ACMSF Minutes: 24 September 2009

Meeting held at Aviation House, 125 Kingsway, London WC2B 6NH

Present:

Chair: Professor S O’Brien

Members: Mr J Bassett
Mrs V Buller
Prof J Coia
Mrs R Glazebrook
Dr R Holliman
Prof T Humphrey
Prof P Hunter
Mr A Kyriakides
Mr P McMullin
Dr S Millership
Mrs J Morris
Prof P Williams (chaired item 6)

Assessors: Mr S Wyllie (Defra)
Ms L Redmond (FSA)

Secretariat: Dr P Cook (Scientific Secretary)
Mr R Martin (Administrative Secretary)
Mr A Adeoye
Miss S Butler

Others:
Dr Roy Betts, Campden & Chorleywood Food Research Association
Dr Mary Brennan, FSA Social Science Research Committee
Ms Susan Campbell, Defra
Ms Bridgette Clarke, Bakkavor Ltd
Mr Tom Miller, Retired consultant
Ms Carole Owen, Brakes
Mr Rick Pendrous, Food Manufacture Magazine
Mr Alan Procter,
Dr Bernard Rowe, Consultant, Tesco
Ms Karen Sims, Waitrose
Mr Michael Wood, Norpath Scientific Services

1. Chair’s Introduction

1.1 The Chair welcomed ACMSF Members and members of the public to the 70th meeting of the Committee. She reminded Members that this was the first meeting since March 2009 as the June meeting had been cancelled. She introduced Ms Liz Redmond, head of the Agency’s new Hygiene and Microbiology Division, who had taken over from Dr Judith Hilton as the FSA Assessor to the Committee, and Mr Bob Martin, who had taken over from Dr Lucy Foster as Administrative Secretary on an interim basis. She also welcomed Drs Iain Gillespie and Bob Adak (HPA), who would be presenting agenda item 6, Professor Peter Jackson and Dr Mike Howard, Social Science Research Committee (SSRC), who would be presenting agenda item 7, and Dr Anne Gravett (FSA) and Mr Ethan Taylor (UKFSS programme manager) who would be presenting agenda item 9.

2. Apologies for absence

2.1 Apologies for absence had been received from Dr David Brown.

2.2 The Chair also informed Members that, since the last meeting, Prof Mike Gasson’s term of appointment had expired and Mr Robert Rees had resigned from the Committee. On behalf of Members she wished to record her thanks to both of them for their input to the work of the Committee.

3. Declarations of interest

3.1 The Chair reminded Members of the need to declare any conflicts of interests relating to items on the agenda. She declared an interest under agenda item 6 as she was one of the authors of the paper on campylobacteriosis which was to be discussed. For this reason Prof Williams had agreed to chair this item. Dr Millership also declared an interest under item 6 as she had been involved in the case control study. Mr McMullin declared an interest under item 6 as his some of his clients were chicken producers and item 8 because of involvement with microbiological testing in relation to E. coli O157 in meat. Prof Coia declared that he undertook consultancy work for Tesco. Mr Kyriakides declared an interest in item 6 and a potential conflict of interest relating to the work of the Surveillance Working Group surveys of chicken and red meat, as his employer sold these products.

4. Minutes of the 69th meeting

4.1 Members approved ACM/MIN/69 as a correct record of the previous meeting. The Secretariat was asked to arrange for the minutes to be posted on the Committee’s website.

5. Matters arising

5.1 The Secretariat had produced a summary of action taken on matters arising from previous meetings (ACM/952). These were self explanatory and did not elicit any comments from Members.

6. Campylobacter case control study

6.1 Prof Williams took the Chair for this item. He reminded Members that at the last meeting following a presentation on the changing age pattern of campylobacteriosis in England and Wales, the HPA had been asked to re-analyse the data that had formed the basis of their presentation, to generate further hypotheses on factors that might have contributed to changes in the age-specific rates of human Campylobacter infection in England, and to present the findings to a subsequent meeting. He invited Dr Iain Gillespie to present paper ACM/953.

