Food Safety and Defense
Foodborne illness in the United States is estimated to sicken 48 million people, cause more than 128,000 hospitalizations, and lead to 3,000 deaths every year. Hospitalizations due to foodborne illnesses are estimated to cost more than $3 billion dollars, and lost productivity is estimated to cost between $20 billion and $40 billion each year. The U.S. Department of Agriculture (USDA) estimates that foodborne illnesses are costing the United States economy more than $15.6 billion annually. NACCHO strives to support and work with local health departments to improve food safety and prevent foodborne illness.
See all of NACCHO's food safety resources for local health departments here.
The Toolkit is a resource that provides research, resources, and support to decision-makers to adopt the most recent versions of FDA's Food Code.
Working to improve methods to detect, investigate, control and prevent foodborne disease outbreaks.
NACCHO’s mentorship program supports local health departments pursuing the Food and Drug Administration’s Voluntary National Retail Food Regulatory Program Standards. The program provides opportunities for local health department staff to learn about the NACCHO Mentorship Program through active participation and training, to share experiences, tools and, and to support the ongoing effort to increase use of the standards nationwide. Local health departments seeking assistance are matched with seasoned peer mentors to help progress the work toward meeting the retail program standards while building sustained capacity within the health department. Mentors assist mentees in preparing self-assessments and verification audits and in developing improvement plans.
For webinars related to the Retail Program Standards, go to the mentorship program webpage.
Specialized Food Processes- Acidified Foods (May 2021)
Acidified foods are considered risky because a product that is not produced correctly may cause serious illness to those who consume it. For this reason, acidified foods have their own specific set of regulations as outlined by the Code of Federal Regulations and in the Food Code (Special Processes 3-502.11).
This online sharing session will provided local retail food regulators with high-level food safety knowledge and understanding regarding acidified foods.
Specialized Food Processes - Charcuterie (July 2020)
Curing, smoking, and drying of meat, poultry, and fish are considered specialized processes under the U.S. Food and Drug Administration Model Food Code.
This virtual online sharing session focuses on the science and proper implementation of charcuterie and was presented by Dr. Brian Nummer from the Utah State University Food Safety Extension.
COVID-19: Guidance for Agricultural Workers and Employers and Testing Strategy for COVID-19 in High-Density Critical Infrastructure Workplaces (June 2020)
This webinar highlighted the CDC and OSHA Interim Guidance for Agricultural Workers and Employers, and the CDC’s Testing Strategy for Coronavirus (COVID-19) in High-Density Critical Infrastructure Workplaces, both of which are particularly relevant given the importance of these essential workers, and as the summer growing season begins.
COVID-19 and Food Safety (April 2020)
This webinar featured a panel of food safety experts that presented on food safety considerations during the COVID-19 pandemic. Topics that will be addressed include what is known about basic food safety and contact surface sanitation issues and what local retail food regulators can do to minimize the impact of COVID-19 in food establishments. Participants had the opportunity to exchange ideas with their peers virtually throughout the session and ask questions. Presenters included Dr. Brian Nummer from the Utah State University Food Safety Extension, Ben Chapman from North Carolina University, and Dr. Donald Schaffner from Rutgers University.
A Multidisciplinary Approach to Investigating Foodborne Illness Outbreaks (June 2019)
This webinar focused on a multidisciplinary approach to investigating foodborne illness outbreaks. The approach involves staff from environmental health, epidemiology, laboratory, and communications allows local health departments to efficiently detect cases and mitigate future exposures. The session featured Public Health – Seattle & King County’s (PHSKC) experience partnering across these four main disciplines (four legged stool) to address foodborne illnesses in their community as it unfolds live from the start of notification to conclusion, including successes, challenges, and lessons learned.
Fermentation/Curing Webinar (April 2019)
This webinar focused on fermentation and curing of foods at retail food establishments. Presenters discussed the science and proper implementation of fermentation and curing and a local health department's HACCP plan review processes for retail establishments using specialized processes. Presenters included Dr. Brian Nummer from the Utah State University Food Safety Extension and Zachary Lustgarten from the Boulder County Public Health in Colorado.
