Using under-reporting estimates to mobilize the development of targeted, proactive food safety policy (50m Lecture)

Public health policy that targets populations at greatest risk can be used to significantly reduce the burden of foodborne illness. The impacts of salmonellosis and campylobacteriosis are underestimated because foodborne illnesses are under-reported. The purpose of this study was to calculate incidence rates, Disability Adjusted Life Years (DALY) and Quality Adjusted Life Years (QALY) estimates for salmonella and campylobacteriosis, adjusted for under-reporting, to investigate how these measures of disease burden can contribute to the policy debate on the public health significance of foodborne illness. Incidence data for salmonellosis and campylobacteriosis for Ontario were obtained and increased 13 fold for salmonellosis and 23 fold for campylobacteriosis. A Poisson regression analyzed the variation of infections and DALYs and QALYs gained calculations were determined. Incidence rates of salmonellosis and campylobacteriosis in Ontario between 2006 and 2009 were greatest for populations less than five years and greater than 70 years of age. DALYs were greatest for those between the ages of 0 and 4. QALYs gained estimates showed a modest decrease. In conclusion, predominately non-fatal, self-limiting, short duration diseases do not deliver high DALYs and QALYs at the individual level but can do so at the population level due to their high prevalence and incidence. Targeting food safety activities through proactive public health policy and by using under-reporting estimates of reported cases of foodborne illness in Ontario may raise the issue of foodborne illness in the policy agenda and have an impact on the health.