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Hazards and Illnesses

A food safety hazard is a biological, chemical, or physical agent in, or condition of food with the potential to
cause an adverse health effect or injury. However, many types of quality and regulatory defects that occur
during food processing are not considered to be food safety hazards because these would not produce an
adverse health effect if such food were consumed.
Types of Food Safety Hazards
• Microbiological hazards include pathogenic bacteria, fungi, viruses, prions, protozoans, and
helminthic parasites. Manifestations of these hazards typically involve foodborne illnesses with
symptoms including gastrointestinal distress, diarrhea, vomiting, and sometimes death.
• Chemical hazards include allergens, mycotoxins, heavy metals, pesticides, and cleaning and sanitation
chemicals. When ingested, these may cause gastrointestinal distress, organ damage, and
immunological reactions that may result in death. The long-term ingestion of food containing toxic
chemicals can lead to chronic effects, including cancer.
• Physical hazards typically include materials that enter the food throughout its production chain, such
as extraneous vegetable material, stones, bone fragments, wire pieces, broken glass, and wood
splinters. Its presence in food may result in choking, or oral or internal cuts, but rarely result in death.
Foodborne illness – refers to diseases, usually either infectious or toxic in nature, caused by agents that enter
the body through the ingestion/consumption of contaminated food.
Types of Foodborne Illnesses
• Intoxications (food poisoning) occur when a pathogen produces toxin(s) while growing in a food,
before it is eaten. Upon consumption of a sufficient quantity of “poisoned food”, the host becomes ill.
Botulism and staphylococcal food poisoning are the best-known foodborne intoxications. Viruses and
parasite do not cause intoxications.
• Infections are caused when viable pathogens in a food survive passage through the host’s stomach
into the intestine. Some bacteria, all viruses, and parasites cause illness via infection.
• Toxin-mediated infection is caused by eating a food that contains harmful microorganisms that will
produce a toxin once inside the human body.
Foodborne disease outbreak – an incident in which two (2) or more people experience a similar illness after
eating a common food.
Contamination – the presence of substances or conditions in a food that can be harmful to humans. Bacteria
and viruses pose the greatest food safety challenges for all retail food establishments.
Cross-contamination – occurs from the transfer of pathogenic bacteria directly onto high-risk food. These food
items are generally considered to be ‘ready to eat food items’ that require no further cooking.
Microbiological Hazards
Foodborne pathogens are microorganisms that lead the causes of foodborne morbidity and mortality.
Bacteria, viruses, and parasites are examples of pathogens.
Bacteria
These are reported in more cases of foodborne illness than any other hazard. 1Approximately 85% of Traveler’s
Diarrhea is caused by bacteria, and symptoms can last from three (3) to seven (7) days. It has two (2) generic

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types: spore-forming and non-spore-forming/vegetative. Table 4.1 shows a summary of the characteristics of
the two (2) types of bacteria.
Reproduce Grow Produce Toxin Resistant to Stress Harmful if Eaten
Spore x x x x

