Ebook Environmental policy and public health (2/E): Part 1

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Environmental Policy and Public Health Second Edition Environmental Policy and Public Health Second Edition Barry L Johnson and Maureen Y Lichtveld CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2018 by Taylor & Francis Group, LLC CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S Government works Printed on acid-free paper International Standard Book Number-13: 978-1-4987-9939-3 (Hardback) This book contains information obtained from authentic and highly regarded sources Reasonable efforts have been made to publish reliable data and information, but the author and publisher cannot assume responsibility for the validity of all materials or the consequences of their use The authors and publishers have attempted to trace the copyright holders of all material reproduced in this publication and apologize to copyright holders if permission to publish in this form has not been obtained If any copyright material has not been acknowledged, please write and let us know so we may rectify in any future reprint Except as permitted under U.S Copyright Law, no part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying, microfilming, and recording, or in any information storage or retrieval system, without written permission from the publishers For permission to photocopy or use material electronically from this work, please access www.copyright.com (http://www.copyright.com/) or contact the Copyright Clearance Center, Inc (CCC), 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400 CCC is a not-for-profit organization that provides licenses and registration for a variety of users For organizations that have been granted a photocopy license by the CCC, a separate system of payment has been arranged Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe Library of Congress Cataloging‑in‑Publication Data Names: Johnson, Barry L (Barry Lee), 1938- author | Lichtveld, Maureen Y., author Title: Environmental policy and public health / Barry L Johnson and Maureen Y Lichtveld Description: Second edition | Boca Raton : Taylor & Francis, 2017 | “A CRC title, part of the Taylor & Francis imprint, a member of the Taylor & Francis Group, the academic division of T&F Informa plc.” Identifiers: LCCN 2017024274 | ISBN 9781498799393 (hardback : alk paper) Subjects: LCSH: Environmental health Government policy United States | Environmental policy United States | Medical policy United States Classification: LCC RA566.3 J64 2017 | DDC 362.10973 dc23 LC record available at https://lccn.loc.gov/2017024274 Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com About the Cover The authors of this book intend the cover to speak about the book’s contents The centerpiece of the cover is planet Earth, as presented by a striking image from the National Aeronautics and Space Administration (NASA) Earth’s resources provide the basic essentials to sustain life on the planet: air, water, land, and energy Further, human life on our planet depends on healthful air, potable water, and safe sources of food Unfortunately, humankind has not always appreciated the essential nature of Earth’s sustainable resources Arrayed on the cover are examples from the text of humankind’s mismanagement of air, water, and food resources, together with other environmental conditions that can affect human and ecosystem health The images arrayed around planet Earth pertain to climate change (polar bears), air pollution in a major Asian city, a point source of water pollution, devices for inhalation of tobacco products, food waste, plastic waste in the Pacific Ocean, the mosquito that carries the Zika virus, and an American bald eagle, a species saved from extinction, These images on the cover presage the book’s description of specific environmental hazards and policies and practices purposed to prevent or diminish their deleterious effects on the residents of planet Earth Dedication This book is dedicated to those policymakers, scientists, medical investigators, environmental and public health agencies, nongovernmental organizations, and individuals who have advocated science-based environmental health policies that have led to human and ecosystem health protections and improvements in environmental quality Absent their dedicated efforts, our planet and its living organisms would be fewer in number and poorer in well-being Table of Contents Preface xxv Acknowledgments xxvii Authors xxix Section I:  Policymaking Basics, Foundations, and Resources Chapter Fundamentals of Environmental Health Policymaking Chapter Steps in Environmental Health Policymaking 25 Chapter U.S Federal Government’s Environmental Health Structure 51 Chapter General U.S Federal Environmental Statutes 85 Chapter Global Environmental Health Programs and Policies 107 Section II:  Known Environmental Hazards to Public Health Chapter Climate Change 129 Chapter Tobacco Products 159 Chapter Air Quality 189 Chapter Water Quality and Security 225 Chapter 10 Food Safety and Security 259 Chapter 11 Hazardous Chemical Substances 287 Chapter 12 Waste Generation and Management 317 Chapter 13 Environment-Related Infectious Diseases 351 Section III:  Emerging Areas Impacting Environmental Health Chapter 14 Energy Production and Associated Policies 367 Chapter 15 Genetically Modified Organisms 383 Chapter 16 Biodiversity and Endangered Species 399 Chapter 17 The Built Environment 417 Section IV:  Influences on Environmental Health Policymaking Chapter 18 Policy Impacts of Environmental Justice 435 Chapter 19 Policy Impacts of Risk Assessment 461 Chapter 20 Lessons Learned and Authors’ Reflection 481 ix 272 service managers can be hindered when inspection scores are made available to the public [41] On the other hand, in support of communicating food service inspection reports to the public is the acceptance by many health departments that posted reports help improves food safety In a study of foodborne-disease hospitalizations in Los Angeles County, California, it was found that restaurant hygiene grading with public posting of results was an effective means for reducing the incidence of foodborne disease [42] Investigators reported a 13% decrease in the number of foodborne-diseases in the year following implementation of a public posting program for restaurant inspections As this study suggests, public perception can be a powerful motivator for change Much like how the Toxics Release Inventory data have led to voluntary reductions of emission from industrial facilities, food establishments fear a poor rating of their services Therefore some argue that public availability of inspection scores help reinforce food quality standards and practices [42] Regardless of which side one takes on the argument about the public’s access to food inspection reports, the trend seems clear The U.S public will continue to want access to government information that has health and safety relevance to them This trend has been accelerated because of the rapid growth of social media and the public’s access to it Moreover, the wellpublicized news media reports of occasional food poisonings have compounded the public’s concerns and personal interests The challenge is therefore not whether to report food establishment ratings, but how to it in a responsible manner 10.4  GLOBAL FOOD SAFETY AND SECURITY POLICIES The previous sections of this chapter have dealt with U.S food safety and security policies This section describes parallel food polices established by the EU, China, and India Each of these three entities face challenges to their populations’ food safety and security similar to the ones the U.S faces All three have taken policy approaches that are both similar, as well as disparate from those of the U.S 10.4.1 EU Food Safety Policies As stated by the European Commission (EC), a series of food incidents in Europe during the late 1990s drew attention to the need to establish general principles and requirements concerning food and feed law at the Union level [44] Accordingly, in 2002 the EC developed an integrated approach to food safety “from farm to table.” This approach was primarily set out in its White Paper on Food Safety The policy covers all sectors of the food chain, including feed production, primary production, food processing, storage, transport, and retail sale Later in 2002, the European Parliament and the Council adopted Regulation (EC) No 178/2002 establishing the general principles and requirements of food law (General Food Law Regulation) The General Food Law Regulation is the foundation of food and feed law in the EU It establishes an overarching and coherent framework for the development of Environmental Policy and Public Health food and feed legislation both at Union and Member State levels To this end, it states general principles, requirements, and procedures that underpin decision-making in matters of food and feed safety, covering all stages of food and feed production and distribution The General Food Law also established an indepenThe General Food Law dent agency responsible for Regulation is the foundation scientific advice and supof food and feed law in the port, the European Food EU It establishes an overSafety Authority Moreover, arching and coherent framethe law