TIME Diet/Nutrition

14 Most Dangerous Summer Foods

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Avoid leaving food out for more than four hours

Who doesn’t love picnics and barbecues? Thing is, if you don’t practice safe food preparation, outdoor eating can also set the stage for foodborne illness. Every year approximately 1 in 6 Americans gets sick, and 128,000 are hospitalized from foodborne diseases, according to the CDC. Among 31 known pathogens, most deaths occur from Salmonella, Toxoplasma, Listeria, and norovirus. “The rule of thumb is that no food should be left out for four total hours,” says Amy Goodson, RD, a dietitian at Ben Hogan Sports Medicine in Fort Worth, Texas. “This refers to not just four hours at a time, but four accumulated hours.” The following foods are most likely to ruin your good time.

Burgers

Undercooked meat puts you at risk for potentially life-threatening illness from a subtype of E. coli bacteria called O157:H7. An outbreak in 2014 linked to ground beef contaminated with this type of E. coli sickened 12 people from four different states. “Your risk largely depends on the number of cows making up your ground beef,” says Michael Schmidt, PhD, professor at the department of microbiology and immunology at the Medical University of South Carolina (MUSC). “The greater the number of cows the greater chance of having something that was not intended to be in the meat.” Ground beef is riskier than specific cuts of meat that come from a single cow. Regardless, cook burgers or any beef to an internal temperature of at least 160 degrees to kill E. coli.

Sprouts

Topping your burger with a handful of raw sprouts could set the stage for food poisoning. Seeds and beans need warm and humid conditions to grow, which also happen to be ideal conditions for the growth of bacteria, including Salmonella, Listeria, and E. coli. Even homegrown sprouts grown under sanitary conditions can produce harmful bacteria because seeds have been known to be contaminated. “If you are putting sprouts in a salad or on a sandwich/burger, consider sautéing them first,” says Goodson. “Sprouts can easily harbor bacteria and when that is mixed with moisture, food poisoning risk multiplies.”

Caesar dressing

Eating a Caesar salad can make you sick if the dressing is made the traditional way—with raw eggs. (Store-bought bottled dressing is pasteurized; it’s homemade dressing you need to watch out for.) “Pay close attention to anything that could be made with raw or undercooked eggs, especially if they are not pasteurized,” says Lori Zanini, RD, a Los Angeles-based dietitian. The Food and Drug Administration recommends cooking eggs thoroughly and washing all equipment that comes in contact with eggs and your hands with hot soapy water.

Leafy green salads

Once you know the dressing’s safe, you also want to consider the lettuce itself—and the hygiene habits of the person who prepared it. A CDC report revealed that salad greens—such as lettuce, escarole, endive, spinach, cabbage, kale, arugula, and chard—caused 262 outbreaks involving 8,836 reported cases of foodborne illness between 1998 and 2008. There are a few ways greens can be contaminated: at the farm by manure or dirty water rinses; when a sick person preps a salad without washing their hands; and by cross-contamination at home (for example, by using the same cutting board for raw meat and salad prep, which spreads bacteria from meat to produce.) Wash greens before eating by placing them in a large colander and tossing them under your faucet, or by using a salad spinner.

Oysters

If a summertime trip to the shore always includes a stop at a raw oyster bar, consume with caution: Vibrio parahaemolyticus and Vibrio vulnificus can both can be contracted by eating raw shellfish, especially oysters. In fact, the CDC reported a 52% increase in Vibrio poisonings between 2011 and 2013. Both of these bacteria cause diarrhea, vomiting, and abdominal pain in healthy people. For people with liver disease, diabetes, cancer, stomach disorders, or any other condition that affects the immune system, Vibrio vulnificus is extremely dangerous: it can invade the bloodstream, causing a life-threatening illness. Half of all Vibrio vulnificus bloodstream infections are fatal.

