Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD, USA.
Risk Anal. 2013 Sep;33(9):1568-81. doi: 10.1111/risa.12005. Epub 2013 Jan 11.
Listeria monocytogenes is a leading cause of hospitalization, fetal loss, and death due to foodborne illnesses in the United States. A quantitative assessment of the relative risk of listeriosis associated with the consumption of 23 selected categories of ready-to-eat foods, published by the U.S. Department of Health and Human Services and the U.S. Department of Agriculture in 2003, has been instrumental in identifying the food products and practices that pose the greatest listeriosis risk and has guided the evaluation of potential intervention strategies. Dose-response models, which quantify the relationship between an exposure dose and the probability of adverse health outcomes, were essential components of the risk assessment. However, because of data gaps and limitations in the available data and modeling approaches, considerable uncertainty existed. Since publication of the risk assessment, new data have become available for modeling L. monocytogenes dose-response. At the same time, recent advances in the understanding of L. monocytogenes pathophysiology and strain diversity have warranted a critical reevaluation of the published dose-response models. To discuss strategies for modeling L. monocytogenes dose-response, the Interagency Risk Assessment Consortium (IRAC) and the Joint Institute for Food Safety and Applied Nutrition (JIFSAN) held a scientific workshop in 2011 (details available at http://foodrisk.org/irac/events/). The main findings of the workshop and the most current and relevant data identified during the workshop are summarized and presented in the context of L. monocytogenes dose-response. This article also discusses new insights on dose-response modeling for L. monocytogenes and research opportunities to meet future needs.
单增李斯特菌是美国食源性疾病导致住院、胎儿流产和死亡的主要原因。2003 年,美国卫生与公众服务部和美国农业部公布了一项对 23 种即食食品类别的李斯特菌感染相对风险的定量评估,该评估有助于确定存在高李斯特菌感染风险的食品和操作,并为潜在干预策略的评估提供了指导。剂量反应模型是量化暴露剂量与不良健康结果概率之间关系的重要组成部分,也是风险评估的重要组成部分。然而,由于数据空白和现有数据及建模方法的局限性,存在很大的不确定性。自风险评估公布以来,已有新的数据可用于建模单增李斯特菌剂量反应。与此同时,单增李斯特菌病理生理学和菌株多样性的最新认识也需要对已公布的剂量反应模型进行重新评估。为了讨论单增李斯特菌剂量反应建模策略,机构间风险评估联盟(IRAC)和食品与应用营养联合研究所(JIFSAN)于 2011 年举办了一次科学研讨会(详情可在 http://foodrisk.org/irac/events/ 查阅)。本文总结了研讨会的主要发现和研讨会期间确定的最新和最相关数据,并结合单增李斯特菌剂量反应进行了介绍。本文还讨论了单增李斯特菌剂量反应建模的新见解和满足未来需求的研究机会。