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Nordic NewsÅke Möller |
Microbial contamination of pharmaceutical products during the 1950s gave rise to scares because of, among other things, infected wound powder and cases of blindness due to infected eye ointment. Food problems also occurred at that time due to Salmonella in meat and in baby milk powder. Now Sweden has problems with meat imported from the rest of the European Union on E.U. Food Certificates that can be unreliable.
A lot has happened over the years in the field of cleanroom technology to combat the problems of microbial contamination. The Scandinavian contamination control society, R3-NORDIC have held 30 symposia and more than 200 courses as well as giving the subject considerable exposure in its journal and has exerted a great influence on the subject.
The Nordic countries in 1971 began to follow European (Pharmaceutical Inspection Convention) Good Manufacturing Practice rules for Pharmacy and, since 1995, European Union rules. They also started to adopt EUROVENT standards for clean air filters in the 1970s and, since 1990, have taken an active part in the development of European and International standards on the subject.
In spite of all these good intentions and rules, problems still arise. One example is that Legionella infections still occur in Sweden due to energy-saving measures that encourage the use of low temperature warm water for showers, both in private homes and hospitals. This spring, there were again deaths at hospitals due to Legionella. In addition to that, unsatisfactory storage of food still causes outbreaks of serious infections among the elderly and the hospitalised.
New micro-organisms such as multi-resistant Salmonella bacteria, Escherichia coli 0157, U.K. prions and new Hong Kong avian viruses (H5N1) are now easily spread around the globe with modern, fast means of transport. The latest example is the specific E. coli strain EHEC. The solution to many of these problems is simply to apply cleanroom technology principles along all the avenues of infection. The ISO standards now coming forward will be of great assistance in this connection.
Sweden has strict and demanding hygiene rules related to food, and this has caused problems and debate since Sweden entered the European Union. Hygiene Certificates are therefore very important in the growing inter-state trade but in Sweden they have now been found to be unreliable. A recent study has shown that 20% of certified E.U. deliveries have been infected with Salmonella and up to 80% of the certificates from some countries were found to be misleading. However, there is now a feeling in some quarters that Sweden concentrates too much on Salmonella when there are many other infections, like E. coli strain EHEC, to be considered.
Swedish tourists who had visited more distant hot countries accounted last year for 3,864 cases of Salmonella poisoning and 569 of dysentery.
Another risk is the reduction of border health safety control between countries. Twenty years ago, travellers carried health certificates. This is not the case today. Diphtheria can now reach Sweden in a few hours, carried by visitors from Russia and the Baltic states, where the disease still exists and is growing. Venereal diseases also are now "imported" from the East. The barrier principle of cleanroom technology must be applied soon.
A seminar entitled "Salmonella—can we trust the controls?" was held in February at the government Food Control Board in Uppsala. An audience of more than 100 listened to lectures by seven well-known experts in the field. One of the lecturers questioned the ability of Sweden to solve the existing Salmonella problems, given the relaxation of border controls. For instance, a Swedish study showed that E.U. Food Certificates were not reliable. A report will be sent to the E.U. this autumn covering our experience of the use of these certificates over a period of three years.
In September and October 1998, there will be courses run by the Food Control Board under the title: "EHEC—our new danger?" Sweden has already several cases of EHEC but there have not been any deaths as yet, although there have been several in other countries. Seven experts will lecture about this new "contaminant", which is spread by surface water, food and contact with living animals.
An important contribution to solving these problems would be to make more use of cleanroom technology to prevent the growth and spread of infective agents in the production chain. The principles and methods of contamination control ought to be part of general education in the Nordic countries.