Homemade ice cream

It sounds like a luscious treat, but homemade ice cream prepared with raw eggs could contain Salmonella, says Leigh Tracy, RD, dietitian at the Center for Endocrinology at Mercy Medical Center in Baltimore, MD. “The FDA recommends using a custard base or pasteurized eggs.” Cooking and pasteurization kills Salmonella. Store-bought ice cream can contain harmful bacteria as well, but it’s much more rare. In 2015, both Blue Bell Creameries of Texas and Jeni’s Ice Cream of Ohio produced ice cream contaminated with Listeria. The Blue Bell ice cream was linked to 10 illnesses, including three deaths. All that said, you generally shouldn’t worry about the safety of store-bought ice cream;Listeria is rarely found in the sweet stuff because it can’t grow at cold temperatures.

Melons

Cantaloupes have been linked to Listeria outbreaks, and watermelon can also cause problems. Listeria traced back to a North Carolina farm and another outbreak in Colorado sickened more than 140 people and resulted in 30 deaths. Unlike other germs, Listeria can grow in refrigerator-level temperatures. It has no smell or taste and only heat can kill it. But if heated food cools, the Listeria may grow again, according to the FDA. Since the germs live on the outside peel, rinse all melons under running water and scrub with a produce brush before eating or cutting the fruit, even if you peel it first. Cutting into the rind can spread bacteria from the outside of the fruit to the inside.

Chicken

Chicken is commonly contaminated with Salmonella and needs to be thoroughly cooked to kill the germs. A 2014 Consumer Reports analysis found that 97% of all chicken breasts, including organic, were contaminated with harmful bacteria. Use a food thermometer when cooking meats and chicken to ensure you’ve heated them to a safe temperature. Chicken should be cooked to an internal temperature of 165 degrees and held at between 140 and 145 degrees, says Goodson. “Plus, be careful of storage practices before it’s grilled,” she says. “For example, don’t put raw chicken or beef, even if wrapped in foil, above the salad or fruit bowl when you are transporting it to the BBQ or party, as fluids can drip and cross-contaminate other foods without you knowing.”

Tomatoes

Tomatoes are super healthy, and can be tossed into salads or sliced as a burger topping. But because they aren’t cooked (which generally kills bacteria) they have been linked to foodborne illness outbreaks. Cases of Salmonella poisoning in 2006 were traced to a packinghouse in Ohio. Overall, 190 people were sickened across 21 states before the source of the outbreak was discovered. Salmonella is found in the feces of animals or in some habitats including ponds as drainage ditches. “It is important to wash your tomatoes thoroughly under running water,” says Tracy. “Additionally, discard any bruised or spoiled tomatoes.”

Deviled Eggs

The risk of Salmonella is highest in deviled eggs when they’re not held at the right temperature (at or below 40 degrees Fahrenheit), says Goodson. Salmonella can live on both the inside and outside of eggs and the egg can still appear perfectly normal, according to the CDC. Deviled eggs are cooked, of course, which should kill any germs in the eggs. But because you combine a bunch of eggs together for the filling, and then it sits for hours at room temperature, bacteria can grow to dangerous levels if an egg is undercooked or contaminated after cooking. Buy eggs only from stores or other suppliers that keep them refrigerated at or below 40 degrees Fahrenheit, and serve deviled eggs on ice at all times.

Macaroni salad

Staphylococcal aureus is type of bacteria found primarily on skin and hair, and can cause food poisoning when a person prepping a dish contaminates it and then fails to refrigerate it properly. It’s most common in foods that require handling, but no cooking—like macaroni salad. Some strains of Staphylococcal aureus are capable of producing a highly heat-stable protein toxin, and unlike some germs that can take up to two weeks to cause symptoms, S. aureus can make you sick within 6 hours and sometimes as little as 30 minutes. Any food that should be held either hot to cold, left in the danger zone (40 to 140 degrees F), puts you at risk for foodborne illness.

