Using expert elicitation to link foodborne illnesses in the United States to foods

U.S. foodborne illness risk analysis would benefit greatly from better information on the relationship between the incidence of foodborne illness and exposure to foodborne pathogens. In this study, expert elicitation was used to attribute U.S. foodborne illnesses caused by the nine FoodNet pathogens, Toxoplasma gondii, and noroviruses to consumption of foods in 11 broad categories. Forty-two nationally recognized food safety experts responded to a formal written expert elicitation survey. For each pathogen, respondents gave their best estimate of the distribution of foodborne illnesses associated with each of the food categories and the 90% confidence bounds on each of their estimates. Based on the work of Paul Mead and his coauthors, food attribution percentage estimates from this study were used to attribute case, hospitalization, and death incidence estimates to foods according to pathogen. These attribution estimates indicate that 15 food-pathogen pairs account for 90% of the illnesses, 25 pairs account for 90% of hospitalizations, and 21 pairs account for 90% of deaths.     

Hexabromocyclododecanes in indoor dust from Canada, the United Kingdom, and the United States

alpha-, beta-, and gamma-hexabromocyclododecane diastereomers (HBCDs) were measured in house dust from Birmingham, U.K. (n=31, median concentration=730 ng sigmaHBCDs g(-1)); Amarillo/Austin, TX (n=13, 390 ng g(-1)); and Toronto, Canada (n=8, 640 ng g(-1)). Concentrations in dust (n=6, 650 ng g(-1)) from U.K. offices were within the range for UK homes. Concentrations from each country were statistically indistinguishable. In one UK house dust sample, 110,000 ng g(-1) was recorded-the highest recorded in indoor dust to date. While upper bound average U.K. dietary exposures for adults and toddlers, respectively, are 413 and 240 ng sigmaHBCDs day(-1), U.K. adults and toddlers daily ingesting, respectively, 50 and 200 mg of dust contaminated at the 95th percentile concentration are exposed, respectively, to 1100 and 4400 ng sigmaHBCDs day(-1). Normalized to body weight, this high-end exposure scenario estimate for toddlers is within the range reported elsewhere for occupationally exposed adults. While in commercial formulations gamma-HBCD predominates (>80%), alpha-HBCD in dust constitutes 14-67% of sigmaHBCDs (average 32%). Hence the predominance of the alpha-diastereomer in humans may arise partly from dust ingestion, and not solely to in vivo metabolism (when alpha-HBCD is formed from bioisomerization of other diastereomers), or dietary exposure (where alpha-HBCD predominates in most foodstuffs).     

Costs of acute bacterial foodborne disease in Canada and the United States

Bacterial foodborne disease is increasing in industrialized as well as developing countries. For Canada and the United States many millions of cases are believed to occur each year, based on extrapolations of survey data, human enteric isolations and reported foodborne disease cases. The economic impact of such a large number is probably in billions of dollars but the precise figure is difficult to calculate. Medical costs and lost income are easier to determine than losses to food companies, legal awards and settlements, value of lost leisure time, pain, grief, suffering and death. The evaluation of costs at the national level for Canada and the United States based on all available costs for 61 incidents showed that company losses and legal action are much higher than medical/hospitalization expenses, lost income or investigational costs. It was reckoned that on an annual basis an estimated 1 million cases of acute bacterial foodborne illness in Canada cost nearly $1.1 billion and 5.5 million cases in the United States cost nearly $7 billion. The value of deaths was a major contributor to the overall costs especially for diseases like listeriosis, salmonellosis, Vibrio infections, and haemorrhagic colitis. Salmonellosis is the economically most important disease because it affects all parts of the food system, unlike typhoid fever and botulism, which are largely controlled by public health authorities and the food industry.     

