Held on 18 October 2001 at Aviation House, 125 Kingsway, London WC2 starting at 10.30 am.
Chairman: Professor D L Georgala
Members: Dr G R Andrews
Dr D W G Brown
Professor M J Gasson
Dr K M Hadley
Professor T J Humphrey
Mrs P Jefford
Professor A M Johnston
Mr A Kyriakides
Ms E Lewis
Professor P Mensah
Dr S J O'Brien
Mr B J Peirce
Mr D J T Piccaver
Dr Q D Sandifer
Professor W C S Smith
Dr T D Wyatt
Assessors: Mr P J R Gayford (DEFRA)
Dr S Pryde (FSA/Scotland)
Dr R Skinner (FSA)
Secretariat Dr J Hilton (Medical Secretary)
Mr C R Mylchreest (Administrative Secretary)
Mrs E A Stretton (Administrative Secretariat)
Others Dr P E Cook (FSA) : for item 6
Professor E Taylor (University of Salford) : for item 9
Dr A Belcher (FSA) : for item 9.
1. Chairman's introduction
1.1 The Chairman welcomed Members, particularly those attending their first ACMSF meeting, to the Committee's 41st meeting. He thanked new Members for putting themselves forward for membership of the Committee and for submitting themselves to the long selection process. He hoped they would find the work both intellectually challenging and rewarding. So as not to delay proceedings, he did not propose to ask Members to introduce themselves individually at the start of business. Instead, the Secretariat had put together short pen portraits of the Chairman and the Committee Members (ACM/545). Professor Georgala hoped that there would be a future opportunity ¿ eg the planned Campylobacter workshop - for Members to get to know each other better.
1.2 The Chairman also welcomed Dr Susan Pryde from the Food Standards Agency (Scotland) to the meeting. Dr Pryde had replaced Dr Martin Donaghy as the Scottish assessor.
1.3 The Chairman drew Members' attention to the need for them to declare any interests in agenda items. He explained that the Secretariat would be writing to them to obtain their wider declarations of interest, for inclusion in the ACMSF's Annual Report for 2001. They thus now needed only to declare interests arising from specific agenda items. Detailed rules on declarations of interest were included in Annex A to the Guidance Notes prepared for Members (ACM/523).
1.4 In the context of declarations of interest, Mr Kyriakides recorded in relation to agenda item 6 the fact that his employers (Sainsbury's Supermarkets Ltd) were major retailers of poultry meat and that, in relation to agenda item 9, Sainsbury¿s were marketing in-shell pasteurised eggs.
1.5 Also in relation to agenda item 9, Mrs Jefford registered the fact that she was a trustee of the Chartered Institute of Environmental Health and that CIEH were a major provider of food hygiene training.
1.6 Finally, the Chairman drew Members¿ attention to 2 tabled information papers, ACM/529/1 ¿ the minutes of the first meeting of the Foodborne Disease Strategy Consultative Group; and ACM/542 ¿ a DEFRA report on developments in relation to Foot and Mouth Disease.
2. Apologies for absence
2.1 Apologies for absence had been received from 2 of the Members, Ms Davies and Professor Hunter, and 2 assessors, Professor McMurray (NIDARD) and Dr Doherty (NIDHSSPS).
3. Minutes of the 40th meeting
3.1 The draft minutes of the 40th meeting (ACM/MIN/40) were accepted as a correct record.
4. Matters arising
4.1 Members noted the Secretariat paper ACM/521 recording action taken on the various points arising from the draft minutes of the 40th meeting.
5. Welcoming new Members and preparation for December 2001 open meeting
5.1 The Chairman added a number of detailed points to what he had said earlier in welcoming new Members. He hoped that Members would find the Guidance Notes (ACM/523) helpful. He stressed that Members had been appointed not as representatives of particular interest groups but for the personal expertise and wisdom which they could bring to the Committee's deliberations. He hoped that they would not feel inhibited in contributing in areas outside their direct personal experience. With regard to the ACMSF's work, the Chairman explained that this arose in part in response to requests for advice emanating from the Food Standards Agency (FSA). A recent example was the FSA's request for advice on Mycobacterium bovis (agenda item 8). However, the Committee also generated a sizeable proportion of its work itself. In this connection, he encouraged Members to bring to the Committee's attention any emerging topics they thought would merit the Committee's attention. This could be done during the course of one of the Committee's routine quarterly meetings, or bilaterally through the Chair or the Secretariat. Professor Georgala was also at pains to stress the Committee's independent role. Whilst the FSA made appointments to the ACMSF, defrayed the Committee's costs, and also provided accommodation for meetings, and full Secretariat services, the Committee was not part of the Agency. Indeed, the FSA's Chairman (Sir John Krebs) was very keen that the Committee should be a source of independent expert advice to the Agency on the microbiological safety of food.
