CDC MMWR - An Increase in Chemical Contamination Issues Associated with Cleaning Chemicals During COVID-19 Pandemic

There has been a marked increase in the number of chemical contamination issues since March 2020 due to misuse of chemical cleaners and disinfectants due in large part to consumers reacting to the COVID-19 pandemic.  Young children represented a large percentage of the cases.  Bleaches accounted for the largest percentage increase among cleaners whereas nonalcohol disinfectants and hand sanitizers accounted for the largest percentages of the increase among disinfectants.  Inhalation represented the largest percentage increase for exposure routes.

"The daily number of calls to poison centers increased sharply at the beginning of March 2020 for exposures to both cleaners and disinfectants (Figure). The increase in total calls was seen across all age groups; however, exposures among children aged ≤5 years consistently represented a large percentage of total calls in the 3-month study period for each year (range = 39.9%– 47.3%) (Table). Further analysis of the increase in calls from 2019 to 2020 (3,137 for cleaners, 4,591 for disinfectants), showed that among all cleaner categories, bleaches accounted for the largest percentage of the increase (1,949; 62.1%), whereas nonalcohol disinfectants (1,684; 36.7%) and hand sanitizers (1,684; 36.7%) accounted for the largest percentages of the increase among disinfectant categories. Inhalation represented the largest percentage increase from 2019 to 2020 among all exposure routes, with an increase of 35.3% (from 4,713 to 6,379) for all cleaners and an increase of 108.8% (from 569 to 1,188) for all disinfectants.

The two cases used to showcase the issue:

1. "An adult woman heard on the news to clean all recently purchased groceries before consuming them. She filled a sink with a mixture of 10% bleach solution, vinegar, and hot water, and soaked her produce. While cleaning her other groceries, she noted a noxious smell described as “chlorine” in her kitchen. She developed difficulty breathing, coughing, and wheezing, and called 911." 
2. "A preschool-aged child was found unresponsive at home and transported to the ED via ambulance. A 64-ounce bottle of ethanol-based hand sanitizer was found open on the kitchen table. According to her family, she became dizzy after ingesting an unknown amount, fell and hit her head. She vomited while being transported to the ED, where she was poorly responsive. Her blood alcohol level was elevated at 273 mg/dL (most state laws define a limit of 80 mg/dL for driving under the influence); neuroimaging did not indicate traumatic injuries."

Keys:

• Do not mix chemicals
• Follow label instructions
• Keep chemcials out of the reach of children (or adults who don't read instructions).

CDC MMWR

Cleaning and Disinfectant Chemical Exposures and Temporal Associations with COVID-19 — National Poison Data System, United States, January 1, 2020– March 31, 2020

FDA Issues Warning Letters to Three Importers Due to FSVP Issues

FDA issued Warning Letters for non-compliance for the Foreign Supplier Verification Program (FSVP) to three companies:

• Nassif Wholesale LLC., of Palm Springs, FL did not have a FSVP for Sesame seeds, tahini and Semolina imported from (b)(4).
• Fatima Brothers Inc. located at 5601 56th Dr. Maspeth, NY did not have a FSVP in place for Boiled Rice and Cake rusk.
• Prime Line Distributors Inc., located at 2800 SW 42nd St. Ft. Lauderdale FL did not have a FSVP for  Hazelnut Paste, Gran Padano Cheese and Parmigiano Reggiano Cheese

https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/warning-letters/nassif-wholesale-llc-604640-03192020
WARNING LETTER
Nassif Wholesale LLC
MARCS-CMS 604640 — March 19, 2020

FDA Warning Letter - Processor Out of Compliance with Acidified Foods Regulation.

FDA issued a Warning Letter to a New Jersey processor of acidified food and dry food mix products.  The main issue was that they did not file a process with FDA as part of the Acidified Foods regulation.  Specifically, the company must file a process "for heat processing and control of pH, salt, sugar, and preservative level, and source and date of the established process, for each acidified food in each container size, as required by 21 CFR 108.25(c)(2). However, [FDA's] inspection revealed that [the company] failed to file a scheduled process with FDA for [the] firm’s shelf-stable acidified products, including, but not limited to, Garlic in Oil; Hot Sauce; Gravy Booster & Color Sauce; Deluxe Barbecue Sauce; Sweet & Smoky BBQ Sauce; and Ranch, Italian, French, Thousand Island, Russian, Creamy Italian, and Caesar salad dressings."

