The chemicals in your poultry.

By Janet Reynolds

But before you plan your centennial years, consider this. That poultry you've been consuming may be as much a health problem as that steak you gave up. Not in the clogging-your-arteries way--although if you're going to eat your chicken fried with the skin on you might as well have a Philadelphia cheese steak.

No, poultry's potential poison is more insidious and, ultimately, more threatening in the long term. The problem with poultry comes from the antibiotics these birds are fed in their meal, drugs used primarily to make them more productive rather than to cure sickness.

These drugs in turn can help make doctor-prescribed antibiotics less effective--and in the most dire cases, completely ineffective--against disease in the humans eating the chicken. Add to this a processing procedure that critics say is a health hazard in and of itself, and you've got a health crisis in the making (see "A Day in the Death").

Before we go further, a couple of caveats. As with all dietary discussions, moderation and common sense are of the essence. If you eat a raw egg every day, never wash your chicken before cooking it and use the same knife to cut up your poultry and your vegetables, then it's your own damn fault if you eventually get salmonella or campylobacter, the two most common forms of food-borne illnesses from poultry. "It's consumer education as much as the processor," says UConn professor and extension poultry specialist Michael Darre. "If you don't follow up at home, all that good work beforehand is useless."

The caveat continues with the antibiotic angle. Scientists and researchers everywhere agree that the major culprit in the increasing number of antibiotic resistant bacteria--super bugs if you will--are doctors who prescribe an antibiotic at the least sneeze. These people are closely followed by the patients who come in and demand a drug for said sneeze, especially if the sneeze, runny nose and sore throat belong to a child. All you working parents out there know exactly who you are.

To make an increasingly bad situation worse, too many people don't finish their prescriptions. They feel better a few days later and figure they'll save the rest of their prescription to get a jump on the next illness.

The problem is that although the drug may have killed off 90 percent of the bacteria, that remaining 10 percent becomes stronger and more resistant to the drug, rendering it increasingly ineffective as this pattern continues.

These caveats aside, the health world is becoming progressively worried about the increase in these antibiotic-resistant strains and turning to the animal agricultural world to find part of the solution. Currently 70 percent of all antibiotics produced go into our livestock. Although other food animals such as cattle and pork are fed antibiotics for reasons other than to cure an illness, neither group receives as much as poultry. The Union of Concerned Scientists (UCS) a nonprofit partnership of citizens and scientists working to preserve health, estimates in its January 2001 report, "Hogging It: Estimates of Antimicrobial Abuse in Livestock," that livestock producers in the United States use 24.6 million pounds of antimicrobials for nontherapeutic use every year. Of this, about 3.5 million pounds is given to cattle, 10.3 million pounds to hogs, and 10.5 million pounds to poultry. That tonnage would be even higher if therapeutic use was included.

And nonprofits like the UCS aren't the only ones paying attention. Government agencies have also begun to tackle the problem, creating task forces and programs to better monitor overall drug use. Concludes the Centers for Disease Control and Prevention (CDC) after one study of salmonella infections in humans, "There is an urgent need to emphasize non-antimicrobial infection control strategies."

Driven primarily by increased use in poultry, overall use of antimicrobials for nontherapeutic purposes has risen by about 50 percent since 1985, according to the report. In poultry, nontherapeutic use since the 1980s has increased by over 8 million pounds, a dramatic 307 percent increase on a per-bird basis. (Growth in industry size accounted for about two-fifths of the overall increase.) In contrast, humans receive 3 million pounds annually.

"For sheer overprescription, no doctor can touch the American farmer," notes a Newsweek article called "The End of Antibiotics." "Farm animals receive 30 times more antibiotics (mostly penicillins and tetracyclines) than people do. The drugs treat and prevent infections. But the main reasons farmers like them is that they also make cows, hogs and chickens grow faster from each pound of feed. Resistant strains emerge just as they do in humans taking antibiotics--and remain in the animal's flesh even after it winds up in the meat case."