5.2 As regards the ACMSF's working practices, the Chairman noted that there were only 4 plenary sessions of the Committee each year and that, where in-depth consideration of specific issues was required, the Committee adopted a system of Working (or, in some cases, Ad Hoc) Groups which reported back to the full Committee. The output from such Groups had to be considered in plenary sessions and adopted as the advice of the full Committee before being conveyed to the FSA. Professor Georgala forewarned that he would shortly be approaching Members to join particular Groups. One of these, the standing Surveillance Working Group was charged with facilitating the provision of ACMSF advice to Government in connection with its microbiological food surveillance programme and other surveillance relevant to foodborne disease, particularly in relation to the design, methodology, sampling and statistical aspects; and reporting back regularly to the ACMSF. The Surveillance Group tackled some of the detailed elements associated with complex surveillance projects which did not lend themselves to consideration by the full Committee at one of its quarterly meetings. The first task of a newly-constituted Surveillance Working Group would be to comment on the draft protocol for the FSA's survey of the prevalence of Salmonella in UK shell eggs which the ACMSF had recommended should be carried out.
5.3 The Chairman also signalled the possible need to set up an Ad Hoc Group to contribute in connection with the FSA's research strategy which was being evolved in the light of the review of FSA research carried out by Professor Sir John Arbuthnott. In discussing the question of the FSA's research strategy, Members stressed the need for good coordination across Government Departments, among funders, and throughout the UK, not least to avoid overlaps and duplication. Both Mr Gayford and Dr Hilton re-assured Members that Departments were endeavouring to ensure proper coordination. Dr Hilton undertook to provide an information paper about the coordination function carried out through the Microbiological Safety of Food Funders' Group.
5.4 Turning to the question of preparation for the 5 December 2001 open meeting, the Chairman drew Members' attention to ACM/522 which provided information on the ACMSF's first open meeting (held on 5 December 2000), including the lessons learned, and proposed procedures for the conduct of business at the second open meeting. Professor Georgala said that the Committee had taken the decision that one of its routine quarterly meetings each year should be held in public, rather than constructing a special, perhaps anodyne, agenda for the occasion. Indeed, some of the topics discussed at the first open meetings had the potential to attract keen public and media interest. Thirty to 35 members of the public (in practice, mostly representatives from professional bodies and from special interest groups) had attended. However, Members had not been inhibited by the presence of the public and business had been conducted in a normal manner. It had been important for the efficient conduct of business that Members had contributed in a disciplined manner and that the public question and answer session had been channelled through the Chair, with individual Members being asked to respond to particular questions within their sphere of expertise.
5.5 In discussion, Members made a number of points. It was thought that it might be useful if Members had brief information prior to the meeting of those members of the public who were going to attend and their particular areas of interest, although inviting the public to submit any questions they might have in advance ran the risk of making the proceedings too formalistic. Members recognised the importance of ensuring careful briefing of any media representatives present, to avoid the risk of precipitating food scares. The Chairman reminded Members that he was the Committee¿s formal spokesperson and would conduct interviews on the day, enlisting the help of Members if and when necessary. Professor Georgala said that, more widely, he was accustomed to media approaches for interviews in his capacity as ACMSF Chairman. In such interviews, he was able to present a consistent ACMSF line. Approaches by the media to individual Members were potentially more problematical. If approached for an ACMSF line, Members should direct the request to the Chairman. If approached for a personal view, Members should make clear that they were responding personally and were not giving an ACMSF line.
