How does Canada's food safety system work?

Responsibilities of the various organizations involved

The federal, provincial, territorial and municipal governments (and/or Regional Health Boards) have shared responsibility for food safety as a result of the division of powers in Canada's Constitution. The food processing sector also has its own legal obligations related to the production and sale of safe foods. And all of us as consumers have a role to play. Some of these responsibilities are unique while others are shared. To help understand why the 2008 listeriosis outbreak was so complex and difficult to address, it is helpful to have a clearer sense of who does what.

Consumer

While this report focuses on food processors and governments, as consumers we have to be mindful that we also have a role to play. Food safety depends as much on our own individual actions as those of others.

Many people will be surprised to learn that foodborne illnesses are usually the result of the things individual consumers do - or do not do - once purchased food is taken home from the store. Research indicates that the vast majority of foodborne illnesses (up to 97%) are because of the way people store or prepare food. Keeping our families safe from harmful bacteria also depends on making sure we do simple things like clean, separate, cook and chill¹ our foods.

That said it is important to emphasize that consumer practices were not a contributing factor in the 2008 listeriosis outbreak.

Food processing industry

Food processors provide a critical link in the food supply chain, which begins at the farm gate and ends at your plate. There are many different steps and people involved at each stage starting with farmers and ranchers, followed by employees in slaughter facilities and food processing plants, as well as those working in the transportation, distribution and warehousing sectors; and finally, restaurants and grocery stores. Whatever their role, all of those engaged in the food supply chain have a responsibility to ensure that they take all necessary measures to ensure the foods Canadians eat are safe.

Food processors take various ingredients, including vegetables, flour, eggs and meat, and transform these raw materials into a variety of new food products that generally have a long shelf life.
Meat processors represent the largest sector of Canada's food processing industry, accounting for 10% of Canada's agri-food shipments and employing more than 63,000 Canadians. It is also one of Canada's leading manufacturing sectors with annual sales of over $20 billion.

Some meat processors make products that are called 'ready-to-eat,' which simply means that generally you do not have to do anything else to the food before eating it, except maybe thawing or warming. Ready-to-eat meat products include del. meat, pepperoni, bacon bits, liver pâté and dry salami.

Local and/or regional authorities

The organization of food safety at the local or regional level varies significantly across provinces and territories in Canada. There are regional health authorities in Western Canada and the Atlantic provinces, local public health units in Ontario, and health and social service regions and municipalities in Quebec.

Regardless of the organizational set-up, local and regional authorities contribute to food safety by inspecting local food processors, and food service and food retail establishments that are not federally registered. Some health authorities provide food handler training and information to increase awareness among consumers of safe food handling, preparation, storage, and serving methods. Local/regional public health authorities also conduct surveillance of foodborne illnesses and report confirmed cases to provincial ministries of health. Finally, local/regional public health officials carry out epidemiological investigations if a foodborne illness outbreak is suspected or confirmed.

Provincial and territorial governments

Provincial and territorial governments set food safety standards for plants licensed in their jurisdiction and enact and enforce food safety laws that apply to food produced and distributed within their jurisdiction. They also have the authority to investigate and take action to control human illness outbreaks, including foodborne illness outbreaks, within their borders.

Federal government

Responsibility for food safety within the federal government is assigned primarily to three organizations: Health Canada, the Canadian Food Inspection Agency (CFIA) and the Public Health Agency of Canada (PHAC). A fourth organization, Agriculture and Agri-Foods Canada, supports food safety policies through food quality research.

Health Canada establishes policies and standards for the safety and nutritional quality of food sold in Canada. Food policy decisions are based on assessments of risks associated with products or processes from a public health perspective. In some situations, when an unacceptable risk is identified, the product or process may be prohibited. Health Canada is also responsible for assessing the effectiveness of the CFIA's food safety activities.

