Risk Sciences International, 449 Sussex Drive, Suite 200, Ottawa, ON K1N 6Z4, Canada.
Risk Anal. 2009 Nov;29(11):1506-20. doi: 10.1111/j.1539-6924.2009.01286.x. Epub 2009 Aug 28.
We have developed a simulation model to quantify and characterize the response of the public health system and the impact of public health advisories in the event of an intentional contamination of the food supply. The model has three components: (1) definition of individual exposure over time and the outcomes of exposure, (2) definition of the geographical dispersal of exposures, and (3) response of the public health authorities to symptomatic individuals. The model explicitly considers the variation in the multiple interrelated facets of the response system, including differences among individuals' responses to exposure, variation between health care providers, and the subsequent processing of samples and confirmation of cases. To illustrate use of the model, case studies with Escherichia coli O157:H7 and Salmonella spp. in three categories of food vehicle were compared. The level of detail required to run the public health component of the model is not trivial. While some data may not be available for hazards of particular interest in potential bioterrorism events, the application of expert judgment permits comparisons between different agents, different system reactions, and other assumptions within the system. The model provides the capacity to study the impact of system changes, to compare scenarios and to quantify the benefits of improvement in terms of averted exposures and risk reduction, and constitutes a significant aid to understanding and managing these threats. Essentially, the model provides an explicit valuation of time saved in the identification and intervention in terrorist events in the food supply.
我们开发了一个模拟模型，用于量化和描述公共卫生系统的反应，以及在食品供应受到故意污染的情况下公共卫生建议的影响。该模型有三个组成部分：（1）随时间定义个体暴露和暴露结果，（2）定义暴露的地理分布，（3）公共卫生当局对症状个体的反应。该模型明确考虑了反应系统的多个相互关联方面的变化，包括个体对暴露的反应差异、医疗服务提供者之间的差异，以及随后对样本的处理和病例的确认。为了说明模型的使用，比较了三种食品载体中大肠杆菌 O157:H7 和沙门氏菌的病例研究。运行模型公共卫生部分所需的详细程度不小。虽然对于特定生物恐怖主义事件中特别关注的危害，有些数据可能不可用，但专家判断的应用允许在不同的病原体、不同的系统反应和系统内的其他假设之间进行比较。该模型提供了研究系统变化影响的能力，比较场景并量化改进带来的益处，即避免暴露和降低风险，并构成理解和管理这些威胁的重要辅助手段。从本质上讲，该模型提供了在食品供应中识别和干预恐怖事件所节省时间的明确价值。
