Briefly, hazard analysis is the assessment of the hazards that may be associated with a food commodity in a particular food processing establishment, with the final output of finding out which hazards are “significant” and have to be addressed in a HACCP (hazard analysis critical control points) plan. Risk assessment is more complex and requires the use of more sophisticated data analysis to characterize the risk for a given pathogen/food commodity combination. These are just very brief distinctions in concepts, but these terms have been stretched to mean a few other things. Yet the results are different. Here I would like to further explain my reasoning and emphasize that the use of technical terms can be confusing because basic terms, such as “hazard” and “risk,” are sometimes not clear in our minds.

There are large differences in the way the public and scientists look at and interpret risk. There are topics that consistently polarize opinions, and people tend to end up with extreme views. Keep in mind that I am referring to issues that are under the realm of science and are part of current scientific efforts or endeavors. There are some good examples of these topics and the division in the opinions between scientists and the public in the survey report published in January 2015 by the Pew Research Center. This survey included the public and scientists who are members of the American Association for the Advancement of Science. For instance, from the group of scientists surveyed, 87 percent thinks that climate change is due to human activities, while only 50 percent of the public surveyed thinks the same. When it comes to genetically modified organisms (GMOs), 88 percent of the scientists thinks they are safe to eat, while only 37 percent of the public thinks the same. There are no proven cases of any human getting sick or dying because of the consumption of commercial GMOs foods, yet we still have a high annual incidence of Salmonella associated with the consumption of food. Why do we ignore the basic science behind hazards in foods (e.g., bacteria), pay too much attention to perceived hazards, and choose to consume high-risk foods at all costs (e.g., uncooked burgers)? These contradictions and the lengths people go through to justify risky decisions have always fascinated me.

This large variation in the interpretation of risk among all of us applies to almost any field or topic, but I am careful in addressing hazards in foods. Whenever I have the chance, I make sure food processors understand that addressing hazards in foods is more in-depth than what we think it is. I mainly refer to “biological” hazards (bacteria, parasites, viruses, etc.), whose appearance is difficult to predict and distributions difficult to exactly mimic with the current probability models. Yet we have made important progress over the years. This progress is in part due to the application of HACCP, in which the first principle is to conduct a “hazard analysis,” and thanks to “risk assessment,” which is the science component of the risk analysis model applied to foods.

Over the past few years, I have included a dice game in my HACCP classes to explain the differences between hazard, a harmful event, and risk, the probability of an event occurring. I also make sure the definition of hazard includes the words “known” and “concrete” to frame the discussion. I try to make sure food processors understand that we are talking about known, concrete hazards so these processors address the most probable hazards (significant) associated with their products that can make people sick.

Interestingly enough, most processors still consider chemical hazards and GMOs to be the most important. Pesticides are definitely used in food production, but the cases of pesticide intoxication due to approved pesticides in the U.S. are related to the handling of the actual chemicals and not to the consumption of foods that were treated with appropriate, approved pesticides following appropriate application practices. These processors also underestimate Salmonella, and some really believe that we have controlled it already. In my experience, the words Campylobacter and Norovirus are almost unknown words to most processors. Borrowing from the studies on the psychology of risk perception, it is the “unknown knowns”— those hazards which we intentionally refuse to acknowledge that we know, or we ignore them altogether — which are the most significant hazards in food safety. Perceived but not real hazards and our belief that we are less likely than other people to experience negative events (optimism bias) are really a bad recipe for food safety.

I also make sure that the concept of risk, when referring to food safety, is associated to “a harmful, concrete event,” a “negative” event, if you will, to emphasize that we are not talking about events with “positive” results. In some cases, one may risk giving money and can end up wealthier — winning the lottery, for instance. In most cases, I also remind class participants of the risk formula by Peter Sandman, in which risk = hazard + outrage, with special, big emphasis on the word “outrage”: the driving force in risk perception.

As an educator, I wonder why we don’t explain simple terms, such as hazard and risk, which are usually not clear and sometimes are considered synonyms in people’s minds. Nobody can build up on the understanding of complex technical terms if basics terms are not well-defined. That is also fascinating.