6.2 Dr Gillespie reminded Members that since 2000 there had been a change in the age structure of cases of campylobacteriosis with a reduction in those aged 0-9 years, a rise in cases aged 20-59 years, and an even greater rise in those aged 60 years and over. These changes were independent of gender, season or geography. Members of ACMSF had requested a sub-set analysis of the recent national case control study of Campylobacter infection in England. The case-control study had taken place between 1 April 2005 and 30 June 2006 involving 5 Health Protection Units in England.

6.3 Dr Gillespie reported that, following analysis of the data from the case control study, various risk factors had been identified. These related to health factors (for example taking acid suppression medication), food safety practices in the home, and whether or not the person lived alone.

6.4 Members had queries about what had been asked in the study questionnaire. Prof O’Brien undertook to email the questionnaire to Members.

Action: Chair

6.5 Dr Holliman asked about the numbers of people excluded from the study because of travel abroad. Dr Gillespie stated that the data on foreign travel had not been included in the original study because when people travelled abroad their exposures were different to those who had not travelled. About 500 cases had been excluded from a total of 3,000 because the original research had focussed on UK-acquired infection. Dr Holliman also asked whether or not it was possible to present the absolute risk associated with acid suppressing medication rather than the odds of illness. However, because of the original study design this was not possible.

6.6 Prof Hunter questioned whether data were sufficiently robust to identify changes in mortality. Dr Gillespie replied that this had not been possible as campylobacteriosis was rarely recorded as the primary cause of death, especially where there was co-morbidity.

6.7 As the study indicated that cases who had been prescribed acid suppression medication appeared to be at higher risk of infection, Prof Hunter asked whether the appropriate regulatory authority (possibly the Medicines and Healthcare products Regulatory Agency) should be made aware of these findings. Mr McMullin supported this as such authorities would be unlikely to obtain such information by other means. Dr Holliman sounded a note of caution saying that it would be premature to make any statement about an association with this sort of medication, which was prescribed for good reason, at this stage. Prof Hunter agreed that it was only a hypothesis and it would be for the appropriate authority to deliberate on. In summing up Prof Williams said that there was agreement that there was sufficient concern about the information that may need to be given to elderly people to share the findings of the data with the relevant medical regulatory agency.

Action: Secretariat

7. Listeria in the over 60s

7.1 The Chair reminded Members that in March 2009, the Committee had agreed the final draft of the Ad Hoc Group on Vulnerable Groups’ Report on the increased incidence of listeriosis in the UK subject to some minor edits, and the Report had been published on 14 September.

7.2 The Report had recommended (para. 6.31) that the Agency should refer the report to its Social Science Research Committee to consider food storage and handling practices of elderly people in the home. At the March 2009 ACMSF meeting, Prof Humphrey, chair of the Ad Hoc Group had informed the Committee of work being done in association with the FSA’s Social Science Research Committee (SSRC). Prof Humphrey said that he had given a presentation to the SSRC to help define the scope of the work they were being asked to carry out.

7.3 The Chair invited Prof Peter Jackson and Dr Mike Howard to present the work undertaken by the SSRC.

7.4 Prof Jackson said the SSRC had agreed to investigate possible social science explanations for the increase in listeriosis in the elderly such as what older people eat, how they store food and prepare it. A preliminary literature search had been undertaken and interviews with relevant experts had been undertaken. He said that the Committee had not conducted any primary research. The review of literature had shown that across the areas of food and ageing, lifestyle changes and food safety practices, research was fragmented and limited, particularly with respect to those over 60.

7.5 Dr Howard outlined a number of options for further work that could be considered. These included a more comprehensive literature review and/or conducting primary research. The latter could include a specially designed survey linked to the FSA’s new Food Issues Survey (FIS) to provide baseline data on the range of food safety knowledge and practices in elderly people. Members agreed that, in the absence of historical information, it would be important to establish a baseline in order to be able to measure any changes that might have contributed to the rise in listeriosis and/or campylobacteriosis in the future. Several Members stressed the need to focus on people’s actual behaviour in the way they handled food, rather than their opinions on what they thought they should be doing. Members recognised the importance of obtaining information in relation to sub-groups within those over 60 and that it is likely to be valuable in considering factors for listeriosis and campylobacteriosis among this age-group. However they also acknowledged the difficulty in obtaining information from elderly people who were ill.