"We fully realize the human side is a good part of the picture," says Dr. Deborah Huang, a science policy fellow at the Center for Science in the Public Interest, a nonprofit education and advocacy organization that focuses on improving the safety and nutritional quality of our food supply. "We feel there's enough science out there to support the conclusion that antibiotic use in animals can contribute to resistance in humans."

That poultry has the potential to have a huge impact on our health is not surprising given its increasing popularity in recent years. In 1960, eggs accounted for 61 percent of gross chicken income in the U.S., with broilers at 34 percent, according to Karen Davis of United Poultry Concerns, a nonprofit educational group focusing on poultry. By 1975, broilers supplied 50 percent of the gross chicken income with eggs coming in at 49 percent.

Negative news about cholesterol and increasingly frenetic lifestyles helped bring an end to the big breakfast in America and with it, a drop in egg consumption. Between 1960 and 1990, egg consumption dropped from about 321 to 235 eggs per person annually.

At the same time, chicken and turkey began to be regarded as an inexpensive and convenient low-fat protein source. In 1993 U.S. hog producers killed in one week 1.7 million pigs, an average of 10,000 pigs an hour, that standing in single file, would stretch 1,200 miles from New York City to Kansas City.

But in that same week U.S. broiler producers killed 135 million chickens, an average of 800,000 chickens an hour, enough to stretch in single file 25,000 miles or completely around the middle of the earth.

That demand has driven the market to new lengths to fill consumer need. Although chicken farms existed for centuries, the industry itself is still relatively young. Before the 1920s, most chicken farms were second-income operations on the family farm. The focus was on the eggs, with the meat just a by-product once a hen's laying days were over. The first year-round broiler production operation began in 1926 when Cecile Long Steele and her husband built a year-round farm capable of producing 10,000 chickens. Today, that would be considered small.

It would also be considered economically inadequate. In the early days of the industry, the birds were slaughtered at 14 weeks of age, at which point they weighed about two pounds. Today's broilers are slaughtered at 7 weeks and weigh between four and six pounds.

A large part of that change can be traced to the increased use of drugs, which in addition to treating sick birds are used nontherapeutically to prevent disease and help promote growth. According to the Union of Concerned Scientists, tetracycline, penicillin, erythromycin and other antimicrobials important to human use are among those used extensively in livestock.

Of course, no one begrudges farmers keeping their poultry healthy. It is the preventative and growth-promotion drug use that has everyone from the World Health Organization and the Centers for Disease Control and Prevention to the Union of Concerned Scientists and the Center for Science in the Public Interest demanding government usage guidelines and restrictions.

A look at some recent reports and trends illustrates why health professionals and others are increasingly concerned. Each year an estimated 1.4 million human salmonella infections occur in the U.S., causing an estimated 80,000 to 160,000 people to seek medical attention, resulting in 16,000 hospitalizations and nearly 600 deaths. According to the CDC, in 1999, salmonella and campylobacter comprised the lion's share--almost 82 percent--of the total food-borne illness cases.

Both of these diseases are increasingly associated with poultry. Studies show that campylobacter grows best at the body temperature of a bird, which can carry it without becoming ill. More than half the raw chicken in the U.S. has campylobacter in it, according to www.factoryfarming.com, a website devoted to the agriculture industry.

The CDC notes that most human salmonella infections come from the ingestion of contaminated food, especially those of animal origin. An estimated 20 percent of retail poultry is contaminated with salmonella.

As anyone who has suffered from food poisoning knows, these diseases are not pleasant. People with campylobacteriosis typically have diarrhea, cramping, abdominal pain and a fever within two to five days of exposure. The diarrhea may be bloody and accompanied by nausea and vomiting, with the symptoms typically lasting one week. Salmonella is a bacterial infection of the intestinal tract causing nausea, vomiting, abdominal cramps, diarrhea, fever, chills, weakness and exhaustion.

