Review points to holes in CFIA food safety system

24.09.2008 08:01 Shopping - Source: cbc.ca

The Canadian Food Inspection Agency isn't sure how to conduct investigations after food has been recalled from the market, and there's no clear policy on when the agency needs to alert the public about tainted food.

The inside housing of a slicer machine at a Maple Leaf Foods plant is disassembled for sanitization in the wake of the listeria outbreak.(Maple Leaf Foods Inc./CP)This indictment comes not from the agency's growing chorus of critics in the wake of an outbreak of listeriosis, which was connected to meat from a Maple Leaf food packing plant and had been linked to 18 deaths across the country by late September 2008. Nor did the indictment come as a result of Prime Minister Stephen Harper's Sept. 3 announcement of an investigation into the crisis. Rather, the criticism is contained in an internal review of the CFIA's food emergency response program, done in 2005.

Amir Attaran, an editor at the Canadian Medical Association Journal who is calling for a formal government inquiry into the crisis, has read the Food Emergency Response Review and says its conclusions about the agency's recall system are troubling.

"It's fair to say that the government is endangering Canadians' lives three times a day: It's called breakfast, lunch and dinner," he told CBC News. "And unless we have a very serious look at food safety regulation to re-empower food inspectors … we're going to see this kind of thing happen again."

Prime Minister Stephen Harper set the terms of reference on Sept. 6, 2008, for an investigation into the listeriosis outbreak linked to processed meat products. The probe is to:

• Examine the events, circumstances and factors that contributed to the outbreak.
• Review the efficiency and effectiveness of the response by federal agencies in terms of prevention, the recall of contaminated products, and collaboration and communication among partners in the food safety system and the public.
• Make recommendations aimed at enhancing prevention of future outbreaks and the removal of contaminated products from stores and warehouses.

Unlike a formal inquiry under the Inquiries Act, an investigation does not involve a judge or have powers of subpoena requiring people to appear and give evidence. Investigators will not express any conclusion or recommendation about civil or criminal liability of individuals or organizations. The report is due before March 15, 2009.

The inspection agency's review was conducted from January to March 2005. CBC News obtained the review in 2007 under the federal Access to Information Act, as part of a joint investigation with the Toronto Star into food safety.

The CFIA's corporate planning, reporting and accountability branch examined three areas that, at the time, were deemed to "require immediate attention":

1. The need to clarify and communicate the responsibility for recall decisions.
2. The need to improve the risk/assessment process.
3. The need to improve followup activities.

On the issue of food recalls, the CFIA's internal review concluded:

1. "A public warning may be issued depending on the seriousness of the health risk. There is no clear policy on when a recall requires public warning."
2. On the matter of conducting followup inspections after a recall: "Within the [Canadian Food Inspection Agency] there is no common understanding of what is meant by recall followup, more specifically for longer term followup."
3. And on the matter of dealing with troublesome companies: "… processes and strategies do not appear to be in place for systematically dealing with repeat [recall] offenders."

It's difficult to determine whether there have been changes to the CFIA's procedures as a result of the report, as the agency has refused to be interviewed on the subject by the CBC and the Toronto Star.

Even though the observations about the food emergency system were made in 2005, CFIA inspectors say problems still exist, according to Bob Kingston, president of the Agriculture Union of the Public Service Alliance of Canada, which represents the inspectors.

• Within CFIA there is no common understanding of what is meant by recall followup, more specifically for longer-term followup.
• Concerns have been raised that too much reliance is being placed on information provided by the establishment, or in the case of imports, the foreign country.
• In some areas, it has been noted that inspection staff may not be receiving sufficient hands-on experience in inspection activities and interview techniques.
• This situation [problems in the inspections and warning process] results from confusion regarding who has the lead. It causes delays in obtaining required information, questions are raised about the laboratories concerning the appropriateness of taking additional samples and/or different advice [is] given to the area field staff on the need to expand the investigation to other projects or firms.
• Information on recalls could be shared more widely: A public warning may be issued depending on the seriousness of the health risk. There is no clear policy on when a recall requires public warning.

After circulating the internal review to the union's members, Kingston said one inspector wrote to him in an e-mail that, "Industry just calls a voluntary recall and no enforcement action is taken. We have no teeth to speak of."

In another e-mail, Kingston said a second inspector wrote: "If a recall is deemed ineffective, Food Safety [CFIA] will ask for the recall to be repeated and a letter is written…. Some inspectors may have time to do followup inspections, but mostly they move on to the next complaint/recall."

For their part, food safety critics outside the Canadian Food Inspection Agency say the government has been aware of the these problems for years and, what's worse, many of the same concerns highlighted in the 2005 review were made in two previous internal reviews dating back to when the agency was first established in 1997. In 2000, Canada's auditor general expressed similar concerns.

After reading the latest report, Mike McBane, national director of the public health-care advocacy group Canadian Health Coalition, was incredulous. "It's shocking. No clear policy on a recall. Can you imagine? An emergency response program that has no policy on recalls?"