Leftovers

Leftovers should be handled properly as well. Once everyone has eaten, put the food in its appropriate hot or cold environment, says Goodson. “Food left out becomes a problem because it enters the temperature danger zone, between 40 and 140 degrees Fahrenheit.” Count how many hours the food has been left out overall. If it’s close to or over four hours, trash it, says Goodson. “Do this especially if the food was left out a good part of the day, and at the hottest part of the day, just get rid of it,” Goodson says. “Don’t take the risk of getting sick.”

Charred meats

Though most summer food hazards come from food poisoning germs, here’s one danger you may not have thought of: Grilling meats has been shown to form cancer-causing substances, according to the American Institute for Cancer Research (AICR). Studies have also demonstrated that one of the possible cancer-causing substances could be reduced when the meat, poultry, or fish has been marinated for at least 30 minutes with a mixture of vinegar, lemon juice, or wine with herbs and spices. “Cooking the meat over a low flame as well as trimming off the fat and flipping it frequently can help reduce the formation of the cancer-causing substances,” says Tracy.

Potato salad

When you see potato salad on a picnic table, you can probably assume that it’s safe to eat, but there’s one instance in which it can become dangerous: when the potatoes are baked ahead of time and then stored in foil. Spores of Clostridium botulinum—the group of bacteria that causes botulism—can survive the potato-baking process. Leaving the cooked potatoes wrapped in foil at room temperature produces perfect conditions for those spores to germinate and grow, and release their deadly toxin. In 1994, an El Paso, Texas Greek restaurant kept baked potatoes at room temperature for several days before using them in a dip; 30 people contracted botulism. Botulism is exceedingly rare, but even still, you’re best off prepping potatoes the same day you plan on making them into a salad.

This article originally appeared on Health.com

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Read next: The Best Way to Treat Food Poisoning

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TIME ebola

A Rapid Ebola Test Can Diagnose the Disease In Just Minutes

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The new test is faster and as effective as the current standard practice, one study finds

A new Ebola diagnostic test that can identify in minutes whether a person has Ebola has proven to be faster and just as sensitive as diagnostics performed in a lab, according to new data published in the journal The Lancet.

Currently, to confirm someone has Ebola, a vial of blood must be sent to a specialized laboratory where it is tested. The new rapid diagnostic test (RDT), called Corgenix ReEBOV Antigen Rapid Test kit, can be done right at the bedside with just a drop of blood. A rapid test puts fewer people at risk of infection, significantly cuts down on waiting time and helps health care workers determine who has the disease so they can be quickly isolated.

In a study of 106 suspected Ebola patients in Sierra Leone, researchers tested the patients with both the new tool and the standard laboratory procedure. They found that both tests detected all of the confirmed cases of Ebola, and the RDT was faster.

“Although the RDT requires refrigeration, this is already available in many health centers in endemic areas, particularly those that store vaccines and other medical products,” said study co-author Dr. Jana Broadhurst from Partners In Health in a statement.

The current Ebola outbreak infected 27,443 people in Sierra Leone, Guinea and Liberia, killing 11,207. Though the outbreak appears to be waning, having a better diagnostic tool is still desirable—and having a tool at the ready, should another outbreak arise in the future, could be critical to quicker diagnosis.

TIME public health

CDC Finds Increase in Outbreaks Linked to Hot Tubs and Pools

Half of the outbreaks associated with treated-recreational water were caused by cryptosporidium, a parasite that causes diarrhea

The U.S. saw 90 outbreaks of illnesses associated with pools and hot tubs between 2011 and 2012, a number that has has “significantly increased,” officials said.

The Centers of Disease Control and Prevention released a report this week on the outbreaks, which spanned 32 states and Puerto Rico, led to 1,788 cases, 95 hospitalizations, and one death. Half of the incidents associated with treated recreational water—pools and hot tubs—were caused by cryptosporidium, a parasite found in fecal matter that causes diarrhea. That’s a large increase since the first cryptosporidium-related outbreak was detected in 1988, the CDC said.