To be fair, the incident rates themselves can make the hype seem a tad shallow, especially when you consider the sheer number of meals eaten daily by the U.S. population. But what can be merely unpleasant in a relatively healthy person can become potentially life-threatening in the young, whose immune systems are typically less developed, and in the elderly or immuno-suppressed. It is these people who typically seek medical attention for these diseases--and who are more likely to die if the antibiotics to cure them don't work. Critics also worry that these trends could be the beginning of what might ultimately, when tied in with overuse in human medicine, be a return to a pre-antibiotic world.

In 1990 and 1995 the CDC found that 40 percent of people with salmonella infections who sought medical attention were treated with antimicrobial agents. Ciprofloxacin, a fluoroquinolone, was the most commonly prescribed antibiotic. Enrofloxacin, ciprofloxacin's counterpart for animals, has been given to U.S. poultry since 1995.

In humans, fluoroquinolones are considered one of the most valuable antimicrobial drug classes because they are effective against a wide range of bacterial infections, in particular food-borne infections often resistant to other microbials. People understandably became worried when reports from scientific and public-health communities began noting more occurrences of fluoroquinolone-resistant campylobacter infections, especially since no resistant strains had been recorded prior to the use of this class of antibiotic in poultry.

As a result of this new disturbing development, last year the FDA's Center for Veterinary Medicine proposed to withdraw approval of enrofloxacin in poultry. After Bayer, the company that manufacturers it, complained, however, the FDA held off. The proposal is still under review. Meanwhile, sarafloxacin, another fluoroquinolone used in poultry since 1995, has been taken off the market.

But these are not the only problem drugs. In April, the FDA's Center for Veterinary Medicine decided to conduct a quantitative risk assessment on the human health impact of the development of the streptogramin-resistant enterococcus in humans and its association with the use of virginiamycin in food-producing animals. Enterococci are bacteria in a normal intestinal tract that can cause infection if they get out of their normal environment.

Virginiamycin has been used on livestock since 1974. The use of Synercid, which is closely related, in humans was only approved in 1999 but may already be running into trouble. Scientists say the effectiveness of Synercid, an injectable drug of last resort for the treatment of serious or life-threatening vancomycin-resistant infections, is at risk because of the use of virginiamycin as a growth promoter in chickens and pigs in the U.S. Virginiamycin is found in as much as 50 percent of supermarket chicken, turkey and pork.

In Europe virginiamycin, as well as three other growth-promoting antibiotics, has already been banned, following recommendations from the World Health Organization.

Another area of concern is vancomycin-resistant enterococci (VRE) infection. In Europe, VRE has been isolated from raw poultry products associated with the use of avoparcin as a feed additive. Avoparcin is not used in the U.S. nor has VRE been isolated from poultry at this time. However, University of Maryland professor Glenn Morris recently reported the isolation of VRE in commercial chicken feed, underscoring the increasing wide environmental distribution of this organism.

The discovery is particularly disturbing given that vancomycin is the antibiotic of last resort, the only remaining drug effective against the most deadly of all hospital-acquired infections: methicillin-resistant staphylococcus aureus, according to an article in this month's Scientific American. Also, once a patient is colonized with VRE--and survives--he is colonized for life. To date, VRE been identified in 33 states.

Those in the industry dismiss these trends as so much hype. The Animal Health Institute, for instance, disputes the figures put out by the Union of Concerned Scientists. The institute, which is a U.S. trade association representing manufacturers of animal health care products, pharmaceuticals, vaccines and feed additives, estimates nontherapeutic use of antibiotics at 17.8 million pounds total for all animals.

Besides, the preventative measures are well worth it, says Richard Lobb, public relations director of the National Chicken Council, a trade association to which over 90 percent of chicken producers belong. "The birds coming into the processing plant today are the healthiest they've ever been," he says.

