Boy, I’m away for only a week and find out I’ve missed on so much! I really, really don’t want to have to be such a downer already, but it seems that not just one, but three food safety scandals have been making the newsrounds in China these last two weeks. And as a family/community doctor also focused on public health, I do feel it’s my duty to provide this information to my expat patients in order to protect their health and take proactive steps. So, let’s jump in:

#1. Dirty Chopsticks — The Global Times had an article discussing a CCTV expose of the reusable chopstick industry and found that the majority were being improperly cleaned with unhealthy chemicals including paraffin wax, sulfur and hydrogen peroxide. Here’s a good quote:

Disposable chopsticks used in Beijing come from Hunan and Heilongjiang Province, where the raw materials bamboo and timbers abound, according to Dong Jinshi with Kaifa Environment Technology Consultation Center.

A consumer rights veteran, Dong has been helping to raise awareness of the potential impact of these chopsticks on health. “Eighty percent of these things are not safe,” he said, “and when you consider the packaging, it is only worse. Some plastic sleeves are made of garbage plastic.”

“The way they are made and packaged could potentially cause many diseases,” he said. “An overdose of sulfur dioxide gives you asthma. And talcum powder can cause gallstones.”

What can we do? I think an ultimate answer is to always carry around your own metal chopsticks. Many stores sell metal chopsticks that you can unscrew in the middle and carry in a tiny box. I personally do this at work and am considering just throwing one in my bag as well. That not only cuts down on the environmental impact of needing less disposable/reusable chopsticks, but also eliminates the above issue of dangerous cleaning chemicals. That also eliminates the frequent problem of incompletely washed chopsticks you often find in the smaller restaurants, where bacteria and viruses could still be on them. Of course, none of this stops the slightly disturbing practice of banquet dining in China, where everyone dips and redips their chopsticks into the shared dishes. A recent study definitely showed a large increase in multiple bacteria in those shared dishes, and clearly this is a risk for disease transmission. That’s why the top restaurants should provide a separate spoon or chopstick for each dish — but I find those places to be very rare.

#2. Dangerous Take-out Boxes – The Global Times reported this week on a civil lawsuit against two Beijing restaurants for using take-away boxes that had dangerous levels of chemicals which can affect your health. It seems that the combination of these cheaper plastics and waste can interact with oils and vinegars in the leftovers and rapidly leach the dangerous chemicals into your food — especially if you reheat them in the plastics or styrofoam.

The quality problem is very serious in the manufacturing industry of one-off plastic tableware. A large amount of industry-used calcium carbonate, paraffin wax and recycled waste are added to the production materials, making the products react easily to vinegar or oil, which leaches into the food, the report said.

Industry-used calcium carbonate and paraffin wax can damage our digestive and nervous systems, and are triggers of cancer. The recycled waste may be traded to the left-over bits and pieces of industrial material, or even medical waste, the China Youth Daily reported.

It’s a sobering article and quite relevant to all our daily lives. What can we do? Well, it’s not practical to bring your own Tupperware to a restaurant, but as soon as you get home, you should transfer the food to proper containers — glass is always preferable to plastic. And definitely do not microwave the food in the original container!

#3. Dirty Reused Cooking Oil — Lastly was the big news that many smaller restaurants and street vendors try to save money by using dumped cooking oil that literally was retrieved from the sewers, then purified overnight just enough to look clear again but keeping in many toxic and dangerous chemicals.  As usual, the increasingly excellent Global Times covers the story well:

Huang Fenghong, deputy director of the Oil Crops Research Institute at the Chinese Academy of Agricultural Sciences, told the Global Times that, after seven years of field research, his research team has concluded that the use of recycled oil is rampant in some areas, especially where cash-strapped migrant workers and students are major diners.

Recycled cooking oil, dubbed “drainage oil,” is refined from discarded kitchen waste and reused in the preparation of meals at restaurants and canteens.

“The use of drainage oil will put the public’s health in peril because it may contain heavy metal, waste antibiotics or aflatoxins, a highly toxic substance that could cause cancer,” he said.

Apparently, maybe 10% of Chinese are ingesting this oil every year.

Is There A Lesson Here?

As my Chinese in-laws point out, none of these issues are new — there seems to be a continuous wave of food safety issues that temporarily get fixed and then sneak out again after the press moves on. But we have to eat, right? So I suppose the best thing is to apply the health care industry’s universal precautions protocol to food. Universal precautions is a recent movement that most health agencies now enforce as a way to cut down on infectious disease risks like getting HIV or hepatitis from needle sticks. It basically assumes that anyone can potentially be a carrier of infectious disease, so when healthcare workers get bodily fluids (needles, bedpan changes) we should always use gloves and gowns and other barriers. Yes, this may seem like common sense, but even just 20 years ago many, if not most, doctors and nurses were not regularly using gloves for these.

Regarding food, I think we should all just apply the same universal precautions to food here in China — simply assume that wherever you are, there may be risk of ill health from not only the food but the food delivery (waiters, cooks, utensils, etc). That doesn’t have to be a scary thing, just a practical one. It means you know darn well that street vendors and smaller stores carry a higher risk, but even a 5-star isn’t immune if the prep cook didn’t wash their hands after the toilet or their takeaway box supplier tried to cut corners on quality. So just take simple common sense precautions, bring your own chopsticks, and enjoy!