Environmental Public Health Journal 2019 | BCIT Institutional Repository

Environmental Public Health Journal 2019

Adequacy of hand washing apples
Background: Foodborne illnesses linked to fresh produce has been on the rise in recent years. This increase in illnesses pose a massive burden to the healthcare system. One way to prevent this is through educating the public the importance of handwashing produce. There are many studies that have tested ways of washing and sanitizing fresh produce to reduce surface pathogens. However the average consumer mainly hand washes produce before consuming it. Thus this study intends to test the efficacy of hand washing by testing surface ATP on apples before and after they have been washed. Methods: Apples were purchased from the bulk section of a super market. ATP swabs were used to test the concentration of ATP on the surface of the apples. The values were recorded. All the apples were hand washed under running tap water for 15 seconds and the surface ATP concentration were obtained and recorded. The values were then compared to draw a conclusion. Results: The results show that there is statistically significant reduction in surface ATP values on apples after washing them (mean ATP value of 33.2) compared to before washing them (mean ATP value of 116.67). The p-value obtained was 0.00033 when α = 0.05. Conclusion: This study was able to conclude that there was a significant reduction in surface ATP values following handwashing of the apples. There was an observed 60% reduction in the mean values of ATP of before and after hand washing. In conclusion, hand washing apples do provide an adequate reduction of surface ATP values thus attaining surface cleanliness., Peer reviewed, Peer-reviewed article, Published, Project submitted in partial fulfillment of the requirement for the degree of Bachelor of Technology in Environmental Health, British Columbia Institute of Technology, 2019., Outbreaks, ATP, Cross contamination, Apples, Sanitization, Foodborne illness, Cleaning methods, UltraSnap swabs, Luminometer, Pathogens, Fresh produce
Association of electronic cigarette usage and nicotine consumption frequency of young adults in British Columbia
Background Electronic e-cigarette ever users has been increasing as of 2015, the most prevalent ever users being young adults aged 20-24 years old. The implication of e-cigarette ever user developing into long term users is a emerging public health concern. Methods Electronic cigarette usage frequency and nicotine consumption was measured through a self-administered online survey of young adults (n= 54). Survey was advertised through social media sites between January 2019 till February 2019. Descriptive and inferential statistic was conducted using NCSS 12 to examine the association between electronic cigarette usage and nicotine consumption. Results Among young adults aged 19 to 24 years old, the frequency of e-cigarette usage was 51% high usage, 31% no usage and 16% medium and low usage. For nicotine consumption, respondents were 25% daily, 40% no use, 18% infrequent, and 14.8% frequent. Conclusion There is an association between more frequent electronic cigarette usage and higher nicotine consumption among young adults in British Columbia. Frequency e-cigarette users were found to consumption nicotine at higher frequency then non users. Further research is needed to fully understand the extent of the relationship of if e-cigarette usage promotes daily nicotine consumption or daily nicotine consumption results in higher e-cigarette usage., Peer reviewed, Peer-reviewed article, Published., British Columbia, Electronic cigarette, E-cigarettes, nicotine, young adults, Project submitted in partial fulfillment of the requirement for the degree of Bachelor of Technology in Environmental Health, British Columbia Institute of Technology, 2019.
Can risk rating tool results be used to predict results of inspection categories of dairy processing plants?