The Canadian Food Inspection Agency's main role is to enforce the food safety and nutritional quality standards set out by Health Canada for domestic and imported products. The Agency delivers inspection programs in food safety and quality, and plant and animal health across Canada, including food processing plants. It also ensures that all food products meet federal packaging and labelling requirements. The Agency takes enforcement action when food safety standards are not met or when health risks are identified. When public safety is threatened, it conducts food investigations and product recalls. In carrying out this role and in fulfilling its responsibility for all federal food inspection activities, the CFIA's objective is to ensure the safety of Canada's food supply.

The Public Health Agency of Canada plays an active role once an illness caused by food is detected in humans. The PHAC supports action in preventing injury and disease across the country, including diseases transmitted by food or animals (foodborne and zoonotic²) and to promote national and international public health.

In a foodborne illness outbreak, the PHAC conducts national public health surveillance and may provide assistance to provincial authorities by contributing to epidemiological studies. The PHAC's laboratories provide reference services³ to identify and differentiate the various types of micro-organisms involved in the illness as well as systems to assist surveillance and the sharing of information. The PHAC maintains national databases for all foodborne diseases and operates the Listeriosis Reference Service, jointly with Health Canada.⁴

Understanding the federal regulatory system overseeing meat processors

Canada's 2007 Food and Consumer Safety Action Plan

In December 2007, Prime Minister Harper announced "Canada's Food and Consumer Safety Action Plan."⁵ The Plan is designed to strengthen food, health and consumer product safety by better supporting the collective responsibilities of government, industry and consumers for product safety.⁶

The Action Plan is based on the understanding that modernizing our food safety system demands an integrated approach, new and better information on food risks in the Canadian marketplace, and the full involvement of industry and Canadians in responding to potential hazards.

The Action Plan includes both legislative amendments to the Food and Drugs Act to replace outdated statutes and expanded program measures to enhance Canada's food safety system. The proposed changes to the Food and Drugs Act would help streamline the food safety system, provide more consistent regulatory tools across all food sectors and better enable the Government of Canada to fulfill its food safety mandate.

Overview of legislative framework

All meat processing companies that distribute and sell their products in more than one province and/or in other countries are governed by rules and requirements set out by the Government of Canada⁷. The rules cover food safety, quality, ingredients, packaging and labelling. These rules and requirements are found in several federal laws, mainly the Food and Drugs Act and the Meat Inspection Act.

Under the Food and Drugs Act, Health Canada sets out food safety standards, including the types of ingredients, that apply to all food sold or imported for sale in Canada. Under the Meat Inspection Act, the CFIA establishes the quality, packaging and labelling standards for companies selling in more than one province or exporting to other countries, as well as for companies importing food to be sold in Canada. The CFIA is the federal organization responsible for verifying that all the rules and requirements are respected by companies under both laws.

The way the federal government fulfills these duties has changed in recent years.

Federal rules and requirements

The CFIA Meat Inspection Regulations flow from the Meat Inspection Act. The regulations require meat processing companies that sell products in more than one province or to other countries to be federally registered and licensed. Licensed operators, such as Maple Leaf Foods, must establish safety measures and controls at every step of the food production process in order to comply with the regulations.

Food Processors

Food processors are required by regulations to develop their own food safety plan, which includes a key component called the "Hazard Analysis and Critical Control Point" (HACCP) plan. The HACCP plan for each plant must be endorsed by the CFIA. This systematic preventive approach (see box) to food safety is now considered the universal standard.

HACCP has been approved by the Codex Alimentarius Commission⁸, the global body established by the Food and Agriculture Organization of the United Nations and the World Health Organization. The Commission oversees food standards, guidelines and codes of practice under the Joint Food and Agriculture Organization / World Health Organization Food Standards Programme, which aims to protect consumers' health and ensure fair trade practices in the food trade.

Food processors that want to market their food inter-provincially and/or internationally must implement, at minimum, HACCP plans in order to export their products. Each individual plant's food safety plan must cover all aspects of food safety including safety standards in the building where the food is produced, the land surrounding it as well as the equipment used in food preparation and packaging. The plan also outlines safety procedures for people working at the facility and their movements within the plant.

