Form 0920-0980 Food Safety Training Program

Attachment 4- NEARS Food Safety Program Training Webinar

NEARS: Identifying Environmental Factors
Contributing to Foodborne Illness Outbreaks

Laura G. Brown, Ph.D.
Division of Environmental Health Science and
Practice

National Center for Environmental Health

CDC NEARS Webinar
Please dial in with your phone for audio

Phone number: 855-644-0229
Pass code: 4541827

National Center for Environmental Health

CDC’s National Center for Environmental Health
Objectives

Improve identification of
environmental factors
contributing to foodborne
illness outbreaks

Support of environmental
assessments at the state
and local level
through

Collection and analysis of
environmental assessment
data at the national level
4

Environmental Factors Contributing to
Foodborne Outbreaks
Contributing FactorsThe ”How”
Environmental Factors

include

Environmental
AntecedentsThe “Why”

5

Environmental Factors Contributing to Outbreaks
Contamination
• Cross-contamination of
ingredients
• Contact by an
infectious/ill worker

Contributing Factors
Proliferation
• Improper cold holding
due to malfunctioning
equipment
• Improper cold holding
due to improper
procedure

Survival
• Insufficient time/temp
during reheating
• Insufficient time/temp
during freezing

Environmental
Antecedents
• People
• Economics
• Processes • Food
• Equipment
6

Environmental Factors Contributing to Outbreaks
Environmental
Antecedents

• Worker in a
hurry
• Worker had not
been trained on
avoiding cross
contamination

Contributing
Factor
• Cross
contamination
- Worker used
same utensils
on raw ground
beef and
salads

Outbreak
• E. coli outbreak
caused by
salads eaten at
Restaurant A

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Outbreak Environmental Assessments
Describe how the environment
contributes to the introduction and
transmission of illness agents

Are conducted by environmental
health program staff

Involve a thorough review of the
processes and practices used with
suspected food items

Are guided by known information
about the outbreak (e.g., agent)

May include food flows, staff
interviews, observations of food
preparation, sampling

Generate recommendations for
intervention
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The Need to Improve Reporting of Environmental
Assessment Data


Environmental assessment data are key to:
•
•
•

Understand how and why outbreaks occur
Develop appropriate guidelines, policies and practices
Prevent future outbreaks



Engage food safety officials responsible for conducting
environmental assessments



Limited environmental assessment data reported at a
national level

7

Environmental Assessment Training

10

Support of Environmental Assessments at the
State and Local level
Development and launch of environmental assessment training


Designed to improve environmental health programs’ competency in
conducting environmental assessments during outbreaks



Over 6,000 people from federal, state, local government agencies have
registered for the training



Free, web-based, interactive, self-paced



CEUs are available



Participants are showing a 25 percentage point increase
in pre to post test scores
11

Environmental Assessment Training


Module 1: Foundation Skills
•

Lesson 1: Your Assignment

•

Lesson 2: Overview of Foodborne Illness Outbreak Environmental Assessments

•

Lesson 3: Effective Interviewing Skills

•

Lesson 4: Observation and Records Review

•

Lesson 5: Environmental Sampling

•

Lesson 6: Critical Thinking Skills

•

Lesson 7: Organizing Assessment Information

•

Lesson 8: Control Strategies and Conducting Actions
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Environmental Assessment Training




Module 2: Skill Building
•

Lesson 1: Guided walkthrough of an environmental assessment for a fictitious C.
perfringens outbreak linked to a private school cafeteria

•

Lesson 2: Virtual environmental assessment of a fictitious Salmonella Enteriditis and
Salmonella Pomona outbreak linked to a local catering establishment

•

Lesson 3: Guided walkthrough of an environmental assessment for a fictitious
E. coli O157:H7 outbreak linked to a grower and distributor of organic herbs

•

Lesson 4: Virtual environmental assessment of a fictitious Listeria outbreak in a cheese
plant

Module 3: Food Defense
•

Lesson 1: Overview of food defense concepts

•

Lesson 2: Overview of food defense planning

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Collection and Analysis of Environmental Assessment
Data at the National Level
Development and launch of National Environmental Assessment
Reporting System (NEARS)


Companion surveillance system to the National Outbreak
Reporting System (NORS)



Repository for state and local programs to report data
collected from their environmental assessments



31 state and local agencies are currently registered to
begin reporting data into NEARS
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Collection and Analysis of Environmental Assessment
Data at the National Level
Programs report data into NEARS on:
Outbreak
Characteristics

• Did the exposure(s) take place in a single or multiple locations?
• Was this outbreak reported to a national surveillance system?

Establishment
Characteristics

• What is the establishment’s source of potable water?
• Do customers have direct access to unpackaged food such as a buffet line or
salad bar?

Establishment
Policies
(Manager interview)
Establishment
Practices
(Observation)

• Does this establishment have a policy or procedure that requires food workers
to tell a manager when they are ill?
• Are hand sinks available in the employee restroom(s)?
• Were the temperatures of all foods measured in cold holding at 41°F or
below?

15

Collection and Analysis of Environmental Assessment
Data at the National Level
Programs report data into NEARS on:
Suspected/
Confirmed food

• Was a specific ingredient or multi-ingredient food suspected or confirmed in
this outbreak?
• Is the ingredient an animal product, and if so, what kind?

Environmental
Sampling

• Were any samples taken?
• If environmental, where was the sample taken?

Contributing
Factors

• Were any contributing factors identified?
• What activities were used to try to identify contributing factors?

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Short-term Benefits of NEARS Participation
Annual report from
CDC summarizing
your NEARS data
*Complements
FDA Standard 5
Requirements

Collaboration/
communication with
other states/localities
participating in
NEARS

Potential scientific
publication
opportunities

Ability to document
and track foodborne
outbreak response
data
17

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88%
Average # of
Visits to
Complete an
Environmental
Assessment

2 Visits

outbreaks
reported
to NORS

Contributing
Factors
C10
C11
C12

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Long-term Benefits of NEARS Participation
Data to
improve
foodborne
outbreak
response

What investigation
characteristics lead to
identification of
environmental factors?
Do worker interviews
make contributing factor
identification more
likely?

Data to
improve
retail food
safety

What environmental
antecedents are linked
with specific
contributing factors?
Is lack of ill worker
policies linked with
workers working while
ill?

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Summary
Support of environmental
assessments at the state and
local level

Collection and analysis of
environmental assessment
data at the national level

Improved identification of environmental factors
contributing to foodborne illness outbreaks
Improved prevention and intervention

Improved food safety; fewer outbreaks
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Begin Reporting Environmental Assessment
Data to NEARS


Commit to conducting environmental assessments



Complete NEARS Registration Form(s)
•

•

State Notice and Acknowledgment of Local Participation
Notice of Participation Form
o



https://www.cdc.gov/nceh/ehs/nears/registration.htm

Complete CDC’s free online environmental assessment
training
•

https://www.cdc.gov/nceh/ehs/elearn/ea_fio/index.htm

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Thank you
For more information, contact NCEH
1-800-CDC-INFO (232-4636)
TTY: 1-888-232-6348
www.cdc.gov
Follow us on Twitter @CDCEnvironment
The findings and conclusions in this report are those of the authors and do not necessarily represent the
official position of the Centers for Disease Control and Prevention.