Food Protection Trends - July/August 2024 - 284

foodborne pathogens, how FANOs manage food safety
concerns and comply with food safety standards, especially
among the vulnerable populations that they often serve,
are critical components of public health, safety, and food
and nutrition security (3, 58). Complex food safety policy
and the scope of FANOs complicate research and practice,
resulting in food waste and the risk of foodborne illnesses.
This article presents an overview of the subject matter drawn
from federal and state policy and the scholarship of nonprofit
management, public policy, and food safety.
FANOS AND FOOD SAFETY
Nonprofits play a critical role in the food supply chain
from preproduction to production, distribution, and
consumption (37). FANOs engage in the food supply chain
through (1) education, training, and advocacy on behalf of
producers and consumers; (2) agricultural production; (3)
distribution of food through food banks and pantries; and
(4) meal programs. At each stage of the food supply chain,
nonprofits inevitably encounter the need to implement
food safety measures to ensure that safe foods reach consumers
(3, 59). Foods, especially foods that reach food and
nutrition-insecure consumers, cannot serve their function
as a health-sustaining source of life if their consumption
causes illness (57). Figure 1 portrays the typical network
of FANOs in any given community, demonstrating the
complexity of a system of FANOs and how implementing
consistent food safety practices across a community of food
sources may prove challenging.
Food safety risks
Food safety protocols follow a set of standards that describe
the proper production, handling, storage, preparation, and distribution
of consumable food to manage the risk of foodborne
illness (57). It is documented that >200 known diseases are
transmitted through foods, and the causative agents include,
but are not limited to, viruses, bacteria, parasites, and toxins
(35). In the United States, based on comprehensive long-term
active and passive surveillance data and other sources, the
leading cause of foodborne illness is noroviruses, followed by
bacteria (i.e. nontyphoidal Salmonella spp., Clostridium perfringens,
and Campylobacter spp.) (6, 39).
To prioritize prevention efforts, epidemiologists attribute
foodborne illness to specific commodities. For example,
from 1998 to 2008, 46% of foodborne illness was attributed
to produce and more deaths were caused by poultry than by
other commodities (37). In 2021, the Centers for Disease
Control and Prevention compiled multistate outbreaks and
identified 74 foodborne outbreaks of contaminated foods;
they were primarily linked to Salmonella spp., Shiga toxin-
producing Escherichia coli and pathogenic serotypes, and
Listeria monocytogenes found in cooked chicken and leafy
greens (7). Overall, these outbreaks caused 3,615 illnesses,
1,011 hospitalizations, and 26 deaths. Notably, more than
284 Food Protection Trends July/August
one third were due to Salmonella from backyard poultry
and contact with chickens, ducks, geese, and turkeys. Other
Salmonella outbreaks have been linked to undercooked
ground beef and raw cookie dough (5). These various
outbreaks of foodborne illness demonstrate their prevalence
as a health issue while also posing the question of what role
FANOs play in such outbreaks. For example, multiple cases
of Salmonella infections were determined to be a result of a
frozen chicken product distributed in Ruby's Pantry, a food
pantry with locations in Minnesota and Wisconsin (1).
In 2022, 534 orders of Jif peanut butter distributed across
food banks in northeastern Ohio were linked to multistate
Salmonella outbreak (2). Ultimately, these two examples
illuminate the need to define the role that FANOs play in
ensuring food safety in the food supply chain as well as the
importance of assessing the adequacy of the current safety
practices for food handling, preparation, and distribution.
Risk of foodborne illness in nonprofits
Food safety standards are implemented to ensure that
food systems practices prevent the risk factors associated
with foodborne illness (28). Noncompliance with retail food
safety standards is higher among organizations that require
food storage or provide emergency food delivery (9). Food
banks and food pantries face challenges in storing significant
amounts of food options for longer periods of time and are
limited by low budgets and decentralized systems (3). Unlike
in the commercial food industry, food inflow and outflow
can be unpredictable in nonprofit food banks and food
pantries. These FANOs depend upon the availability of food
donations. External factors such as emergencies or welfare
programming changes affect demand. Unstable supply and
demand destabilizes such nonprofits and can pull resources
away from compliance oversight.
OPPORTUNITIES AND CHALLENGES OF FOOD
SAFETY RESEARCH AND FANOS
Some FANOs are driven by missions or incorporate
program components to educate consumers, food handlers,
and producers on the importance of food safety to
reduce foodborne illness (42). Although education efforts
are an important component of reducing foodborne illness
among food handlers (33), other systems-based interventions
have also been recommended, such as improving
transportation efficiency (13). In this investigation, we
identify three challenges in food safety-related issues and
nonprofit organizations. These challenges elucidate areas
of opportunity for improvement through changes in practice,
policy, and research. First, poor food safety practices
in FANOs can lead to food waste. Second, such practices
are driven by inadequate knowledge of safe food handling
by FANO staff, volunteers, and clientele. Third, complex
and unclear food safety policy implementation perpetuates
these problems.
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