Starting with the Basics in Pharmacy Temperature Monitoring

Three down, one to go: food and beverage coolers

So far we’ve looked at store temperature as a good indicator of shelf-stable food and medication storage conditions that maintain food and medication quality and safety. We’ve also looked at refrigerated and frozen pharmaceutical storage temperatures as a good indicator of the safety and efficacy of these medications. And we’ve looked at the benefit of automatic temperature monitoring to help ensure that when temperatures exceed or fall below recommended storage conditions, particularly those devices that provide alert and alarm messages when out of range conditions occur. It's time to turn our attention to refrigerated and frozen foods.

Generally I’m comfortable buying food from pharmacies, especially when prices are fair and it’s convenient. Because turnover can be longer than other stores I often check expiration dates more diligently than grocery stores. I have never found out of date items, so my confidence is growing.

That being said, the task of food vendors all over are insuring their frozen food coolers keep food frozen. In the summer, especially in humid climates, even the best glass front coolers fog up and customers open the doors to browse, complicating the problem of maintaining freezer or refrigerator temperatures. This may be one reason grocers, convenience stores and pharmacies keep their stores cold, to prevent or minimize condensation on freezer doors and prevent frozen food from partially thawing.

In my mind the first task of pharmacists and pharmacy managers is to ensure the safety and efficacy of refrigerated and frozen medications with regular, preferably automatic temperature monitoring. The second task is to do the same for room temperature drugs and food products both of which have similar storage requirements. Frozen and refrigerated foods can be added with little effort.

I could argue that frozen and refrigerated food cooler monitoring is as important as those used for medications. This is because food borne illnesses can be attributed to food stored at elevated temperatures, temperatures where harmful microorganisms grow and multiply quickly. Indeed, we read many more cases of food poisoning or food borne illnesses than those from medications and the liability can be just as significant in either case.

The U.S. Food and Drug Administration (FDA) recommends the following for refrigerated and food storage. (Link to FDA Source)

• Keep the refrigerator temperature at or below 40° F (4° C). The freezer temperature should be 0° F (-18° C).
• Stick to the "two-hour rule" for leaving items needing refrigeration out at room temperature. Never allow meat, poultry, seafood, eggs, or produce or other foods that require refrigeration to sit at room temperature for more than two hours, one hour if the air temperature is above 90° F (32° C).
• Refrigerated ready-to-eat foods such as luncheon meats should be used as soon as possible. The longer they're stored in the refrigerator, the more chance Listeria, a bacterium that causes food borne illness, can grow, especially if the refrigerator temperature is above 40° F (4° C).

The danger for pharmacies is that when food and freezers lose power, break down or have doors left ajar can warm up quickly, and like drugs, food safety can be compromised just as quickly. Fortunately when a store loses power, keeping freezer and refrigerator doors closed will delay products from being exposed to elevated temperatures. But if a manager or pharmacist opens the store the morning after a power outage s/he will not know what the freezer and refrigerator temperatures were overnight and which foods or drugs are safe unless there is an automatic temperature monitoring device recording these events.

Of course it would be best if a manager, pharmacist, or staff member were alerted to the problem and took action before products were exposed to potentially harmful temperatures. The next and final piece in this series will explore options for temperature monitoring to both meet regulations and keep drugs and food safe.