 The purpose of this film is to demonstrate sanitary surveillance and inspection of food preparation areas aboard ship. You will learn the significance of time-temperature relationships in the preparation, storage, and handling of foods. You will learn how to monitor and evaluate food service personnel, sanitary conditions, the effectiveness of cross-contamination barriers, and handling of leftovers. One of your responsibility as the medical department representative is the physical examination of food service personnel for disease or poor personal hygiene practices that could contribute to foodborne illness. These men have previously been examined, and their records indicate that they are free from communicable disease. At musters such as this, you will be looking for symptoms of upper respiratory illness, acne, and open lesions of the face, neck, and hands. Everyone in these areas will be clean. Nails will be cut short and will be clean. Hair length will be within appropriate limits about the head and face, and will be controlled during food preparation and service by appropriate caps, hair nets, beard bags, or snoods. Of course it is to be expected that personnel and their uniforms will be clean and neat during muster when anticipating inspection. What you need to be alert for is what happens in the course of the working day in the galley and adjacent food handling and storage areas, to the food, to the equipment, and to the personnel. Sanitary surveillance and inspection is a continuing requirement, at scheduled inspections to be sure, but also on an unscheduled basis, at random intervals throughout the working day, frequently enough so you can effectively monitor and study time related aspects of the prevention of foodborne illness over the entire food preparation cycle. You should be looking for sanitary work habits during your inspections, and for your guidance, let's review basic principles and their application during your evaluation of food service preparation areas. Among the most fundamental principles are those concerning the time and temperature relationships that either permit or inhibit the growth of bacterial organisms. They are related particularly to the preparation and handling of potentially hazardous foods, meaning any perishable food that consists in whole or in part of milk or its products, eggs, meat, poultry, fish, shellfish, edible crustaceans, or other ingredients, including synthetics that are capable of supporting rapid growth of pathogens. Pathogens for pathogenic activity are unfavorable at temperatures below 40 degrees Fahrenheit. Become increasingly favorable at about room temperature, and become unfavorable again above 140 degrees Fahrenheit when many pathogens are destroyed. Studies have shown that growth of pathogens is reduced when potentially hazardous foods are maintained at temperatures below 40 degrees Fahrenheit or above 140 degrees Fahrenheit. The danger region lies between these temperatures and particularly at room temperature, where harmful bacteria and toxins develop rapidly in protein foods. Studies also show that the hazard increases the longer such foods are held in the temperature danger region. Even if potentially hazardous foods are intermittently refrigerated, the effect is cumulative, because pathogenic activity resumes if food is then re-exposed to hazardous temperatures. Accordingly, potentially hazardous foods held between 40 and 140 degrees Fahrenheit for more than three hours are considered unsafe for consumption and must be destroyed. When such foods are not served immediately after cooking, they must either be chilled below 40 degrees Fahrenheit or held at 140 degrees Fahrenheit or higher. An indispensable tool for checking food handling and storage conditions is a calibrated thermometer or other temperature sensor that can measure the temperature range between zero degrees to 220 degrees Fahrenheit. You will be checking temperatures in numerous places at various times. Galley temperature, for example, should not exceed 80 degrees Fahrenheit. Storage spaces for potentially hazardous foods must be maintained within specified temperature ranges, freezers at zero degrees or lower. Dairy product boxes between 32 and 34 degrees Fahrenheit. Fall boxes between 32 and 35 degrees Fahrenheit. And fall boxes between 36 and 38 degrees Fahrenheit. The reading must compare with your calibrated thermometer within plus or minus 3 degrees Fahrenheit. If food is not chilled below 40 degrees Fahrenheit, it must be maintained at more than 140 degrees until ready to be served to keep it out of the danger zone. It is for this reason also that water in steam tables must be at elevated temperatures, 180 degrees Fahrenheit or higher, so that taking energy losses into consideration enough heat will still be transferred to the food container to maintain it at more than 140 degrees Fahrenheit. Under no circumstances is the steam table to be used to bring food up to that temperature due to the time it would take for the food to reach proper temperature. Similarly, the refrigerated salad bar is designed to keep foods cold and should never be used to chill foods down from room temperature. Potentially hazardous foods should have been pre-chilled in the chill box to be low 40 degrees Fahrenheit. But checking foods to see if they're cold or hot enough at any given time is only part of the challenge you face in sanitary surveillance. The other is monitoring the amount of time foods spend in various temperature ranges. For this, it is necessary to track batches of food through successive stages of preparation. Fall boxes, for example, are to be maintained in the temperature range of 36 to 38 degrees Fahrenheit. Ideal for the preferred slow thawing of frozen foods such as meat, poultry and fish. Food should remain in original containers and wrapping to ensure uniform thawing and to reduce moisture loss. Once foods are thawed, they should be held below 40 degrees Fahrenheit or cooked promptly and held above 140 degrees. Refreezing is prohibited because this increases the potential for pathogenic growth and toxin production in potentially hazardous foods and reduces shelf life. When adequate refrigeration space is unavailable, frozen foods can be thawed at room temperature provided certain requirements are followed. Room temperature must not exceed 80 degrees Fahrenheit. The food must remain in the original sealed wrappers or containers. Negative heat, warm air currents or immersion in water are not permitted. Proper precautions must be taken to ensure that foods once thawed are not allowed to remain at room temperature. Again in accordance with time and temperature rules, they must be chilled or cooked and maintained at appropriate temperatures. You as medical department representative must be notified if these rules are not observed. Every surveillance and inspection have other aspects too. For example, health standards for food service