created the main work for the development procedures and tools for the of food and feed legislation management of emergenboth at Union and Member cies and crises, as well as State levels the Rapid Alert System for Food and Feed The General Food Law Regulation ensures a high level of protection of human life and consumers’ interests in relation to food, while ensuring the effective functioning of the internal market [44] The key provisions of the Regulation follow: Safety requirements: The safety of food is of critical importance Consumers must have confidence and assurance that the food they buy will them no harm or have an adverse effect The General Food Law Regulation establishes that only safe food and feed can be placed on the Union market or fed to food-producing animals It also establishes basic criteria for establishing whether a food or feed is safe Traceability: Tracing food and feed throughout the food chain is very important for the protection of consumers, particularly when food and feed are found to be faulty The General Food Law Regulation defines traceability as the ability to trace and follow food, feed, and ingredients through all stages of production, processing and distribution Traceability: • Facilitates withdrawal of faulty food/feed from the market • Provides consumers with targeted and accurate information on specific products • Covers all food and feed, all food and feed business operators, without prejudice to existing legislation on specific sectors • Affects importers who are required to be able to identify from whom the product was exported in the country of origin • Obliges businesses to be able to identify at least the immediate supplier of the product in question and the immediate subsequent recipient, with the exemption of retailers to final consumers-one step back-one step forward (unless specific provisions for further traceability exist) […] Operators’ responsibilities: Primary responsibility for ensuring compliance with food law—and in particular the safety of the food—rests with the food (or feed) business operators To complement and support this principle, the competent 273 Food Safety and Security authorities of the Member States must assure adequate and effective controls When food or feed is unsafe, business operators are obliged to withdraw or recall it […] Implementation guidance: A guidance document aims to assist all players in the food chain to better understand the Regulation and to apply it correctly and in a uniform way […] As a rule, the guidelines not address specific issues faced by particular types of businesses [45] There are other implementing documents that give more details to the food management community on their responsibilities under the provisions of the General Food Law 10.4.2 Food Safety Policies in China China updated its food safety policy in 2015 As summarized by Sim and Yang, on April 24, 2015, the Standing Committee of China’s National People’s Congress revised the 2009 Food Safety Law of the People’s Republic of China (Food Safety Law) [46] “The revised law came into effect on October 1, 2015 The revisions to the Food Safety Law are wide-ranging, imposing stricter controls and supervision on food production and management On December 9, 2015, the China Food and Drug Administration (CFDA) published draft amendments to the Implementing Regulations of the Food Safety Law (Implementing Regulations) for public consultation Highlights of the changes are summarized below Record-keeping and registration mechanisms for food producers and importers: The primary enforcement powers for food safety used to be divided among different agencies Since 2013, the State Council has commenced a structural adjustment for the purpose of establishing a more centralized system, with CFDA under the State Council responsible for the supervision of food production, distribution and restaurant/catering services.[…] Food producers must maintain a record system to record the supply and examination of food ingredients, food additives, and food-related products Such record must be kept for a period of 6 months after the expiration date of the relevant food products, or 2 years if the expiration date is not specified Food importers and importing agents must be recorded with the General Administration of Quality Supervision, Inspection and Quarantine (AQSIQ) Manufacturers of imported food products must also be registered with the AQSIQ Online food platforms: Ordering food online is now a global trend and the safety of food purchased over the Internet has raised issues Under the new law, providers of third-party online food trading platforms must review a trader’s permit and register the real identity of the trader If a platform provider becomes aware of food safety violations, the provider must immediately stop the trader from such illegal activities and report the same to local FDAs […] Health foods: Health foods that contain ingredients outside the approved list of health food ingredients must be registered with CFDA CFDA registration is required for health foods that are imported for the first time and serve to supplement vitamins, minerals, and other nutrients Other health foods must be recorded with provincial level FDAs […] Consistent with existing regulations for health foods, the new law prohibits labels and instructions of health foods from referring to any preventive or therapeutic function They should also contain the statement “this product cannot replace medicine.” […] Baby food: A key revision under the new law is stricter regulation of baby formula food The ingredients, food additives, formula, and labels of baby formula food must be recorded with provincial level FDAs Formulas for baby milk must be registered with CFDA Reports and other materials showing the development process and safety of the formula must be submitted for formula registration […] Genetically modified foods: The new law introduces rules on genetically modified foods and provides that packages of genetically modified foods must be labeled as such, and the information on the labels must be accurate […] Foods for special medical purposes: Formula foods for special medical purposes must be registered with CFDA The product formula, production technology, labels, instructions, and materials showing the safety and nutritional adequacy of the product and clinical effects of special medical use must be submitted for product registration The new law stipulates that relevant regulations for pharmaceutical advertising apply to advertisements of foods for special medical purpose […] Increased sanctions: […] For food traders, engaging in the production of foods or food additives without proper permit will be subject to an administrative fine up to 20 times the products’ value Likewise, failure to register health foods, formula foods for special medical use, or baby milk formulas is subject to an administrative fine up to 20 times the products’ value and the food permit may be revoked in serious cases […] The new law places more emphasis on the supervision and control of every step of food production, distribution, sale and recall Special provisions are set out for food products that have been a focus in food safety incidents in recent years, especially health foods and infant milk formulas Meanwhile, the new law has also taken into account new types of food trading activities, including food sold on a third-party trading platform and food imported through e-commerce channels With respect to the latter, the draft Implementing Regulations propose that food imported through e-commerce channels are subject to the same regulations as those applicable to food products imported through traditional channels” [46] 274 10.4.3 Food Safety Policies in India On August 23, 2006 the Parliament of India consolidated a number of existing provincial food safety policies into the Food Safety and Standards Act of 2006 As summarized by Arora, in India the Food Safety and Standards Authority of India (FSSAI) is the country’s apex food regulator [47] “It is empowered by and functions under the Ministry of Health and Family Welfare, Government of India The FSSAI implements and enforces food regulations as prescribed in the Food Safety and Standards Act, 2006 (FSS Act) The FSS Act is an act of Parliament, popularly known as the Food Act […] The regulations of the FSS Act became effective in 2011 with FSSAI as its regulatory body Though the act continues to evolve it needs to be further harmonized with standards of international agencies for global parity In the FSSAI regulations, food products fall into two categories—standardized and non-standardized The standardized food products are those for which standards are prescribed and not require product approval prior to manufacture, sale, distribution, or import The first time manufacturer or importer of standardized foods only requires an FSSAI license to begin a food business” [47] Key excerpts from the FSSAI regulations follow: “Non-standardized food products not have standards as their safety parameters are either not known or not yet ascertained Presently FSSAI has standardized only 380 articles of food in 16 categories so all other foods require product approval if they are not listed among these 380 food items FSSAI is working to standardize another 