According to CBS News, the CDC issued a 2014 report that recommends the installation of ultraviolet light, ozone, or some other supplemental disinfectant to kill germs like cryptosporidium.

The best way to keep swimmers and swimming facilities healthy, according to the CDC:

  • Stay out of the water if you have diarrhea.
  • Shower before you get in the water.
  • Don’t pee or poop in the water.
  • Don’t swallow the water.
TIME public health

Leading Health Experts Call For Fossil Fuel Divestment to Avert Climate Change

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'Divestment rests on the premise that it is wrong to profit from an industry whose core business threatens human and planetary health'

More than 50 of the world’s leading doctors and health researchers called on charities to divest from fossil fuel companies in an open letter Thursday. The letter, published in the Guardian, argues that climate change poses a dire risk to public health and that fossil fuel companies are unlikely to take action to reduce carbon emissions without prodding.

“Divestment rests on the premise that it is wrong to profit from an industry whose core business threatens human and planetary health,” the health experts wrote. The case for divestment brings “to mind one of the foundations of medical ethics—first, do no harm.”

The letter is the latest show of support for efforts to halt climate change from the medical community. Recent research has outlined a variety of public health issues caused by climate change, from heath stroke deaths to increased asthma rates. Just this week a study in The Lancet outlined how climate change could erode 50 years of health advances.

Read More: How College Kids Helped Divest $50 Billion From Fossil Fuels

The open letter alluded to those impacts and suggested that divestment would be the best way for global charities to address them. Engaging with fossil fuel companies’ boards has not been shown to work, the researcher wrote, likening the oil industry to the tobacco industry.

“Our primary concern is that a decision not to divest will continue to bolster the social licence of an industry that has indicated no intention of taking meaningful action,” researchers wrote.

The long list of signatories include the editors of The Lancet and BMJ, leading medical journals, as well as medical professors from across the United Kingdom.The letter specifically calls on the Wellcome Trust and the Gates Foundation, two nonprofits that are leading contributors to global health causes, to divestment their multi-billion endowments from fossil fuel companies. Together the companies control total endowments worth more than $70 billion.

TIME Diet/Nutrition

Should I Eat Sushi?

You now have the blessing of five health experts to eat sushi—but there are some things you should know before ordering.

“Sushi is a nice and healthy meal if you make the right choices,” says Sunniva Hoel, a PhD candidate at Sør-Trøndelag University College in Norway. It comes with all the health benefits you’d expect from fish, like omega-3 fatty acids and lean protein, but the problem is often what it’s wrapped in. “Maki and nigiri sushi mainly consist of rice, which is just fast carbohydrates,” she says. Eating sashimi, slices of raw fish accessorized with vegetables, is the better way to order.

It should be noted, too, that sushi is raw, so people with immune deficiency, like the elderly or chronically ill, and pregnant women should take care when eating foods that haven’t been heat-treated, she says. “Raw fish can transmit infectious diseases,” adds Dr. David Katz, director of the Yale University Prevention Research Center, “so you need to choose a very well-run establishment.”

Store-bought sushi might face even more of a quality challenge than the kind you eat at a restaurant, since its longer shelf life gives bacteria more of an opportunity to flourish, Hoel says. A study by Hoel and her colleagues found that almost half of the 58 samples of supermarket sushi they sampled had unsatisfactory levels of bacteria. “The main concern is to maintain an unbroken cold chain during production, distribution, and display in stores and all the way to the consumer’s tables,” she says.

Needless to say, rolls that are deep-fried and smothered with mayo are less healthy choices, says Kristin Kirkpatrick, RD, manager of wellness nutrition services at Cleveland Clinic Wellness Institute. She tells her patients to focus on lean sources of fresh fatty fish, get plenty of sea vegetables and wrap it in brown rice, or no wrap at all. “If that’s how you approach a night at the sushi bar, then a portioned controlled thumbs up to you,” she says.