Reduced Oxygen Packaging (April 2018)
Reduced Oxygen Packaging (ROP) such as vacuum packaging, cook-chill and sous vide processes are considered specialized processes under the U.S. Food and Drug Administration Model Food Code. The use of ROP has become increasingly popular in restaurants across the nation. Building a positive relationship between industry members and regulators is an important component in making sure ROP is implemented correctly for consumer food safety. During the first portion of the sharing session, food safety experts Chef Don Brizes and Chef Robert Brener provided an industry perspective of implementing ROP in the restaurant. The second portion featured a presentation from Vas Hofer on Maricopa County, AZ’s Variance and HACCP plan review processes for restaurants using ROP.
Development of Standards for Cannabis-Infused Products (January 2018)
ASTM is currently the organization taking the lead to develop standards as it relates to cannabis and cannabis-infused products. Hear from ASTM Committee D37 on Cannabis as to what ASTM is doing to develop cannabis standards, what areas they are developing cannabis standards in, timeline expected, and how you can get involved. You will also hear from NEHA on useful cannabis-infused product tools and resources currently in development for state and local regulatory programs.
This webinar was held in collaboration with the National Environmental Health Association (NEHA), the National Association of County and City Health Officials (NACCHO), and ASTM.
State-Level Variation in the Regulation of Edible Cannabis Products (November 2017)
This webinar features a presentation on how how states regulate the ways in which edible cannabis products used for medicinal or recreational purposes are cultivated, labeled, packaged, distributed and sold, with respect to THC limits and homogeneity requirements, labeling and packaging requirements, and pesticide testing. The webinar also discusses an online survey of cannabis dispensary staff, including data pertaining to risk disclosure and labeling practices for edible products.
This webinar was held in collaboration with the National Environmental Health Association (NEHA), the National Association of County and City Health Officials (NACCHO), and RTI International.
Edible Marijuana Webinar (June 2017)
This webinar focused on edible marijuana. With the legalization of recreational marijuana in states across the country, many public health professionals now face new health concerns and issues in their communities. The first presentation discussed on the changing state regulations and the governmental entities involved in regulating edible marijuana. In the second presentation, the Denver Department of Environmental Health discussed the food safety-related issues surrounding edible marijuana in their community.
Speakers included Karmen Hanson, MA, Program Director, National Conference of State Legislatures and Danica Lee, Director, Public Health Inspections Division, Department of Environmental Health, City and County of Denver.
- Recorded Webinar
- Chat and Q&A Log
Active Managerial Control Webinar (May 2017)
This webinar focused on Active Managerial Control (AMC). Annex 4 of the FDA Food Code cites the common goal of regulators and industry as producing safe, quality food for customers and credits AMC over foodborne illness risk factors as the best way to accomplish this goal. The first presentation highlighted how the Fairfax County Health Department in Virginia recognizes its responsibility to promote and encourage AMC within food service operations and tackles this initiative through providing industry education, offering AMC tools and resources, and administering AMC recognition and voluntary enrollment programs. In the second presentation, Dr. Hal King provided a retail food establishment operator’s perspective on Active Managerial Control.
- Recorded Webinar
- Chat Transcript
- Fairfax County, VA AMC Toolkit Part I
- Fairfax County, VA AMC Toolkit Part II
- Article: Implementing Active Managerial Control Principles in a Retail Food Business
Food Defense Community of Practice Webinar (2017)
This webinar features a presentation from the Cuyahoga County Board of Health, Ohio on how they have partnered with its food retailers and the FDA to establish retail food defense in order to prevent intentional contamination of the local food supply.
