FDA Cannabis: Final Qualitative Assessment of Risk to Public Health from On-Farm Contamination of Produce

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Hazard Identification

The Hazard Identification provides an overview of the biological agents capable of causing
adverse health effects that may be present in produce. Hazards are identified from relevant sources,
including the scientific literature, outbreak data, and other sources such as the Reportable Food Registry

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Biological Hazards
1. CDC Data Historical data reported to the U.S. Centers for Disease Control and Prevention (CDC) indicate that, in the 25 year span between 1973 and 1997, outbreaks of foodborne illness in the United States associated with produce increased both in absolute numbers and in proportion to all reported
foodborne outbreaks [189]. By “outbreak,” we mean the occurrence of two or more cases of a similar
illness likely resulting from the ingestion of a common food. Between 1973 and 1997, CDC reports that
190 produce-associated outbreaks occurred, 16,058 people became ill from these outbreaks, 598 people were hospitalized, and eight died [189].More recently, in the 11 year span between 1998 and 2008, CDC reports that 455 total produce-associated outbreaks occurred [48], more than twice that reported in the prior 25 year span between 1973 and 1997. These outbreaks were caused by a wide variety of pathogens, including bacteria (e.g., Salmonella, Escherichia coli (E. coli) O157:H7, non O157:H7 Shiga toxin-producing E. coli (STEC), viruses (e.g., Hepatitis A and Norovirus), and parasites (e.g., Cyclospora cayetanensis) [48, 189]. The pathogen-commodity pairs responsible for the most illnesses during the 1998-2008 reporting period were norovirus and leafy vegetables (4,011 illnesses) and Salmonella and vine-stalk vegetables (3,216 illnesses). The pathogen-commodity pairs responsible for the most hospitalizations and deaths were Salmonella and fruits/nuts (452 hospitalizations, 14 deaths), Salmonella and vine-stalk vegetables (441 hospitalizations) and STEC and leafy vegetables (301 hospitalizations, 7 deaths) [48]. Among outbreaks occurring in a single year, in 2006, that were likely caused by a single food vehicle (n = 243), 17 percent of cases were attributed to leafy greens (including mixed salads) and 16 percent were attributed to fruits (including juice) and nuts[42]. Produce
constituted the single largest category of foodborne illness cases attributed to a single food vehicle in
2006 [42]. Among outbreaks occurring in 2013 reported to be attributed to a single food vehicle (n =
210), the most illnesses were attributed to produce: 5% of which were associated with leafy greens and
11 % associated with fruits [49].

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