英美加三国食品监管法规及监督检查现状

近年来,食品安全事件频发,食品安全问题开始受到人们越来越多的重视,成为了公众关注的焦点。纵观世界范围,各国政府都在保障本国食品安全方面做着巨大努力。本文以英国、美国和加拿大等发达国家为例,对其食品监管法律法规及监督检查情况进行梳理和总结,分析了英、美、加3国食品安全监管模式以及值得借鉴的经验与成果,结合我国食品安全监管实际情况提出了意见与建议,为我国下一步食品安全相关法律法规的制修订及食品安全监管工作的开展提供参考。     

Filter ventilation and nicotine content of tobacco in cigarettes from Canada, the United Kingdom, and the United States

OBJECTIVES: The purpose was to determine filter ventilation and the nicotine content of tobacco and their contribution to machine-smoked yields of cigarettes from the United States, Canada, and the United Kingdom. METHODS: Ninety-two brands of cigarettes (32 American, 23 Canadian, and 37 British brands) were purchased at retail outlets in State College, Pennsylvania, United States, Toronto, Canada, and London, United Kingdom. A FIDUS FDT filter ventilation tester measured the percentage air-dilution from filter vents. High-pressure, liquid chromatography was used to measure the nicotine content of tobacco. Regression techniques were used to examine the contributions of tobacco nicotine content and filter ventilation to machine-smoked yields of tar, nicotine, and carbon monoxide (CO). RESULTS: Ninety-four per cent of the American brands, 91% of the Canadian brands, and 79% of British brands were ventilated. The total nicotine content of tobacco and percent nicotine (by weight of tobacco) averaged 10.2 mg (standard error of the mean (SEM) 0.25, range: 7.2 to 13.4) and 1.5% (SEM 0.03, range 1.2 to 2) in the United States, 13.5 mg (SEM 0.49, range: 8.0 to 18.3) and 1.8% (SEM 0.06, range: 1.0 to 2.4) in Canada, 12.5 mg (SEM 0.33, range: 9 to 17.5) and 1.7% (SEM 0.04, range: 1.3 to 2.4) in the United Kingdom. Multiple regression analyses showed that ventilation was by far the largest factor influencing machine-smoked yields of tar, nicotine, and CO. CONCLUSION: Filter ventilation appears to be the predominant method for reducing machine-smoked yields of tar, nicotine, and CO in three countries. However, some brands contain about twice as much nicotine (total content or percent nicotine) as do others, indicating that tobacco types or blends and tobacco castings can be used to manipulate nicotine content and nicotine delivery of cigarettes.     

Salmonella and broiler processing in the United States: Relationship to foodborne salmonellosis

Salmonella is one of the leading causes of foodborne illness worldwide, with over 40,000 cases reported each year in the United States alone. Salmonella is often associated with foods of animal origin, with chicken and dishes containing chicken often thought to be the most likely source. The Food Safety Inspection Service of the United States Department of Agriculture keeps data on the serotypes of Salmonella isolated from Hazard Analysis Critical Control Point verification samples obtained each year. The Centers for Disease Control and Prevention (CDC) publishes the most common Salmonella serotypes isolated from human disease each year. In addition, CDC maintains records of all reported foodborne outbreaks and the vehicle of illness, when determined. This review examines the overall prevalence of Salmonella serotypes isolated from broilers, the serotypes most commonly associated with human illness, and serotypes most commonly found in foodborne salmonellosis associated with chicken or chicken containing products.     

Economic burden from health losses due to foodborne illness in the United States

The Centers for Disease Control and Prevention (CDC) recently revised their estimates for the annual number of foodborne illnesses; 48 million Americans suffer from domestically acquired foodborne illness associated with 31 identified pathogens and a broad category of unspecified agents. Consequently, economic studies based on the previous estimates are now obsolete. This study was conducted to provide improved and updated estimates of the cost of foodborne illness by adding a replication of the 2011 CDC model to existing cost-of-illness models. The basic cost-of-illness model includes economic estimates for medical costs, productivity losses, and illness-related mortality (based on hedonic value-of-statistical-life studies). The enhanced cost-of-illness model replaces the productivity loss estimates with a more inclusive pain, suffering, and functional disability measure based on monetized quality-adjusted life year estimates. Costs are estimated for each pathogen and a broader class of unknown pathogens. The addition of updated cost data and improvements to methodology enhanced the performance of each existing economic model. Uncertainty in these models was characterized using Monte Carlo simulations in @Risk version 5.5. With this model, the average cost per case of foodborne illness was $1,626 (90% credible interval [CI], $607 to $3,073) for the enhanced cost-of-illness model and $1,068 (90% CI, $683 to $1,646) for the basic model. The resulting aggregated annual cost of illness was $77.7 billion (90% CI, $28.6 to $144.6 billion) and $51.0 billion (90% CI, $31.2 to $76.1 billion) for the enhanced and basic models, respectively.     