personnel require that there be no smoking in food preparation and service areas and that hand washing facilities be conveniently accessible and suitably equipped because food service personnel are required to wash hands before assuming duty and after trips to the head. Personnel are to be reminded of both requirements by conspicuously posted signs in the food service area but it is only by continued observation at random intervals that you can monitor compliance with these and other more basic preventive medicine concepts. Another basic principle you should be aware of is the need to establish barriers to prevent spread of contamination originating in equipment, mass personnel or in the foods they handle. It makes sense to wash hands that are dirty or contaminated to prevent spread of disease. It is less obvious that one food may be a source of contamination to another food. Having processed one batch of food, food service personnel must wash, rinse and sanitize equipment. Hands must be washed also before processing a different food item using the same equipment. By this action, a barrier is established that aids in preventing cross-contamination from one food to another. This is a key concept but you can determine compliance only if you are there often enough to see what actually happens. Keeping potentially hazardous foods out of the temperature danger zone as long as possible is equally important as preventing cross-contamination because hand processing of salad mixtures containing potentially hazardous foods increases the risk of contamination and takes time that must be counted against the three hour limit. Individual items should be refrigerated to below 40 degrees Fahrenheit until all ingredients are ready to be mixed. The same time and temperature principles must also be applied to dehydrated foods that have been reconstituted because they are then as susceptible to contamination as fresh items. Greens and head vegetables such as lettuce and cabbage are cleaned more thoroughly when broken apart. This step is essential if these foods are of uncertain origin or are suspected of being contaminated with pathogenic organisms. Sanitizing in a solution containing the appropriate amount of disinfectant is then required for specific periods of time. Vegetables must be thoroughly rinsed before being cooked or served. By developing a sharp awareness of the many ways in which time and temperature relationships and the establishment of barriers to the spread of contamination can contribute to sanitary conditions in the galley, you go far toward assuring that the food you and your shipmates are served is wholesome, appetizing, and above all safe to eat. Sanitary surveillance and inspection based on these principles extend beyond initial preparation to include the handling of leftovers. Potentially hazardous foods such as salad dressing in bulk containers should be placed out for service in small amounts and discarded at the end of the meal period. Potentially hazardous foods composed of ingredients that have been chopped, diced, peeled, or sliced by hand must also be discarded because the three hour time limit is usually taken up in preparing, chilling, and serving the food. On the other hand, foods that are to be retained as leftovers must be handled with due regard for certain additional basic concepts. Freezing of leftovers is strictly forbidden. Prior to refrigeration, the food must be labeled with the time and date of preparation so that storage time can be monitored accurately. Eating leftover food after more than 36 hours is prohibited. Further, it is prohibited to store leftovers at a depth greater than 3 inches. The reason again is the time and temperature relationship. The food must be chilled as rapidly as possible to remove it from the temperature danger zone. If the food mass is very extensive, the chill line may not reach the center before the permitted three hours have expired. The center of the food mass may remain warm long enough to allow growth of harmful bacteria or development of toxin. When the food mass is small enough, prompt and thorough chilling to 40 degrees Fahrenheit or below to the center of the food mass within the required time frame can be achieved. Specifically, leftovers to be chilled must be placed in shallow pans to a depth of no more than 3 inches and covered with lids, waxed paper, or other appropriate coverings. Part of your responsibility as medical department representative is to monitor the handling of leftovers in accordance with the basic principles we've just reviewed. The responsibility for sanitary surveillance and inspection continues throughout the cleanup following the meal period. From the lids on garbage containers and the search for insect infestations to the cleaning of deck, walls, food preparation areas, and equipment, your view needs to be thorough enough to assure that clean and sanitary conditions are achieved after each meal period. For example, you need to verify that proper equipment and procedures are being used to clean food contact surfaces and that no steel wool or metal polish is being used on these surfaces. You should be familiar with the procedures that apply to the cleaning of steam kettles, urns, and the component parts of these devices and other equipment throughout the galley and bakery. During one visit or another, you should observe everything that could affect the wholesomeness of food that is prepared and served. Along with utensils and all food preparation surfaces, check out cutting boards for nicks, cuts, scratches, and cracks that might harbor bacteria. Look for safety hazards such as loose wires or cables in electric ovens. Inspect for defective or missing safety guards over lighting units. Check walls, ducts, and piping for loose paint, soot, or condensation that could contaminate foods being prepared or served. Make sure that steam safety release valves operate properly and be particularly vigilant when looking for cross connections between potable and non-potable water. To avoid the possibility of backflow and contamination, there should be an air gap of at least two pipe diameters between the potable water feed line and possible sources of contamination. Cross connections may occur wherever potable water feeds a piece of equipment. In the steam table, for example, potable water supply is well above the drain. But in some installations, you might find a hazardous condition. The potable water inlet submerged in water. This could permit contaminants to feed back into the potable water system. Your efforts in conducting comprehensive evaluations of the food preparation area will significantly reduce the possibility of foodborne illness. Results of your inspection should be reported to the commanding officer using the food service inspection form NAVMED 6241. The recommendations you provide to correct unsanitary conditions may be the critical factors to protect the health of the crew.