Microbiologists employed by each food processor do all the swabbing of equipment and scientific testing to detect bacteria according to the standards laid out in the plant's food safety plan. Food processors also have quality assurance officers who do internal verifications such as making sure that temperature controls are precise, charts are kept up to date and so on. There are a minimum of three people per quality assurance team: one person undertakes the activity; a second person monitors the activity; and, a third person verifies the activity.

Canadian Food Inspection Agency's compliance verification

In addition to industry's in-house food safety plans and controls, the CFIA conducts inspections at food processing plants to ensure food processors respect federal laws and regulations.

These inspections include an assessment of the plant's HACCP plans which must be endorsed by the CFIA. With the introduction in April 2008 of the Compliance Verification System (CVS), the CFIA inspectors are required to conduct specific inspection activities at registered federal meat plants each day. These inspections activities, include daily and monthly tasks, and are based on known risks associated with food processing and the facility.

With the introduction of the CVS (see box), the CFIA inspectors are to audit the plant's key control systems within a two-year period, in addition to their daily inspections.

Aside from its inspection powers the CFIA, under the authority of the Food and Drugs Act and the Canadian Food Inspection Agency Act, can remove products from the market when a suspected contaminated food poses a risk to public health and safety. Such intervention can take place whether the product has been produced in a federally registered or provincially (territorially) licensed plant, or imported for sale into Canada. The CFIA has broad powers to investigate, search, seize and hold food products that violate the Food and Drugs Act. An inspector can enter any food processing facility or vehicle and open any package that is suspected of containing a contaminated product.⁹

The Canadian Food Inspection Agency warns the public when a specific food has been identified as a risk to human health and can order a company to recall particular products. Recalls are almost always done voluntarily by the responsible food processor. In the past 12 years since the CFIA was created, the Agency has conducted several thousand investigations that concluded in an average of 235 primary recalls per year in recent years. Of all the recalls since 1997, only seven were mandatory.

Listeria Policy

In 2004, Health Canada, in collaboration with the CFIA, updated and implemented the federal Listeria policy¹⁰. The current policy is based on the principles of HACCP and an approach that assesses the risks of contaminated foods to human health. It includes a combination of inspection, environmental sampling and end product testing.

The 2004 policy focuses on ready-to-eat foods which have been linked to outbreaks of listeriosis and those that support growth of Listeria monocytogenes with a greater than 10-day refrigerated shelf-life. It recognizes that the risk of contamination by Listeria monocytogenes can be reduced, but that Listeria cannot always be eradicated from finished products or the food processing plant environment.

The 2004 Policy guides food processors on food safety standards and risk management approaches to controlling Listeria monocytogenes, including effective sanitation programs to address Listeria monocytogenes in the environment of their plant.

In addition, the policy sets out food processors' responsibility with respect to the development of sampling approaches and the use of microbiological testing to verify that their control measures, eg. sanitation, are working as intended.

Food additives and technologies

In Canada, the Food and Drugs Act governs the use of all substances in food processing and manufacture. Under the Act, the Food and Drug Regulations permit the use of additives which can be used to preserve food or to control harmful bacteria. The regulatory definition of food additive includes "any substance the use of which results, or may reasonably be expected to result, in it or its by-products becoming a part of or affecting the characteristics of a food."¹¹. Regulations can include a list of foods in which the additive may be used and their level of use, as well as a requirement that the additive be declared on the label of a prepackaged food.>

There are other substances used during food processing and manufacture that do not meet the definition of food additive, which are commonly referred to as food 'processing aids.. These include chemicals and treatments, such as some antimicrobial substances, antifoaming agents, filtration and fining agents. Use of processing aids does not affect the natural characteristics of the food and results in no or negligible residues of the substance or its by-products in or on the finished food.

Additives that can inhibit Listeria growth

Additives such as sodium diacetate and sodium lactate have been approved for use in the United States for close to a decade to inhibit Listeria growth. The two chemicals have been used singly or in combination by American food processing companies. They are also used in other jurisdictions, including the UK, the EU, Australia and New Zealand, and have proven safe and effective in controlling the proliferation of Listeria bacteria.

These additives are endorsed by industry associations including the Canadian Meat Council and the American Meat Institute and international bodies such as the Codex Alimentarius as successful ways to inhibit Listeria growth. Both chemicals were approved by Health Canada in the fall of 2008 on an interim basis but new regulations have yet to be finalized.