5.6 One Member noted that, at the first open meeting, the public question and answer session was conducted at the end of business, and suggested that it might have been more effective if the public had been able to intervene at the end of each agenda item. The Chairman said that a great deal of thought had been given to this possibility. On balance, it had been felt that providing an opportunity at the end of the day minimised disruption of normal business and also allowed people additionally to ask questions and make statements on topics not covered by agenda items. The question was also posed as to whether Members had been nominated in advance by the Chair to respond to public questions. Professor Georgala said that he had indicated to Members that if topics arose within their particular areas of expertise, he might invite them to respond but that there had been no detailed planning in this area. Indeed, neither he nor the Secretariat had any advance knowledge of what topics might be raised and what questions might be posed. Finally, in response to a question by a Member, Professor Georgala said that, for the most part, the intention was to conduct proceedings on an informal basis, in precisely the same way as non-open meetings were conducted.
6. FSA contamination of UK chicken target. Results of baseline survey
6.1 Mr Kyriakides declared an interest in respect of this item (see paragraph 1.4).
6.2 Dr Cook (FSA) introduced paper ACM/524. He reminded Members that the survey had been undertaken for the purposes of establishing a baseline against which progress towards the FSA's target of reducing levels of Salmonella in UK-produced chicken on retail sale by 50% by 2005 could be measured. A detailed protocol had been developed at the beginning of 2001. The ACMSF¿s Surveillance Working Group had commented on the draft protocol and their comments had been taken into account by the FSA in developing the final version. Retail sampling of chicken had been carried out on a UK basis over an 8 week period between April and June 2001. Sampling in England and Wales had been conducted by National Milk Records, with microbiological testing by ADAS in their Wolverhampton laboratories. Other sampling had been carried out by the Scottish Agriculture College. Two laboratories, in Aberdeen and Auchincruive, examined samples from Scotland and Northern Ireland respectively. The survey had been designed to give a one-time snap shot of the position, based on retail market shares. It had not been aimed to produce a picture of specific production types.
6.3 Dr Cook said that the headline data had been published by the Food Standards Agency on 16 August (see ACM/530). Further analysis of data was in hand. All Campylobacter isolates had been archived and more detailed analysis would be undertaken once isolates had been confirmed, speciated and typed. ACM/524 should therefore be regarded as an interim report. It was intended that the final report should be published in two parts. The Salmonella element would be finalised first ¿ possibly by the end of 2001. The Campylobacter element would follow in the first half of 2002.
6.4 Turning to the results, Dr Cook noted that the average Salmonella contamination level of 5.8% was markedly lower than the levels seen at the time of the 1993/94 prevalence survey (when Salmonella contamination was found in around 1 in 3 chickens sampled). At the time of publication of its Poultry Meat Report, the ACMSF had said that it saw no reason in principle why the prevalence of Salmonella contamination in the finished raw product should not within the next few years be reduced to a single figure percentage on the basis of existing technology. It appeared that the industry had successfully achieved what the ACMSF had regarded as possible, suggesting that substantial progress had been made in tackling the problems in broilers. A higher proportion of frozen chickens were contaminated than chilled chickens. This was consistent with results from previous comparable surveys. The contamination rate for fresh chicken was lowest in Northern Ireland. This also reinforced the results of previous comparable work. There appeared to be no marked differences between results for UK and imported samples. The serotypes found were markedly different from the situation in 1993/94. Then, S. enteritidis had predominated. In the latest survey, the predominant serotype had been S. typhimurium, S. enteritidis having fallen to fifth place. The leading antibiotic-resistant isolates were S. typhimurium DT104/104B. Multiply-resistant DT104 had been a particular problem during the 1990s.
6.5 With regard to the Campylobacter results, the overall prevalence was 50%, with contamination of fresh chicken (63%) being higher than frozen (33%). However, archived data were still to be fully assessed. There had been a marked difference in Campylobacter prevalence on fresh chicken sampled in different parts of the UK, but further work was needed to tease out the basis of the findings and to identify further trends. Similar surveillance carried out by other groups suggested that the contamination levels found in Scotland and Northern Ireland were closer to the levels they were routinely finding, with Campylobacter prevalence of around 90%. This raised the question of whether levels of expertise were comparable between the various laboratories analysing samples and whether there was a significant level of false negative results. Dr Cook said that there was no reason to doubt the expertise of the laboratories concerned, which all worked to the same, standard protocol. Once the further planned work on isolates had been completed, a clearer picture might emerge. He noted that the clear differences between laboratories were confined to fresh, rather than frozen, samples.
