sub-therapeutic levels for growth promotion- there isnt even data that shows it makes them grow
Poorly absorbed by the animal gut and
%25-%75 excreted unaltered in feces (so sprayed out all over the fields) Humans can be exposed to resistant bacteria through the ingestion of retail meats, ground water and surface water. some are not allowed in animals (like vancomycin). These farmers are hella exposed to these bacteria.

39
Q

Organophosphates (phosphoric acid- insect), Carbamates, Thiocarbamates (made from carbamic acid- insect, herb, fungi)

A

Control pests by acting on the nervous system it interferes with nerve-impulse transmissions by disrupting the enzyme cholinesterase that regulates acetylcholine (a neurotransmitter) -> excess acetylcholine -> bug short circuits- not just on negative instects but all insects it touches. Less persistent in soil, food or feed for animals than other families, such as organochlorine pesticides, and not as toxic to humans. Altho even in a low dose in a child it could modulate DNA expression

40
Q

Organochlorines (DDT) (chlorinated hydrocarbons)

A

DDT p much same disrupts nerve impulses, stays in environment super long time and accumulate in fatty tissue. moquitoes resistant to DDT.

41
Q

Pesticide ground control

A

1) soil- runoff from fields, you shouldn’t plant your field right up until the border you should have a “riparian area buffer”
and 2) abandoned wells- it takes effort to plug a well up and we’ve had a huge consolidation of farms so the little ones all shut down, dangerous because it’s a direct connection to groundwater. USGS can find them through magnetic data.

42
Q

FIFRA federal insecticides, fungicides and rodenticides act

A

Regulates application, control of movement to groundwater, control of runoff. Regulates the use and composition of pesticides (down to an infinite level of detail)

44
Q

food quality protection act FQPA

A

1996 coordination of registration & tolerance decisions. require a health based standard of a “reasonable certainty of no harm” for allowable residues of pesticides on food.​Economics are not considered.

45
Q

EPA risk assessment 4 steps

A

1- Hazard ID (millions of formulations)
2- dose response assessment
3- exposure assessment (post harvest interval)
4-risk characterization (high end then 10x factor)

Studies & calculations based on mice

46
Q

Endocrine disrupting compounds

A

“an exogenous agent which interferes with the synthesis, secretion, transport, binding action, or elimination of natural hormones in the body which are responsible for homeostasis, reproduction, development, or behavior.” some sources- unlined landfills, cemeteries
EPA EDC Screening Program- looks at estrogen, androgen, & thyroid.

47
Q

Estrogen, antiandrogen, thyroid

A

estrogen & antiandrogens- Feminization of male: evidence for increases in hypospadias, undescended testicles and lowered sperm counts; Overstimulation of female at times when estrogen is low (in utero, prepubertal, postmenopause); ?polycystic ovary, precocious puberty, premature breast development; ?prostate, testicle, breast, ovary Ca. Male small mouth bass feminized in potomac river. DDT!
thyroid: CNS development

48
Q

Persistent Organic Pollutants (POPs)

A

Toxic, transported, through air, water and migratory species, across international boundaries and deposited far from their place of release; resist degradation; bioaccumulate in terrestrial and aquatic ecosystems. Most banned in europe, starting to ban in USA.
​Dioxins come from chlorine burning out of plastic
​PUFA= polyunsaturated fatty acid = omega 3 & 6
Ω6- veg oil & meats, too much can be bad and americans eat like 15x too much but fish have Ω3. So everyone is eating them BUT farmed salmon have 10x the pesticides in them as wild caught, so we need to change diet of farmed fish

49
Q

6 regulation types

A

Code of Federal Regulations (CFR) dense af

(1) Process rules- ingredients & identity
(2) Performance standards & limits (BAM- bacteriological analytical manual- limits)
(3) Liability regulations
(4) Food labeling rules – provides information about risk to consumers- allergen rules
(5) Research
(6) Consumer education- how to prepare

50
Q

SDWA

A

1974
health based standard, feasibility (of removal and/or analysis of the pesticide) is an issue, separate risk assessment strategy
Authorizes EPA to regulate 91 contaminants in water. Includes either a MCL=maximum contaminant level or TT= treatment technique and MRDL=maximum residual disinfectant levels
Primary standards- microorgs, DBP, inorganic chems, synthetic org chems, radionuclides
Secondary- metals, odor, chloride, sulfate
Publish consumer confidence reports