12,000 more foods […] Traditional foods also not require product approval as they are being consumed for centuries in India The ingredients and preparation methods are well known and this guarantees their safety If, however, traditional foods use any new ingredients or food additive or new technologies in preparation, they need product approval Foods Imported into India have to follow the FSS Act, Rules and Regulations If the food articles are standardized, the importer only needs a FSSAI license to import them The importer also needs to comply with FSSAI regulations for sale and distribution of the food products If a new or unknown food article is introduced for import, it is considered non-standardized and requires product approval under the §22 of the FSS Act, 2006 The FSS Act, 2006 does not apply to foods being exported out of India Exporters not require FSSAI product approval as these food products are not sold to Indian consumers Non-standardized food products, awaiting product approval, are assessed for safety in four categories To expedite product approval, a 90-day outer limit is now in place for completion of the application review process However, if the product is referred to the Scientific Panel for further scrutiny, the time limit could be extended The 90-day time limit has three, 30-day cycles that constitute the various application review stages […] New Draft Regulations have been formulated by FSSAI Of special interest is §22 of the FSS Act, which deals with ‘Nutraceuticals, Functional Foods, Novel Foods, and Health Supplements.’ For the first time regulations have been Environmental Policy and Public Health proposed for this category of foods If these products propound nutritional or medicinal benefits they need to have sound scientific evidence The products must not contain either steroids or psychotropic drugs Ingredients like vitamins and minerals must conform to the recommended dietary allowances for Indians, as proposed by the Indian Council of Medical Research” [47] 10.4.4 U.S Global Food Security Act, 2016 In a bipartisan action between the U.S Congress and the Obama administration, the Global Food Security Act of 2016 (H.R 1567) was enacted and signed into law by President Obama This bill requires the President to develop and implement a Global Food Security Strategy to promote global food security, resilience, and nutrition The key sections of the statute are as follows [48]: (Sec 2) This section specifies that it is in the U.S national security interest to promote global food security, resilience, and nutrition, consistent with national food security investment plans through programs and activities that: • Accelerate inclusive, agricultural-led economic growth that reduces global poverty, hunger, and malnutrition; • Increase the productivity, incomes, and livelihoods of small-scale producers; • Build resilience to food shocks among vulnerable populations and households while reducing reliance upon emergency food assistance; • Create an environment for agricultural growth and investment; • Improve the nutritional status of women and children; • Align with and leverage U.S strategies and investments in trade, economic growth, science and technology, agricultural research and extension, maternal and child health, nutrition, and water, sanitation, and hygiene; • Strengthen partnerships between U.S and foreign universities that build agricultural capacity; and • Ensure the effective use of taxpayer dollars in achieving these objectives (Sec 3) This section sets forth definitions that apply to this bill (Sec 4) The President must coordinate a whole-of-­ government strategy to promote global food security, resilience, and nutrition, consistent with national food security investment plans This section specifies required goals and criteria for the strategy The President must coordinate the efforts of federal departments and agencies to implement the strategy by establishing: (1) monitoring and evaluation systems, coherence, and coordination across federal departments and agencies; and (2) platforms for regular consultation and collaboration with key stakeholders and congressional committees [48] 275 Food Safety and Security The USDA will have major responsibilities for implementation of this law, with the law’s impacts to be assessed in subsequent years Perspective: The food safety policies of the EU, China, and India all illustrate the importance that is given to preventing the distribution of unsafe food to populations within their borders While this section has provided summaries of the operative food safety laws and regulations, the actual implementation of these policies is a matter for performance by designated authorities These three sets of food safety policies share sub-policies of registration of foods imported into the respective countries, reviews of new food products, labeling of foods, and reporting of adverse effects to food authorities 10.5  STATE OF FOOD SECURITY IN THE U.S Even though the U.S is an affluent country in many respects, including food production, the country’s disparities in income and cultural structure have manifested in food insecurity for a portion of the country’s population Put simply, hunger exists in the U.S The USDA conducts surveys of food patterns in the U.S From these surveys, the USDA reports that most U.S households have consistent, dependable access to enough food for active, healthy living—they are food secure But a minority of American households experience food insecurity at times during the year, meaning that their access to adequate food is limited by a lack of money and other resources USDA’s food and nutrition assistance programs increase food security by providing low-income households access to food, a healthful diet, and nutrition education The USDA also monitors the extent and severity of food insecurity in U.S households through an annual, nationally representative survey Reliable monitoring of food security contributes to the effective operation of the federal food assistance programs, as well as that of private food assistance programs and other government initiatives aimed at reducing food insecurity The survey report presents statistics covering households’ food security, food expenditures, and use of federal food and nutrition assistance [38] Key findings in the report for 2014 include: • The estimated percentage of U.S households that were food insecure remained essentially unchanged from 2013 to 2014; however, food insecurity was down from a high of 14.9% in 2011 The percentage of households with food insecurity in the severe range— described as very low food security—was unchanged • In 2014, 86.0% of U.S households were food secure throughout the year The remaining 14.0% (17.4 million households) were food insecure Food-insecure households (those with low and very low food security) had difficulty at some time during the year providing enough food for all their members due to a lack of resources The changes from 2013 (14.3%) and 2012 (14.5%) to 2014 were not statistically significant; however, the cumulative decline from 14.9% in 2011 was statistically significant • In 2014, 5.6% of U.S households (6.9 million households) had very low food security, unchanged from 5.6% in 2013 In this more severe range of food insecurity, the food intake of some household members was reduced and normal eating patterns were disrupted at times during the year due to limited resources • Children were food insecure at times during the year in 9.4% of U.S households with children Children were food inse(3.7 million housecure at times during 2014 holds), essentially in 9.4% of U.S households unchanged from 9.9% with children (3.7 million in 2013 These househouseholds) These households were unable at holds were unable at times times during the year during the year to provide to provide adequate, adequate, nutritious food for nutritious food for their children their children [38] Food insecurity in the U.S has healthcare consequences A study by researchers at the Boston University School of Medicine used data from the USDA, Census Bureau, and research on food security journal publications between 2005 and 2015 to estimate these health care costs [49] The investigators examined the costs of treating diseases and health conditions associated with household food insecurity They included earnings lost when people took time off work because of these illnesses or to care for family members with illnesses related to food insecurity The investigators estimated that the absence of food security in the U.S carries enormous healthcare costs, more than $160 billion in 2014 In comparison, this figure is about five times the whole year 2016 budget request of the U.S National Institutes of Health, the country’s foremost federal health research agency 10.6  GLOBAL STATE OF FOOD SECURITY In 2015 the FAO released its annual summary of global food security [50] The FAO reported “About 793 million people are undernourished globally, down 167 million over the last decade, and 216 million less than in 1990–1992 The decline is more pronounced in developing regions, despite significant population growth In recent years, progress has been hindered by slower and less inclusive economic growth as well as In 2015 FAO reported political instability in