- Recorded Webinar
- Presentation PDF Part I
- Presentation PDF Part II
- Presentation PDF Part III
- Presentation PDF Part IV
Food Truck Webinar (June 2016)
This webinar focused on local regulatory issues dealing with mobile food units. The first presentation highlighted how local regulatory agencies in southern New Jersey addressed challenges with mobile food units by forming a regional mobile task force to standardize mobile food establishment processes and applications.The second presentation focused on challenges with local regulation from the perspective of mobile food unit owners and managers and how regulators and industry can work together to ensure food safety.
- View Sharing Session Recording
- Food Truck Sharing Session Slides
- Revised Regional Mobile Vendor Application For 2013
- Temp Coordinator
- Te Food Vendor List
- Presenters' Contact Information
Cottage Foods Webinar (April 2016)
This webinar focused on local and state food safety regulatory perspectives and concerns related to cottage foods. The presentation will highlight state cottage food regulations implemented across the nation; how one state health department has partnered with local health departments to regulate, educate, and enforce cottage food laws; and the experience of a local health department in a “food freedom” bill state.
Raw Milk Series (April-May 2015)
This webinar series focused on the legal and regulatory issues with raw milk. The first session provided a general overview of raw milk regulation in the United States, as well as a detailed account of recent raw milk regulations and outbreaks in Utah. The second session examined health department experiences responding to outbreaks associated with raw milk and working with communities impacted by outbreaks, as well as legislating its consumption.
- I. Legal Aspects of Raw Milk
- II. Raw Milk and the Public's Health: Stories from the State and Local Health Department
For webinars related to the Retail Program Standards, go to the mentorship program webpage.
Factors Associated with Local Health Departments’ Initial and Continual Enrollment in the U.S. Food and
Drug Administration Voluntary National Retail Food Regulatory Program Standards: A Qualitative Study
This study reveals why some local health departments unenroll or never enroll in the U.S. Food and Drug Administration's Voluntary National Retail Food Regulatory Program Standards.
COVID-19 Impact on Local Retail Regulatory Food Safety Programs
Food safety programs responding to NACCHO's COVID-19 assessment in 2020 noted that they have experienced varying levels of impact to their routine operations.
2018 Continuous Improvement of Retail Food Safety Assessment
NACCHO conducted an assessment to understand how local, state, tribal, and territorial governmental public health agencies are using the U.S. Food and Drug Administration (FDA) Voluntary National Retail Food Regulatory Program Standards (Retail Program Standards) as a tool for fostering continuous improvement in their retail food regulatory programs.
Retail Food Establishment Scoring, Grading, and Placarding Studies
NACCHO, with support from the Food and Drug Administration (FDA), conducted research to learn more about scoring, grading, and placarding systems used by retail food regulatory programs in the United States. Read the research briefs and case studies available below.
- NACCHO Study of Retail Food Establishment Inspection Scoring and Grading Systems
- NACCHO Research Brief: Study of Retail Food Establishment Inspection Scoring and Grading Systems
- NACCHO Summary of Retail Food Inspection Scoring, Grading, and Placarding System Case Studies
- NACCHO Retail Food Inspection and Grading Case Study: Southern Nevada Health District
- NACCHO Retail Food Inspection and Grading Case Study: Louisville, Kentucky
- NACCHO Retail Food Inspection and Grading Case Study: Kern, CA
- NACCHO Retail Food Inspection and Grading Case Study: New Jersey
- Summary of Retail Food Inspection Scoring, Grading, and Placarding Systems in Journal of the Association of Food and Drug Officials (pg. 63)
- Impact of a Letter-Grade Program on Restaurant Sanitary Conditions and Diner Behavior in New York City
- The Toronto food inspection and disclosure system: A case study
- Los Angeles Restaurant Grades Lower Illness While Boosting Awareness and Consumer Engagement
- Restaurant Grading Toolkit: A Guide to Develop a Food Grading Program In Your Community
The Council to Improve Foodborne Outbreak Response (CIFOR) is a multidisciplinary collaboration of national associations and local, state and federal agencies representing epidemiology programs, environmental health programs, public health laboratories, and regulatory agencies. Since 2006, CIFOR has worked together to improve methods to detect, investigate, control, and prevent foodborne disease outbreaks. The food industry is represented on the CIFOR Industry Workgroup.