7.6 The Chair summarised the discussion which had concluded that there was support for cross-disciplinary research (rather than a further literature search) to establish baseline data using evaluative methods linked to the FIS in order to better understand people’s food safety knowledge and behaviour in the home.

Action: FSA

8. E. coli Inquiry

8.1 Prof Humphrey declared an interest, having been involved in the Inquiry investigation.

8.2 The Chair invited Ms Liz Redmond to present paper ACM/955. Ms Redmond explained that although the report of the Public Inquiry into the E. coli O157 outbreak in South Wales in 2005 was primarily concerned with risk management issues, nevertheless the ACMSF had indicated they should discuss the findings to consider if there was a role for the Committee in advising the FSA. The Public Inquiry report had been discussed by the FSA Board and a Food Hygiene Delivery Programme had been set up in response. A summary of the projects which formed the basis of this Programme was given in ACM/955 as well as a list of the recommendations from the Public Inquiry report. Ms Redmond invited Members for their comments on the Public Inquiry report, and the FSA response. In particular, she asked whether they thought the Committee had any contribution to make on risk assessment in relation to recommendation 24 of the Public Inquiry report which related to identification of “supershedder” cattle.

8.3 Prof Coia questioned whether being able to identify supershedders on-farm would be the most cost-effective intervention for E. coli control in the food chain as that there was evidence from the US that indicated control was most effective in the abattoir. He added that the impact of any on-farm activity would need assessment, especially if not applied across all herds. Mr Wyllie commented that Defra was sponsoring research in this area. The Chair also mentioned a presentation at a recent meeting of the Pathogenic E. coli Network (PEN) and suggested that a summary of the key outputs from that meeting along with information on current research and risk assessments on E. coli O157 would be a useful item to have for a future ACMSF meeting.

Action: Secretariat

8.4 Mr Kyriakides pointed out that due to the large number of deficiencies in food hygiene practice involved in the Wales outbreak there was a need for good risk management in order to discover the small number of food businesses where good hygiene practices were either not understood or were not being carried out. Mrs Buller stressed the need for businesses to have a good system of procurement in place which should include careful checking of suppliers. Ms Redmond confirmed one of the FHD Programme projects included advice about procurement.

8.5 Dr Millership commented on the difficulty of identifying clusters in an outbreak and that some were being missed. The Chair, whilst declaring an interest, mentioned a project by Stephen Palmer on differences between outbreak premises and non-outbreak premises which could be circulated to Members. Prof Coia (also declaring an interest) commented that the report highlighted the need for robust microbiological typing as an important factor in identifying outbreaks.

Action: Secretariat

9. UK Food Surveillance Database

9.1 The Chair invited Dr Anne Gravett and Mr Ethan Taylor of the FSA’s Implementation and Delivery Division to present work on developing a UK-wide food surveillance database, the UK Food Surveillance System (UKFSS).

9.2 Mr Taylor, Project Manager for the UKFSS, explained that the database brought together details and results of formal food sampling and testing by UK local authorities, port health authorities and Public Analyst laboratories. He began the presentation by outlining the benefits of the database: it enhances communication with the laboratory service in relation to the analysis of official control samples, and it provides the FSA with sample data, in a standardised format. The data do not include details of premises from which samples are taken, which remain with the local authority. He reported on the rollout of the database across the UK: in Scotland it is being routinely used by 29 out of 32 councils and all partner labs with 14,000 samples submitted annually; in Northern Ireland it is used by 26 Local Authorities with 15,000 samples submitted annually; and in England and Wales, where the rollout is on a larger scale, it is currently being used by 34 Local Authorities. A programme of training for Local Authority and FSA staff is underway.

9.3 Dr Gravett informed the Committee how the data were being used, for example, by the Scottish Food Enforcement Liaison Committee who would be publishing a report using data from microbiological sampling in Scotland. Work on the UKFSS was ongoing with HPA and NPHS being included in future phases as much of the microbiological testing in England and Wales was undertaken by these bodies.