Vegetative x

Table 4.1 Characteristics of Spore and Vegetative Bacteria

 Spore-forming bacteria are able to produce endospores that are resistant to physical and chemical factors
such as heat, dehydration, and acidification. They can survive in any environment for a very long time.
However, these are not able to grow or reproduce. Examples of spore-forming bacteria are:
• Clostridium botulinum. Associated with improperly canned food, lightly preserved vegetables, salted
fish, and meats. Symptoms usually appear within 12 to 48 hours and include nausea, vomiting, blurred
and double vision, and paralysis of respiratory and motor muscles that may progress rapidly.
• Clostridium perfringens. These are usually found in animal intestines and soil and commonly
associated with hot-held food such as meats and gravies. Diarrhea is the principal symptom of the
mild illness caused by this pathogen. Symptoms appear within six (6) to 24 hours after ingestion.
• Bacillus cereus. A bacterium that can survive with or without oxygen, and has been associated with
vomiting and diarrhea. It is normally found on grain products such as rice, potatoes, pasta, corn,
cornstarch, soybeans, tofu, and flour.
 Non-spore-forming or vegetative bacteria are easily inactivated by heat. Illnesses caused by this type
result from the ingestion of a large number of cells. All bacteria exist in a vegetative state when these
grow, reproduce, and produce wastes just like other living organisms. Examples of vegetative bacteria are:
• Salmonella. It is the most commonly reported cause of human foodborne diseases. Humans become
infected if they consume animal products or water contaminated with feces. Salmonella enteritidis is
associated with eggs, poultry, meat, raw fruits, and vegetables. Symptoms usually appear one (1) to
three (3) days after infection and can last up to seven (7) to 14 days. Infected persons can become
carriers and shed the bacteria for weeks or months, becoming the source of infection for others
through poor hygiene practices.
• Staphylococcus aureus. It is a bacterium that produces a heat-stable toxin as it grows on food. Such
organisms can be transferred to food easily, and these can grow in food items that contain high salt
or sugar, and a lower water activity. This organism can be found in cooked ready-to-eat food items
such as luncheon meat, vegetables, salads (like taco, potato, and tuna salad), custards, and other dairy
products. Proper handwashing is encouraged to prevent growth and presence of this microorganism.
Cooking will not inactivate the toxin.
• Escherichia coli (E. coli). The majority of human outbreaks caused by this bacteria were linked to the
consumption of contaminated meat and raw milk. Sources of contamination also include feces from
infected animals, use of contaminated manure as fertilizers, fecal contamination of meat at slaughter
plants, raw manure and slurry from dairy farms, and cross-contamination of other food products at
the farm.
• Campylobacter spp. (C. jejuni and C. coli) are the most frequently identified cause of acute infectious
diarrhea in developed countries. Poultry meat products are the most common foodborne source of
Campylobacter infection in humans. Humans become infected by ingesting contaminated food,
untreated water or contaminated non-pasteurized or improperly pasteurized milk.

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• Listeria monocytogenes is an environmental contaminant of which primary means of transmission to

humans is through food that can become contaminated during production and processing. Ready-to-
eat (RTE) food items that are refrigerated before consumption and do not receive substantial
treatment, such as soft cheese, RTE meats, and RTE seafood, have been implicated in outbreaks of
listeriosis. Human contamination occurs through consumption of raw milk or products manufactured
with raw milk.
• Shigella. Shigellosis is associated with contaminated food and water and caused by one (1) of four (4)
Shigella species that spread as a result of unsanitary conditions, contaminated food and water, and
overcrowded living conditions. Symptoms usually last four (4) to seven (7) days. The illness may
progress to bloody diarrhea with mucus and the constant urge to pass stools. Shigella bacteria can be
shed from a person’s gastro-intestinal system for up to three (3) months after symptoms disappear.
Treatment includes antibiotics.
• Vibrio. Associated with contaminated water and raw or undercooked fish and shellfish and causes
Cholera, an acute gastro-intestinal infection. Risk to travelers is low and vaccination is advised only for
medical and rescue personnel working in endemic areas. The infection can lead to severe dehydration
and death in undernourished persons or those with compromised immune systems or kidneys.
Bacterial Growth
Bacteria reproduce when one (1) bacterial cell divides to form two (2) new cells. This process is called binary
fission. The reproduction of bacteria and the increase in the number of organisms is referred to as bacterial
growth.
Phases of Bacterial Growth
1. Lag phase – bacteria exhibit little or no growth. The bacteria adjust to its surroundings during this
phase that lasts only a few hours at room temperature.
2. Log phase – growth is very rapid during this phase. Bacteria are doubling in number every few minutes.
3. Stationary phase – in this phase, the number of bacteria being produced equals the number of
organisms that are dying off. The bacteria have used up much of the space, nutrients, and moisture in
the food by this phase of the growth curve.
4. Decline phase – final phase of the growth curve. Here, bacteria die off rapidly because it lack nutrients
and are poisoned by its own toxic wastes.
Conditions Needed for Bacterial Growth
 Food. A suitable food supply is the most important condition needed for bacterial growth. Most
bacteria prefer food that is high in protein or carbohydrates like meats, poultry, seafood, dairy
products, and cooked rice, beans, and potatoes.
 Acidity. Most food are acidic and have a pH less than 7.0. The pH symbol is used to designate the
acidity or alkalinity of a food. pH is measured on a scale that ranges from zero (0) to 14. Very acidic
food (pH below 4.6) like lemon, limes, and tomatoes, will not normally support/slow down the rate of
growth of disease-causing bacteria.
Most bacteria prefer a neutral environment (pH of 7.0) but are capable of growing in food items that
have a pH in the range of 4.6 to 9.0. A pH above 7.0 indicates that a food is alkaline like olives, egg
whites, or soda crackers. Hence, disease-causing bacteria grow best when the food it lives on has a pH
of 4.6 to 7.0 like meat, fish, and milk.