Along with this, the company did not have validated systems, trained employees in Better Process Control, record keeping, and testing.  They also did not have a Preventive Control plan.

FDA Warning Letter
https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/warning-letters/allied-food-products-inc-606511-04142020
Allied Food Products Inc
MARCS-CMS 606511 — April 14, 2020

This Week in Mislabeled Product for Week Ending April 18, 2020

The Whole Foods Market store located at 7111 E Mayo Blvd. Phoenix, AZ 85054 is voluntarily recalling Queso Sauce because it may contain cashews (a tree nut).  The issue was discovered after a customer reported a reaction. One reaction has been reported to date.

https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/allergy-alert-issued-undeclared-cashews-queso-sauce-sold-single-whole-foods-market-store-phoenix
Allergy Alert Issued for Undeclared Cashews in Queso Sauce Sold at a Single Whole Foods Market Store in Phoenix, Arizona
Summary
Company Announcement Date:  April 16, 2020
FDA Publish Date:  April 16, 2020
Product Type:  Food & Beverages
Reason for Announcement:  Undeclared cashews
Company Name:  Whole Foods Market
Brand Name:  Whole Foods Market
Product Description:  Queso Sauce

Virginia Company Recalls Butter After Positive Listeria Test

Homestead Creamery Inc of Wirtz, VA, is recalling our unsalted butter because of the potential contamination of Listeria monocytogenes,  There have been no reported illnesses.  The potential for contamination was noted after routine testing by Homestead Creamery and revealed the presence of Listeria monocytogenes in our unsalted butter.

https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/homestead-creamery-recall-unsalted-butter-because-possible-health-risk
Homestead Creamery Recall “Unsalted” Butter Because of Possible Health Risk
Summary
Company Announcement Date: April 01, 2020
FDA Publish Date:  April 17, 2020
Product Type:  Food & Beverages   Butter/Butter Product
Reason for Announcement:  Foodborne Illness Potential to be contaminated with Listeria monocytogenes
Company Name:  Homestead Creamery Inc.
Brand Name:  Homestead Creamery
Product Description:  Unsalted Butter

Wasted Food - Food Supply Chain Ripple Effects from COVID-19 Pandemic

While many were concerned that there may not be enough food during the pandemic, that has not been the case.  The biggest impact so far has been food going to waste or not being made due to the dramatic loss of sales through the food service sector.  The article from Bloomberg gives a glimpse at how food that would have gone to the food service sector may not get used at all.   Farmers plowing crops under, milk getting dumped, are some examples.

Why?  People normally eat out a lot, and when they eat out, they eat a lot.  The foods they eat are more varied.  At home, people eat less and stick with staples they know how to cook...potatoes for example.  And people waste less at home.  

So items like chicken wings...probably not going to make those at home.  Kids who drank milk at school, are probably not drinking milk at home.  Clam chowder....love it, but never make it at home.

Exotics like mangoes...people are not making mango drinks at home.  Stores are more concerned about carrying the staple food items like potatoes and onions, may decide not to carry mangoes at this time.  The result, mangoes are not getting harvested.

Another issue is packaging such as container size.  Processors who pack primarily or solely for the food service sector cannot simply retool their operation.  If you pack in #10 cans (1 gallon) for food service, well this is not an item for consumers.  And putting a processing line is for 16 oz cans (303 cans) is not possible without a large expenditure of many.

Finally, it is not easy to change distribution channels.  Developing efficient channels can take years.  If you have a field of fruit that you sold to a a processor who made product for the food service trade, you simply can't decide to make process grade crops into consumer-ready items.

Many will say then donate it.  Well for a plant or packing house that supplies the several state to the entire US with product, you can only donate so much to your local food bank.  There is too huge of a cost to distribute that product broadly.  With crops in the field with a limited shelf-life, that task is even more difficult.