Background: Dairy products are consumed by a large portion of the population. The dairy processing plants (DPP) that produce these perishable products may create health hazards (chemical, physical, biological). In order to minimize any health risks from these products, DPP are inspected by regulating authorities. This study examined secondary data derived from the BCCDC dairy program’s semi-quantitative risk ranking tool (RRT) to examine trends over time with DPP inspections, and to assess risk factors within the tool. Methods: RRT based data from individual DPP inspections from 2015 through 2018 were entered into a master spreadsheet. The RRT has two overall risk categories, inherent and measured risk. Inherent risk categories in the tool were sourced from surveys of dairy plants, while measured risks in the tool were sourced from inspection visits (routine and in-depth), environmental and food result submissions from dairy plants and inspectors, and based on compliance and history. In total, 107 items were assessed within the eight categories. Descriptive analyses were conducted, and statistical analyses performed using NCSS 12 software (NCSS, 2018). Results: A total of 128 inspection reports from 30 different DPP were included in this study. From these inspections, 65% were considered low risk, 12% moderate and 23% high risk. DPP that were located on-farm were found to have significantly higher overall inspection risk scores than dairy plants located off-farm (average on-farm inspection risk ranking score = 694; average off-farm inspection risk ranking score = 153; p=0.0003, power=95%). When the microbiological scores category, derived from environmental swabs and food submissions, were compared to the inspection score category, these categories were statistically significantly correlated (p=0.0000, power=100%); when inspection score increases, so too does microbiological score. Higher risk scores were also found in DPP producing more than one category of dairy product (comparing one product versus 6 or 7 products, p=0.009, power=76%). Conclusion: Dairy inspections ensure DPP follow good manufacturing practices and therefore help to protect the population from disease outbreaks or other contaminations. This study demonstrated that there is increased risk of having a dairy processing facility located on-farm, that more complex dairy processing operations that produce more than one type of dairy product have higher risk rating scores and that higher inspection score violations positively correlated to positive microbiological scores. This study further showed that in the absence of microbiological results, a risk score could still be calculated by analyzing the inspection violations alone. The Food Safety Specialists at the BCCDC can use this data to focus their inspection time on higher risk areas and items to maximize time spent out in the field., Peer reviewed, Peer-reviewed article, Published, Project submitted in partial fulfillment of the requirement for the degree of Bachelor of Technology in Environmental Health, British Columbia Institute of Technology, 2019., audit, dairy, processor, risk, British Columbia, inspection, BCCDC, milk
Co-use of cannabis with commonly used licit and illicit drugs
Background: Following the recent legalization of medical cannabis in Canada, and many other countries around the world, people are turning to this drug for both medical and recreational reasons. Naturally, as human’s age, many rely on medication to maintain a better quality of life. Surveys show that, once legal, there will be an increase in cannabis consumption. Many adverse health reactions may occur by concurrently taking cannabis and other medications. Methods: A survey was distributed in-person throughout Vancouver targeting people who do not consume cannabis. The same survey was distributed in Vancouver, but to people coming out of dispensaries, targeting people who do consume cannabis. The survey consisted of seven knowledge questions asking about possible adverse drug interactions occurring between cannabis and commonly used licit and illicit drugs. A chi-square analysis was used to compare knowledge of users and non-users of cannabis. Results: Both users and non-users seemed to be most knowledgeable on the interaction between cannabis and alcohol; 39 out of 57 users (68%) and 23 out of 30 non-users (77%) gave the correct response. As for all the other interactions, neither group was very knowledgeable. The distribution of questions that were answered incorrectly seemed evenly spread between the two groups. The knowledge between users and non-users were significantly different when participants were asked on the possible adverse reactions between cannabis and opioid drugs (p=0.005), and cannabis and sedative drugs (p=0.002). In these cases, cannabis users were more knowledgeable about cannabis interactions than non-users. Conclusion: This study indicates that the general public is not very knowledgeable on the possible adverse reactions that may come about as a result of mixing cannabis and other commonly used licit and illicit drugs. Actions should be taken to provide the public with tools that will aid them in making the right decision when thinking about concurrently using cannabis and other licit and/or illicit drugs., Peer reviewed, Peer-reviewed article, Published, Project submitted in partial fulfillment of the requirement for the degree of Bachelor of Technology in Environmental Health, British Columbia Institute of Technology, 2019., Environmental health, Cannabis, Prescriptions, Drugs, Licit drugs, Illicit drugs, Drug interactions, Adverse interaction, Public health
Did anyone get sick this weekend?
