Methodological Framework for World Health Organization Estimates of the Global Burden of Foodborne Disease

RESEARCH ARTICLE Methodological Framework for World Health Organization Estimates of the Global Burden of Foodborne Disease Brecht Devleesschauwer1,2,3,4*, Juanita A. Haagsma5, Frederick J. Angulo6, David C. Bellinger7,8, Dana Cole6, Dörte Döpfer9, Aamir Fazil10, Eric M. Fèvre11,12, Herman J. Gibb13, Tine Hald14, Martyn D. Kirk15, Robin J. Lake16, Charline Maertens de Noordhout2, Colin D. Mathers17, Scott A. McDonald18, Sara M. Pires14, Niko Speybroeck2, M. Kate Thomas10, Paul R. Torgerson19, Felicia Wu20, Arie H. Havelaar4,21,22, Nicolas Praet3 OPEN ACCESS Citation: Devleesschauwer B, Haagsma JA, Angulo FJ, Bellinger DC, Cole D, Döpfer D, et al. (2015) Methodological Framework for World Health Organization Estimates of the Global Burden of Foodborne Disease. PLoS ONE 10(12): e0142498. doi:10.1371/journal.pone.0142498 Editor: Mirjam E. E. Kretzschmar, The National Institute for Public Health and the Environment, NETHERLANDS Received: July 20, 2015 Accepted: October 22, 2015 1 Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium, 2 Insitute of Health and Society (IRSS), Université catholique de Louvain, Brussels, Belgium, 3 Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium, 4 Department of Animal Sciences and Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States of America, 5 Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands, 6 Centers for Disease Control and Prevention, Atlanta, GA, United States of America, 7 Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States of America, 8 Department of Environmental Health, Harvard School of Public Health, Boston, MA, United States of America, 9 Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin in Madison, Wisconsin, United States of America, 10 Public Health Agency of Canada, Guelph, Ontario, Canada, 11 Institute of Infection and Global Health, University of Liverpool, Leahurst Campus, Neston, United Kingdom, 12 International Livestock Research Institute, Nairobi, Kenya, 13 Gibb Epidemiology Consulting, Arlington, VA, United States of America, 14 National Food Institute, Danish Technical University, Lyngby, Denmark, 15 National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, Australia, 16 Institute of Environmental Science and Research, Christchurch, New Zealand, 17 Department of Health Statistics and Information Systems, World Health Organization, Geneva, Switzerland, 18 Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands, 19 Section of Epidemiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland, 20 Department of Food Science and Human Nutrition, Department of Agricultural, Food, and Resource Economics, Michigan State University, East Lansing, MI, United States of America, 21 National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands, 22 Utrecht University, Utrecht, Netherlands * Published: December 3, 2015 Copyright: © 2015 World Health Organization. This is an open access article distributed under the Creative Commons Attribution IGO License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/ licenses/by/3.0/igo/, This article should not be reproduced for use in association with the promotion of commercial products, services or any legal entity.. Data Availability Statement: All relevant data are within the paper and its Supporting Information files. The R source code is also available from https:// github.com/brechtdv/FERG. Funding: This study was commissioned and paid for by the World Health Organization (WHO). Copyright in the original work on which this article is based belongs to WHO. The authors have been given Abstract Background The Foodborne Disease Burden Epidemiology Reference Group (FERG) was established in 2007 by the World Health Organization to estimate the global burden of foodborne diseases (FBDs). This paper describes the methodological framework developed by FERG's Computational Task Force to transform epidemiological information into FBD burden estimates. Methods and Findings The global and regional burden of 31 FBDs was quantified, along with limited estimates for 5 other FBDs, using Disability-Adjusted Life Years in a hazard- and incidence-based PLOS ONE | DOI:10.1371/journal.pone.0142498 December 3, 2015 1 / 20 WHO/FERG Methodological Framework permission to publish this article. Gibb Epidemiology Consulting, LLC, provided support in the form of salaries for author [HJG], but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of this author are articulated in the ‘author contributions’ section. Competing Interests: All authors serve as members of the World Health Organization advisory body—the Foodborne Disease Burden Epidemiology Reference Group—without remuneration. The authors declare no competing interests. Co-author Herman J. Gibb is the owner of Gibb Epidemiology Consulting. There are no patents, products in development or marketed products to declare. This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials. approach. To accomplish this task, the following workflow was defined: outline of disease models and collection of epidemiological data; design and completion of a database template; development of an imputation model; identification of disability weights; probabilistic burden assessment; and estimating the proportion of the disease burden by each hazard that is attributable to exposure by food (i.e., source attribution). All computations were performed in R and the different functions were compiled in the R package 'FERG'. Traceability and transparency were ensured by sharing results and methods in an interactive way with all FERG members throughout the process. Conclusions We developed a comprehensive framework for estimating the global burden of FBDs, in which methodological simplicity and transparency were key elements. All the tools developed have been made available and can be translated into a user-friendly national toolkit for studying and monitoring food safety at the local level. Introduction The Foodborne Disease Burden Epidemiology Reference Group (FERG) was established in 2007 by the World Health Organization (WHO) to estimate the global burden of foodborne diseases (FBDs) [1]. In 2012, FERG established a Computational Task Force (CTF) to derive FBD burden estimates using epidemiological information generated by the hazard-based and source attribution task (...truncated)