On the other side of the chain, you have the food banks who relied to a great degree on the food service sector....not that these 'middlemen' are no longer producing product, that link between the field and the food bank is severed.  And as mentioned, the 'extra made' product in the food service sector that hopefully was making its way to the food banks, drove a lot of volume from the producers - the farms, packers, processors.

 Bloomberg

https://www.msn.com/en-us/money/companies/food-makers-get-shot-of-reality-now-that-panic-buying-has-waned/ar-BB12J4SI?ocid=spartanntp_edu
Food Makers Get Shot of Reality Now that Panic Buying Has Waned
Isis Almeida, Mike Dorning and Marvin G. Perez 10 hrs ago

Controlling Aerosols - Pennsylvania Requires Masks for Essential Workers While Working

Pennsylvania issued a directive requiring essential workers to wear masks when working.  The issue for controlling aerosols from those who may have the virus.

"A business that is authorized to maintain in-person operations, other than health care providers, pursuant to the Orders that the Governor and I issued on March 19, 2020, as subsequently amended, shall implement, as applicable, the following social distancing, mitigation, and cleaning protocols:
(10) provide masks for employees to wear during their time at the business, and make it a mandatory requirement to wear masks while on the work site, except to the extent an employee is using break time to eat or drink, in accordance with the guidance from the Department of Health and the CDC. Employers may approve masks obtained or made by employees in accordance with Department of Health guidance;

There are other requirements including cleaning, maintaining limits on people to maintain spacing, etc.

While many may question the need for this.  A study from Western details how aerosols travel through the air.   while the work was done in a chamber, there is recognition that other factors will influence speed and loft.

The study details how a cough puts aerosols into the air.  At peak velocity, aerosols are moving at 1.2 m/sec (4 ft /sec) and 10% of the particles stay suspended after 4 seconds.    So as suggested by the article, a 6 foot physical separation may not be enough in itself.

Click on the article link for viewing aerosol ejection from the mouth.

Pennsylvania Department of Health

file:///C:/Users/mwb124/AppData/Local/Microsoft/Windows/INetCache/Content.Outlook/8XX8W1BK/20200415-SOH-worker-safety-order%20(2).pdf

Order of the Secretary of the Pennsylvania Department of Health Directing Public Health Safety Measures for Businesses Permitted to Maintain In-person Operations  

 

Two Eastern PA Facilities Rocked by COVID-19

Two Pennsylvania food processing facilities rocked by COVID-19. Cargill's facility in Hazleton and JBS facility in Souderton, PA both closed after numerous cases.

Philadelphia Inquirer
https://www.inquirer.com/business/meat-plants-pennsylvania-cargill-jbs-souderton-covid-20200409.html
Hazleton meat-packaging plant closes with 130 workers testing positive for COVID-19. Union leader at Souderton plant died last Friday.
by Bob Fernandez, Updated: April 9, 2020- 5:07 PM

Cargill Meat Solutions, a 900-worker plant in Hazleton, Pa., that packages meat in plastic for supermarket shelves in Pennsylvania and surrounding states, shut down temporarily on Tuesday as 130 hourly workers have tested positive for COVID-19 and a rash of employees called out sick, a union leader said.

FDA Warning Letter - Bakery with Listeria Issues

FDA issued a warning letter to an Indiana bakery after "investigators found serious violations of the [GMPs and Preventive Controls Regulations]. Additionally, FDA collected environmental samples (i.e., swabs) from various areas in [the] processing facility. FDA laboratory analysis of the environmental swabs found the presence of Listeria monocytogenes (L. monocytogenes), a human pathogen, in your facility, including the same strains found during FDA inspections in 2018 and 2016"

The facility was producing croissants, and not that those have a history as a vehicle of Listeria, never the less, the organism had been found in the facility in subsequent inspections as well as the current.  It appears that the cleaning of the facility was not very good, thus allowing the Listeria to persist over time.

https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/warning-letters/cafe-valley-bakery-llc-603875-03182020
WARNING LETTER
Cafe Valley Bakery, LLC
MARCS-CMS 603875 — March 18, 2020