Post-processing bacteria 'kill steps'

While some processes are used during the stage when food is being processed, others are used in the period before or during packaging. These activities are clustered under the general category of post-processing bacteria 'kill steps' such as:

• Heat and UHP (ultra high pressure): These procedures to kill Listeria include heating, steam, submersion in hot water, radiant oven heat, high pressure processing, consumer reheating;
• Post-processing, post-pasteurization or post-lethality alternatives: These are physical treatments such as chemical antimicrobials: biological: lactic acid bacteria, bacteriocins/bacteriophages that can destroy the bacteria;
• Irradiation. Food irradiation is a safe method to decontaminate foods for human consumption, although it is controversial with consumers. It has been proven to be the single most effective methods of eradicating bacteria, and it does not alter appearance, taste or texture of foods. Despite its many advantages, this proven technique is unlikely to be adopted by food processors without a major consumer education program.

Emerging technologies

Bio-sensors: These highly sophisticated devices can detect minute changes to reveal the presence and concentration of contaminants in food. Because bio-sensors can reveal even very small amounts of contamination, they hold promise for enhancing food safety in the future. However, these technologies are still in the developmental phase and are not yet in use in the food processing industry.

Sanitizers used to control Listeria

The Listeria bacteria have the ability to form bio-films - microorganisms that adhere to surfaces - that are resistant to conventional industrial cleaning methods. Recognizing this, a number of meat processing industries in North America, including Canada and the United States, as well as in the European Union, the United Kingdom, Australia and New Zealand use sanitizers to control Listeria in their manufacturing processes.

The meat industry uses four main types of sanitizers: hot water, chlorine, iodophors and quaternary ammonia. Sanitizers approved for use in meat production facilities combine both products and sanitation techniques to eradicate Listeria bacteria that are harmful to humans.

Several of these sanitizers (quaternary ammonium and idophors) are most effective when combined with post-processing steam and heat treatments.

The introduction of sanitizers has made a noticeable difference in the incidence of Listeria contamination in ready-to-eat foods in the US. Listeriosis cases have declined there by as much as 40 % since the late 1990s, when these new sanitizing procedures were encouraged in the aftermath of a serious listeriosis outbreak in that country. This approach has had the greatest impact in reducing the number of pathogens in ready-t-eat poultry and red meat products.

Design of food processing equipment

All food processing plants are comprised of numerous pieces of equipment. The design of this equipment can facilitate, or complicate, the sanitation measures needed to produce safe foods.

Specific direction on sanitation and other maintenance guidance that affect food safety is provided through directives issued periodically by the CFIA. Food processing equipment, including slicers that can affect the safety of food, is part of each plant's food safety plan approved by government.

Understanding public health and the organizations involved

Public health involves much more than hospitals and doctors - what most Canadians think of as the health care system.

Public health covers a wide range of disciplines. Unlike the health care system which treats each patient individually, public health practitioners are concerned with the health of the entire population.

The Public Health Agency of Canada was established in 2004 in response to growing concerns about the capacity of Canada's public health system to anticipate and respond effectively to public health threats, including foodborne illnesses. The Agency's creation followed recommendations from leading public health experts who called for clear federal leadership on public health matters and improved collaboration within and between jurisdictions.

The PHAC describes public health as a shared responsibility. While governments enact laws, develop policies and provide resources to fund public health activities, it takes the combined efforts of a variety of organizations, sectors, and people, both within and outside government, to address health challenges."¹²

In the event of foodborne illnesses, provincial or territorial officials generally have the mandate to investigate human illness outbreaks that occur within their own borders.

The federal government delivers health care services to First Nations and Inuit populations, as well as war and Canadian Forces veterans. It also provides funding to provincial and territorial health systems. A further function of Health Canada and the Public Health Agency of Canada is to conduct scientific research, carry out consultations with Canadians to determine how to best meet their long-term health needs, communicate information about disease prevention to protect Canadians from avoidable risks and encourage Canadians to take an active role in their health¹³.