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 Temperature. All bacteria do not have the same temperature requirements for growth.
• Psychrophilic – grow within a temperature range of 32°F to 70°F (0°C to 21°C). These
microorganisms are especially troublesome because these are capable of multiplying at both
refrigerated and room temperatures.
• Mesophilic – grow at temperatures between 71°F to 110°F (22°C to 43°C), with most rapid growth
at human body temperature (98.6°F or 37°C).
• Thermophilic – grow best at a temperature above 110°F (43°C). All thermophilic bacteria are
spoilage organisms.
Most disease-causing bacteria can grow within a temperature range of 41°F to 135°F (5°C to 57°C),
most commonly referred to as the food Temperature Danger Zone (TDZ). Temperature abuse is the
term applied to food items that have not been heated to a safe temperature or kept at an improper
temperature.
 Time. Under ideal conditions, bacterial cells can double in number every 15 to 30 minutes. For most
bacteria, a single cell can generate over one (1) million cells in just five (5) hours. A rule of thumb in
the foodservice industry is that bacteria need about four (4) hours to grow to high enough numbers
to cause illness.
 Oxygen. Bacteria also differ in its requirements for oxygen. Controlling oxygen conditions may not be
an effective way to prevent foodborne illness. Regardless of available oxygen, some disease-causing
bacteria will find the conditions suitable for growth. Below are the types of bacteria depending on its
oxygen requirement:
• Aerobic – must have oxygen in order to grow.
• Anaerobic – cannot survive when oxygen is present because it is toxic to them. These grow well in
vacuum packaged food or canned food items where oxygen is not available.
• Facultative – can grow with or without oxygen. Most foodborne disease-causing microorganisms
are facultative anaerobes.
• Microaerophilic – have a very specific oxygen requirement, usually in the range of 3-6%.
 Moisture. Like most other life forms, moisture is an important factor in bacterial growth. Scientists
have determined that it is not the percentage of moisture or “water by volume” in a food that most
affects bacterial growth. Rather is the amount of “available water” or water available for bacterial
activity.
Water activity (Aw) is a measure of the amount of water that is not bound to the food and is, therefore,
available for bacterial growth. Aw is measured on a scale of 0-1.0. Disease-causing bacteria can only
grow in food items that have an Aw higher than 0.85.
Potentially Hazardous Food
Food items that provide a good environment for the growth of disease-causing microorganisms are called
potentially hazardous food (PHF) items. These are also called TCS (time/temperature control for safety) food.
All these food items, plus any food prepared with any of them, are potentially hazardous:
• Any food derived from animals, or any food containing animal products, including meat, poultry, fish,
shellfish, eggs, and dairy products.

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• Any food derived from plants that have been cooked, partially cooked, or otherwise heat-treated. This
category includes not only cooked vegetables but also such items as cooked pasta, cooked rice, and
tofu (soybean curd).
• Raw seed sprouts
• Sliced melons
• Cut tomatoes
• Garlic and oil mixtures that haven’t been specifically treated to prevent the growth of pathogens
(because the oil seals the garlic from the air, fostering the growth of anaerobic bacteria, as explained
above).
Food items that are not potentially hazardous include dried or dehydrated food, food items that are strongly
acidic, and commercially processed food items that are still in its original unopened, sealed containers.
Viruses
These are much smaller than bacteria and these require a living host (human, animal) in which to grow and
reproduce. Viruses do not multiply in food, however, a susceptible person needs to consume only a few viral
particles in order to experience infection. Examples of viruses are:
• Hepatitis A Virus. This virus has been associated with many foodborne infections as it causes a liver
disease called infectious hepatitis. This type of virus is a particularly important hazard to food
establishments because food workers can harbor it up to six (6) weeks and not show symptoms of
illness.
• Norwalk Virus. This common type of virus has been associated with many foodborne infections.
Common symptoms caused are nausea, vomiting, diarrhea, and abdominal pain. A headache and low-
grade fever may occur. Preventions, like using of potable water when preparing shellfish and avoiding
consumption of raw seafood, are helpful tips to avoid such virus.
• Rotavirus. This causes several diseases known as rotavirus gastroenteritis and is the leading cause of
severe diarrhea among infants and children. Common symptoms are vomiting, watery diarrhea, and
low-grade fever with the onset time ranges from one (1) to three (3) days. Infected food workers may
contaminate food items that require handling and no further cooking, and also via contaminated
hands.
Parasites