Background Recreational water illnesses are not as well known as food borne illnesses in the media. There are several pathogens associated with ingesting surface water including Giardia, Cryptosporidium, and Toxoplasmosis. The use of technology for public health surveillance is also little known to the public and can provide much insight into other illnesses on social media not otherwise reported to public health and medical professionals. Illnesses on social media could represent a portion of unreported cases. These cases could be found on social media as a popular outlet for individual expression. Methods Social media posts were found using a variety of keywords including symptoms of significant waterborne illnesses and terms associated with human and environmental contamination. Social media posts were collected from forums and popular social media platforms such as reddit. The posts were then correlated with beach water quality data for a sampling site as geographically close to a case location as possible. Results Social media and water quality data collected from the Columbia river region were correlated. The correlation coefficient of 0.2335 indicates that there is no correlation between social media posts and beach water quality data. Numerous limitations may have impacted the correlation coefficient. Keywords associated with symptoms were more effective in obtaining quality threads and posts compared to other terms. Conclusions Correlating social media posts to water quality data in the Columbia river region does not provide statistically significant results. Manual gathering of social media data for public health surveillance is found to be inefficient and impractical. Further study is required in order to determine the effectiveness of using social media for public health data gathering. It remains to be seen whether correlating posts about illness on social media to water quality data is an effective method of surveillance for public health., Peer reviewed, Peer-reviewed article, Published, Project submitted in partial fulfillment of the requirement for the degree of Bachelor of Technology in Environmental Health, British Columbia Institute of Technology, 2019., Social media, Kite surfing, Swimming, Itchy, Scratchy, Illness, Infection, Vomiting, Sick, Sewage, Sinus, Bacteria
The effect of probiotics as a starter culture for producing yogurt
Background: Many comprising studies showed that probiotics can manifest antimicrobial activity. Due to positive health effects of probiotics, they have been added in a fermentation of various foods to increase the nutrient content and to improve the quality of the foods. Furthermore, probiotics are used as a starter culture for several fermented foods like a yogurt. Probiotics may contain strains that are capable of initiating fermentation of the foods, however, a safety of the foods is not certain. Therefore, the study is done to analyze use of probiotics as a starter culture for a yogurt. Methods: The study was designed to analyze the pH pattern of three different yogurt groups (control, commercial starter culture, and probiotics). Each group had three samples that were made using Dairyland 2% milk and corresponding cultures. The control group samples were not inoculated with any culture. The commercial starter culture group samples were inoculated with Yogourtmet Freeze-Dried Starter and the probiotics group samples were inoculated with probiotic capsule, Jamieson 10 Billion Probiotic. The samples were incubated for 7 hours and every 45 minutes the pH was measured using Hanna Professional Portable Yogurt pH Meter. Results: The statistical analysis of the pH measurement showed significant different between the control groups and other two groups. The control group samples pH decreased a bit, but it was not enough to turn the samples to a yogurt. The pH pattern of the commercial group samples showed rapid decrease in pH after 180 minutes and the average pH of the last reading was 4.10. The pH of the probiotics group samples decreased linearly, and the average pH of the last reading was 4.58. Conclusions: The commercial starter culture and the probiotics group samples initiated fermentation and enough acidification occurred to decrease the pH below 4.6. With 7 hours of incubation period, the probiotics group samples just met the pH that makes the yogurt safe to consume. Therefore, the use of the probiotics as a starter culture for producing yogurt can be suggested with adequate incubation period., Peer reviewed, Peer-reviewed article, Published, Project submitted in partial fulfillment of the requirement for the degree of Bachelor of Technology in Environmental Health, British Columbia Institute of Technology, 2019., Acidification, Yogurt, pH, Probiotics, Starter culture, Fermentation
An evaluation of the usefulness of British Columbia's guideline in educating food bank operators
Background: Food Distribution Organizations (FDOs), such as food banks, community kitchen, and meal programs, are essential resources to relieve food insecurity in British Columbia. FDOs collect, process, store, and distribute donated food to the needy population. The BC Centre for Disease Control (BCCDC) published the Guidelines for Food Distribution Organizations with Grocery or Meal Programs in 2016 with purpose to educate FDOs on food safety and assist with their operational challenges. The guideline plays an important role especially for food bank operators who are not required to take food safety training. The purpose of this study was to evaluate the extent of the guideline use among food bank operators and assess its usefulness. This study also determines if the guideline use had a statistically significant association with higher knowledge in food safety. Methods: Self-administered electronic surveys created on Survey Monkey Canada were distributed to Foodbanks BC members by weekly online newsletter and email. The survey assessed the extent of usage of the guideline, current issues and knowledge level of FDO operators in BC. The survey response was collected over three weeks long period. Results: Among 37 FDO operators participated, 30 completed the survey. The majority of the operators was from BC, worked in food banks and had longer than 5 years long experience. 47% of participants did not know about the guideline. Among the guideline users, 83% agreed or strongly agreed that the guideline was useful. While retailers and groceries were the most common food donors, caterers and restaurants were the least common. Assessing each food item for safety was the most commonly encountered issue for FDOs. The least commonly encountered issue was having another FDO taking our donation from the donor. There was no association between the guideline use and level of food safety knowledge according to the Chi-square test (p= 0.89). There was no association between the years of experience and level of food safety knowledge (p= 0.23). The results did not show a statistically significant result potentially due to small sample size (n= 30). Conclusion: The results indicated while the guideline is useful among the users, the extent of its use should be widened. There is a need to improve accessibility of the guideline by modifying the content to address current practical issues, formatting it in a more user-friendly way, and utilizing better distribution means., Peer reviewed, Peer-reviewed article, Published, Project submitted in partial fulfillment of the requirement for the degree of Bachelor of Technology in Environmental Health, British Columbia Institute of Technology, 2019., Food safety, Food distribution organization, Food bank, Food donation, Food donation guideline
Is that food RTE?
