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Encyclopedia of Health and Medicine

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24 Preventive <strong>Medicine</strong><br />

cantly reduce this stress <strong>and</strong> its corresponding<br />

injuries. An improved method might be as simple<br />

as using a footstool or sliding ladder instead <strong>of</strong><br />

reaching for items on shelves, or could require<br />

retraining employees in proper use <strong>of</strong> equipment<br />

<strong>and</strong> machinery.<br />

Ergonomic factors account for about 4 million<br />

injuries among Americans each year, about half <strong>of</strong><br />

which are serious enough to require medical care<br />

or limit participation in daily activities. Ergonomic<br />

injuries further account for a third <strong>of</strong> lost work<br />

time. Most <strong>of</strong> these injuries are musculoskeletal.<br />

The US Occupational <strong>Health</strong> <strong>and</strong> Safety Agency<br />

(OSHA) develops <strong>and</strong> administers guidelines for<br />

ergonomic st<strong>and</strong>ards <strong>and</strong> improvements in the<br />

workplace. Though implemented changes to<br />

improve the ergonomics <strong>of</strong> job tasks can prevent<br />

future injuries, people who have already experienced<br />

ergonomic-related injuries may have longterm<br />

or permanent health consequences.<br />

See also ACCIDENTAL INJURIES; OCCUPATIONAL<br />

HEALTH AND SAFETY; REPETITIVE MOTION INJURIES.<br />

food safety FOODBORNE ILLNESSES sicken 76 million<br />

Americans each year, 5,000 <strong>of</strong> whom die as a<br />

result. Public health efforts target food safety on a<br />

community as well as an individual level. At the<br />

public safety level, the US Department <strong>of</strong> Agriculture<br />

(USDA) <strong>and</strong> the US Food <strong>and</strong> Drug Administration<br />

(FDA) oversee numerous programs that<br />

regulate food safety in the United States. These<br />

programs cover the gamut <strong>of</strong> food production <strong>and</strong><br />

include pesticide <strong>and</strong> herbicide use, animal feed<br />

<strong>and</strong> use <strong>of</strong> supplements, food additives, product<br />

packaging <strong>and</strong> labeling, <strong>and</strong> safe food h<strong>and</strong>ling<br />

practices among wholesalers <strong>and</strong> retailers (including<br />

grocery stores <strong>and</strong> restaurants). These agencies<br />

inspect production facilities <strong>and</strong> test produce,<br />

grains, dairy products, meats, <strong>and</strong> other foods for<br />

biological <strong>and</strong> chemical contaminants.<br />

The US Centers for Disease Control <strong>and</strong> Prevention<br />

(CDC) monitors foodborne illness outbreaks,<br />

in coordination with state <strong>and</strong> local health<br />

departments. These agencies investigate illnesses<br />

<strong>and</strong> recommend corrective procedures to prevent<br />

future outbreaks. They also provide education <strong>and</strong><br />

training for people who work in food services<br />

industries. Though the public tends to fear outbreaks<br />

<strong>of</strong> foodborne illnesses that originate from<br />

settings such as cruise ships or restaurants, most<br />

foodborne illness occurs as a result <strong>of</strong> contamination<br />

in home-prepared foods.<br />

Summertime picnics, holiday parties, <strong>and</strong> other<br />

events where people entertain large groups in<br />

their homes or other private venues are common<br />

sources <strong>of</strong> “food poisoning.” Nearly always, these<br />

events can be traced to improper food preparation,<br />

h<strong>and</strong>ling, serving, <strong>and</strong> storage. Using the same<br />

surfaces <strong>and</strong> implements to prepare meat or poultry<br />

<strong>and</strong> then vegetables <strong>and</strong> fruits allows crosscontamination<br />

<strong>of</strong> BACTERIA that may be present on<br />

countertops <strong>and</strong> cutting boards, in the air, or on<br />

foods.<br />

Proper cooking kills the bacteria in the meat or<br />

poultry, but raw vegetables <strong>and</strong> fruits can carry<br />

bacteria <strong>and</strong> the potential for illness to those who<br />

eat them. The tendency to leave food out so people<br />

may help themselves or while other festivities<br />

take place can allow bacteria to flourish. Salads<br />

made with mayonnaise, cooked turkey, <strong>and</strong> pies<br />

left out too long at warm temperatures are commonly<br />

to blame for foodborne illness. More <strong>of</strong>ten<br />

than not, contaminated foods look <strong>and</strong> taste fine.<br />

KEY INDIVIDUAL MEASURES<br />

FOR PREVENTING FOODBORNE ILLNESSES<br />

• Wash h<strong>and</strong>s frequently with soap <strong>and</strong> warm water, especially<br />

before <strong>and</strong> after preparing food.<br />

• Use separate surfaces for preparing meats <strong>and</strong> other foods.<br />

• Thoroughly cook meats.<br />

• Keep hot foods heated <strong>and</strong> cold foods chilled when serving<br />

them buffet-style.<br />

• Promptly refrigerate leftovers <strong>and</strong> throw away most leftovers<br />

after five days.<br />

See also HAND WASHING; WATERBORNE ILLNESSES.<br />

fluoridation Fluoride is a naturally occurring<br />

element that enhances a tooth’s ability to retain<br />

hardening minerals such as calcium. US federal<br />

regulations began requiring communities to add<br />

fluoride to their water supplies, when naturally<br />

occurring levels <strong>of</strong> fluoride fall below 0.7 parts per<br />

million (ppm), in 1945 as a means <strong>of</strong> reducing<br />

DENTAL CARIES (cavities). Fluoride <strong>of</strong>fers the greatest<br />

protection when it is in the bloodstream as the<br />

TEETH are forming, so it becomes part <strong>of</strong> the<br />

enamel. Even after the teeth have fully developed,

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