some “About 793 million people developing regions, such as are undernourished globally, Central Africa and western down 167 million over the Asia last decade, and 216 million The year 2015 marked less than in 1990–1992 The the end of the monitoring decline is more pronounced period for the Millennium in developing regions” [50] Development Goal (MDG) 276 targets (Chapter 2, Section 2.6.4) For the developing regions as a whole, the share of undernourished people in the total population has decreased from 23.3% in 1990–1992 to 12.9% Some regions, such as Latin America, the east and south-eastern regions of Asia, the Caucasus and Central Asia, and the northern and western regions of Africa have made fast progress Progress was also recorded in southern Asia, Oceania, the Caribbean, and southern and eastern Africa, but at too slow a pace to reach the MDG 1c target of halving the proportion of the chronically undernourished A total of 72 developing countries out of 129 have reached the MDG 1c hunger target Most enjoyed stable political conditions and economic growth, often accompanied by social protection policies targeted at vulnerable population groups For the developing regions as a whole, the two indicators of MDG 1c—the prevalence of undernourishment and the proportion of underweight children under 5 years of age—have both declined” [50] Perspective: These FAO data are encouraging in the sense that global progress is occurring in nations’ providing levels of food security But the report also is discouraging because the FAO estimates that 793 million people still lack adequate food nourishment For sake of perspective, this number is approximately the 2016 combined populations of the U.S., Indonesia, and Brazil [51] As will be described in this section, several factors are contributing to food insecurity in areas of the world 10.6.1 Threats to Food Security As noted in the prior section, according to FAO data global progress has been made in achieving food security, especially in developing nations Further encouraging data about global production of food came from a study conducted by researchers at the Potsdam Institute for Climate Impact Research in Germany [60] The researchers were interested in the relationship between food waste and the waste’s generation of GHGs This study provides a systematic approach to estimate consumer level food waste on a country scale and globally, based on food availability and requirements The study revealed that in the year 2010, food availability was 20% higher than was required on a global scale Surplus between food availability and requirements of a given country was considered as food waste The global food requirement changed from 2300 kcal/cap/day to 2400 kcal/cap/day during the last 50 years, while food surplus grew from 310 kcal/cap/day to 510 kcal/ cap/day Similarly, GHG emissions related to the food surplus increased from 130 Mt CO2eq/year to 530 Mt CO2eq/year, an increase of more than 300% Moreover, the global food surplus may increase up to 850 kcal/cap/day, while the total food requirement will increase only by 2%–20% by 2050 Consequently, GHG emissions associated with the food waste may also increase tremendously to 1.9–2.5 Gt CO2eq/year Reflection on the FAO report and the Potsdam study leads to the conclusion that food security is greatly influenced by food distribution systems Put into different words, surplus food isn’t getting to those in need Moreover, there are many factors that contribute to lack of food security domestically and globally Six of these factors will be discussed herein As Environmental Policy and Public Health will be evident, all six are factors derivative of anthropogenic causes 10.6.1.1  Human Population Growth and Food Security The human population continues to increase, both in numbers and complexity of social structures Although some disagreement exists regarding population forecasts, there is no disagreement that the 2016 world human population of approximately 7.3 billion will increase by billions during the twenty-first century For the purposes of this book, population estimates developed by the UN will be utilized, “Currently, the world population continues to grow though more slowly than in the recent past Ten years ago, world population was growing by 1.24% per year Today, it is growing by 1.18% per year or approximately an additional 83 million people annually The world population is projected to increase by more than one billion people within the next 15 years, reaching 8.5 billion in 2030, and to increase further to 9.7 billion in 2050 and 11.2 billion by 2100” [52] Further, nine countries are expected to make up half of the world’s population growth between now and 2050: India, Nigeria, Pakistan, Congo, Ethiopia, Tanzania, the U.S., Indonesia, and Ghana Africa has the world’s highest rate of population growth [52] This projected increase in population presents numerous sociopolitical questions, not the least of which is, “Will there be enough food?” In consideration of this question, FAO concluded in 2009, “Political turmoil, social unrest, civil war and terrorism could all be on the table unless the world boosts its food production by 60% come mid-century, the UN’s main hunger fighting agency has warned The world’s population is expected to hit billion people by 2050, which, coupled with the higher caloric intake of increasingly wealthy people, is likely to drastically increase food demand over the coming decades […] Exacerbating this problem is a convergence in diets worldwide, with reliance on an ever smaller group of crops leaving global food supplies increasingly vulnerable to inflationary pressure, insects and disease” [53] The FAO notes that progress has been made in the battle against global hunger, with vegetable production in Asia and the Pacific—where more than three-quarters of the world’s vegetables are grown—increasing by 25% over the last decade However, FAO estimates that 842 million people in the world remain undernourished, with nearly two-thirds of them living in the Asia-Pacific region One in four children under the age of 5 years is stunted due to malnutrition To combat the problem, FAO has outlined two primary options: increasing arable land areas as well as productivity rates A lack of available arable land and more sluggish growth rates in staple crops have complicated efforts to bolster these two pillars of food security Over the past 2 years, productivity rates for rice and wheat have hovered around 0.6%–0.8% Those rates would have to stabilize around 1% in order to offset serious shortages [53] “Environmentalists have also urged better food distribution methods In February, the FAO, World Bank and World Resources Institute estimated that the world is losing 25%– 33% of the food it produces—nearly billion metric tons Food Safety and Security More efficient agricultural production, better means of storing food and biologically diverse, local food systems less susceptible to global changes have also been proposed as solutions to help tackle the growing threat of food insecurity” [54] Increased human population has contributed to greater interconnectivity between food-importing and food-exporting nations This interconnectivity has been investigated by researchers interested in the effects of disruptions (e.g., climate change) on food security In one investigation, by Columbia University researchers annual staple food production and trade data from 1992 to 2009 were used to analyze the changing properties of the global food system “Over the 18-year study period, we show that the global food system is relatively homogeneous (85% of countries have low or marginal food self-sufficiency) and increases in complexity, with the number of global wheat and rice trade connections doubling and trade flows increasing by 42% and 90%, respectively The increased connectivity and flows within these global trade networks suggest that the global food system is vulnerable to systemic disruptions […] To test this hypothesis, we superimpose continental-scale disruptions on the wheat and rice trade networks We find greater absolute reductions in global wheat and rice exports along with larger losses in network connectivity as the networks evolve due to disruptions in European wheat and Asian rice production Importantly, our findings indicate that least developed countries suffer greater import losses in more connected networks through their increased dependence on imports for staple foods” [55] A separate investigation was organized by Lloyd’s of London, a global insurance company The company was interested in the impacts of serious disruptions in food security in regard to the impact on insurance claims [56] “Research for the project was led by Anglia Ruskin University’s GSI, and based on its GRO modelling initiative The report explores the scenario of a near-term global food supply disruption, considered plausible on the basis of past events, especially in relation to future climate trends The global food system, the authors find, is ‘under chronic pressure to meet an ever-rising demand, and its vulnerability to acute disruptions is compounded by factors such as climate change, water stress, ongoing globalisation and heightening political instability” [57] Lloyd’s scenario analysis shows that food