In the recently released Current Good Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for Human Food from the U.S. Food and Drug Administration, the concepts are to perform a “hazard analysis” to identify foreseeable hazards and to perform a “hazard evaluation,” and then apply “risk-based preventive controls” to control hazards. The term “risk-based” appears at least once per page in the first 30 pages of the document. I also emphasize that there is no standard, consistent definition of “risk” when applying this term to food safety, and this is the reason I intentionally include words such as “concrete” when defining hazards and “negative” when defining risk. Again, the intention is to frame the discussion to focus on actual hazards. Understanding the basic definitions of hazard, risk and risk perception allow food processors to later understand what are the components of risk-based food safety programs. These programs are based on science and not on perception, and I try to make sure that food processors understand their own perceptions and understand how to recognize their customers’ perceptions.

We all have our own perceptions of hazards in foods. Some of us take it as a life crusade to right what we think is wrong, and sometimes we decide what is right or wrong based on perceptions. Yet we keep ignoring those preventable “unknown knowns” that bring a tremendous burden to our public health system, a public health system that is suffering from federal and state budget cuts that impact our ability to deal with even well-known hazards.

Sometimes I am told that food safety is boring. Isn’t that fascinating as well?

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This second report was published in the Morbidity and Mortality Weekly Report (MMWR) and is part of the Grand Rounds by the U.S. Centers for Disease Control and Prevention (CDC). From this second report, I like both the title, “Getting Smart about Antibiotics,” and the fact that the authors present an appalling number of figures pointing out the impact of inappropriate antibiotic use in human medicine.

There is no doubt that the “increasing prevalence of antibiotic-resistant bacteria is one of the most serious threats to public health in the 21st century.” But there is also no doubt that this is a complex issue, and pitting one food system against others will not solve the problem. Blaming the use of antibiotics in medicine versus veterinary medicine will not solve the problem either. But for some reason, the discourse about antibiotics resistance has taken the form of blaming somebody or something.

The study of antibiotic resistance is extremely complex because of the variability in the methods of testing for antibiotic resistance and the temporal and spatial inconsistencies in the results. An example of this variability can be seen in Figure 1 (see graph below) created with the interactive feature from the website of the National Antimicrobial Resistance Monitoring System (NARMS).

There is no argument against the fact that human activities of all kinds have resulted in the increase of antibiotic use in the past 50 years, with the consequence of selecting for those bacteria that are resistant. These resistant bacteria may have the genetic components to become resistant or have the physiological properties to quickly adapt and become resistant in the presence of antibiotics in the environment. This consequence is not surprising either, as many scientists have been telling us about the issue of antibiotic resistance, and for a long time.

Most recently, bacteria isolates from ancient Arctic soil and from the microbes that are present in the intestinal tract of an isolated, uncontacted indigenous population of Yanomami Amerindians in South America have revealed the presence of antibiotic resistance. So bacteria have been evolving different resistance mechanisms against antibiotics because these bacteria have been competing with each other for resources in the same environment, mainly in the soil, for thousands of years. These articles that do not get too much attention but provide us with thoughtful insights should be discussed more. That’s why I like the article published in MMWR. The authors offer a sort of “mea culpa,” if you will, but move on to show us figures that are, again, appalling. The fact that we have “142,000 adult emergency visits annually” because of adverse reactions to antibiotics is telling us that maybe the current antibiotics groups may not be the best approach to combat pathogenic bacteria in the long run. Yet, the search for new classes of antibiotics has not been accelerated over the years, and it may have been slowed down in reality. An extensive study by The Pew Charitable Trusts is unambiguous about this trend: There are too few drugs in development to meet current and anticipated patient needs. The public should be exposed to these types of reports, too — those reports that show us that everybody should share the burden of antibiotic resistance, and we should not just keep finding scapegoats for a problem that will stay here longer if we do not change the way we understand it. (To sign up for a free subscription to Food Safety News, click here.)