6.6 In relation to the survey generally, Members regarded the work as comprehensive and very useful. It was felt that it would have been helpful to have had the results presented by country of production rather than by country of purchase of samples. Dr Cook said that the survey had been carried out in the way it had to enable participants in the various parts of the UK to assess the local situation. However, comprehensive data had been gathered on samples, including production and packing information, so further analysis was clearly possible. Members regarded the Salmonella results as encouraging, reflecting the great strides made by industry to improve the microbiological status of poultry meat, but were concerned about the levels of Campylobacter contamination. It was noted that current knowledge was insufficient to enable Campylobacter prevalence data to be related to the organism¿s potential for causing disease in humans. Further work was also needed to establish the significance of seasonality. Members felt that it would have been helpful to have had the data expressed numerically as well as in percentage terms. They noted that, in addition to work which was being carried out on serotyping, phage typing and resistance to antimicrobials, archiving of samples also opened up the possibility of further analysis at a later date. In this connection, they noted that there appeared to have been no significant difference in imported and home-produced samples but that further analysis would be carried out for the final report.
6.7 With regard to the possibility of using the survey results to focus on particular sales outlets, Dr Cook cautioned against attempting to draw conclusions which the data would not support. Professor Georgala confirmed that the ACMSF had, in the past, been critical of such over-analysis. However, it was felt that it would be very helpful if significant differences at production level could be utilised to help lift the performance of the poorer performers to that of the best.
6.8 Finally, Dr Skinner reassured Members that the re-focusing of the FSA¿s priorities to give greater attention to Campylobacter did not mean that Salmonella would be ignored. When the target of reducing Salmonella in UK-produced chicken on retail sale by at least 50% by 2005 had been adopted, the Agency had anticipated a baseline contamination figure of between 20 and 30%. However, this had been overtaken by events which resulted in the FSA's reduction target being met well ahead of schedule. The decision had thus been taken to focus greater attention on Campylobacter. However, an average prevalence level of 5.8% across the UK meant that there was still a significant amount of Salmonella-contaminated retail chicken in the UK. The FSA would therefore be maintaining pressure to drive this down still further. The Chairman welcomed this assurance which reflected the conclusions of the ACMSF¿s Poultry Meat Report that Salmonella contamination of poultry meat could be reduced to a single figure percentage in the shorter-term, and effectively eliminated in the longer-term.
7. Campylobacter workshop and Working Group
7.1 The Chairman introduced ACM/525. He reminded Members that the Committee had decided in 2000 to focus fresh attention on Campylobacter. The ACMSF¿s Interim Report on Campylobacter had been published in 1993 and had triggered a considerable body of research. ACM/525 now proposed terms of reference for a new Working Group. It was suggested that these should be to identify any important gaps and omissions in action taken to reduce Campylobacter in food and food sources and in the knowledge base; and to develop advice which will assist the FSA in evolving its strategy for reducing the incidence of foodborne Campylobacter infection in humans. Professor Georgala said that, if Members were content with the proposed terms of reference, he would proceed to contact individuals bilaterally over the next week or so with a view to recruiting Members to serve on the Working Group.
7.2 Members welcomed the proposal to set up a Working Group. It was pointed out, however, that sentinel studies by the Public Health Laboratory Service had identified other important, non-food, vehicles for the transmission of Campylobacter and that environmental vectors had been accorded scant attention in the past. There was a suggestion that as much as 50% of Campylobacter infection could derive from non-food sources. It was acknowledged that this might need to be reflected in the terms of reference, but that the ACMSF¿s principal responsibility for advising on the microbiological safety of food should not be overlooked. It was suggested that it would be useful to co-opt external, industry expertise on to the Working Group as necessary, as the ACMSF had traditionally done when setting up subject-specific Working Groups. The importance was also recognised of learning any relevant lessons from the way Campylobacter had been tackled in other countries. It was noted that the Codex Committee on Food Hygiene had also identified Campylobacter for particular attention and that the FSA, who would be participating in the Codex work, would be well placed to keep the Working Group informed of developments in that forum. Members also recognised the EU's commitment to setting up a European Food Agency and the importance of any ACMSF recommendations on Campylobacter being compatible with thinking in that quarter.