These are small or microscopic creatures that need to live on or inside a living host to survive. Parasitic
infection is far less common than bacterial or viral foodborne illnesses. Approximately 10% of Traveler’s
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Diarrhea (is a digestive tract disorder that commonly causes loose stools and abdominal cramps from eating
contaminated food or drinking contaminated water.) is caused by protozoans. These one-celled
microorganisms are transmitted to humans through consumption of contaminated food and water. Examples
of these microorganisms are:
• Anisakis are nematodes (roundworms) associated with foodborne infection from fish. These worms
are about 1-1 ½ inches long and the diameter of a human hair. If the worms attach themselves to the
victim’s stomach, typical symptoms are vomiting and abdominal pain. Coughing is the most common
symptom if the worms attach themselves. Inspecting and handling seafood carefully and cooking it at
proper temperature are some preventions for this kind of parasite.
• Cyclospora cayetanensis is a parasite that has been reported more frequently beginning in the 1990s
where most outbreaks have been associated with fresh fruits and vegetables that were contaminated

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at the farm. Symptoms include loss of appetite, weight loss, bloating, stomach cramps, nausea,
vomiting, muscle aches, low-grade fever, and fatigue. Avoiding contact with contaminated food or
water, and purchasing ready-to-eat food from inspected and approved supplier are very important
preventive tips for this kind of pathogen.
• Toxoplasma gondii is a parasite common in warm-blooded animals including rats, cats, pigs, cows,
sheep, chickens, and birds. Symptoms of mild cases of the illness include swollen lymph glands, fever,
headache, and muscle aches. The onset time is 10 to 13 days after exposure. Parasites are commonly
found in red meat, especially pork, lamb, and beef. Fruits and vegetables can also be contaminated
with feces. Avoid eating raw and undercooked meat to avoid such parasite.
• Trichinella spiralis is a foodborne roundworm that causes infection. Found mostly in pork and wild-
game animals such as bear and wild boar, first symptoms of trichinosis are nausea, vomiting, diarrhea,
and abdominal pain. Onset time is two (2) to 28 days after eating the contaminated meat. Cooking
pork and wild-game animals to the proper temperature would be the most important prevention a
person can do.
• Cryptosporidium parvum is a single-celled microorganism that is found in water that has been
contaminated with cow feces. The most common cryptosporidiosis is severe watery diarrhea, which
usually lasts two (2) to four (4) days. Fertilizing salad vegetables with manure is another possible
source of human infection. Providing a potable water supply in the food establishment and handling
foods more carefully can prevent contamination and cross contamination. Food workers must practice
good personal hygiene in order to prevent the spread of such pathogen.
• Giardia lamblia is a single-celled microorganism found in the feces of wild animals, domestic pets, and
infected persons. Giardiasis may cause diarrhea within one (1) week of ingestion of the cyst and may
last as much as a month. Infections from contaminated vegetables that are eaten raw cannot be ruled
out. Same prevention as the above protozoan is also applicable.
• Entamoeba histolytica is a protozoan that causes most cases of Amoebiasis
(is an infection which occurs via the fecal–oral route, either directly by person-to-person contact or
indirectly by eating or drinking fecally-contaminated food or water). The majority of which are
asymptomatic (persons do not exhibit symptoms). In rare instances, it can also cause lesions in the
liver. Treatment includes taking medication belonging to the nitroimidazole family of drugs.
Chemical Hazards
Naturally occurring chemicals include toxins that are produced by a biological organism. Examples include
allergens, ciguatoxin, mycotoxins, scombrotoxin, and shellfish toxins.
• Food Allergen. It causes a person’s immune system to “overreact.” In severe situations, a life-
threatening allergic reaction called anaphylaxis can occur. Anaphylaxis is a condition that occurs when
many parts of the body become involved in the allergic reaction.
When a person eats a particular food again, the pre-formed antibodies swing into action and trigger a
cascade of reactions in the tissues that result in some or all of the typical symptoms of food allergy,
like mouth itching and swelling, rash, hives, runny nose, vomiting, abdominal pain, diarrhea, and
swelling of throat and tongue (Healey, 2016). Table 4.2 shows a summary of the differences between
a food allergy and food intolerance.

