The need for Partnerships for Food Safety.

Editor's note: NEHA strives to provide up-to-date and relevant information on environmental health and to build partnerships in the profession. In pursuit of these goals, we will feature a column from the Environmental Health Services Branch (EHSB) of the Centers for Disease Control and Prevention (CDC) in every issue of the Journal.

EHSB's objective is to strengthen the role of state, local, and national environmental health programs and professionals to anticipate, identify, and respond to adverse environmental exposures and the consequences of these exposures for human health. The services being developed through EHSB include access to topical, relevant, and scientific information; consultation; and assistance to environmental health specialists, sanitarians, and environmental health professionals and practitioners.

EHSB appreciates NEHA's invitation to provide monthly columns for the Journal. In the coming months, EHSB staff will be highlighting a variety of concerns, opportunities, challenges, and successes that we all share in environmental public health.

We who work in food safety know the numbers. The Centers for Disease Control and Prevention (CDC) estimates that foodborne diseases cause 76 million illnesses, 325,000 hospitalizations, and 5,000 deaths each year. In 2000, the U.S. Department of Agriculture (USDA) estimated the costs associated with five major bacterial foodborne pathogens to be $6.9 billion. The Food and Drug Administration's (FDAs) 2005 Food Code states, "The estimated cost of foodborne illness is $10-$83 billion annually." These numbers show the large medical and financial burdens caused by foodborne disease in America. What the numbers do not show, however, is the pain and suffering of consumers and their families as a result of foodborne illness.

Working together in partnerships, we can prevent or reduce much of the burden of illness due to unsafe food. Partnerships bring together groups in mutual trust and understanding for the purpose of preventing foodborne disease. Food safety is a priority action area in the national health promotion and disease prevention objectives set forth in Healthy People 2000 and Healthy People 2010. Food Safety Objective 10-1 in Healthy People 2010 was established (with baselines and targets) to reduce infections caused by key foodborne pathogens. This objective is to be achieved through the cooperative efforts of federal, state, and private-sector groups. As described below, important progress has been made in this effort.

The Foodborne Diseases Active Surveillance Network (FoodNet) at CDC is a partnership project of CDC, 10 states, USDA, and FDA to help public health officials better understand the burden of foodborne disease in the United States. In the April 14, 2006, issue of Morbidity and Mortality Weekly Report (MMWR), FoodNet reported that the incidence of infection caused by six pathogenic organisms has declined and that the incidence for two of the six is approaching levels targeted by Healthy People 2010. "Much remains to be done to reach the national objectives for foodborne illness," the MMWR article states. "Declines in the incidence of STEC 0157 [Shiga-toxigenic E. coli 0157] infections observed in recent years suggest that coordinated efforts by regulators and industry have been effective in reducing contamination and illness related to ground beef."

If we are to continue to move toward the target of reducing foodborne disease, existing partnerships must continue and others must be formed. Additional examples of food safety partnerships include the Conference for Food Protection (regulators, industry, consumers, and academia) and the Partnership for Food Safety Education (health educators, food safety regulators, and industry). The Partnership for Food Safety Education, for example, launched Fight BAC![R], a public-education campaign that outlines steps people can take to keep foods safe from harmful bacteria.

At CDC, the Environmental Health Services Branch (EHSB) has been involved in a number of partnerships. One of these is the Environmental Health Specialists Network (EHS-Net) (www.cdc.gov/nceh/ehs/EHSNet/default.htm), a partnership of nine states, FDA, USDA, the U. S. Environmental Protection Agency, and centers at CDC. EHSB has also formed partnerships with the National Association of County and City Health Officials and the Association of Food and Drug Officials to help reduce foodborne disease. NEHA has formed a partnership with CDC to provide epidemiologic training (Epi-Ready) to teams of sanitarians, nurses, epidemiologists, and laboratory personnel to improve investigation of foodborne-disease outbreaks.

Although much of the focus has been on partnerships at a national level, it is also important to form partnerships at the state and local levels. No single organization has the resources to achieve the objective of reducing foodborne disease. While working in food safety at a local health department, I saw firsthand the value of partnerships. The local health department partnered with local food service establishments, health educators, and health departments in adjacent jurisdictions to convince local legislators to adopt the FDA 1999 Food Code. For the local health department to respond properly to foodborne-disease outbreaks, the environmental health section needed to partner with the laboratory and epidemiology sections.

Since September 11, the number and type of partnerships in food safety has increased. We who work in food safety need to form partnerships with law enforcement, hospitals, pharmacies, and others to support the activities required to respond to and prevent intentional contamination of our food supply.

The closing passage from the 2005 Food Code refers to the food industry and government agencies, but it applies as well to all groups that partner to promote public health: "Working together, we will rise to the challenge of making sure all consumers continue to enjoy a safe food supply"

Corresponding Author: Vince Radke, Sanitarian, National Center for Environmental Health, CDC, 4770 Buford Highway, NE, MS F28, Atlanta, GA 30341-3724. E-mail: [e-mail]

Vince Radke, M.P.H., R.E.H.S., C.F.S.P.

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