Food safety management strategies based on acceptable risk and risk acceptance

Foodborne illnesses are a significant cause of morbidity and mortality worldwide and are therefore important to manage for the protection of public health. In the course of the last half century, when it comes to prioritizing resources for their management, there has been a gradual shift of focus from the hazards that cause the illnesses (microorganisms, chemical and physical agents) to the actual risk that these hazards pose to the population (probability and severity of adverse health effects in relation to hazards in food) and their impact on public health. To accommodate these different schools of thought, new health metrics could be operationalized (DALY, Disability Adjusted Life Year) but also new benchmarks were created for the control of foodborne hazards in food supply chains (ALOP, Appropriate Level of Protection; FSO, Food Safety Objective). These risk-based metrics have been proposed by international organizations as a means of establishing a link between governmental public health policy and the management of hazards in the food supply chain. The aim of this thesis was to develop four different case studies on the operationalization of these risk-based metrics (DALY, ALOP, FSO). Cases were selected so as to deal with different microbial hazards, food products and population groups as well as addressing a number of different real life settings faced by competent authorities in various countries. The first case study used a range of publicly available data to rank all foodborne risks in Greece on the basis of DALYs, in order to set national priorities for food safety management. The use of the results of this study for setting ALOPs is part of the general discussion of the thesis. The second case study dealt with setting of ALOP and FSO targets for Listeria monocytogenes in deli meats in the Netherlands. Here the focus was on a severe, low incidence disease, mainly relevant for susceptible subpopulations, usually associated with medium to high doses of the pathogen in contaminated products consumed on a regular basis by the vast majority of the Dutch population. The third case study concerned the implementation of risk-based targets for Salmonella in poultry meat in the Netherlands and in 22 other EU Member States. Here the focus was on a mostly mild but, on occasion, severe disease, due to longer term sequelae, usually associated with ingestion of low doses of the pathogen through contaminated or undercooked products consumed frequently by the vast majority of the European population. The last case study addressed the application of the targets for Clostridium perfringens in Cornish pasties in the United Kingdom. Here the focus was on a mostly self-limiting, rarely fatal illness, usually associated with very high doses of the pathogen in a Protected Geographical Indication product, infrequently consumed by the British population. The developed case studies showed that the operationalization of the new metrics is feasible and valuable in creating insight and for making food safety more transparent and quantifiable despite data scarcities, inherent uncertainty and variability in the risk estimates and the need for decisions to be made on the interpretation of the metric definitions and their communication to the public.</p

Food safety management strategies based on acceptable risk and risk acceptance

Foodborne illnesses are a significant cause of morbidity and mortality worldwide and are therefore important to manage for the protection of public health. In the course of the last half century, when it comes to prioritizing resources for their management, there has been a gradual shift of focus from the hazards that cause the illnesses (microorganisms, chemical and physical agents) to the actual risk that these hazards pose to the population (probability and severity of adverse health effects in relation to hazards in food) and their impact on public health. To accommodate these different schools of thought, new health metrics could be operationalized (DALY, Disability Adjusted Life Year) but also new benchmarks were created for the control of foodborne hazards in food supply chains (ALOP, Appropriate Level of Protection; FSO, Food Safety Objective). These risk-based metrics have been proposed by international organizations as a means of establishing a link between governmental public health policy and the management of hazards in the food supply chain. The aim of this thesis was to develop four different case studies on the operationalization of these risk-based metrics (DALY, ALOP, FSO). Cases were selected so as to deal with different microbial hazards, food products and population groups as well as addressing a number of different real life settings faced by competent authorities in various countries. The first case study used a range of publicly available data to rank all foodborne risks in Greece on the basis of DALYs, in order to set national priorities for food safety management. The use of the results of this study for setting ALOPs is part of the general discussion of the thesis. The second case study dealt with setting of ALOP and FSO targets for Listeria monocytogenes in deli meats in the Netherlands. Here the focus was on a severe, low incidence disease, mainly relevant for susceptible subpopulations, usually associated with medium to high doses of the pathogen in contaminated products consumed on a regular basis by the vast majority of the Dutch population. The third case study concerned the implementation of risk-based targets for Salmonella in poultry meat in the Netherlands and in 22 other EU Member States. Here the focus was on a mostly mild but, on occasion, severe disease, due to longer term sequelae, usually associated with ingestion of low doses of the pathogen through contaminated or undercooked products consumed frequently by the vast majority of the European population. The last case study addressed the application of the targets for Clostridium perfringens in Cornish pasties in the United Kingdom. Here the focus was on a mostly self-limiting, rarely fatal illness, usually associated with very high doses of the pathogen in a Protected Geographical Indication product, infrequently consumed by the British population. The developed case studies showed that the operationalization of the new metrics is feasible and valuable in creating insight and for making food safety more transparent and quantifiable despite data scarcities, inherent uncertainty and variability in the risk estimates and the need for decisions to be made on the interpretation of the metric definitions and their communication to the public