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.

[1]  S. Hoffmann,et al.  Getting to risk-based food safety regulatory management: lessons from federal environmental policy. , 2005 .

[2]  W. Adger,et al.  Eliciting Information from Experts on the Likelihood of Rapid Climate Change , 2005, Risk analysis : an official publication of the Society for Risk Analysis.

[3]  Richard A. Parker,et al.  Designing and Conducting Survey Research: A Comprehensive Guide , 1992 .

[4]  Alan D. Lopez,et al.  Comparative quantification of health risks: Conceptual framework and methodological issues , 2003, Population health metrics.

[5]  Alan D. Lopez,et al.  Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study , 1997, The Lancet.

[6]  C. Hedberg,et al.  Food-related illness and death in the United States. , 1999, Emerging infectious diseases.

[7]  B. Hope,et al.  An Overview of the Salmonella Enteritidis Risk Assessment for Shell Eggs and Egg Products , 2002, Risk analysis : an official publication of the Society for Risk Analysis.

[8]  Joey F. George,et al.  Countering the anchoring and adjustment bias with decision support systems , 2000, Decis. Support Syst..

[9]  Silja Renooij,et al.  Probability elicitation for belief networks: issues to consider , 2001, The Knowledge Engineering Review.

[10]  N. Skovgaard Scientific Criteria to Ensure Safe Food: Institute of Medicine, Natural Research Council of the National Academies. The National Academy Press, Washington D.C.; www.nap.edu; xxi+401 pages; soft cover, $35.95; ISBN 0-309-08928-X (hard cover) , 2004 .

[11]  John Painter,et al.  Attributing Illness to Food , 2005, Emerging infectious diseases.

[12]  Division on Earth Risk Assessment in the Federal Government: Managing the Process , 1983 .

[13]  Edward M. Zadjura,et al.  Food Safety and Quality. Uniform, Risk-Based Inspection System Needed to Ensure Safe Food Supply, , 1992 .

[14]  M. Tobin-D'Angelo,et al.  Preliminary FoodNet Data on the incidence of infection with pathogens transmitted commonly through food--10 States, 2008. , 2009, MMWR. Morbidity and mortality weekly report.

[15]  Max Henrion,et al.  Uncertainty: A Guide to Dealing with Uncertainty in Quantitative Risk and Policy Analysis , 1990 .

[16]  C. Sharbaugh,et al.  Reliability and validity of the 24-hour recall. , 1981, Journal of the American Dietetic Association.

[17]  Robert T. Clemen,et al.  Making Hard Decisions: An Introduction to Decision Analysis , 1997 .

[18]  G. Yohe,et al.  Societal Adaptation to Climate Variability and Change: An Introduction , 2000 .

[19]  H. J. van der Fels-Klerx,et al.  A Structured Expert Judgment Study for a Model of Campylobacter Transmission During Broiler‐Chicken Processing , 2005, Risk analysis : an official publication of the Society for Risk Analysis.

[20]  P. Kendall,et al.  Consumer food-handling behaviors associated with prevention of 13 foodborne illnesses. , 2003, Journal of food protection.

[21]  Elizabeth A. Casman,et al.  Elicitation of Expert Judgments of Uncertainty in the Risk Assessment of Herbicide‐Tolerant Oilseed Crops , 2004, Risk analysis : an official publication of the Society for Risk Analysis.

[22]  A. Naugle,et al.  Estimate of Illnesses from Salmonella Enteritidis in Eggs, United States, 2000 , 2005, Emerging infectious diseases.

[23]  Nebojsa Nakicenovic,et al.  Characterizing Climate-Change Uncertainties for Decision-Makers , 2004 .

[24]  M. Morgan,et al.  Categorizing Risks for Risk Ranking , 2000, Risk analysis : an official publication of the Society for Risk Analysis.

[25]  Robert A. Moffitt,et al.  The Uses of Tobit Analysis , 1980 .

[26]  N. Epley,et al.  Putting Adjustment Back in the Anchoring and Adjustment Heuristic: Differential Processing of Self-Generated and Experimenter-Provided Anchors , 2001, Psychological science.

[27]  P. Cieslak,et al.  FoodNet estimate of the burden of illness caused by nontyphoidal Salmonella infections in the United States. , 2004, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[28]  R. Cooke Experts in Uncertainty: Opinion and Subjective Probability in Science , 1991 .

[29]  R. Cooke,et al.  Expert judgement elicitation for risk assessments of critical infrastructures , 2004 .

[30]  Michael McWilliams,et al.  Informing risk-mitigation priorities using uncertainty measures derived from heterogeneous expert panels: A demonstration using foodborne pathogens , 2008, Reliab. Eng. Syst. Saf..

[31]  A. Tversky,et al.  Judgment under Uncertainty: Heuristics and Biases , 1974, Science.

[32]  Nebojsa Nakicenovic,et al.  Characterizing Climate-Change Uncertainties for Decision-Makers. An Editorial Essay , 2004 .

[33]  R D Benz,et al.  Priority-based assessment of food additives database of the U.S. Food and Drug Administration Center for Food Safety and Applied Nutrition. , 1991, Environmental health perspectives.

[34]  Shama Desai Ahuja,et al.  Risk factors for sporadic Campylobacter infection in the United States: A case-control study in FoodNet sites. , 2004, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[35]  Marc J. Leclere THE DECOMPOSITION OF COEFFICIENTS IN CENSORED REGRESSION MODELS: UNDERSTANDING THE EFFECT OF INDEPENDENT VARIABLES ON TAXPAYER BEHAVIOR , 1994, National Tax Journal.

[36]  David W. Keith,et al.  When is it appropriate to combine expert judgments? , 1996 .

[37]  M. Blaser,et al.  A review of human salmonellosis: III. Magnitude of Salmonella infection in the United States. , 1988, Reviews of infectious diseases.