Food Outlets Dietary Risk (FODR) assessment tool: study protocol for assessing the public health nutrition risks of community food environments.

BACKGROUND: Availability and accessibility of nutritious foods can vary according to the food outlets present within a neighbourhood or community. There is increasing evidence that community food environments influence food choice, diet and the risk of diet-related chronic disease, however contemporary community food environments assessments (e.g. unhealthy fast food outlets versus healthy supermarkets or fruit and vegetable shops) may be too simplistic to accurately summarise the complexities of their impacts on food choice. This study protocol describes the development of the Food Outlets Dietary Risk (FODR) assessment tool for use by local government in Perth, Western Australia. METHODS: Similar to food safety risk assessment, the FODR assessment tool rates the potential harmful public health nutrition impact of food outlets by identifying and characterising the issues, and assessing the risk of exposure. Scores are attributed to six public health nutrition attributes: 1) availability of nutrient-poor foods; 2) availability of nutritious foods; 3) acceptability and appeal; 4) accessibility; 5) type of business operation; and 6) complex food outlet considerations. Food retail outlets are then classified as having a low, medium, high or very high dietary risk based on their total score. DISCUSSION: A local government administered tool to rate the public health nutrition risk of food outlets requires data which can be collected during routine assessments or sourced from the internet. The ongoing categorical classification of foods available within food outlets as either unhealthy or nutritious will require nutrition scientists' input. An objective risk assessment of the dietary impact of food retail outlets can guide local government planning, policies and interventions to create supportive community food environments. It is intended that locally relevant data can be sourced throughout Australia and in other countries to apply the local context to the FODR assessment tool. Utility and acceptability of the tool will be tested, and consultation with environmental health officers and public health practitioners will inform future iterations.

Human campylobacteriosis related to cross-contamination during handling of raw chicken meat: Application of quantitative risk assessment to guide intervention scenarios analysis in the Australian context.

Quantitative Microbiological Risk Assessment (QMRA) is a methodology used to organize and analyze scientific information to both estimate the probability and severity of an adverse event as well as prioritize efforts to reduce the risk of foodborne pathogens. No QMRA efforts have been applied to Campylobacter in the Australian chicken meat sector. Hence, we present a QMRA model of human campylobacteriosis related to the occurrence of cross-contamination while handling raw chicken meat in Western Australia (WA). This work fills a gap in Campylobacter risk characterization in Australia and enables benchmarking against risk assessments undertaken in other countries. The model predicted the average probability of the occurrence of illness per serving of salad that became cross-contaminated from being handled following the handling of fresh chicken meat as 7.0 × 10-4 (90% Confidence Interval [CI] ± 4.7 × 10-5). The risk assessment model was utilized to estimate the likely impact of intervention scenarios on the predicted probability of illness (campylobacteriosis) per serving. Predicted relative risk reductions following changes in the retail prevalence of Campylobacter were proportional to the percentage desired in the reduction scenario; a target that is aiming to reduce the current baseline prevalence of Campylobacter in retail chicken by 30% is predicted to yield approximately 30% relative risk reduction. A simulated one-log reduction in the mean concentration of Campylobacter is anticipated to generate approximately 20% relative risk reductions. Relative risk reduction induced by a one-log decrease in the mean was equally achieved when the tail of the input distribution was affected-that is, by a change (one-log reduction) in the standard deviation of the baseline Campylobacter concentration. A scenario assuming a 5% point decrease in baseline probability of cross-contamination at the consumer phase would yield relative risk reductions of 14%, which is as effective as the impact of a strategic target of 10% reduction in the retail prevalence of Campylobacter. In conclusion, the present model simulates the probability of illness predicted for an average individual who consumes salad that has been cross-contaminated with Campylobacter from retail chicken meat in WA. Despite some uncertainties, this is the first attempt to utilize the QMRA approach as a scientific basis to guide risk managers toward implementing strategies to reduce the risk of human campylobacteriosis in an Australian context.