7.3 Turning to the proposal to hold a workshop as a precursor to the Working Group getting under way, Dr Hilton explained that ACM/544 provided an outline of the aims and structure of such a workshop. It was important to avoid researchers simply reporting on the research they had carried out, and identifying further research needs. There should instead be a focus on key questions, on whether these had been resolved and, if not, whether answers were still required. The aim would be to produce a distillate of current knowledge, gaps in the knowledge base which needed to be filled, and practical options for tackling Campylobacter.
7.4 There was general support among Members for the idea of a workshop. It was suggested that an adversarial approach could be beneficial, with experts being questioned by Members with a view to getting behind the evidence assembled to date. The workshop should not be turned purely into a research seminar or an occasion for researchers to bid for new funding. ACM/544 envisaged a 1.5 day workshop. Some Members questioned whether this was sufficient and there was a general feeling that 2 complete days, with participants prepared to stay overnight immediately prior to Day 1 to permit an early start on the first day, would be preferable. After further discussion of the options, Members confirmed their support for a workshop, to be held in January 2002, and asked that, in finalising the programme, further consideration should be given to the optimum duration of the workshop, the structure, and the final list of (non-ACMSF) participants.
8. Draft Report of Mycobacterium bovis Working Group
8.1 The Chairman recalled that the FSA had sought the ACMSF¿s advice on the possible health risks to consumers of meat from cattle with evidence of M. bovis infection. A Working Group, chaired by Professor Johnston, had been set up to consider this question. Professor Georgala expressed gratitude for the Working Group¿s endeavours and for its draft Report. This now needed to be examined and approved (with amendments, if necessary) by Members so that it could go forward to the FSA as a report of the full Committee.
8.2 At Professor Georgala¿s invitation, Professor Johnston introduced the draft Report (ACM/526). He said that the Working Group had considered the various aspects of the topic - M. bovis in humans, M. bovis in cattle and UK meat inspection procedures. The draft Report contained a number of recommendations aimed at improving:
- the diagnosis of M. bovis infection in humans;
- post mortem meat inspection procedures and slaughterhouse practices; and
- the collection of data by the Meat Hygiene Service; and
- maintaining enhanced surveillance.
8.3 Professor Johnston noted the problems surrounding the collection of reliable data on the prevalence and incidence of M. bovis infection in humans in the UK. He also drew attention to the FSA¿s intention of commissioning a study to investigate whether M. bovis was present in the edible tissues of salvaged carcasses from cattle which had reacted to the tuberculin test or shown evidence of M. bovis infection at post mortem inspection. In the absence of hard information, the Working Group had carried out what it saw as a reasonable assessment of risk. This gave grounds for believing that the risk of M. bovis infection from eating meat was very low. The Working Group had nevertheless offered for consideration by the FSA a number of possible management options for reducing the risk still further.
8.4 In discussion, Members indicated their support for the Working Group¿s conclusions but offered a few detailed drafting suggestions which they thought would add further clarity to the Report, in particular, that the possible practical problems associated with the risk management options should be spelled out in greater detail. Professor Johnston undertook to amend the draft to reflect these suggestions. It was agreed that the Report should then go forward as a report of the full ACMSF.
9. Safe use of eggs by caterers
9.1 Mr Kyriakides and Mrs Jefford declared interests in relation to this item (see paragraphs 1.4 and 1.5).
9.2 The Chairman explained that the FSA had commissioned a pilot study to estimate the nature and extent of adherence by the catering industry to Government and ACMSF advice on the safe use of eggs. The results of the pilot study were reported in ACM/527. ACMSF Members were being asked to comment on whether they regarded the research methodology as robust; to advise on the need for further work to provide a sounder basis for risk assessment, including repeating the work nation-wide; to comment on whether any of the sectors surveyed was of greater concern than the others; to advise on any necessary action on residential home disclaimers; and to consider whether, in the light of the survey¿s findings, existing advice and methods of dissemination remained appropriate. The research had been carried out by the University of Salford. Professor Georgala invited the project leader, Professor Eunice Taylor, to introduce ACM/527.