Collective kitchens in Canada: a review of the literature.

PURPOSE: Collective kitchens are community-based cooking programs in which small groups of people cook large quantities of food. They have developed over the past 20 years, and hundreds of groups have been formed across the country. However, collective kitchens described in the literature vary considerably in structure, purpose, and format. The purpose of this review is to synthesize research on this topic. METHODS: Articles and theses were collected through searches of major databases, and synthesized to improve understanding of current information, and of continuing gaps in the knowledge of collective kitchens in Canada. RESULTS: The limited published research on collective kitchens suggests that social and learning benefits are associated with participation. Some indication exists that participants also find the food cooked to be high quality, culturally acceptable, and acquired in a manner that maintains personal dignity. Whether collective kitchens have an impact on food resources as a whole is unclear, as research has been limited in scale. CONCLUSIONS: The role of collective kitchens in community building and empowering participants often is noted, and bears further investigation. Dietitians and nutritionists have a unique opportunity to facilitate the health promotion and food security benefits of collective kitchens.     

Assessing quantities and disposal routes for household hazardous products in the United Kingdom

The disposal of household products containing hazardous substances (household hazardous wastes; HHW) is of concern due to possible health and environmental effects as a consequence of environmental pollution. The potential risks of disposal are proportional to the amounts of products used and waste generated, but much of the data relating to quantities are old, inconsistent, or nonexistent. Hence, full-scale risk assessment is not yet feasible. This pilot study was aimed at an initial assessment of the amounts of hazardous products used or stored within the household and potential disposal routes. Representatives of 400 households from southeast England were interviewed about socio-demographic factors, perception of the risks associated with the use and disposal of hazardous waste generated in households, quantities of particular products currently in use or stored within the household, and times and methods of disposal of such products. The estimates of quantities obtained were compared with sales figures and waste estimates to improve understanding of product flow through to the HHW stream. The disposal routes investigated demonstrated that most householders claim to use the entire product priorto disposal in the general refuse bin. The relationship with socio-demographic factors demonstrated a difference between neighborhood size and length of residence in a household with regard to product quantities possessed and the disposal habits adopted.     

Fresh produce: a growing cause of outbreaks of foodborne illness in the United States, 1973 through 1997

Fresh produce is an important part of a healthy diet. During the last three decades, the number of outbreaks caused by foodborne pathogens associated with fresh produce consumption reported to the Centers for Disease Control and Prevention has increased. To identify trends, we analyzed data for 1973 through 1997 from the Foodborne Outbreak Surveillance System. We defined a produce-associated outbreak as the occurrence of two or more cases of the same illness in which epidemiologic investigation implicated the same uncooked fruit, vegetable, salad, or juice. A total of 190 produce-associated outbreaks were reported, associated with 16,058 illnesses, 598 hospitalizations, and eight deaths. Produce-associated outbreaks accounted for an increasing proportion of all reported foodborne outbreaks with a known food item, rising from 0.7% in the 1970s to 6% in the 1990s. Among produce-associated outbreaks, the food items most frequently implicated included salad, lettuce, juice, melon, sprouts, and berries. Among 103 (54%) produce-associated outbreaks with a known pathogen, 62 (60%) were caused by bacterial pathogens, of which 30 (48%) were caused by Salmonella. During the study period, Cyclospora and Escherichia coli O157:H7 were newly recognized as causes of foodborne illness. Foodborne outbreaks associated with fresh produce in the United States have increased in absolute numbers and as a proportion of all reported foodborne outbreaks. Fruit and vegetables are major components of a healthy diet, but eating fresh uncooked produce is not risk free. Further efforts are needed to better understand the complex interactions between microbes and produce and the mechanisms by which contamination occurs from farm to table.     

