Risk assessment strategies as a tool in the application of the Appropriate Level of Protection (ALOP) and Food Safety Objective (FSO) by risk managers.

In the course of the last decade, the Appropriate Level of Protection (ALOP), the Food Safety Objective (FSO) and their associated metrics have been proposed by the World Trade Organization and Codex Alimentarius as a means for competent authorities to ultimately translate governmental public health policy regarding food safety into risk-based targets for the food industry. The industry needs to meet these targets through the effective choice of control measures that are part of its operational food safety management system. The aim of this study was to put the practical application of ALOP and FSO to the test in the case of Salmonella in chicken meat in the Netherlands. Two different risk assessment approaches were applied to derive potential ALOP and FSO values, a 'top-down' approach based on epidemiological data and a 'bottom-up' approach based on food supply chain data. To this end, two stochastic models specific to the Dutch situation were built. Comparisons between 23 countries in Europe were also made using the top-down model. The mean estimated current Level Of Protection values were similar for the two approaches applied, with the bottom-up model yielding 87 cases per 100,000 inhabitants per year (95% CI: 0.03, 904) and the top-down model 71 (95% CI: 9.9, 155). The estimated FSO values on the other hand were considerably different with the mean 'top down' FSO being -4.6 log CFU/g (95% CI: -5.4, -4.1) and the mean 'bottom-up' FSO -6.0 log CFU/g (95% CI: -8.1, -2.9) reflecting major differences in the output distributions of this parameter obtained with the two approaches. Significant differences were observed between current LOP values for different EU countries, although it was not clear whether this was due to actual differences in the factors influencing the risk of salmonellosis or due to the quality of the available data.

Perspective on the risk to infants in the Netherlands associated with Cronobacter spp. occurring in powdered infant formula.

Cronobacter spp. has been responsible for severe infections in infants. Relative risks associated with this organism in powdered infant formula (PIF) have been described in several studies. To set priorities and decide on risk management options, it is important for risk managers to have a quantitative perspective on the absolute level of risk of this pathogen within the totality of the burden of illnesses in the population. This study set-out to establish such a perspective for The Netherlands. It addresses the impact of heterogeneity in the distribution of the micro-organism in PIF on risk levels. Based on the assumptions in this study, 60% of formula-fed infants are estimated not to be exposed to Cronobacter spp. during their neonatal period. The mean exposure was calculated to be about 1cfu per infant over the total neonatal period. Even after thorough mixing, artificially contaminated powder shows counts which are more variable than expected from a normal, homogeneous distribution. Therefore, mean exposure levels may not represent a good basis for calculating risks. The burden of disease of Cronobacter infections to the Dutch population was estimated to be 19-24 Disability Adjusted Life Years (DALYs) per year, of which 95% are due to meningitis. As compared to other illnesses Cronobacter infections represent 0.5-2.4% of the total estimated burden of foodborne infections and intoxications. The organism is estimated to be responsible for 0.5-0.7% of the meningitis burden to the entire population of The Netherlands.