Rick Holley, a professor of food microbiology and food safety in the department of food science at the University of Manitoba in Winnipeg, read the document as well. "The safety of food in Canada is somewhat unpredictable," Holley said. "There should be a reasonable level of confidence that the food that we eat is not going to make us sick. One fatality is one fatality too many. It just shouldn't have to happen."

More self-policing

Though critics have long complained about the weaknesses they perceive in Canada's food safety surveillance, their concerns intensified in April 2008 when the Canadian Food Inspection Agency implemented the "compliance verification system." It allows companies to inspect themselves while the CFIA inspectors review the company's paperwork.

"Prior to April 1, they [CFIA inspectors] actually toured their plants that they worked in to get a general feel for conditions and they would notice things like excessive humidity, or excessive temperature or condensation on ceilings where it wasn't supposed to be," said Kingston of the agriculture union. "After April 1, they don't do that anymore. They just sit in an office and read about it. We know that things are less likely to go off the rails when they're being closely monitored."

Although the CFIA has refused to be interviewed by the CBC and the Toronto Star, agency manager Richard Arsenault was quoted in August commenting on this new verification system: "All I can say is that with the new system that has been set up, there's always an adjustment phase."

A food inspector in Montreal takes cheeses that may have been contaminated with listeria away to be destroyed. (Peter McCabe/CP)In addition to fewer inspections, critics also point to government cutbacks. According to the government's own spending estimates, released before the listeriosis outbreak started in summer 2008, there would be less money for food inspection over the following three years.

The plans call for the agency's net spending to decrease by approximately 12 per cent during those three years. An additional five per cent cutback during the same time period is aimed at staffing.

Critics say this is one of the reasons why the major political parties are promising to hire more inspectors.

But how much money is enough? And how many inspectors is enough? Those kinds of questions are difficult to answer, especially at a time when the federal government is squeezing departments and agencies to save money - or put another way in this internal note that CFIA president Carole Swan sent to her employees: "CFIA was one of 17 organizations that undertook a strategic review of its programs and put forward a series of proposals that identified where program spending could be reinvested more effectively."

Complex web

For all the emphasis on the Canadian Food Inspection Agency, it is important to realize that it is not the only player in the public health food safety system.

Other departments such as Health Canada and the Public Health Agency of Canada play vital roles, and were also been criticized in the CFIA's 2005 internal review. The provincial ministries of health are important, as are the municipal health officials and physicians who have the first contact with victims of food poisoning. For the system to operate reliably, there can be no breakdowns in communication, no procedures that waste time.

Every year, the Canadian Food Inspection Agency conducts about 3,000 safety investigations. About one-tenth of those investigations — roughly 360 a year — lead to recalls.

• 45 per cent are categorized as Class 1. Tainted food in this category kills. The recall of Maple Leaf Foods' 220 products fits into this category.
• 45 per cent of recalls are classified as Class 2. The risk of injury is less serious, and there isn't always a need for a recall, but still cause for much concern.
• The rest are categorized as Class 3, which are foods not likely to cause any harm.

And yet that's what happened in the listeriosis outbreak.

It took more than three weeks for Canadians to learn about the tainted meat, when people should have received the warnings within days, as is the case in jurisdictions such as New Mexico.

Dr. Don Low, the medical director of the Ontario Public Health Laboratories and the chief of the department of microbiology at Mount Sinai Hospital in Toronto, told the CBC and Toronto Star that the three weeks it took to alert the public to the threat of listeriosis was inexcusable, and conceded that the provincial labs were ill-equipped to determine that the first two cases came from the same Toronto-area nursing home.

"By the time that was identified and the investigation was initiated, there's a significant time lag that to my mind shouldn't have happened," he said.

Dr. Low was recruited in wake of the SARS outbreak to help bring Ontario's provincial labs "into the 21st century." While he says his officials are making progress, they're still years away from having laboratories good enough to handle the workload - some four million samples a year - and respond more quickly during a public health crisis.

This is one of the reasons why critics are calling for an inquiry on the scale of those held in the wake of tainted blood scandal, the water crisis in Walkerton, Ont., and SARS. So far, Harper has only promised an investigation.

"An inquiry is different from an investigation," explained the Canadian Medical Association Journal's Attaran, who is also a law professor at the University of Ottawa. "An inquiry has a specific meaning in the law under something called the Inquiries Act. It means that there will be a person like a judge to look into the evidence of what went wrong. An investigation doesn't have that sort of judge."

Attaran adds that an inquiry is open to the public, whereas an investigation is not. "An inquiry allows witnesses to be placed under subpoena; that is, if someone doesn't want to testify, you can order them to testify. And you can order them to bring documents. Well, an investigation such as Harper has asked for doesn't have the power of subpoena. It can't order anybody to attend. It can't order anybody to give evidence."

Whether the listeriosis outbreak leads to an inquiry and changes to the Canadian food inspection system is still an open question. Meanwhile, as the issue makes headlines during the campaign for the Oct. 14 federal election, the parties continue to position themselves to tackle the issue of food safety after the ballots are cast.

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