Complaint-based surveillance for foodborne illness in the United States: a survey of local health departments

Foodborne illnesses are an important public health problem in the United States in terms of both the burden of illness and cost to the health care system. Strengthening foodborne illness surveillance helps address the growing issues of food safety in the United States. Very little is known about the use of consumer complaint surveillance systems for foodborne illness. This study evaluates the use of these surveillance systems by local health departments (LHDs) in the United States and their practices and policies for investigating complaints. Data for this study were collected through two Web-based surveys based on a representative sample of LHDs in the United States; 81% of LHDs use complaint-based surveillance. Of those that did not have a complaint system, 64% reported that the state health department or another agency ran their complaint system. Health departments collect a wide variety of information from callers through their complaint systems, including food intake history. Most of the LHDs, however, do not store the information in an electronic database. Outbreak rates and complaint rates were found to be positively correlated, with a Pearson's correlation coefficient of 0.38. Complaints were the most common outbreak detection mechanism reported by respondents, with a median of 69% of outbreaks during the previous year found through complaints. Complaint systems are commonly used in the United States. Increasing the rate at which illnesses are reported by the public and improving investigation practices could help increase the number of outbreaks detected through complaint surveillance.     

Detection and enumeration of four foodborne pathogens in raw commingled silo milk in the United States

A nationwide survey was conducted to obtain qualitative and quantitative data on bacterial contamination of raw commingled silo milk intended for pasteurization. The levels of total aerobic bacteria, total coliforms, Enterobacteriaceae, Escherichia coli, and Staphylococcus aureus were determined using the TEMPO system. The prevalence rates and levels of presumptive Bacillus cereus, E. coli O157:H7, Listeria monocytogenes, and Salmonella spp. were determined in 214 samples. B. cereus was detected in 8.91% of samples, at 3.0 to 93 CFU/ml. E. coli O157:H7 was detected in 3.79 to 9.05% of samples, at <0.0055 to 1.1 CFU/ml, depending on the assay utilized. Salmonella spp. were recovered from 21.96 to 57.94% of samples, at <0.0055 to 60 CFU/ml. L. monocytogenes was detected in 50.00% of samples, at <0.0055 to 30 CFU/ml. The average log-transformed counts of total viable bacteria were slightly lower in samples containing no pathogens. No correlation was observed between the levels of organisms detected with the TEMPO system and the presence or levels of any pathogen except E. coli O157:H7. A higher average log-transformed count of total viable bacteria was observed in samples positive for this organism. The high prevalence rates of target pathogens may be attributed to a variety of factors, including detection methods, sample size, and commingling of the milk in the silo. The effects of commingling likely contributed to the high prevalence rates and low levels of target pathogens because of the inclusion of milk from multiple bulk tanks. The high prevalence rates also may be the result of analysis of larger sample volumes using more sensitive detection methods. These quantitative data could be utilized to perform more accurate risk assessments and to better estimate the appropriate level of protection for dairy products and processing technologies.     

美国明智选择计划标签的特点、失败原因与警示

包装正面(Front of Package, FOP)标签是帮助消费者快速选择健康食品的新型营养标签。虽然美国的FOP标签起步早,种类多,对世界影响力大,但并非都是成功案例。在我国FOP标签启动阶段,分析美国明智选择计划标签失败原因具有警示意义。通过梳理相关文献发现,美国明智选择计划标签清晰直观且认证标准公开透明,因对非健康食品认证而被美国食品和药物管理局(Food and Drug Administration, FDA)停止使用。该标签失败的原因主要是认证标准偏低、政府监管存在漏洞、行业自律缺失和营养事实标签宣教不足等。因此,在我国开放FOP标签认证的前提是政府制定高标准的认证要求,健全市场监管机制,确立认证退出机制,发挥行业协会协调监督作用,创新营养成分表科普方式以提高居民使用意识。     

Veterinary drug residues in seafood inspected by the European Union, United States, Canada, and Japan from 2000 to 2009

Veterinary drugs are used to treat or prevent a wide array of production-related diseases in aquaculture. Residues of these drugs in seafood products may pose risks to consumers, prompting governments to set drug residue tolerance levels and inspect seafood for violations of these standards. This study characterizes veterinary drug inspection policies and violations among four inspecting bodies (European Union (E.U.), United States (U.S.), Canada, and Japan), using government-collected veterinary drug violation data from 2000 to 2009. Most veterinary drug violations were detected in species that are commonly farm-raised. Asian seafood products, including shrimp and prawns, catfish (or fish sold as catfish), crab, tilapia, eel, and Chilean salmon were most frequently in violation of veterinary drug residue standards. Vietnam had the greatest number of violations among exporting countries. Concentrations of most veterinary drugs in seafood found in violation did not differ between inspecting bodies that reported drug concentrations. Transparency in seafood inspection reporting varied widely among inspecting bodies. Estimation of violations in the untested fraction of seafood was precluded by a lack of information from inspecting bodies regarding the distinction between targeted and random sampling. Increased transparency could facilitate a more rigorous characterization of public health risks from consuming imported seafood.     