"We believe our use is responsible and limited," Lobb continues. "All this is approved by the FDA. Any trace of the drug is gone by the time the bird is processed. We feel our industry, pork and others are being blamed for antibiotic resistance problems (created by human misuse). The route of transmission of antibiotic-resistant pathogens is a rather long and tenuous one."

Others who are in the barnyards agree. "Our perception of the risk is way off from the reality," UConn's Darre says. "Risk assessment vs. risk perception have to get in line somehow.

"If it was half as bad as the critics said, we'd all be dead years ago," he continues. Darre notes, for instance, that the government has strict guidelines about antibiotic withdrawal. Farmers must wean poultry and other animals from the antibiotics, whether therapeutic or nontherapeutic, a certain time before they can be slaughtered. "The sky is falling to a certain extent but not to the extent they say it is. There are no proven facts that eating antibiotics makes humans resistant. The number-one problem is overuse and misuse by humans."

In the meantime, critics are calling for change--or at least more review. In "Hogging It," the Union of Concerned Scientists suggests that the FDA establish a system so that companies that sell antimicrobials for food animals or that mix them in animal feed or water must provide annual reports on the quantities sold. This information should be broken out by species and antimicrobial, the scientists say, and the USDA should improve completeness and accuracy of its periodic surveys of antimicrobial use in livestock production.

Others would like the federal government to speed up implementation of the Public Health Action Plan to Combat Antimicrobial Resistance. Under this plan the government would create a monitoring system, improve surveillance and coordinate national surveillance.

Meanwhile, there is another tactic already in effect that might help. Called competitive exclusion, this procedure takes the microflora from healthy adult chickens and gives it to baby chicks. "It gives them all the microorganisms they need and excludes the bad ones," says UConn's Darre, noting that the procedure helps give chicks healthier starts without the drugs. "It will help alleviate the fear."

Bird Words

Here's a list of words used within the industry so that you can make a more informed choice about the poultry you eat.

Kosher: This word may be used only on the labels of meat and poultry products prepared according to Jewish dietary laws. Salt is added as part of the process. Kosher chickens are slaughtered in person by a rabbi.

Natural: Food labeled "natural" cannot contain artificial ingredients and has to be minimally processed. Whole, fresh, unseasoned chicken, therefore, is "natural." That term does not relate to how the chicken was fed, raised, slaughtered, handled or packed.

Organic: According to the National Organic Program of the U.S. Department of Agriculture, animals for slaughter must be raised under organic management from the last third of gestation, or no later than the second day of life for poultry. Producers are required to feed livestock agricultural feed products that are 100 percent organic, but may also provide allowed vitamin and mineral supplements. Organically raised animals may not be given hormones to promote growth or antibiotics for any reason. Preventive management practices, including the use of vaccines, can be used to keep animals healthy. All organically raised animals must have access to the outdoors, including access to pasture for ruminants.

Free range: USDA regulations require chickens labeled "free range" to have had "some sort of access to the outdoors for some portion of the day." Free-range chickens are generally confined to a pen adjacent to their enclosed chicken houses.

"The impression everyone has is that they're raised in a pasture and run around finding worms and bugs to eat and picking at grass," says the National Chicken Council's Richard Lobb, noting that very few, if any, farmers would allow chickens free-run of their farms. "As far as we can tell [free range] is more of a marketing concept than a method of animal husbandry." The National Chicken Council is a trade organization representing chicken producers.

Sell-by Date: No federal regulations require a date on packages of chicken or chicken products. However, many stores and processors put on a date voluntarily. Typically stores take chicken off the shelves 10 to 14 days after the chicken is processed and may then cook it at the store's deli for sale.

Fresh: This refers to a chicken whose internal temperature has never been below 26° F, the approximate freezing temperature of chicken. Since water freezes at 32°, it is possible for a "fresh" chicken to appear icy.

Frozen: This describes a chicken whose internal temperature has been at or below zero. (Strange as it seems, chickens at temperatures between zero and 26° aren't officially "frozen"; no term applies to them.)