production across the planet could be significantly undermined due to a combination of just three catastrophic weather events, leading to shortfalls in the production of staple crops, and ensuing price spikes In the scenario, which is ‘set in the near future,’ wheat, maize and soybean prices ‘increase to quadruple the levels seen around 2000,’ while rice prices increase by 500% This leads to rocketing stock prices for agricultural commodities, agricultural chemicals and agriculture engineering supply chains, leading to […] geopolitical mayhem as well as escalating terrorism and civil unrest” [57] While this report raises troubling issues of global import, it is important to understand that the model used in the research did not include any sociopolitical adjustments made over time that could mitigate the model’s projected dire outcomes 277 As described in this section, food security will need to adjust for increased numbers of humans Food security specialists have begun to reflect on what adjustments will be needed and how to achieve them An interesting reflection comes from a group of water scientists who stated that the world’s population may have to switch almost completely to a vegetarian diet over the next 40 years to avoid catastrophic food shortages Humans now derive about 20% of their protein from animal-based products; this figure may need to decrease to just 5% in order to feed the globe’s increased population, expected to grow by two billion by 2050 Animal protein-rich food consumes 5–10 times more water than a vegetarian diet Water scientists recommended adopting a vegetarian diet as one option to increase the amount of water available to grow more food in an increasingly climate-erratic world [58] 10.6.1.2  Food Waste A contributor to food insecurity is wasting of food Food wastage is a major problem, especially in countries that are ill equipped to adequately grow, harvest, transport, distribute, and utilize food supplies Figure 10.2 shows an example of food wastage FAO has provided estimates of the globe’s food wastage [59]: • “The global volume of food wastage is estimated at 1.6 billion tons of “primary product equivalents.” Total food wastage for the edible part of this amounts to 1.3 billion tons • The carbon footprint of food wastage is estimated at 3.3 billion tons of CO2 equivalent of GHGs released into the atmosphere per year • Similarly, 1.4 billion hectares of land—28% of the world’s agricultural area is used annually to produce food that is lost or wasted • A low percentage of all food wastage is composted; much of it ends up in landfills, and represents a large part of municipal solid waste Methane emissions from landfills represent one of the largest sources of GHGs emissions from the waste sector • Developing countries suffer more food losses during agricultural production, while in middle-and FIGURE 10.2  Example of food waste (From UN FAO (UN Food and Agriculture Organization), Food wastage: Key facts and figures, Office of Director-General, Rome, Italy, 2016.) 278 high-income regions food waste at the retail and consumer level tends to be higher • The direct economic consequence of food wastage (excluding fish and seafood) is estimated at $750 billion annually” [59] Adding to these FAO data are the findings from a study by researchers at the Potsdam Institute for Climate Impact Research in Germany [60] As previously discussed, the researchers were interested in the relationship between food waste and the waste’s GHGs The study revealed that in the year 2010, food availability was 20% higher than was required on a global scale Similarly, GHG emissions related to the food surplus increased from 130 Mt CO2eq/year to 530 Mt CO2eq/year, an increase of more than 300% Moreover, the global food surplus may increase up to 850 kcal/cap/ day, while the total food requirement will increase only by 2%–20% by 2050 Consequently, GHG emissions associated with the food waste may also increase tremendously to 1.9–2.5 Gt CO2eq/year [60] Other aspects of food waste are described in Chapter 12 (Waste Generation and Management) 10.6.1.3  Climate Change According to a modeling study conducted by University of Oxford investigators, the effects of climate change on food security could be consequential [61] The investigators linked an agricultural modeling framework, the International Model for Policy Analysis of Agricultural Commodities and Trade, to a comparative risk assessment of changes in fruit and vegetable consumption, red meat consumption, and bodyweight for deaths from coronary heart disease, stroke, cancer, and an aggregate of other causes of mortality The model was used to calculate the change in the number of deaths attributable to climate-related changes in bodyweight and diets The model projected that by year 2050, climate change will lead to perperson reductions of 3.2% (SD 0.4%) in global food availability, 4.0% (0.7%) in fruit and vegetable consumption, and 0.7% (0.1%) in red meat consumption These changes will be associated with 529,000 climaterelated deaths worldwide (95% CI = 314,000–736,000), representing a 28% (95% CI = 26–33) reduction in the number of deaths that would be avoided because of changes in dietary and weight-related risk factors between years 2010 and 2050 Twice as many climate-related deaths were associated with reductions in fruit and vegetable consumption than with climate-related increases in the prevalence of underweight individuals The model predicted that most climate-related deaths would occur in South and East Asia Adoption of climate-stabilization pathways would reduce the number of climate-related deaths by 29%–71%, depending on their stringency [61] In a different investigation, major “shocks” to global food production were investigated Examples of major shocks would be protracted droughts, massive flooding, and prolonged high air temperatures The study found these major shocks will be three times more likely within 25 years because of an increase in extreme weather brought about by global warming The likelihood of such a shock, where production of the world’s four Environmental Policy and Public Health major commodity crops (maize, soybean, wheat, and rice) falls by 5%–7%, is currently once-in-a-century But such an event will occur every 30 years or more by 2040, according to the study by the UK–US Taskforce on Extreme Weather and Global Food System Resilience [62] Such shocks could plausibly see the UN’s food price index—which measures the international price of major commodities—rise by 50%, based on an analysis of how the market would likely respond Increased food production volatility will mostly affect those developing countries experiencing high levels of poverty and political instability, such as countries in the Gulf or Sub-Saharan Africa As climate change causes temperatures to rise even higher in the second half of the century, even more serious food shocks—where production drops by up to 10%—are also likely to occur much more often by the year 2070 [63] Examples of loss of food security due to climate change are already present For instance, UN bodies, international aid agencies, and governments have cautioned that droughts and floods triggered by one of the strongest El Niño weather events ever recorded have left nearly 100 million people in southern Africa, Asia, and Latin America facing food and water shortages and vulnerable to diseases including Zika [64] For example, in Mozanbique, El Niño, the natural weather phenomenon that upturns normal weather patterns every few years in southern Africa, caused the country to come to the end of another dry rainy season 2016 For the second consecutive year, the town of Mbalavala’s maize fields were empty and the soil in vegetable gardens was like sand The small amount of water from an emergency borehole must be shared between cattle and people Mbalavala and 170,000 people in several hundred similar villages in Gaza and Inhambane, Mozambique’s two most vulnerable provinces survived in 2016 and 2017 due to British food aid [65] Lack of food security poses major economic and social consequences beyond that of hunger and insufficient nutrition For instance due to widespread food shortages A global food source, resulting from a prolonged marine life, will be affected drought, Zimbabwe has by climate change, which been forced to seek $1.6 is postulated to seriously billion in aid from global impair fish stocks A 2015 aid agencies to help pay for study lists climate change as grain and other food [66] one of the main reasons for Regarding social impacts the decline of marine speof food insecurity, the UN’s cies in the last 30 years World Food Programme noted that women and children are bearing the brunt of a malnutrition and hunger crisis in Mauritania, while tens of thousands of Malian refugees face food shortages due to a lack of funding In 2015 malnutrition reached emergency levels in six  of  Mauritania’s 15 regions, affecting at least one in six people, and the proportion of malnourished children under five across the country rose to 14% from 10% in 2014 Pregnant women were at special risk [67] Another source of food, marine life, will be affected by climate change, which is postulated to seriously impair fish stocks The Marine Stewardship Council cites a 2015 study Food Safety