The sharing of these responsibilities is laid out in Canada's Constitution.

Detecting and investigating foodborne illness

Surveillance of foodborne illness

The routine monitoring of important conditions and diseases, including foodborne illness, carried out by public health, is called surveillance. This is one of the six core functions of public health. The purpose of surveillance in foodborne illnesses is to prevent the spread of infection to susceptible people. Surveillance is carried out by all three levels of government.

Most cases of foodborne illness are not part of recognized outbreaks but occur as individual or 'sporadic' cases. However, some may be part of unrecognized outbreaks. As the 2008 listeriosis outbreak demonstrated, detecting large outbreaks can be a challenge especially where illness occurs across large geographic areas and local jurisdictions may see only one or two cases. That is where laboratory tools for DNA fingerprinting of disease organisms (described later) are valuable in making connections between cases and in linking them to a specific food or other source.

Certain diseases have been made 'notifiable', meaning that when they are diagnosed they must be reported to public health authorities. Surveillance of a notifiable foodborne illness usually begins with a report to local public health by a physician who has made the diagnosis or by the laboratory that detected a positive lab specimen. The patient information is recorded in an electronic surveillance system which is uploaded into a provincial information system. If the disease is nationally notifiable, information is also transferred to the Public Health Agency of Canada.

In 2008, listeriosis was a notifiable disease in most but not all Canadian provinces. However, it was not nationally notifiable¹⁴. The list of notifiable diseases at the federal level is agreed to by consensus with the provinces and territories, as they must supply the reports. Since the 2008 outbreak, the process to add listeriosis to the list of notifiable diseases has been undertaken by all jurisdictions.

Public health officials monitor the illness reports they receive to look for increased numbers of cases or clusters that could indicate an emerging problem. The systems that monitor notifiable illnesses vary from province to province. Many systems monitor illnesses and identify spikes in the number of cases. If the number increases, provincial/territorial public health officials may alert all local and regional health units, as well as those in other jurisdictions, to enhance surveillance which may lead to preventative measures.

The Public Health Agency of Canada has several national surveillance systems in place for foodborne illness. The National Enteric Surveillance Program¹⁵ is designed to provide timely analysis and reporting of lab-confirmed enteric (intestinal) disease cases in Canada.. Their National Microbiology Lab coordinates PulseNet Canada, an electronic laboratory network that identifies clusters of foodborne pathogens including Listeria monocytogenes based on their DNA fingerprints. PulseNet allows DNA fingerprints to be compared in real time so that foodborne illness from a common source can be identified.

Another national initiative, the Canadian Integrated Outbreak Surveillance Centre (CIOSC)¹⁶ plays a key role in detecting disease outbreaks by receiving, posting and distributing electronic alerts about respiratory or enteric diseases to public health practitioners across Canada and related organizations like the CFIA. This encourages others to look for similar cases that might be connected. CIOSC alerts may be initiated at any level of the public health system and are not restricted to notifiable diseases.

Investigating foodborne illness

When an apparent cluster of cases is detected, public health officials first determine whether the cases represent a real increase above the expected number of cases and whether they really might be related. Once an outbreak is strongly suspected, an investigation begins.

Typical steps in an investigation include:

• search for more cases among people who might have been exposed
• case definition developed to describe typical cases
• description of the outbreak - who is affected, graph of cases over time
• additional sampling as needed to determine the organism responsible
• interviews to identify potential foods that might be implicated
• formal epidemiological investigation to measure the association between the illness and the suspected source of food
• investigation into the implicated food - its ingredients, preparation and microbiological culture of leftover ingredients or the food itself (if available)

The epidemiological investigation often provides enough evidence to establish the source of the outbreak and how it is being spread. This allows appropriate control measures to be taken. In other circumstances additional laboratory studies (for example to link human illness and the implicated foods) are needed to provide the evidence needed for action.

When outbreaks of foodborne illness occur, epidemiological investigations are handled by the local/regional public health departments, a province or territory or the federal government, depending on the scope of the illness or the capacity to manage the investigation. The Public Health Agency of Canada becomes involved when provincial or territorial government requests assistance or once an illness extends beyond a single province or territory.

