Food Hygiene and Global Health

IS IT SAFE TO EAT? MEDIA reports of contaminated food imported from China have aroused concerns about food safety and public health in the United States and worldwide. The United States and China have recently moved to tighten the control of food inspection and enforcement of food laws. In the 21st century, the global economy ties local markets to international markets on an unprecedented scale. The process of food production, processing, and transportation frequently passes through many nations. Contaminated food is thus not restricted to Chinese imports, but involves a dozen countries in Asia, Europe, and Latin America.1 Be that as it may, American consumers are rightly concerned about food imported from China. Does China have laws and regulations regarding food hygiene and safety? The answer is yes. Food safety in China is regulated by the Food Hygiene Law of 1995, which has 57 articles elaborating specific regulations governing food hygiene standards, hygiene of containers, packaging, utensils, and equipment, measures for food hygiene control, and legal responsibility for violations of the law.2 In the history of the People’s Republic of China, there have been several stages in the effort to safeguard food hygiene and public health. In our examination of the Chinese Public Health Collection at the National Library of Medicine, we found that food hygiene and safety was a central concern in the public health education and propaganda movements of the 1950s through the 1980s. Having examined over 3000 health posters, such as the one illustrated on this page, we observed that they constantly hammer into the viewers’ minds the visual messages: “pay attention to food hygiene” and “prevent diseases from entering through the mouth.”3 These public health posters emphasize simple hygienic methods—cleanliness, nutrition, exercises, and vaccination—for an inexpensive and highly effective program of disease prevention. Health posters instructed people to buy fresh fruits and vegetables, wash them with hot water if eaten raw, drink boiled water, and wash hands before meals and after using bathrooms. Many diseases, such as cholera and typhoid fever, were eliminated, and others, such as childhood diarrheal diseases, were greatly reduced. During the period of socialist reconstruction and revolution in the 1950s to 1970s, hygienic methods were often promoted with political slogans favoring increased production. Food hygiene was said to be directly linked to the health of workers and therefore their productivity. Being hygienic became a standard of exemplary behavior for both adults and children—part of being good, progressive, moral, modern, and civilized. Food hygiene, water hygiene, personal hygiene, environmental hygiene and sanitation, manure disposal and management, and eradication of flies, mosquitoes, and other pests were all part of the campaign to prevent infectious diseases among the people. “Carefully Carry Out the Five Sets of Four Rules of Hygiene in the Food Industry.” Produced by the Patriotic Health Movement Committee and the Health and Prevention Station of Qinghai Province, China. February 1964. Source. Prints and Photographs Collection, History of Medicine Division, National Library of Medicine. Official instruction in food hygiene and prevention of diseases culminated in the so-called “five four rules” (five sets of four rules each) issued by the Ministry of Health and the Ministry of Commerce of China on March 12, 1960, as a supplement to their Joint Announcement of Strengthening Hygienic Work in the Food Industry. The rules instructed people not to buy or sell bad food, to keep food safely stored, to keep food utensils clean, and to maintain good personal hygiene and environmental sanitation. The “four don’ts” were don’t buy, keep, use in cooking, or sell rotten foodstuffs; the “four separations” were to separate cooked food from raw, food from medicine, ready-made from half-cooked foods, and foods from untreated water. The “four processes” for cleaning food utensils were washing, scrubbing, rinsing, and sterilizing. The “four designations” for environmental sanitation were to designate people, material, time, and quality. Finally, the “four frequents” of personal hygiene were to frequently wash hands and cut fingernails, bathe and have haircuts, wash clothes and bedding, and change work clothes often. Until 1980, traditional methods of farming and food production dominated China’s state-run economy. However, beginning around 1980, when the market economy was introduced into agriculture, and chemicals began to be used in food production, new legal mechanisms were needed to deal with the changing economy. The first Chinese food hygiene law was enacted in 1982, which established governmental food inspections and gave all citizens the right to file charges in court reporting any violation of the law. The Chinese Ministry of Health printed 400000 posters to promote the new food hygiene law to the public (see poster on this page). The key points of the law included food hygiene regulations, clear labeling of ingredients and production dates, and criminal punishment for violations of the law. “Pictorial Explanation of the Food Hygiene Law of the People’s Republic of China.” Produced by the Patriotic Health Movement Committee of the Central Government and the Ministry of Health, China, circa 1982. Source. Prints and Photographs Collection, History of Medicine Division, National Library of Medicine. The supervision and enforcement of the food hygiene law proved an administrative challenge in China, because there was no central agency to coordinate such enforcement. Especially since the 1990s, greed for higher profits in China’s booming market economy, combined with the lack of effective inspection and law enforcement, and the abandonment of public health and hygiene educational campaigns, have all contributed to the worsening situation of food safety. China is now reaping the consequences. More than 30 000 people were reported to have died from food poisoning in China in 2001 and 2002.4 The central government finally established a Food and Drug Administration in 2003 as the central authority to supervise and administer food and drug safety. The execution of its former director, Zheng Xiaoyu, for corruption reveals both the serious failure to safeguard the public from harmful foods and drugs and the Chinese government’s desperate attempt to correct the situation. In a survey of Chinese opinion in early 2007, more than 65% of the respondents were concerned about food safety. In a global economy, contaminated food harms people without regard to national boundaries. The recent tainted food scandals have alerted both consumers and national governments to the issues of food safety. Indeed, we suggest that the time has come to create an international mechanism to guarantee standards for food hygiene and ensure the public’s health.