and Security that lists climate change as one of the main reasons for the decline of marine species in the last 30 years Three billion people rely on fish as their major source of protein Fish and aquaculture assure the livelihoods of 12% of the world’s population, creating economic benefits of $ 2.9 trillion USD per year Climate change affects fish and fisheries through the following factors: ocean acidification, habit loss due to temperature increase, extreme, unpredictable weather events; and rising sea levels These changes affect fisheries worldwide, but the impacts are likely to be particularly damaging for fisheries in developing countries [68] 10.6.1.4  Loss of Pollinators Another factor that affects food security is the decline in numbers and diversity of pollinators Farmers and gardeners know the vital value of the creatures that serve Nature as pollinators of flora, trees, and others that require pollen transfer in order to reproduce Loss of pollinators portends loss of food sources and diminished food security The Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services has reviewed the current situation in regard to loss of pollinators Excerpts from their findings follow: More than three quarters of the leading types of global food crops rely to some extent on animal pollination for yield and/or quality Pollinator-dependent crops contribute up to 35% of global crop production volume Given that pollinator-dependent crops rely on animal pollination to varying degrees, it is estimated that 5%–8% of current global crop production, with an annual market value of $235 billion–$577 billion worldwide, is directly attributable to animal pollination The vast majority of pollinator species are wild, including more than 20,000 species of bees, some species of flies, butterflies, moths, wasps, beetles, thrips, birds, bats, and other vertebrates Wild pollinators have declined in occurrence and diversity (and abundance for certain species) at local and regional scales in North West Europe and North America The International Union for Conservation of Nature Red List assessments indicates that 16.5% of vertebrate pollinators are threatened with global extinction (increasing to 30% for island species) Regional and national assessments indicate high levels of threat for some bees and butterflies In Europe, 9% of bee and butterfly species are threatened and populations are declining for 37% of bees and 31% of butterflies (excluding data deficient species, which includes 57% of bees) Where national Red List assessments are available, they show that often more than 40% of bee species may be threatened The abundance, diversity, and health of pollinators and the provision of pollination are threatened by direct drivers that generate risks to societies and ecosystems Threats include land use change, intensive 279 agricultural management and pesticide use, environmental pollution, invasive alien species, pathogens, and climate change [69] Perspective: Declines in the prevalence of pollinators portends decreased food production at a time when global food diversity is a challenge But as with other threats to food security, efforts in conservation, research on causes of declines, and policies on protection of pollinating species will be necessary 10.6.1.5  Soil Security and Arable Land Humankind’s harvesting of plants grown in soil has sustained our and other species for eons Over time, humans learned how to cultivate soil, sow seeds or transplant seedlings, harvest crops, and consume the food grown for that purpose In other words, humans learned how to farm Unfortunately, as with other threats to food security, there are problems globally with the condition and amount of arable soil Of note, 40% of the planet’s land is now devoted to human food production, up from 7% in 1700 In a study by the University of Sheffield’s Grantham Centre for Sustainable Futures, researchers assert that the world has lost a third of its arable land in the past 40 years due to erosion or pollution Their study calculated that nearly 33% of the world’s adequate or high-quality foodproducing land has been lost at a rate that far outstrips the pace of natural processes to replace diminished soil Researchers attribute the continual ploughing of fields, combined with heavy use of fertilizers, as factors in the global degradation of soils They observed that erosion is occurring at a pace of up to 100 times greater than the rate of soil formation This is a dire warning, since it takes around 500 years for just 2.5 cm of topsoil to be created amid unimpeded ecological changes [70] Farming practices and land use are being scrutinized for their impact on the environment and public health In particular, what is called “intensive agriculture” has become the subject of debate amongst agriculturalist, environmentalists, and public health specialists Intensive farming is an agricultural intensification and mechanization system that aims to maximize yields from available land through various means, such as heavy use of pesticides and chemical fertilizers According to one environmental source, this intensification and mechanization has also been applied to the raising of livestock with billions of animals—such as cows, pigs, and chickens— being held indoors in what have become known as factory farms Intensive farming practices produce more—and less expensive—food per acre and animal, which has helped feed an ever increasing human population and may prevent surrounding land from being converted into agricultural land However, intensive farming has become a major threat to the global environment through the loss of ecosystem services and as a contributor to global warming [71] Furthermore, intensive farming kills beneficial insects and plants, degrades and depletes the very soil it depends on, creates polluted runoff and clogged water systems, increases susceptibility to flooding, causes the genetic erosion of crops and livestock species around the world, decreases biodiversity, destroys natural habitats, and, significant contributors to the build-up of 280 GHGs in the atmosphere However, certain aspects of intensive farming have helped ease climate change by helping boost yields in already cleared land that may be under-performing, which prevents the clearing of additional land There are both pros and cons to intensive farming, but compared to the disadvantages, the advantages are fewer The world is in transition from an era of food abundance to one of food insecurity With 40% of the planet’s land devoted to human food production, up from 7% in 1700, and as the world’s demand for food rises 70% by 2050, feeding a rapidly growing human population can and should be done by adopting a sustainable food production approach that can run indefinitely with minimized impacts on the environment, animal welfare and human health [71] Perspective: As the world’s human population grows, demands on food security will correspondingly increase The production of food supplies will need to adapt to population increase, but to other realities of the twenty-first century, such as climate change Land use and farming practices, as well as reliance on fish stocks and ocean seafood, will continue to be stressed Two policies, conservation and sustainability, will need to be globalized if food insecurity is to be avoided 10.6.1.6  Genetically Modified Food Food supplies are already being influenced by increased numbers of genetically modified foods, as will be discussed in detail in Chapter 15 As discussed there, controversy has accompanied this development The nature of policies and attendant controversies about genetically engineered (GE) food are discussed in Chapter 15, but suffice it to say here that GE food is present in the food chain of the U.S and many other countries In this section are three examples of this trend In May 2015 the FDA approved potatoes that won’t bruise and apples that won’t brown The agency approved both GE foods, characterizing them as safe and nutritious as their conventional counterparts [72] Also in 2015, the FDA gave approval of genetically modified salmon for consumer use This marked the first GE food animal endorsed for sale in the U.S [73] As the third example, in January 2015 the USDA granted “nonregulated” status to genetically modified cotton and soybean plants These are herbicide-tolerant crops to be used with a new herbicide intended to fight problematic weed resistance on farm fields [74] For all three examples, considerable criticism arose in reaction to the approvals of these GE foods It remains to be seen whether any of these approved GE foods will become widespread in commercial food supplies As a global issue, some countries (e.g., Scotland and Germany) have eschewed GE crops and produce based on concerns from farmers and food consumers [75] Environmental Policy and Public Health provide food and assistance Further, resources are needed for improving land and water security Some representative food security resources are described herein 10.6.2.1  UN World Food Programme The WFP is the world’s largest humanitarian agency fighting hunger worldwide The WFP is part of the UN system and is voluntarily funded It was established in 1961 by the U.N.’s FAO and the UN General Assembly The WFP “pursues a vision of the world in