按传播源划分的疾病负担趋势(美国,2005-2020 年)和食品危害识别:重点关注奶源性疾病。

IF 3.8 4区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Journal of Epidemiology and Global Health Pub Date : 2024-09-01 Epub Date: 2024-03-28 DOI:10.1007/s44197-024-00216-6
Michele M Stephenson, Margaret E Coleman, Nicholas A Azzolina
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引用次数: 0

摘要

背景:全球、国家和地区的传染性和非传染性疾病负担,尤其是与饮食有关的疾病负担,需要跨学科或跨学科合作才能有效地为风险分析和政策决策提供信息:对 2005-2020 年美国所有传播源的疫情数据进行分析,以了解传染病和食源性疫情的负担趋势:方法:使用系统查询和数据透视表对 58 个 Microsoft Access® 数据表中的疫情数据进行结构化处理,以便按传播源、病原体和日期进行分析。使用图形表示法、平滑样条、Spearman's rho 等级相关性和非参数趋势测试对趋势进行检验。根据疾病的数量和严重程度进行了危害识别:证据不支持食源性传染病负担呈上升趋势,但观察到其他传染源呈强烈上升趋势。发病率和死亡率以人传人为主;食源性和其他传播源占疾病负担的一小部分。确定了与四种主要食源性细菌疾病相关的危害最大的食物。致命的食源性疾病主要是水果、蔬菜、花生酱和巴氏杀菌乳制品:现有证据与巴氏杀菌奶的零风险假设和生奶的疾病负担增加趋势相冲突。对于未来以证据为基础的风险管理,跨学科风险分析方法对于平衡传染性和非传染性疾病以及食品安全和粮食安全至关重要,同时要考虑科学、可持续、经济、文化、社会和政治因素,以支持人类和生态系统的健康和福祉。
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Trends in Burdens of Disease by Transmission Source (USA, 2005-2020) and Hazard Identification for Foods: Focus on Milkborne Disease.

Background: Robust solutions to global, national, and regional burdens of communicable and non-communicable diseases, particularly related to diet, demand interdisciplinary or transdisciplinary collaborations to effectively inform risk analysis and policy decisions.

Objective: U.S. outbreak data for 2005-2020 from all transmission sources were analyzed for trends in the burden of infectious disease and foodborne outbreaks.

Methods: Outbreak data from 58 Microsoft Access® data tables were structured using systematic queries and pivot tables for analysis by transmission source, pathogen, and date. Trends were examined using graphical representations, smoothing splines, Spearman's rho rank correlations, and non-parametric testing for trend. Hazard Identification was conducted based on the number and severity of illnesses.

Results: The evidence does not support increasing trends in the burden of infectious foodborne disease, though strongly increasing trends were observed for other transmission sources. Morbidity and mortality were dominated by person-to-person transmission; foodborne and other transmission sources accounted for small portions of the disease burden. Foods representing the greatest hazards associated with the four major foodborne bacterial diseases were identified. Fatal foodborne disease was dominated by fruits, vegetables, peanut butter, and pasteurized dairy.

Conclusion: The available evidence conflicts with assumptions of zero risk for pasteurized milk and increasing trends in the burden of illness for raw milk. For future evidence-based risk management, transdisciplinary risk analysis methodologies are essential to balance both communicable and non-communicable diseases and both food safety and food security, considering scientific, sustainable, economic, cultural, social, and political factors to support health and wellness for humans and ecosystems.

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来源期刊
CiteScore
10.70
自引率
1.40%
发文量
57
审稿时长
19 weeks
期刊介绍: The Journal of Epidemiology and Global Health is an esteemed international publication, offering a platform for peer-reviewed articles that drive advancements in global epidemiology and international health. Our mission is to shape global health policy by showcasing cutting-edge scholarship and innovative strategies.
期刊最新文献
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