51
Q

FDA

A

Everything but beef & eggs. Animal feed & vet meds. Interstate, retail, GAPs & GMPs. Recall enforcement, research, education. Grade A milk safety program, pasteurized milk ordinance. Only inspects after tips

52
Q

USDAFSIS

Food safety and inspection service

A

Regulates safety of most meat and egg products, processing of carcasses. Processed egg products, generally liquid, frozen, and dried pasteurized egg products (remember FDA does shell eggs), Catfish (all other seafood is FDA), School Lunch (SNAP and WIC), and HACCP

53
Q

USDA APHIS

Animal and plant health inspection service

A

Oversees health of animals and plants used as foods; veterinary diseases. Slaughter should be quick & painless. Import permit is required for all fresh and frozen fruits and vegetables entering the United States- that’s more for a plant disease concern than human disease like invasive species etc
Biotechnology Regulatory Services (BRS)- reg genetic engineering & mods; Plant Quarantine
Wildlife Services (WS)- a harmonious balance between humans and wildlife

54
Q

CDC & DOH

A

nvestigates sources of food-borne disease outbreaks (with FDA), Surveillance, ID pathogens, advocates for policies, trains food safety personnel

55
Q

Other agencies

A

OAA (national oceanic & atmospheric administration) fish & seafood. DOJ prosecutes & seizes unsafe food. FTC (fed trade commish) enforces false advert laws. Govs also help enforce & inspect, embargo unsafe foods.

56
Q

HACCP

A

1 ID hazards

2) determine critical control points
3) set critical limits
4) establish monitoring procedures
5) set corrective actions
6) record keeping & documentation
7) establish verification procedures

57
Q

Recall classes

A

Class I: Recalls for products with reasonable probability
of causing serious injury or death
Class II: Recalls for products which may cause serious injury or temporary illness, but probability of injury is remote or health consequences are temporary/ reversible
Class III: Recalls for products which are unlikely to cause injury or illness, but that violate FDA regulations- incorrect weight label or added water in meat products

58
Q

FSMA Food safety modernization act

A

Enhances FDA facility inspection frequency & authority, mandatory recalls, access to records, accredited testing labs, better tracing abilities. import certification, more HACCP, new produce regulations must be implemented by FDA, partnerships with other orgs

59
Q

Irradiation

A

“cold pasteurization” dose measured in Grays (Gs), effect measured in D-value (kill 90% of the thing). Delays ripening & prevents bugs up to complete sterilization depending on dose. Gamma (most pop), X (penetrates deeper), or electron (shallow, can be turned off) ray. The more DNA the lower dose to kill (most to least- parasites/insects, bacteria, spores, viruses). Does not work on viruses or prions. Transfers energy to molecules which creates reactive chemicals. Fresh v frozen matters.

60
Q

Food recovery hierarchy

A

(1)source reduction
(2)feed hungry people
​Feeding America- 1 in 8 hungry
​hunger in childhood- more likely to repeat a grade, have social issues, and have permanent ​problems
(3)feed animals
(4)industrial uses
biogeneration- fuel, gas, produced with foodstuff. fats & oils & rendering are put into a ton of commercial products
(5)composting (‘giving up’)
(6)incineration or landfill

61
Q

The Bill Emerson Good Samaritan food donation act

A

if you donate food in good faith you cant get sued, this is a game changer, lawyers put together a legal guide to food recovery

62
Q

RCRA resource conservation and recovery act

A

t national goals for disposal of solid & hazardous waste, protecting health & environment from the potential hazards of waste disposal, Conserving energy and natural resources, Reducing the amount of waste generated, Ensuring that wastes are managed in an environmentally-sound manner.
​1) solid waste program 2) hazardous waste program 3) UST underground storage tank program; laws that say heres how to manage and if you fuck up youre held accountable. but there is no law against…

63
Q

Fracking/UNGD

unconventional natural gas development

A

horrible, highly corrosive salts, carcinogens like benzene and radioactive elements like radium get into water. fracking fluid is another proprietary recipe. Deep injection causes earthquakes, and other ways of disposal put radioactivity into the drinking water

64
Q

Bioterror

A

there are three categories. we didn’t learn the As but we did learn the Bs and category C don’t worry bout it.
what else is going on is this idea of factors assoc with foods at higher risk
1) large batches
2) uniform mixing
3) short shelf life – cant catch it in time
4) ease of access
We now have resources given to us for taking on terrorism that we can translate into just improving public health
Vignette- Schwan’s Ice Cream- it was in the trucks bringing back raw eggs

Food and Water Borne Diseases (2 decks)

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