which every man, woman and child has access at all times to the food needed for an active and healthy life” [76] The WFP addresses both the humanitarian and development needs of human populations in need of assistance In emergencies, it distributes food where it is needed to save the lives of victims of war, civil conflict, and natural disasters After the cause of the emergency abates, the WFP focuses on development, using food to help communities rebuild their lives A review conducted in 2012 of the WFP programs found that on average, the agency annually reaches more than 80 million people with food assistance in 82 countries [77] For sake of perspective, the Democratic Republic of Congo, Germany, Iran, and Turkey each have a human population of approximately 80 million people [51] 10.6.2 Resources for Enhancing Food Security Famine Early Warning Systems Network 10.6.2.2  The Famine Early Warning Systems Network (FEWS NET) is a leading provider of early warning and analysis on food insecurity The FEWS was created by the U.S Agency for International Development (USAID) in 1985 to help decisionmakers plan for humanitarian crises “USAID is the lead U.S Government agency that works to end extreme global poverty and enable resilient, democratic societies to realize their potential” [78] FEWS NET provides evidence-based analysis on some 35 countries Implementing team members include NASA, NOAA, USDA, and USGS, along with Chemonics International Inc and Kimetrica Analysts and specialists in 22 field offices work with U.S government science agencies, national government ministries, international agencies, and NGOs to produce forward-looking reports on more than 36 of the world’s most food-insecure countries FEWS NET’s products include: monthly reports and maps detailing current and projected food insecurity, timely alerts on emerging or likely crises, specialized reports on weather and climate, markets and trade, agricultural production, livelihoods, nutrition, and food assistance [78] FEWS NET works with the humanitarian and development communities, participating in global committees to improve classification, remote sensing, and other aspects of food security analysis They also support and conduct training and capacity-building for national early warning systems, weather services, and other agencies Although global production of food exceeds the requirements of the 2016 world population of approximately 7.3 billion people, there remain millions of people who suffer nutritional deficiencies, and famines occur due to catastrophic weather events In times of food crisis, resources must be mobilized to 10.6.2.3  Natural Resources Conservation Service Except for plant food grown via hydroponics, arable soil is the environmental medium on which the world’s food is grown In a planet experiencing climate change and human 281 Food Safety and Security population growth, conservation of soil and water is vital to food security On April 27, 1935 the U.S Congress passed Public Law 74-46, in which it recognized that “the wastage of soil and moisture resources on farm, grazing, and forest lands… is a menace to the national welfare” and established the Soil Conservation Service (SCS) as a permanent agency in the USDA In 1994, SCS’s name was changed to the Natural Resources Conservation Service to better reflect the broadened scope of the agency’s concerns In doing so, Congress reaffirmed the federal government’s commitment to the conservation of the nation’s soil and water resources Farmers, ranchers, and forest landowners can receive financial assistance from NRCS to make improvements to their land NRCS conservationists provide technical expertise and conservation planning for farmers, ranchers, and forest landowners wanting to make conservation improvements to their land The NRCS provides incentives to farmers, ranchers, and forest landowners wanting to put wetlands, agricultural land, grasslands, and forests under long-term easements Local USDA service centers are located across the U.S The NRCS offers a variety of information, tools, and resources related to conservation [79] 10.6.2.4  Required Agricultural Practices (Vermont) Food security is intertwined with soil security Soil barren of essential nutrients and bacteria for grown of plants will not be part of the food chain Farmers have always known this truth and over the ages learned the principles of soil security One U.S state, Vermont, has enacted legislation for purpose of enhancing soil security In 2006 the Vermont Legislature enacted Bill 6, which mandates the development of regulations for use in protecting water quality and soil security Specifically, “in accordance with 6 V.S.A §§ 4810a and 4810, these regulations are intended to establish statewide requirements designed to improve water quality in the State and to assure practices on all farms that eliminate adverse impacts to water The Required Agricultural Practices Regulations are farm management techniques that will conserve and protect natural resources, maintain the health and productivity of soils and protect the State’s waters from nutrient loading associated with farming activities Persons engaged in farming who are in compliance with these practices shall be presumed to not have a discharge of agricultural pollutants to waters of the State” [80] The Accepted Agricultural Practices are standards designed to reduce nonpoint source pollutant discharges through implementation of improved farming techniques Following is a précis of some of the key farming practices [81]: • Discharges: No direct waste discharge to surface water • Nutrient and Pesticide Application: Apply according to soil tests taken every 5 years • Soil Cultivation: Manage crop fields so that soil erosion loss does not exceed tons per acre (according to Natural Resource Conservation Service standards) […] • Buffer Zones: Maintain 10′ buffers of vegetation, 25′ at runoff points; No manure application in buffer zone; Fertilize and tilling only for maintenance; May be harvested […] Perspective: Farming and agricultural methods and practices were—and to a considerable extent are still—very much independent of government regulations and local ordinances Indeed, many chose farming as a profession because of this kind of freedom But as the human population increased in numbers and complexity, farming became more and more a business, a change that brought business practices and social policy-making One example: farmers who chose to use pesticides on crops found that government intervened by controlling the choice of pesticides and their application 10.7  HAZARD INTERVENTIONS A number of hazard interventions are necessary if food safety and security are to be assured As presented in this chapter, breakdowns in food safety can have serious consequences As noted, annually in the U.S one of every six Americans will experience a foodborne illness; 128,000 are hospitalized, and 3000 die This public health toll occurs in a country with a strong food safety history and legislation Globally, it is estimated that approximately 800 million people suffer from undernourishment Some of the interventions that could reduce the hazard of unsafe food and food insecurity are as follows Food safety policies should be adopted and implemented at all levels of the food supply and consumption chain In particular, food inspections and permits for food services are efficacious policies for prevention of foodborne illnesses The FDA FSMAct of 2011 is an example of a comprehensive food safety statute, with prevention of illness as the operative policy Because a significant proportion of foodborne illness is due to inadequate preparation of food in home residences, education about food preparation is advocated This should be a component of school curriculums Threats to global food security should be understood and appropriate policy actions taken In particular, use of existing technology for enhancing food security should be encouraged as a matter of global food policy For example, adoption of the new generation of temperature and humidity controlled warehouses and silos in the least developed countries will enhance food security [81a] The two primary threats to global food security are continued increases in global human population and the impacts of climate change Resources such as the UN World Food Programme will require both financial and policy support in order to overcome food shortages in geographic areas of famine and undernourishment And international efforts to mitigate climate change will be necessary if global food insecurity is to be prevented 282 Because water security and food security are intimately interrelated, policies to protect and conserve water supplies are necessary for food security Programs and policies to reduce food waste are encouraged in order to mitigate a source of GHGs and to diminish the impact on land and water based food sources Programs and policies for purpose of conserving land and ocean quality from the impacts of unwise waste disposal methods are encouraged Individuals, who have the choice, should gravitate to eco-friendly food consumption In particular, food consumption that contributes to climate change reduction is considered eco-friendly Eating less food made of animal products and preferring organic food are