9.4 The Chair invited comments from Members on the presentation. Prof Hunter declared an interest and commented on the difficulties academic researchers often have in obtaining access to such databases. Dr Gravett replied that one of the project boards was looking at issues of access to data. She said that there was concern that people would try to make links between the data and specific Local Authorities. Stephen Wyllie asked whether it was possible for other Government Departments to obtain access to the data. Dr Gravett said she was aware that the Pesticides Safety Directorate had used some of the data. The Chair thanked Dr Gravett and Mr Taylor for their interesting presentation.

10. Committee sub-groups

Ad Hoc Group on Vulnerable Groups

10.1 Prof Tom Humphrey reported on the work of the Ad Hoc Group. He informed Members that following discussion at the March ACMSF meeting the table of responses to the public consultation on the Ad Hoc Group’s report on the increased incidence of listeriosis had been finalised and published on the FSA website and the report had been published on 14 September. He also reported that the Ad Hoc Group would be considering the FSA’s position paper on Toxoplasmosis before the end of the year. The Committee had referred this issue to the Group in March 2007 and the Group had had an initial discussion on the subject in December 2008.

Working Group on Surveillance

10.2 Prof Humphrey reported that the Working Group had met on 11 September to discuss the Agency’s surveys of Campylobacter and Salmonella in retail chicken and the microbiological contamination of fresh red meats on retail sale.

10.3 Prof Humphrey reminded Members that at the March ACMSF meeting an apparent discrepancy in the Campylobacter results in the retail chicken survey had been noted and was to be discussed with the contractors. This had been done and the survey was expected to be published in October 2009. He informed Members that the Working Group had agreed to draft a commentary paper on surveillance of retail chicken in the UK outlining some issues that had arisen from recent Campylobacter surveys relating to methods and approach, which will provide recommendations for the FSA to consider for future surveillance work. The main Committee would be asked to consider the paper before it was forwarded to the FSA.

10.4 Finally, Prof Humphrey reported that the Group had met to discuss the report of the microbiological contamination of fresh red meats on retail sale survey. Following this discussion some changes were being made to the structure of the report by the FSA, after which the Group would reconsider it.

11. Dates of future meetings

11.2 The Chair drew Members’ attention to Paper ACM/956 which gave the dates for meetings of the full ACMSF for the remainder of 2009 and 2010. All these meetings would be open to the public.

12. Any other business

12.1 The Chair reported that she had attended a General Advisory Committee on Science workshop on horizon scanning in June 2009 and that the report on the event would be tabled when available.

12.2 The Chair drew Members’ attention to the six Information papers provided, particularly to ACM/961 regarding ‘Risk assessments on the use of source segregated composts in agriculture’, and made Members aware that a discussion paper relating to this is expected to be presented at the December 2009 meeting of ACMSF.

13. Public questions and answers

13.1 The Chair reminded the meeting of the Committee’s risk assessment function and invited questions from members of the public present.

13.2 Mr Tom Miller supported the continuing need for the FSA to obtain more data on behaviour in domestic households. He also suggested a need for the FSA to provide more advice to businesses on such things as how to clean surfaces, the chemicals and equipment that should be use. The Chair acknowledged that the point about consumer behaviour was well made and that it would be for the FSA to consider what further advice was necessary.

13.3 Mr Alan Procter, member of the Co-operative Leeds and Wakefield Committee, welcomed the Ad Hoc Group’s Report on listeriosis in the over 60’s but wondered if there was any relationship with the use of proton pump inhibitors. He also asked about what progress there was on the Defra report concerning Mycobacterium avium subsp. paratuberculosis (MAP) that had been mentioned at the ACMSF’s March meeting. In responding, the Chair said that proton pump inhibitors had been prescribed for good reasons and although there is a suggestion that this type of medication may increase the risk of foodborne illness, this required further investigation and people should not stop taking their medication. Mr Wyllie, Defra Assessor, said that the report Mr Procter had referred to was a survey of the prevalence of MAP in the UK cattle population. The survey was being reviewed externally before being finalised and it was expected that it would be published in the next couple of months.

13.4 There being no further business, the Chair thanked Members and members of the public for attending and the meeting was closed.