ood safety requires practices and regulations that prevent foodborne illnesses and safeguard the consumers. The most vulnerable groups include children under five, adults over sixty-five, pregnant women and the immunocompromised. According to the World Health Organisation’s 2022 report, foodborne diseases caused 600 million illnesses and 420,000 deaths annually. Even in a developed country such as the US, 48 million people were affected yearly with foodborne illnesses, leading to 3,000 deaths. According to the 2030 United Nations Agenda for Sustainable Development, ensuring access to safe, nutritious food is vital for addressing global food security and achieving Goals 2, 9, 12 and 13. Understanding and practising food safety help us build a healthier community and ensure a safe meal on every plate.

A 2023 study highlights that food can become harmful to humans through three pathways: biological, chemical and physical hazards. First and foremost are the biological hazards or risks caused by pathogens. Pathogens are disease-causing microorganisms that can contaminate food and cause severe illness in anyone who eats them. Certain foods are more susceptible to pathogens than others. These include undercooked meats, raw shellfish, undercooked eggs and unpasteurised milk. The biggest culprit in pathogenic food contamination is temperature. Most pathogens grow rapidly between 40-degree Fahrenheit and 140-degree Fahrenheit, known as the food safety danger zone. Another opportunity for the growth of illness-causing pathogens is improper reheating of food.

In kitchens, chemical hazards can come from three possible sources: first, residues such as pesticides or hormones left on or in foods from the supplier; second, cleaning agents such as chlorine; and third, toxic metals or compounds used for cooking utensils, such as chipped enamel or peeling Teflon. Physical hazards can occur with the supplier or vendor, such as when foreign particles enter the food product during the harvesting or packing. Physical contamination often occurs during food preparation, especially from hair or metal; using hairnets and avoiding metal scrubbers helps prevent such contamination.

Cross-contamination is another danger during food preparation. Cross-contamination occurs when safe food comes in contact with contaminated surfaces or items, for example when the same cutting board is used for raw chicken and vegetables without proper cleaning. To prevent this, cutting boards must be washed and sanitised between uses. Frequent handwashing with soap and water is essential. Additionally, using appropriate cleaning methods (dry, wet and combined), helps eliminate bacteria, spores, yeasts and molds, ensuring food safety and reducing the risk of cross-contamination during food preparation.

A food allergy is a medical condition where the immune system overreacts to specific food proteins, known as allergens. Even tiny amounts can trigger reactions ranging from mild (hives, digestive discomfort) to life-threatening (anaphylaxis). A 2015 study conducted at a tertiary care centre in Pakistan highlighted wheat and wheat products (e.g., soy sauce, cereals), eggs, certain nuts and dairy as common food allergens. Individuals with atopic conditions are more susceptible to multiple food sensitisations. There is no cure; strict avoidance remains the only prevention. Coeliac disease, a related autoimmune condition, is triggered by gluten in wheat, causing intestinal damage upon ingestion.

Climate change poses serious risks to food safety by increasing foodborne pathogens, chemical contaminants and mycotoxins due to rising temperatures and extreme weather. It also disrupts agricultural production, affecting food availability and complicating safety measures. Addressing these challenges requires coordinated efforts from governments, food industries and researchers. Proactive steps include strengthening food safety systems, adopting climate-resilient farming practices and investing in research to manage emerging threats and ensure a safe and stable food supply.

In Pakistan, 66 percent of foodborne illnesses are caused by bacteria; 26 percent by chemicals; and 4 percent by parasites and viruses.

Consumer food safety education involves proper storage, hygiene and contamination prevention. Proper food storage begins immediately after purchase—using refrigerator, freezer, or dry storage. The first in, first out method ensures that older stock is used first, reducing waste and spoilage. Key rules include labeling; storing items in appropriate areas; and keeping food off the floor. Food-handlers must not store raw meat above ready-to-eat food or allow any contact between the two. Maintaining a clean kitchen through regular, targeted cleaning with correct tools and understanding cleaning supply labels helps minimise foodborne illnesses. Contamination prevention can also be achieved by washing hands thoroughly for 10-15 seconds, checking inventory of cleaning supplies on a regular basis, using gloves or utensils for unpackaged food, washing produce with clean water and sanitising all utensils with warm water and appropriate solutions. Other key practices include avoiding contact with kitchen area when sick and wearing clean clothes.

A 2023 mini-review in the International Journal of Surgery: Global Health noted that in Pakistan, 66 percent of foodborne illnesses are caused by bacteria, 26 percent by chemicals and 4 percent by parasites and viruses. An analysis of 282 food samples revealed 70 percent contamination in street vendor foods and 40 percent in foods from middle- and upper-class restaurants. Salmonella incidence stands at 412 per 100,000. A study in Quetta found 38 percent of ready-to-eat foods unfit for consumption. Campylobacter was detected in 20.8 percent of 600 meat samples in Lahore; highest in chicken (29 percent). Other contaminants included pesticides and heavy metals.

Poor sanitation, food mishandling and under-reporting worsen the crisis resulting in health impacts such as gastrointestinal illness, cardiovascular issues, organ failure and cancer. Urgent action is needed to improve hygiene, food inspection and public awareness.

The review also noted a seasonal rise in Crimean-Congo Hemorrhagic Fever during Eid-ul Azha, linked to livestock handling. Pakistan ranks fourth in the Eastern Mediterranean Region for CCHF prevalence, with Balochistan reporting the most cases (38 percent). Preventive measures include animal health checks, proper carcass disposal, timely reporting and local access to diagnostic and treatment facilities, alongside pest control to reduce tick populations. Another zoonotic concern during the feast is Orf disease, a viral infection transmitted through contact with infected sheep, goats or their meat.

Hazard Analysis and Critical Control Points is a systematic food safety approach that identifies and controls hazards in the food production process. It ensures product safety and regulatory compliance and forms the basis for standards like the ISO 22000. In Pakistan, HACCP is mandatory for seafood exports under the Pakistan Fish Inspection and Quality Control Act, 1997. HACCP certification is becoming increasingly valuable for food businesses in Pakistan, both for local compliance and for gaining access to the global market.

Food safety has emerged as a critical public health concern that requires ongoing attention and action from various stakeholders, including government agencies, food producers and consumers. Ensuring adequate resources and support for government health departments is essential for maintaining food safety standards and protecting public health. Targeted campaigns can employ culturally appropriate messaging and language translations to effectively reach diverse communities. Pakistan’s food safety laws have potential, but in many areas remain ineffective due to poor enforcement.

Article 38(d) of the constitution promises provision of basic needs; safe food should be explicitly added to the list as a fundamental human right for all citizens.

The writer is a family physician at Evercare Hospital, Lahore