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DIFFERENCES BETWEEN FOOD ALLERGY AND FOOD INTOLERANCE (Healey, 2016)

Food Allergy Food Intolerance
o Involves the immune system  Does not involve the immune system
o Symptoms include rash, hives, vomiting, diarrhea,
 Can cause abdominal pain, diarrhea,
abdominal cramps, and occasionally difficulty in
headache, ulcers, hives, and runny nose.
breathing.
 Symptoms can appear within minutes of
o Symptoms usually appear a few minutes to an hour
eating the food or more usually several hours,
after eating the food.
but can take several days to appear.
o Food allergy can be mild or severe and in extreme
 Food chemicals or additives (such as flavors or
cases can cause life-threatening anaphylaxis.
preservatives) are often the cause of food
o Examples of food allergy are allergies to nuts, fish,
intolerances.
shellfish, eggs, and sesame seeds.
Table 4.2 Differences of Food Allergy and Food Intolerance
Symptoms include itching and hives, swelling of the throat and difficulty in breathing, lowered blood
pressure, and unconsciousness. About 90% of all allergies are caused by these eight (8) food items:
milk, egg, wheat proteins, peanuts, soy, tree nuts, fish, and shellfish.
• Ciguatoxin Poisoning. It is caused by eating contaminated tropical fish. The toxin is found in tiny, free-
swimming sea creatures called algae (al-gee; a plant or plantlike organism of any of several phyla,
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divisions, or classes of chiefly aquatic, usually chlorophyll-containing nonvascular organisms), which

live among certain coral reefs. Purchasing fish from a reputable supplier would be the best preventive
measure since the toxin is not destroyed by cooking.
• Mycotoxins. Mycotic organisms or fungi are molds, yeasts, and mushrooms, some of which are capable
of causing a foodborne illness. Fungi are larger than bacteria, and usually prefer food items that are
high in sugar or starches. Many mycotoxins are not destroyed by cooking and have been shown to
cause cancer.
• Scombrotoxin Poisoning. This is also called histamine poisoning since it is caused by eating food items
high in chemical compound histamine. Symptoms of the illness include dizziness, facial rash or hives,
shortness of breath, and a peppery taste in the mouth when contaminated fish is eaten. Storing
seafood at temperatures between 32°F and 39°F (0°C to 40°C) is a good prevention for such toxin.
• Shellfish Toxin Poisoning. It is associated with the algal blooms (red tides) occurring in temperate and
tropical areas. Oysters, clams, mussels, scallops, crabs, and lobsters ingest toxins produced by
dinoflagellates microorganisms.
Man-made chemicals include substances that are added, intentionally or accidentally, to a food during
processing. Examples include cleaning solutions, food additives, pesticides, and heavy metals from containers
or contact surfaces.
• Intentionally added chemicals may include food additives, preservatives, and pesticides.
• Non-intentionally added chemicals may include contamination by chemicals such as cleaning and
sanitary supplies. Also, chemicals from containers or food contact surfaces of metal that are misused
may lead to poisoning.