Sign up to receive updates on new CIFOR resources, funding opportunities, and events.
CIFOR identifies barriers to rapid detection and response to foodborne disease outbreaks and develops products that address these barriers. Some of the Council’s products include:
- CIFOR Guidelines for Foodborne Disease Outbreak Response and its associated Toolkit. The newly released, streamlined and easy-to-read third edition of the CIFOR Guidelines describe the overall approach to foodborne disease outbreaks, and the toolkit aids in implementing the recommendations in the guidelines.
- CIFOR Food Safety Clearinghouse. An online repository of foodborne disease outbreak investigation and general food safety resources that state and local professionals have found to be helpful.
- CIFOR Foodborne Illness Response Guidelines for Owners, Operators and Managers of Food Establishments (Industry Guidelines). These guidelines help outline, clarify, and explain the recommended role of the retail food industry in foodborne disease outbreak investigations.
- CIFOR Outbreaks of Undetermined Etiology (OUE) Guidelines. The CIFOR OUE guidelines provide universal recommendations for collecting, shipping, testing, and retaining foodborne outbreak specimens when an etiology is undetermined, even early in an investigation.
- Economic Evaluation of PulseNet. A peer-reviewed study that estimates the health and economic impacts associated with PulseNet.
- CIFOR Metrics Project. Standardized performance criteria that promote a common understanding of the key elements of foodborne surveillance, outbreak investigation, and control activities.
- CIFOR Law Project. A 2013 analysis of foodborne disease surveillance and investigation laws in select states. Also includes tools to help agencies improve their legal preparedness to conduct surveillance for foodborne diseases and respond to outbreaks.
Are you a leader or champion for food safety? NACCHO’s Food Safety Leaders have the opportunity to provide input on positions and advocacy efforts that help to shape policy at local health departments across the nation; they also receive updates on food safety news, policy updates, events, and call-to-action items.
Follow the instructions below to subscribe to the Food Safety Leaders' List:
- Log in to MyNACCHO (or create a free account).
- Go to “My Subscriptions.”
- Check the box next to the Food Safety Leaders' List (any other e-newsletters you wish you receive).
- Click “Save” at the bottom of the page.
NACCHO's Food Safety Toolkit is a free, online collection of local public health tools produced by members of the public health community. Tools can be used by public health professionals and other external stakeholders to improve their work in the promotion and advancement of food safety objectives. Tools include case studies, presentations, fact sheets, drills, evaluations, protocols, templates, reports, and training materials.
In 2019, NACCHO worked with the organization’s Food Safety Workgroup to review the Toolkit for gaps and to update outdated resources. The gaps identified in the toolkit included resources in the following categories:
- Tabletop exercises/Drills
- Food security
- Edible marijuana
- Food additives
- Mobile foods
- Temporary events
- Homeless feeding
- Third party delivery services
- Plan review of food service establishments, retail food stores, and other food operations
- Community engagement
NACCHO is actively seeking resources that your organization has created (with focus on the above listed gaps) to be included in the Food Safety Toolkit. To submit a resource to the Toolkit, please email email@example.com with a link or copy of the resource, along with a 2-3 sentence description.
Access the Toolkit:
Visit NACCHO's Toolbox and select "Food Safety Toolkit" from the Toolkits dropdown.
NACCHO’s Food Safety Workgroup provides leadership and guidance to NACCHO, local health departments, and partner organizations regarding food safety efforts, health outcomes, and implications at the local level. Membership includes local health department officials, sanitarians, environmental health professionals, and environmental health directors who are interested in enhancing food safety policies and practices. The workgroup holds quarterly conference calls, and works in between meetings. In addition, review of documents and participation in judging model practice applications will be required throughout the year. Appointment is for a two-year term with an option for reappointment to a second two-year term. Message Amy Chang for more information.
Environmental Health Program
Environmental Health Program
Director of Environmental Health