Mercury is still a concern with sushi, says Roxanne Karimi, PhD, 
School of Marine and Atmospheric Sciences at Stony Brook University
. Her research on mercury found that blood mercury levels were positively associated with eating a weekly tuna steak or sushi. But small-bodied fish lower on the food chain have less of it, she says.

Those lesser-known fish lower on the food chain are often the best ones to pick for sustainability, too, says Tim Fitzgerald, director of impact in the oceans program at the Environmental Defense Fund. “The sushi market in general is much more opaque than the larger seafood market,” he says. Unfortunately, three of the most popular items—tuna, salmon and shrimp—aren’t often fished or farmed sustainably, he says.

Opt instead for things with two shells, like scallops, clams and oysters. Roe—fish eggs—are a good choice too and have some of the highest omega-3 levels of any food per volume, Fitzgerald says. Other sustainable options are mackerel and arctic char, which is produced in a much more sustainable way than farmed salmon sushi, he says. (For more on the best fish to order, check out the Environmental Defense Fund Seafood Selector—complete with a sushi guide.)

Some restaurants, too, are raising the bar: Fitzgerald points to Bamboo Sushi in Portland, OR, Miya’s Sushi in New Haven, CT, and Tataki in San Francisco, CA as pioneers in sushi sustainability.

“You don’t have to give up sushi,” Fitzgerald reiterates. “It’s still good for you: just have a cheat sheet when you go in.”

Read next: Should I Eat Tilapia?

TIME workplace injuries

Here’s How Nursing Jobs Could Get a Lot Safer

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OSHA is about to crack down on hospitals

What’s the occupation that reports the most debilitating worker injuries?

It’s not factory work, or hazardous jobs on an oil rig or a construction site. It’s nursing.

Nurses and nursing assistants are plagued by back and arm injuries from lifting and moving patients on a daily basis, and hospitals have done little to prevent those injuries.

On Thursday, the Occupational Safety and Health Administration (OSHA) will announce an effort to crack down on hospitals for such failures for the very first time. The agency’s chief David Michaels told NPR that OSHA will no longer just recommend safe practices for hospitals; it will actually fine hospitals for not adopting them.

Studies have shown that the best way for nurses to move patients is with special equipment such as ceiling lifts. OSHA’s new enforcement program will examine the types of machines hospitals own and the way hospitals train their staff to use them.

Michaels told NPR: “Sadly, there will be some hospitals where we find significant ergonomic hazards, and they are at risk for serious penalties.” Fines will likely total $7,000 per hospital, but could reach as high as $70,000 in instances of deliberate violations.

TIME Sex

Condoms That Change Color In Contact with STD Win Tech Award

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The idea, which involves color-changing protection, remains in its very, very early stages

The old adage goes that teenagers think about sex constantly, but there are at least a few out there who have expressed a very keen interest in the particulars of safe sex.

Three British teens—two 14-year-olds and one 13-year-old—have proposed an idea for a new type of condom that could detect sexually transmitted diseases amongst intimate partners. The Washington Post explains:

There would be antibodies on the condom that would interact with the antigens of STDs, causing the condom to change colors depending on the disease…For instance, if the condom were exposed to chlamydia, it might glow green — or yellow for herpes, purple for human papilloma virus and blue for syphilis.

The proposal won the trio the top prize in the U.K.’s TeenTech Awards, and they have already reportedly been approached by condom companies.

The idea, however, is not without its imperfections. It seems unclear whether the STIs would be detected in just the user’s partner or also the user as well. In addition, there’s the awkward question of what would happen if the condom came into contact with two or more STDs—not to mention the logistical difficulties of figuring out a way to determine the color with sufficient opportunity to make use of those findings.

Nevertheless, if teens are going to think about sex, it’s tough to quibble with them spending more time thinking about ways to make is safer.

[Washington Post]

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