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Food additive is any substance that is not normally consumed as a food in itself and is not normally an
ingredient, but which is allowed to be there if it fulfills a technological function in the final food. People
use some ingredients to help preserve and improve the taste of food for a long period of time and without
certain additives, many processed food items would be unsafe to eat.
Functions of Food Additives (Healey, 2016):
• Acids/Acidity regulators/Alkalis help to maintain a constant acid level in food. This is important for
taste, as well as to influence how other substances in the food function.
• Anti-caking agents reduce the tendency of individual food particles to adhere and improve flow
characteristics.
• Antioxidants retard or prevent the oxidative deterioration of food.
• Bulking agents contribute to the volume of the food, without contributing significantly to its
available energy.
• Colorings add or restore color to food items.
• Emulsifiers facilitate or maintain oil and water from separating into layers.
• Firming agents/stabilizers maintain the uniform dispersion of substances in solid and semi-solid
food items.
• Flavor enhancers enhance the existing taste and/or odor of a food.
• Foaming agents maintain the uniform dispersion of gases in aerated food items.
• Gelling agents modify the texture of the food through gel formation.
• Glazing agents impart a coating to the external surface of the food to improve its appearance.
• Humectants reduce moisture loss/prevent food from drying out.
• Preservatives retard or prevent the deterioration of food by microorganisms, and thus prevent
spoilage.
• Rising agents liberate gases, thereby increasing the volume of a food and are often used in baked
goods.
• Sweeteners replace the sweetness normally provided by sugars in food without contributing
significantly to its available energy.
• Thickeners increase the viscosity to give food its desired consistency.
Physical Hazards
These are foreign objects in food that can cause illness and injury. These include items such as fragments from
broken glasses, metal shavings from dull can openers, unfrilled toothpicks that may contaminate sandwiches,
human hair, jewelry or bandages, rings, earrings, and buttons that may accidentally be lost by a food handler
and enter a food.
Additionally, stones, rocks, or wood particles may contaminate raw fruits and vegetables, rice, beans, and
other grain products.
Physical hazards commonly result from accidental contamination and poor food-handling practices that can
occur at various points in the food chain from harvest to consumer. To prevent physical hazards, wash raw
fruits and vegetables thoroughly and visually inspect food items that cannot be washed like ground beef or
pork. Food workers must be taught to handle food safely to prevent contamination by unwanted foreign
objects such as the ones mentioned above. Lastly, food workers should not wear jewelry and other
unnecessary accessories when involved in the production.
The key hazards that could contribute to food safety being compromised in the food flow are shown in Table
4.3 below (Confederation of Tourism and Hospitality, 2009):

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Physical Chemical Microbiological

Oil, diesel, petrol
Dust and dirt from Cross-contamination;
Delivery/Transportation from vehicle
vehicles; shard glass pathogens present in food
maintenance
Machinery parts;
Pest bait Contaminated food handler
screws, nuts, bolts
Food Processing
Metal shavings/rust; Cleaning Infected food handler –
fragments of bones chemicals “carrier”
Dead insects Pest bait Cross contamination
Storage Cleaning
Packaging materials Pathogens present in food
chemicals
Virus; natural poisons in food;
Fingernails, hair,
infected food handler; cross
jewelry, insects, Cleaning
contamination; food contact
Food Preparation damaged utensils, chemicals,
surfaces; contaminated cloths,
wooden utensils, flaking pesticides/sprays
utensil, and food preparation
paint
equipment
Hair, jewelry, glass Cleaning
Food Service shards from damaged chemicals; Cross contamination
counter sneeze screen cleaning sprays

Table 4.3 Hazards in the Food Flow

References:
Confederation of Tourism and Hospitality (2009). Food hygiene, health, and safety: study guide. London, UK:
BPP Learning Media Ltd.
Healey, J. (Ed.). (2016). Food safety. Thirroul, NSW: The Spinney Press
International Association for Medical Assistance to Travellers (IAMAT). (2016). General health risks: Traveler's
diarrhea. Retrieved from https://www.iamat.org/country/philippines/risk/traveller-s-diarrhea on 28
November 2017
McSwane, D. R. (2008). Food safety and sanitation (4th Edition). Jurong, SG: Pearson Education South Asia Pte.
Ltd.
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Merriam-webster.com
Motarjemi, Y. (Ed.), & Lelieveld, H. (Ed.). (2014). Food safety management: A practical guide for the food
industry. Oxford, UK: Elsevier, Inc.
Wallace, C. A. (2011). Food safety for the 21st century: Managing HACCP and food safety throughout the global
supply chain. Chichester, WS: John Wiley & Sons, Inc.
World Trade Organization (2009). Risk assessment in the international food safety policy arena. Retrieved from
https://www.wto.org/english/res_e/reser_e/ersd200901_e.pdf on 28 November 2017

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