Revitalizing Tennessee's Core Environmental Health Programs: Food Safety and Wate

摘要 田纳西州EHS-Net应用2010年食源性和水源性病原体造成相当大的疾病负担。田纳西州卫生部认为，参与EHS-Net对于推广安全做法、教育环保主义者和流行病学家进行疫情调查、预防疾病、增加关于食品/水安全和环境污染的一般性知识以及向公众展示食品和水安全措施的价值至关重要。该申请将展示我们的EHS-Net目标、我们的EHS-Net成就的历史以及我们未来的EHS-Net计划。我们将继续在EHS-Net食品计划中采取跨部门的方法，为该州两个大型、全面的食品安全计划中的两名全职环保主义者提供支持。这些环境专家和EHS-Net PI将积极为多个州的食品安全项目的各个方面做出贡献，并参与指导委员会和工作组电话会议。新项目将包括：1)完成一项介绍性调查，以全面描述戴维森县纳什维尔232家杂货店的特征；2)在全州范围内实施与餐厅相关的食源性疫情的食品流动和促成因素评估；3)评估正在进行的针对长期表现较低的餐厅的补救食品安全培训的有效性；4)将标准食源性疾病申诉表的使用整合到该州的环境健康信息系统中；5)作为先前项目的后续，分析之前八年的全州餐厅检查数据。继续参与多个州的EHS-Net研究也将是一个高度优先事项。田纳西州自2005年以来参与了EHS-Net水安全计划，在水传播疾病的预防、检测和调查方面取得了许多改进。大量的项目和调查使得与地方、州和联邦利益攸关方的互动成为可能。在2008-2009年间，我们进行了多机构疫情调查，包括一个与供水总管交叉连接的家庭排污口，一个小社区供水系统的水源污染，以及一个城市污水处理绕行到地表溪流。在EHS-Net的支持下，国家公共卫生实验室获得了从粪便和环境现场样本中分离和鉴定隐孢子虫的能力。我们将继续多个州的EHS-Net项目，并开始两个新的当地设计的项目，这些项目被确定为额外研究和数据收集的优先事项：1)确定和了解与田纳西州东部隐孢子虫病报告增加相关的特定物种因素，2)收集田纳西州私人水井和现场污水处理系统的详细位置和使用信息。

Abstract Tennessee EHS-Net Application 2010 Foodborne and waterborne pathogens cause substantial burden of illness. The Tennessee Department of Health (TDH) considers involvement in EHS-Net vital to promoting safe practices, educating environmentalists and epidemiologists in outbreak investigation, preventing illness, adding to the body of generalizable knowledge about food/water safety and environmental contamination, and demonstrating to the public the value of food and water safety measures. This application will demonstrate our EHS-Net objectives, our history of EHS-Net accomplishments, and our future EHS- Net plans. We will continue the interagency approach in EHS-Net Food Program by supporting two full- time environmentalists in two of the state's large, comprehensive food safety programs. These environmental specialists and the EHS-Net PI will actively contribute to all aspects of multi-state food safety projects and participate in steering committee and working group calls. New projects will include the following: 1) complete an introductory survey to fully characterize the 232 grocery stores in Nashville, Davidson County; 2) implement food flow and contributing factor evaluation in restaurant- associated foodborne outbreaks statewide; 3) evaluate the effectiveness of an ongoing remedial food safety training on the long-term performance low-scoring restaurants; 4) integrate use of a standard foodborne illness complaint form into the state's environmental health information system; 5) as follow- on to a previous project, analyze the previous eight years of statewide restaurant inspection data. Continued participation in multi-state EHS-Net studies will also remain a high priority. Tennessee's involvement in the EHS-Net Water Safety Program since 2005 has led to numerous improvements in waterborne disease prevention, detection, and investigation. Numerous projects and investigations have enabled interaction with local, state, and federal stakeholders. During 2008-2009, we conducted multi-agency outbreak investigations, including a household sewage outlet cross connected to the water main supplying a small community, a source water contamination in a small community water system, and a municipal waste water treatment bypass to surface streams. With EHS-Net support, the state public health laboratory gained capacity to isolate and speciate Cryptosporidium from stool and environmental field samples. We will continue multistate EHS-Net projects and begin two new locally designed projects identified as priorities for additional study and data collection: 1) to identify and understand species-specific factors associated with the increased reports of cryptosporidiosis in east Tennessee, and 2) collect detailed location and use information for private water wells and onsite sewage disposal systems in Tennessee.