9.3 Professor Taylor said that, to overcome some of the difficulties inherent in obtaining a representative picture of the catering industry, the study had been based on 4 clearly-identified, high risk sectors, namely nursing homes, restaurants, sandwich operations, and function caterers. All the premises were in the Preston area. A lot of time had been spent pre-piloting access, to ensure representative sampling and an accurate picture of the 4 sectors. Twenty-five businesses were surveyed in each of the 4 sectors. The pre-piloting work had paid dividends in that access was obtained to all 100 sample premises. Researchers asked questions, observed practices and examined documentation. It emerged that, overall, little information on the safe handling of eggs had permeated down to the caterers questioned. Practices seemed to have changed very little over time. There had been little evidence of awareness of the potential of eggs to give rise to food safety problems and, with few exceptions, the handling of eggs did not feature in HACCP documentation. Few of those questioned recognised the inherent perishability of eggs or the advice that they should be consumed within 3 weeks of lay. There was general evidence of good stock rotation but this appeared to be by accident rather than design. There was often pressure on storage space, leading to half of those surveyed storing eggs at ambient temperature. Even where eggs were stored refrigerated, they were often brought out of refrigeration well in advance of cooking. There was little use of pasteurised eggs, although supplies were readily available locally. Although well over 90% of staff in sampled premises had received basic food hygiene training, no more than 25% claimed any recall of egg safety issues raised during food hygiene training. Soft eggs continued to be served in most of the premises sampled, including in nursing homes. Those in nursing homes wishing to consume soft eggs were often required to sign disclaimers acknowledging the associated risks involved and absolving those running the homes from liability. Over 10% of premises surveyed were using raw eggs in dishes designed to be eaten uncooked. There was little knowledge about Lion eggs.
9.4 In response to a Member¿s question, Professor Taylor said that only in the case of function caterers had Yellow Pages been used to help identify businesses. Even then, Yellow Pages information had been supplemented with details taken from the local authority food premises data base. Professor Taylor acknowledged that small and medium sized enterprises often struggled to come to grips with HACCP. However, she emphasised that HACCP principles were not complicated and, in her experience, when they were demystified, they became readily intelligible to SMEs. Professor Taylor accepted that getting food hygiene messages successfully across to caterers depended in large measure on ensuring that audiences were receptive. It was for consideration whether environmental health officers were the best means of disseminating advice, which raised the question of whether they should restrict themselves to enforcement and leave the advisory function to others. It was noted, however, that environmental health officers were currently required to give equal attention to training and enforcement.
9.5 One Member made the point very strongly that extending the pilot study nation-wide was unlikely to reveal a different situation. Things tended to change very little in the catering sector. Caterers generally purchased eggs at least cost. Catering staff were often poorly paid and in those circumstances were unlikely to give proper attention to guidance on storage, handling and use. The exception would be those employed in large catering establishments where staff had obtained catering and hygiene qualifications. Smaller operators especially were under severe time and resource pressures, as were local authority environmental health departments. The only truly effective way of tackling the problem of poor hygiene practice was through more and better education and training, starting in schools. Other Members supported the call for better education. Television was seen as a particularly powerful medium for affecting food hygiene behaviour. If TV chefs were to adopt better practice, this could have a great effect. However, Members recognised the inherent difficulties in achieving this. One Member thought that it might be useful to repeat the pilot study in the same premises after some educational intervention, with a view to assessing whether there had been any improvements.
9.6 In conclusion, Members turned their attention to the particular questions which they had been asked to address. The methodology used in the pilot study was regarded as satisfactory. Members felt generally that the sum of knowledge was unlikely to be improved significantly by extending the survey nation-wide (although a nation-wide survey, simply by virtue of being nation-wide, might engender greater industry confidence in the results). None of the 4 sectors surveyed appeared to be more problematical than the others. The comments made on the need for a standard approach to food hygiene applied equally across all 4 sectors. HACCP appeared to be a common problem across all types of catering establishment surveyed. Members felt that the use of disclaimers in nursing homes was unacceptable. However, they considered that this should be taken up as part of a more general approach to promote the broader responsibility of operators to ensure proper attention to best hygiene practice in kitchens. One Member noted that Care Standards legislation, directed towards improving standards in residential care, would soon enter force. Finally, in relation to the dissemination of advice, Members noted that the FSA had identified catering as a key element in its food hygiene publicity strategy. The Agency would doubtless find the results of the pilot study helpful in that context.
10. FSA review of scientific advisory committees
10.1 The Board of the Food Standards Agency has requested the Agency to undertake a review of the role, methods of operation, and effectiveness of those independent scientific committees which provide it with advice on food issues. A R