cantly reduce this stress and its corresponding
injuries. An improved method might be as simple
as using a footstool or sliding ladder instead of
reaching for items on shelves, or could require
retraining employees in proper use of equipment
and machinery.
Ergonomic factors account for about 4 million
injuries among Americans each year, about half of
which are serious enough to require medical care
or limit participation in daily activities. Ergonomic
injuries further account for a third of lost work
time. Most of these injuries are musculoskeletal.
The US Occupational Health and Safety Agency
(OSHA) develops and administers guidelines for
ergonomic standards and improvements in the
workplace. Though implemented changes to
improve the ergonomics of job tasks can prevent
future injuries, people who have already experi-
enced ergonomic-related injuries may have long-
term or permanent health consequences.
See also ACCIDENTAL INJURIES; OCCUPATIONAL
HEALTH AND SAFETY; REPETITIVE MOTION INJURIES.
food safety FOODBORNE ILLNESSESsicken 76 mil-
lion Americans each year, 5,000 of whom die as a
result. Public health efforts target food safety on a
community as well as an individual level. At the
public safety level, the US Department of Agricul-
ture (USDA) and the US Food and Drug Adminis-
tration (FDA) oversee numerous programs that
regulate food safety in the United States. These
programs cover the gamut of food production and
include pesticide and herbicide use, animal feed
and use of supplements, food additives, product
packaging and labeling, and safe food handling
practices among wholesalers and retailers (includ-
ing grocery stores and restaurants). These agencies
inspect production facilities and test produce,
grains, dairy products, meats, and other foods for
biological and chemical contaminants.
The US Centers for Disease Control and Pre-
vention (CDC) monitors foodborne illness out-
breaks, in coordination with state and local health
departments. These agencies investigate illnesses
and recommend corrective procedures to prevent
future outbreaks. They also provide education and
training for people who work in food services
industries. Though the public tends to fear out-
breaks of foodborne illnesses that originate from
settings such as cruise ships or restaurants, most
foodborne illness occurs as a result of contamina-
tion in home-prepared foods.
Summertime picnics, holiday parties, and other
events where people entertain large groups in
their homes or other private venues are common
sources of “food poisoning.” Nearly always, these
events can be traced to improper food preparation,
handling, serving, and storage. Using the same
surfaces and implements to prepare meat or poul-
try and then vegetables and fruits allows cross-
contamination of BACTERIAthat may be present on
countertops and cutting boards, in the air, or on
foods.
Proper cooking kills the bacteria in the meat or
poultry, but raw vegetables and fruits can carry
bacteria and the potential for illness to those who
eat them. The tendency to leave food out so peo-
ple may help themselves or while other festivities
take place can allow bacteria to flourish. Salads
made with mayonnaise, cooked turkey, and pies
left out too long at warm temperatures are com-
monly to blame for foodborne illness. More often
than not, contaminated foods look and taste fine.KEY INDIVIDUAL MEASURES
FOR PREVENTING FOODBORNE ILLNESSES- Wash hands frequently with soap and warm water, espe-
cially before and after preparing food. - Use separate surfaces for preparing meats and other foods.
- Thoroughly cook meats.
- Keep hot foods heated and cold foods chilled when serving
them buffet-style. - Promptly refrigerate leftovers and throw away most leftovers
after five days.
See also HAND WASHING; WATERBORNE ILLNESSES.fluoridation Fluoride is a naturally occurring
element that enhances a tooth’s ability to retain
hardening minerals such as calcium. US federal
regulations began requiring communities to add
fluoride to their water supplies, when naturally
occurring levels of fluoride fall below 0.7 parts per
million (ppm), in 1945 as a means of reducing
DENTAL CARIES(cavities). Fluoride offers the great-
est protection when it is in the bloodstream as the
TEETH are forming, so it becomes part of the
enamel. Even after the teeth have fully developed,24 Preventive Medicine