When commercial food products are implicated, provincial ministries of agriculture and/or the CFIA also become involved to conduct a detailed food safety investigation to identify the food responsible for causing the illness. This usually includes working closely with the manufacturer to obtain distribution records and additional food samples for testing, and conducting a comprehensive inspection of the manufacturing facility.

Determining and Responding to a Foodborne Illness Outbreak. (From Lessons Learned: The Canadian Food Inspection Agency's Recall Response to the 2008 Listeriosis Outbreak, p8)

Provinces and territories also have the authority to investigate food safety issues and provide notification to the public concerning food safety and conduct recalls within their boundaries if the plant is provincially registered. For instance, the Ontario Ministry of Health and Long-Term Care can issue a food recall of unfit food under the Ontario Health Protection and Promotion Act.

At the federal level food safety investigations are the responsibility of the CFIA, and are carried out in collaboration with Health Canada. Each year, the CFIA conducts approximately 3,000 food safety investigations. These investigations can be triggered by various sources including consumer and industry complaints, inspections, audits, laboratory results or referral from other organizations. As a result of these investigations, approximately 235 primary food recalls are initiated each year to remove products from the market, in most cases before products are consumed.

Key CFIA staff, including those from the national Office of Food Safety and Recall, Area Recall Coordinators and laboratory services, are involved in such food safety investigations. Health Canada's role is to conduct, at the request of the CFIA, an assessment of the health risks from human exposure to contaminated foods.

Coordination of the response to large national outbreaks of foodborne disease is unusually complex because there are many organizations involved at three levels of government. The roles and responsibilities of all governments charged with investigating a foodborne illness outbreak are outlined in the Foodborne Illness Outbreak Response Protocol to Guide a Multi-Jurisdictional Response (FIORP). This protocol has been ratified in 2004 by Deputy Ministers for all fourteen jurisdictions.

Aside from this national-level protocol involving federal, provincial and territorial governments, a number of provinces and territories - British Columbia, Alberta, Saskatchewan, the Northwest Territories, Ontario and Quebec - have specific agreements with the federal government relating to food safety.

Next Chapter

"With the advantage of hindsight, it is easy to see the mix of variables that created the conditions enabling listeriosis to take hold. Among the many variables, is simply the fact that the disease involves a virulent bug that is very difficult to pinpoint and even harder to keep in check..."

¹ Canadian Partnership for Consumer Food Safety Education

² The umbrella term describing diseases that can be passed to humans from animals.

³ Laboratory reference services provide the national expert advice on a particular scientific issue.

⁴ Lessons Learned: Public Health Agency of Canada's Response to the 2008 Listeriosis Outbreak

⁵ Health Canada, Strengthening and Modernizing Canada's Safety for Food, Health and Consumer Products. A Discussion Paper on Canada's Food and Safety Action Plan, (10 January 2008). online

⁶ Public Health Law & Policy in Canada, Second Edition, Bailey, Caulfield, Ries, Chapter 12, Foodborne Illness and Public Health (Ronald L. Doering), Ottawa, p. 492.

⁷ Food processors that sell locally or within a province are governed by the rules of that particular jurisdiction.

⁸ Codex Alimentarius Commission, online

⁹ Public Health Law & Policy in Canada, Second Edition, Bailey, Caulfield, Ries, Chapter 12, Foodborne Illness and Public Health (Ronald L. Doering), Ottawa, p. 489.

¹⁰ The 'Policy on Listeria monocytogenes in ready-to-eat foods' replaced the 1994 Field Compliance Guide.

¹¹ From HC Website

¹² Public Health Agency of Canada, Report on the State of Public Health in Canada 2008, What we mean by public health, online

¹³ Drawn from HC website and "The Government of Canada's role in health"

¹⁴ National Notifiable Diseases

¹⁵ National Surveillance Enteric Program includes C-EnterNet as a pilot initiative to obtain more complete information on enteric disease by conducting surveillance in selected sentinel sites

¹⁶ CIOSC is operated by the PHAC