both eco-friendly [82] Individuals have a responsibility for ensuring that their food supply is healthful and is adequately prepared for consumption 10.8  SUMMARY Described in this chapter are three major federal environmental health statutes that are intended to enhance food safety in the U.S The FDCAct, which dates from 1906, as public health policy prohibits the distribution of adulterated and mislabeled foods, drugs, cosmetics, and medical devices Similarly, as public health policy, the FMIAct, which also dates from 1906, requires that meat and meat products are subject to federal inspection before entering the human food supply The third major U.S food safety statute is the FDA Food Safety Modernization Act of 2011, which is oriented to prevention of foodborne illness and other potential hazards, rather than responding to them All three federal statutes adopt a policy of federal government involvement in inspection of food quality prior to the release of food products into commerce and for human consumption By this process, adulterated or impure food is interdicted before entering the food chain This, of course, is an example of the core principle of public health, prevention of disease and disability In distinction to other environmental hazards, government involvement in food safety is rather limited and involves multiple partners in the public health effort to prevent foodborne illnesses To be more specific, food safety requires the active participation of government, private sector entities, and individual food consumers to a degree not found in issues of air pollution, water contamination, toxics control, and waste management Indeed, U.S states have food quality responsibilities that exceed those of the federal government, as illustrated in this chapter by the state of Georgia’s food quality statute Moreover, private sector entities such as food producers, transporters, and food servers (e.g., restaurants) have quite significant roles and responsibilities for protecting against foodborne illness However, in distinction to other environmental hazards, individuals play the critical role in protecting themselves against foodborne illness For public Environmental Policy and Public Health health purposes, how individuals prepare food in the home is critical After all, even the most wholesome food, if prepared under unsanitary conditions, has the portent to cause human illness Food security was described in this chapter as an issue complementary to food safety Presented here were several factors, such as global population increase and climate change, as factors that will challenge global food security And as discussed in this chapter, food safety and security are also the domain of concern by the EU, China, and India 10.9  POLICY QUESTIONS Let’s consider the matter of food safety Should food safety be a concern of local health departments through inspections of restaurants and other places of commercial food service? If so, why? If not, why not? Assume you were recently hired by an urban municipal health department Your first assignment is to design a public health program to improve food safety in public establishments (a) Discuss the nature and impact of foodborne illness that would be of concern to your health department (b) Using this material, design a public health program to prevent foodborne illness, choosing any four elements of the eight elements shown in Figure 1.1 Use critical thinking, as described in Chapter 1, to the extent possible Summarize the public health benefits of the FMIAct Discuss the ethical implications, if any, of the Act The FDCAct, as amended, gives the FDA the authority to approve drugs to be placed into commerce Assume that the act did not exist, leaving the manufacturer solely responsible for the safety of their products Discuss the public health implications of this kind of market-driven arrangement Visit a local restaurant and look for a posted food inspection report Describe the impact, if any, on your patronage of the selected restaurant (a) What aspects of the food inspection report were of greatest importance to your decision? In your opinion, should food inspection reports be available to the public? If so, how? (b) Discuss the pros and cons of making restaurant inspection scores available to the public (c) Some county health departments post restaurant scores on the internet Using such a website, select a restaurant known to you and access its restaurant score and other background information Critique the adequacy of the restaurant inspection information made available to you As discussed in this chapter, states have a major responsibility for protecting the public against foodborne illnesses Discuss your state’s responsibilities for food safety Be specific in regard to which state agencies have specific responsibilities As discussed in the chapter, foodborne illnesses will annually affect about one in six Americans A substantial but unknown amount of illnesses 283 Food Safety and Security occur because of poor food preparation practices in the home Discuss some practical means of preventing foodborne illnesses caused by home food preparation Discuss the pros and cons of giving meat industry inspectors the authority to supplant government meat inspectors Consider the elements of your most recent meal Discuss the origins of each major food item In your discussion, include the geographic location from which each item originated 10 Discuss three ways that you personally can help reduce the global food shortage Be specific and elaborate on how your help would benefit those persons facing food insecurity 11 One food security source has predicted that global food shortages will inevitably lead to vegetarianism as a lifestyle Assume that this forecast is accurate Could you accept a vegetarian reliance as your choice? Discuss the ramifications of your choice 12 In 2016 the U.S FDA promulgated regulations that curtailed the administration of antibiotics in food sources In your opinion, was this necessary? Discuss the public health benefits of the FDA regulation Also discuss the economic impact of the FDA decision 13 Compare the food safety policies of China and India List three elements in common Discuss any element of significant difference, based on your knowledge of principles of public health 14 Your grandparents still reside on a farm that has been your ancestors’ home for five generations The farm is located in Vermont, which recently enacted a new law that mandates specific farming methods and practices These requirements will be an economic burden on your grandparents In an essay of appropriate depth discuss whether a state should enact this kind of mandate 15 A food expert has suggested that alternate forms of nonanimal protein will be required if global food insecurities are to be avoided One suggestion is to incorporate insects into the human diet Discuss how you would react to being served a beetle burger Discuss any ethical issues that would be a component of your reaction 16 Assume that you have volunteered to serve a charitable organization that raises funds and delivers food to people residing in areas of food insecurity Prepare a one page circular that could be used in your fundraising efforts 17 Assume that you attended a school that provided students with free breakfast and lunch meals funded by a government program Using Internet resources, prepare a two page analysis of the purpose, function, benefits, and decrements of a school meals program 18 Discuss the matter of global food security in the context of sustainable development Present you findings in an essay of appropriate depth Begin your essay by defining sustainable development and its tenets 19 This chapter includes nine potential hazard interventions Present two additional interventions that should be added to this list Justify your two contributed interventions with evidence of critical thinking 20 Congratulations! You have completed your diet of material in this chapter Well done! Please discuss the three most important lessons you learned Was your personal environmental health behavior changed by the content of this chapter? If so, how? If not, why not? REFERENCES FAO (UN Food and Agriculture Organization) 1996 World Food Summit Office of Director-General, Media Centre, Rome, Italy CFSAN 1981 The story of the laws behind the labels Part I 1906—The Federal Food, Drug, and Cosmetic Act Food and Drug Administration, Center for Food Safety and Nutrition, Silver Spring, MD CFSAN (Center for Food Safety and Nutrition, FDA) 1981 The story of the laws behind the labels Part II 1938—The Federal Food, Drug, and Cosmetic Act Food and Drug Administration, Center for Food Safety and Nutrition, Silver Spring, MD FDA (U.S Food and Drug Administration) 2016 What does FDA regulate? 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Health 11 1. 6 .1  Public Health Practice 13 1. 6 .1. 1 Organizational Capacity 13 1. 6 .1. 2 Workforce Competency 13 1. 6 .1. 3 Information/Communication... 14 1. 6 .1. 4 Surveillance 14 1. 6 .1. 5 Epidemic Investigation 14 1. 6 .1. 6 Laboratory Science 14 1. 6 .1. 7 Behavioral Science 15 1. 6 .1. 8 Public. .. 310 11 .5.3  World Health Assembly’s Resolution on Chemicals Management, 2 016 311 11 .6  Hazard Interventions 312 11 .7  Summary 313 11 .8  Policy