Economic input-output life-cycle assessment of trade between Canada and the United States

With increasing trade liberalization, attempts at accounting for environmental impacts and energy use across the manufacturing supply chain are complicated by the predominance of internationally supplied resources and products. This is particularly true for Canada and the United States, the world's largest trading partners. We use an economic input-output life-cycle assessment (EIO-LCA) technique to estimate the economy-wide energy intensity and greenhouse gas (GHG) emissions intensity for 45 manufacturing and resource sectors in Canada and the United States. Overall, we find that U.S. manufacturing and resource industries are about 1.15 times as energy-intensive and 1.3 times as GHG-intensive as Canadian industries, with significant sector-specific discrepancies in energy and GHG intensity. This trend is mainly due to a greater direct reliance on fossil fuels for many U.S. industries, in addition to a highly fossil-fuel based electricity mix in the U.S. To account for these differences, we develop a 76 sector binational EIO-LCA model that implicitly considers trade in goods between Canada and the U.S. Our findings show that accounting for trade can significantly alter the results of life-cycle assessment studies, particularly for many Canadian manufacturing sectors, and the production/consumption of goods in one country often exerts significant energy- and GHG-influences on the other.     

Recent (2011–2017) foodborne outbreak cases in the Republic of Korea compared to the United States: a review

This study analyzes and compares foodborne disease outbreaks reported in the Republic of Korea (KR) and the United States (US) during 2011-2017. The foodborne outbreaks data in the KR and the US were collected from the Ministry of Food and Drug Safety and from the Surveillance for Foodborne Disease Outbreaks United States, respectively. The average number of outbreaks and illness population were higher in the US than in the KR, but the KR’s illness ratio considering population size was 2.4 times higher than that of the US. When the sites of outbreaks compared, the number of illness was the highest at schools in the KR whereas outbreaks at restaurants were more frequent in the US. In the KR, bacterial infections were the primary cause of outbreaks while bacterial and viral infections accounted for the largest share of outbreaks in the US. Specifically, pathogenic E. coli presented a significant risk in the KR whereas Salmonella was the most prevalent in the US. These results indicate that the main microbiological targets for detection and control in the KR should differ from the US, which should be considered for developing food safety related policies.     

Economic losses from and the national research program on mastitis in the United States.

Scientific papers estimating economic losses from mastitis were reviewed. Reduced milk production from cows with subclinical mastitis was responsible for the largest losses. Losses from mastitis in the United States in 1976 were estimated by usable responses to a survey from 33 states representing 9.5 million cows or 86% of the dairy cow population. Losses of milk yields caused by mastitis were 386 kg/cow per yr and losses of discarded milk 62 kg/cow per yr. Annual losses per cow from mastitis were a) reduced milk production, $81.32; b) discarded milk, $12.88; c) cost of veterinary services, $1.97; d) cost of drugs, !3,86; e) increased labor, $2.28; f) decreased sale value, $5.72; g) increased replacement costs, $9.32; h) total, $117.35. For the 11 million cows in the United States 1976 losses from mastitis were $1.294 billion. Mastitis research was supported publicly at 22 locations under 43 projects. Approximately 24 scientist years were involved and $2.7 million of public funds were expended annually. If economic losses from mastitis were reduced 2% per year for 10 yr by research and expenditures for mastitis research remained the same, the benefit to cost ratio from mastitis research would be approximately 9.6 to 1.     

2011—2017年中美两国食源性疾病暴发监测资料比较及对我国监测体系建设的启示

本文介绍了美国食源性疾病暴发监测系统建立的历史,汇总分析2011—2017年美国食源性疾病暴发监测数据,并与同期我国食源性疾病暴发监测数据进行比较。中美两国同期食源性疾病暴发监测数据特征存在明显差异,微生物因素是导致食源性疾病暴发的主要原因。面对全球贸易一体化和后疫情时代的挑战,我国食源性疾病暴发监测体系应加速运用新技术,提高识别预警能力,同时进一步发挥食源性疾病暴发资料对制定我国相关食品安全管理措施的支撑作用。