E. Coli: A Toxic Presence in the Workplace

Nearly 76 million Americans contract food-borne illnesses each year. Approximately 300,000 of these are hospitalized, and 5,000 die.¹ Children under age 4 are sickened by food more than those in any other age group, but adults over age 50 suffer more hospitalizations and death as a result of food-related infections.¹

E. Coli Overview
One specific type of food-related infection is caused by Escherichia coli O157, abbreviated as O157 STEC. This bacteria causes 73,000 illnesses, 2,000 hospitalizations and 60 deaths annually². There is an average of 3-4 days between initial infection with O157 and onset of symptoms.³

Humans usually become infected:

• By eating beef or other contaminated foods,
• By drinking or swimming in contaminated water,
• Through person-to-person transmission, or
• Through contact with infected farm animals.²

Symptoms include diarrhea, stomach cramping and sometimes fever.³ Sixteen percent of infections requiring hospitalization result in hemolytic uremic syndrome (HUS), a complication involving acute kidney failure.² Hemolytic uremic syndrome usually develops seven days after the appearance of first symptoms when diarrhea is improving and may result in death or end-stage renal disease (ESRD).²

Economic Costs and Why Employers Should Care

• The total estimated cost of O157 STEC infections is $405 million — $370 million for premature deaths, $30 million for medical care, and $5 million for lost productivity.²
• Overall, annual medical and pharmaceutical care for O157 STEC cases was estimated to include approximately:
  • 20,000 physician visits.
  • 7,500 emergency department visits.
  • 1,820 hospitalizations without an HUS diagnosis.
  • 348 hospitalizations with an HUS diagnosis.²
  • 5,500 courses of prescription medications.
  • 24,700 retail units of nonprescription medication on an outpatient basis.²
• O157 STEC-infected individuals lose an estimated 24,200 days from work each year

Implications for employers are imminent as almost everyone has some risk of infection.³ Corporate kitchens and catering must be carefully monitored to prevent cross-contamination and ensure safety. Additionally, in-house dining services present an increased risk for exposure.⁴

What Employers Can Do at Home and Work
To prevent O157 infections in the workplace, employers should:

• Educate employees on proper food handling techniques;
• Promote hand washing policies;
• Establish a workplace inspection plan for food preparation facilities⁵
• Schedule an inspection with a trained external professional of food preparation facilities⁵; and
• Communicate food product recalls to employees.

The CDC recommends five general tips for reducing food borne disease:

• Cook meat, poultry, and eggs thoroughly.³
• Separate foods from one another. Wash hands, utensils, and cutting boards well, with soap and hot water, before they come in contact with another food.³
• Chill leftovers promptly to prevent bacteria growth.³
• Clean produce and avoid leaving it at room temperature for long periods of time.
• Wash hands before preparing food, especially after using the restroom or changing diapers.³
• Report suspected food-borne illnesses to your local health department.³

For prevention tips and recall information, especially during the summer months, visit the United States Drug Administration (USDA) Food Safety and Inspection Service Fact Sheets and Food Safety and Inspection Service Food Recalls. Additional information on O157 STEC is also available at the Centers for Prevention and Disease Control (CDC) E. Coli Homepage.

References

1. Harris, Gardiner. U.S. food safety no longer improving. New York Times. Available at: http://www.nytimes.com/2009/04/10/health/policy/10food.html?_r=3. Accessed July 6,2009.
2. Frenzen P, Alison Drake, Frederick Angulo. Economic cost of illness due to Escherichia coli O157 infections in the United States. Journal of Food Production. 2005;68(12):2623-2630.
3. Centers for Disease Control and Prevention. E. coli outbreak investigations. Available at: http://www.cdc.gov/ecoli/outbreaks.html. Accessed July 2, 2009.
4. National Business Group on Health. Quick Survey: Healthy Cafeteria Programs 7/25/2006. Available at: http://businessgrouphealth.org/members/secureDocument.cfm?docID=618. Accessed July 8, 2009.
5. Ben, Kimberly. Guide to workplace inspections: regular workplace inspections keep everyone safe. Business.com. Available at: http://www.business.com/directory/human_resources/workplace_health_and_safety/inspections/. Accessed July 9, 2009.