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

摘要 2010年田纳西州EHS网络应用食源性和水媒病原体造成重大疾病负担。田纳西州卫生部（TDH）认为，参与EHS网络对于促进安全做法、教育环境学家和流行病学家进行疫情调查、预防疾病、增加有关食品/水安全和环境污染的普遍知识以及向公众展示食品和水安全措施的价值至关重要。此应用程序将展示我们的EHS网络目标，我们的EHS网络成就的历史，以及我们未来的EHS网络计划。我们将继续在EHS-净食品计划的机构间方法，支持两个全职环保主义者在国家的两个大，全面的食品安全计划。这些环境专家和EHS-Net PI将积极为多州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的呼吁。新项目将包括以下内容：1）完成一项介绍性调查，以充分描述戴维森县纳什维尔232家杂货店的特征; 2）在全州范围内与餐馆相关的食源性疫情中实施食品流动和促成因素评估; 3）评估正在进行的针对长期绩效低分餐馆的补救性食品安全培训的有效性; 4）将标准食源性疾病投诉表格的使用整合到州环境卫生信息系统中; 5）作为前一个项目的后续工作，分析前八年全州餐馆检查数据。继续参与多州EHS网络研究也将仍然是一个高度优先事项。自2005年以来，田纳西州参与了EHS网络水安全计划，导致了水传播疾病预防，检测和调查的许多改进。许多项目和调查使地方、州和联邦利益相关者能够互动。在2008-2009年期间，我们进行了多机构爆发调查，包括与一个小社区供水主管道交叉连接的家庭污水出口，一个小社区供水系统中的水源污染，以及一个通往地表河流的城市废水处理旁路。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隐孢子虫和对其进行物种鉴定的能力。我们将继续多州EHS网络项目，并开始两个新的本地设计的项目，确定为额外的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物种特异性因素，2）收集详细的位置和使用信息的私人威尔斯和现场污水处理系统在田纳西州。

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.