Background: Rates of foodborne illness linked to consumers misinterpreting, or lack of proper cooking instructions on frozen food products continue to rise. With many recalls and outbreaks in the recent years surrounding frozen breaded chicken (FBC) products due to consumers not adequately cooking products and in turn becoming ill. However, it is not just frozen breaded chicken to blame, frozen microwavable entrees have also contributed to this problem. Therefore, the purpose of this project was to determine what was actually being displayed on the packaging of these frozen foods. Identifying whether or not frozen food products have clear, specific and consistent cooking instructions for the consumers is critical in identifying the risk of cooking and eating these foods. Methods: Secondary data was obtained from the British Columbia Centers for Disease Control (BCCDC) of cooking instructions on FBC packaging, and primary data was collected through visiting grocery stores in the Metro Vancouver area by surveying cooking instructions on frozen microwavable entrees packaging. Four categories of data were assessed, 2008 and 2018 raw FBC products, 2018 cooked FBC, and 2019 frozen microwavable entrees. Parameters such as inclusion of internal cooking temperature, thermometer usage, microwave instructions, and additional food safety handling was gathered. Chi-square tests were used to analyze the results with the statistical software NCSS12. Results: Of all categories surveyed 87.1% (n=122) said to cook the product to a minimum of 74°C, and 12.9% (n=18) did not state anything. 2018 raw FBC always stated an internal cooking temperature (100%), whereas 58% of the 2008 raw FBC stated an internal temperature and 89% of both the 2019 frozen entrees and 2018 cooked FBC did. Out of all 140 products surveyed across categories only 8% stated to use a thermometer when cooking to ensure food has reached proper internal temperature. The frequency of categories to display food safety was as follows, the 2018 raw FBC (82%) and the 2008 raw FBC (79%), followed by the 2019 frozen entrees (42%) and the 2018 cooked FBC (21%). For the microwave instructions the frozen entrees almost always stated this (81%), whereas the 2008 and 2018 raw FBC both never stated to use a microwave (0%). There was a significant association between products and the inclusion of the statement of internal cooking temperature and thermometer usage. This was based on the food product category itself, frozen breaded chicken or frozen entrees, or based on manufacturer of the product. Conclusions: It was evident that the major gap lies in the consistency of instructions. Almost every manufacturer had their cooking instructions presented differently, which could in turn confuse the consumer. Instructions also rarely stated to use a thermometer to check the internal temperature, although almost always stated a specific temperature to cook to. A small portion of manufactures are diligent about displaying all necessary information to the consumer such as, Kraft, Conagra foods, and Olymel which adequately met all parameters assessed. In order to fix the gaps of inconsistency of instructions this information can be used as educational tools by the BCCDC to inform customers on what to look for in cooking instructions of frozen, Peer reviewed, Peer-reviewed article, Published, Project submitted in partial fulfillment of the requirement for the degree of Bachelor of Technology in Environmental Health, British Columbia Institute of Technology, 2019., RTE, Cooking instructions, Frozen breaded chicken, Frozen microwavable entrees, Foodborne illness, Food safety, Public health, Thoroughness
Measles awareness
Background Measles is a highly contagious disease which has been the cause of numerous epidemics and outbreaks worldwide. The introduction of the two-dose Mumps, Measles and Rubella (MMR) vaccine helped to reduce and eliminate the disease in various places and continues to be the most effective method of developing immunity against measles. However, due to high non-vaccination rates and low herd immunity, measles is becoming a serious public health issue again. Additionally, those born between 1970 to 1994 are more at risk of contracting measles because they may have only received one-dose of the MMR vaccine during that time, which is not sufficient to develop immunity. Due to the recent measles outbreaks in Vancouver, B.C, this project surveyed the public regarding their knowledge of measles and the MMR vaccination to determine if they are able to protect themselves from this disease. Methods An in-person survey was conducted at three institutions: British Columbia Institute of Technology (BCIT), University of British Columbia (UBC) and Douglas College. The first section of the survey gathered general information from the participant such as year of birth, country of birth, area of study and municipality of dwelling. The second section of the survey included various true or false and yes or no questions regarding measles, MMR vaccination and recent outbreaks. Results Thirty-four people participated in the study. Four factors were analyzed using the chi-square. There was no statistically significant association found between any of the factors, including, country of birth vs. vaccination status (p=0.3952), year of birth vs. vaccination status (p=0.2563), country of birth vs. knowledge of MMR (p=0.7903) and area of study vs. knowledge of MMR (p=0.9875). It is possible that due to small sample size, there was insufficient power to detect any associations. Conclusions Out of the 34 participants, 21 were vaccinated, 4 were not vaccinated and 9 had an unknown vaccination status. Although the chi-square tests showed no association between any of the factors, the descriptive data still shows that we’ve only achieved a herd immunity of slightly over 50% was achieved within our survey population, which is not high enough to protect against measles. This can be a great opportunity for health authorities to educate individuals who are vaccine hesitant or refuse to immu, Peer reviewed, Peer-reviewed article, Published, Project submitted in partial fulfillment of the requirement for the degree of Bachelor of Technology in Environmental Health, British Columbia Institute of Technology, 2019., Vaccine education, Measles, Mumps, measles and rubella (MMR) vaccine, Immunization, Vaccination, Outbreaks, Vaccine hesitancy, MMR knowledge
Prevelance of Listeria in produce
Background: Fruits, vegetables, and ready to eat processed produce are vulnerable to bacteria contamination during production, harvesting, transportation, packaging, and distribution. Agencies like the Canadian Food Inspection Agency (CFIA), and the Food and Drug Administration (FDA) regulate and create legislative policies to ensure the food is safe for public consumption. When a product does not meet CFIA or FDA regulations or if the product is tested positive to biological, chemical, or physical contamination the product will be recalled. The main objective of this study is to determine if Listeria monocytogenes recalls in produce have increased over the last ten years. Listeria is a food-borne pathogen that is often overlooked and underreported. The diagnosis of Listeriosis can be difficult because symptoms can take up to 70 days to surface. Despite this, it is responsible for 41% of food-borne deaths in Canada. Methods: To determine if Listeria has increased over the last ten years, food recalls were collected from the CFIA, FDA, Food and Safety Inspection Service (FSIS), and Health Canada websites and recorded in Microsoft Excel. All food recalls were counted and analyzed using a one-tailed T-Test conducted in NCSS. Results: The study concluded that produce recalls due to the pathogen Listeria have increased by 60% over the last ten years. During the years of 2016 to 2018 the top pathogen responsible for food recalls was Listeria followed by the pathogens Salmonella and Escherichia coli. The study also concluded that total food recalls during the years of 2016 to 2018 was 45% higher than ten years ago. Conclusion: The results of this study could indicate that there is a need to increase traceability by obtaining produce through approved sources. This could allow for stricter policies, programs, and legislation regarding the use of irrigation water during production and identify breakdowns in sanitation procedures during processing and distribution., Peer reviewed, Peer-reviewed article, Published, Project submitted in partial fulfillment of the requirement for the degree of Bachelor of Technology in Environmental Health, British Columbia Institute of Technology, 2019., Health Canada, Listeria, Listeria monocytogenes, recalls, food recalls, Salmonella, E. coli, Escherichia coli, CFIA, FDA, FSIS
So you think you can cook pot?
Background: With regulations on additional cannabis products including edibles being in the works, Canada is faced with a new layer of food safety challenges as the public becomes increasingly curious about adding cannabis into their diets. Knowledge in both food safety and edible safety is essential to prevent health hazards associated with edible cannabis products. Methods: An online self-administered survey was conducted on a British Columbia population. In addition to demographic data which also included cannabis usage, participants answered two knowledge tests on food safety and edible safety, respectively. The surveys were analyzed for differences in test scores between demographic groups. Results: Users of cannabis edibles have significantly higher knowledge in edible safety than non-users. This was not affected by the purpose or frequency of edible use. A slight positive correlation (0.18) between food safety knowledge and edible safety knowledge suggested the two topic areas to be mutually beneficial. In contrary, knowledge in food safety was not significantly different across all demographic groups. Conclusions: Non-users of cannabis edibles are more at risk of health hazards related to ingestion of cannabis edibles due to lower knowledge in this subject matter and eagerness to experience cannabis products after their legalization. Therefore, there is a need for education programs to help familiarize the public with these products. It is also recommended for the public to strengthen general food safety knowledge because all of it also applies when making edibles., Peer reviewed, Peer-reviewed article, Published, Project submitted in partial fulfillment of the requirement for the degree of Bachelor of Technology in Environmental Health, British Columbia Institute of Technology, 2019., Legalization, Cannabis, Edibles, Food safety, Knowledge, THC