Irradiated: In 1992, the USDA permitted irradiation of raw packaged poultry to control bacteria. As of now, relatively little chicken has been treated. Packages of irradiated chicken must carry the words "treated with irradiation."

--Traci Neal

(Sources: Consumer Reports, March 1998; National Chicken Council; United States Department of Agriculture)

A Day in the Death

Antibiotic use aside, some critics say it's the way poultry is produced that's the problem. Karen Davis is director of United Poultry Concerns, Inc., a nonprofit educational group focusing on all things poultry. In her highly-documented book, Prisoned Chickens, Poisoned Eggs, An Inside Look at the Modern Poultry Industry, she outlines in horrific detail the many ways in which she feels chickens are abused in their short lives.

Among the highlights she presents regarding broiler chickens:

• chronic painful bone problems associated with rapid growth

• sick birds being slaughtered for human consumption: "Every week throughout the South, millions of chickens leaking yellow pus, stained by green feces, contaminated by harmful bacteria, or marred by lung and heart infections, cancerous tumors or skin conditions are shipped for sale to consumers, instead of being condemned and destroyed."

• food restriction to control weight and "blackout housing"

• excretory ammonia that can create a painful inflammation and erosion of the cornea

• overcrowding

• "stunned" birds--birds receive an electric shock before their throats are slit so that their hearts can still pump out the blood before they are placed into the scalding tank to help loosen the muscles holding their feathers, which in turn makes automated feather removal easier, and therefore less damaging to the meat

• 30,000-60,000 broilers enter the scalding tank alive and breathing every day. This means they breathe in contaminated scalding water and are supposed to be condemned for human food. Davis says they're often not.

"You don't do these things," says Michael Darre, extension poultry specialist at UConn, "if you want to sell. A good grower knows the birds are his money."

The farms, for instance, have venting systems to get rid of excess ammonia. He ticks off other pluses: Pancake heaters keep chicks warm; the crates that take birds to slaughter only hold about eight to 10 chickens; the ride to the processing plant is usually short; once the hens are shackled upside down on the conveyor belt, they are put in a dark room, which relaxes them. "We can't anthropomorphize," Darre says. As for the stunning, it renders them "senseless."

Darre points to a relatively new government inspection program as further proof of safety. Called Hazard Analysis and Critical Control Points, or HACCP, the program was begun in 1996 as part of an effort to improve meat safety. Under the plan, the farmer works with government officials to analyze potential problem points and then comes up with plans for remediation or prevention. Government inspectors regularly check for compliance and then issue noncompliance reports if they observe problems.

Continued or excessive NRs, as these reports are known, can result in suspension of inspection service, which means the plant is effectively shut down because no meat can leave a slaughterhouse or processing plant without being inspected by the government. The Food and Safety Inspection Service of the U.S. Department of Agriculture administers the program, which has 7,600 inspectors nationwide.

"We feel that it's working," says Carol Blake, spokesperson for Food and Safety Inspection Service at the USDA.

A damning study by the Government Accountability Project in conjunction with Public Citizen suggests otherwise. Called "The Jungle 2000," after Upton Sinclair's novel decrying descriptions of slaughterhouses nearly a century ago, the report is based on a 14-page survey sent to 2,340 HACCP inspectors working in processing plants. The news from the 451 who responded is not good.

Among the highlights:

• 64 percent said that since HACCP started at their plant there have been instances when they have not taken direct action against contamination (feces, vomit, metal shards, etc.) they saw and would have taken action against under the old system; 62 percent said this occurs daily or weekly

• nearly 20 percent said they had been instructed not to document violations they observed

• 80 percent said they cannot generally enforce the law as well under HACCP as before HACCP

• 78 percent said the primary reason they cannot enforce the law as "realistically" under HACCP is because government inspection tasks are reduced since government monitoring points are now based on company-created HACCP plans

• nearly 80 percent said the public's right to know about food safety information is adversely affected under HACCP

--Janet Reynolds