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.
Working to improve methods to detect, investigate, control and prevent foodborne disease outbreaks.
NACCHO’s mentorship program has historically supported local health departments pursuing the Food and Drug Administration’s Voluntary National Retail Food Regulatory Program Standards. The program has provided 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.
Mentorship Applications: NEHA-FDA Retail Flexible Funding Model grant portal closed October 11, 2023. Grant announcements coming soon.
Learn more at: neha.org/retail-grants.
Sharing Session on Workforce Development (May 2023)
The sharing session focused on issues facing the local governmental public health workforce, including employee retention, workforce burnout, and how these issues were exacerbated by the COVID-19 pandemic. The panel discussion also addressed challenges experienced by Environmental Health Specialists and highlighted recruitment strategies and ways to reengage staff following the COVID-19 pandemic.
Sharing Session on Microenterprise Home Kitchen Operations (November 2022)
NACCHO, with the support of the CDC, hosted an online sharing session on food safety, featuring presentations from Doug Farquhar, JD, from the National Environmental Health Association (NEHA) and Justin Latham, CPFS, from the Wyoming Department of Agriculture, Consumer Health Services Division. Learn more about the speakers through this NACCHO blog. The presentations provided examples about the various laws nationwide that permit Microenterprise Home Kitchen Operations, and similar cottage food operations. The sharing session also discussed the challenges Microenterprise Home Kitchen Operations pose for local retail food regulatory programs.
Sharing Sessions on Retail Food Safety (May and June 2022)
- Part 1: Breaking the Barriers to Implementing Risk-Based Inspections in Retail Food Safety
- Part 2: A Retrospective Look at How Local Retail Food Regulatory Programs Used Risk Factor Intervention Strategies
On May 26, NACCHO and the Conference for Food Protection (CFP), hosted an online sharing session on factors influencing the implementation of risk-based inspections. This sharing session focused on the results of a study conducted in 2021 by NACCHO and CFP to identify, better understand, and assess the application of risk-based inspection methods currently employed by local retail food regulatory programs while seeking to identify the overarching barriers preventing application of risk-based inspection methods. Nine jurisdictions were interviewed, and the participants identified 15 barriers to the implementation of risk-based inspection methods. This sharing session discussed five strategies to overcome these barriers.
On June 2, NACCHO and CFP presented a webinar on the use of risk factor intervention strategies within local retail food regulatory programs. Presenters from NACCHO and CFP discussed the findings of their study conducted in 2021, which aimed to assess jurisdictions’ use of risk factor interventions, including how they were created, implemented, and evaluated for effectiveness.
- Recorded Webinar: Breaking the Barriers to Implementing Risk-Based Inspections in Retail Food Safety
- Recorded Webinar: A Retrospective Look at How Local Retail Food Regulatory Programs Used Risk Factor Intervention Strategies
Sharing Session on Climate Change and Food Safety (April 2022)
NACCHO, with the support of the Centers for Disease Control and Prevention (CDC), hosted an online sharing session on the intersection of climate change and food safety. The following presentations provided examples of the science behind climate change, its impact on the environment and our health, and what this means for food safety and food security. The sharing session also explained some of the recent expansion of climate change work at the federal level and helped provide context on how current food safety issues experienced at the local level are linked to climate change.
Sharing Session on the Retail Program Standards Clearinghouse (June 2021)
NACCHO, with the support of the Food and Drug Administration (FDA), presented a webinar on the Voluntary National Retail Food Regulatory Program Standards (Retail Program Standards) Clearinghouse Work Group. Presenters from the FDA discussed the role of the FDA Retail Food Specialists, the purpose of the Clearinghouse, how to navigate the Clearinghouse Questions and Answers document, and who makes up the Clearinghouse Work Group.
Sharing Session - Edible Marijuana (June 2021)
NACCHO and the National Environmental Health Association, with the support of the Centers for Disease Control and Prevention, hosted an online sharing session on edible marijuana. The sharing session featured presentations from the Colorado Integrated Food Safety Center of Excellence, the Colorado Marijuana Enforcement Division, and the Colorado Department of Public Health and Environment about the potential associated food safety hazards. Participants heard about edible-associated illness outbreaks and other contamination events. Participants also learned about steps being taken in Colorado to ensure the safe production and packaging of edible marijuana, including laboratory testing practices and the roles and responsibilities of different agencies.
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 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 focused 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 were addressed included 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 to 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. This approach involves staff from environmental health, epidemiology, laboratory, and communications allowing 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
- Food Vendor List
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.
Impact of FDA Funding on Voluntary National Retail Food Regulatory Program Standards Conformance (NEHA's Journal of Environmental Health, Volume 86, Number 4)
NACCHO's study analyzed 770 local health departments enrolled in the Retail Program Standards from 2002–2021 to 1) assess if the program’s current guidelines are feasible for LHDs, and 2) evaluate the effect of FDA cooperative agreement programs on conformance with the Retail Program Standards.
NACCHO’s Retail Program Standards Mentorship Program: A 10-Year Retrospective Review
From 2011–2021, our mentorship program provided peer-to-peer assistance and intensive technical support to help enforce the VNRFRPS efficiently and effectively. Experienced state, local, tribal, and territorial retail food regulatory programs advised participating agencies on how to get started and best apply the VNRFRPS to improve their food protection programs. In 2022, NACCHO conducted a retrospective review to assess the effectiveness of the program in achieving these goals over the past decade.
Handling Retail Food Safety During a Public Health Emergency: Recommendations for Local Retail Food Regulatory Programs
The COVID-19 pandemic was an extremely challenging period for public health agencies throughout the world and it highlighted serious flaws in their ability to respond to community needs. Environmental health managers in the U.S. have had to balance the risk of exposing sanitarians to COVID-19 during in-person food safety inspections with the reward of protecting the public from foodborne pathogens. This publication contains recommendations from the field to help local retail food regulatory programs become better prepared for the next public health emergency. NACCHO is grateful to members of its Food Safety Workgroup for their valuable input.
Looking for a quick-hit summary of the recommendations? Click here to download and print our checklist covering six recommendations from partnerships to reporting workplace harassment.
Checklist: Virtual Inspections of Food Service Establishments Through Risk-Based Inspections
When conducting inspections of food service establishments, it is important that local health departments (LHDs) utilize risk-based inspection methods (RBIs) to focus on factors that directly impact public health. The basis of RBIs is to observe behaviors, practices, and procedures that could lead to poorly managed risk factors and to look at the whole food establishment as a system rather than individual components. However, it may not be possible for these specific tasks of RBI methods to be reasonably conducted within a virtual setting—a challenge that many LHDs experienced during the COVID-19 pandemic.
Find out how virtual inspections can help regulatory activity continue during a public health emergency at bit.ly/virtualfoodsafetyinspections.
An Evaluation of Existing Retail Program Standards Networks
A new issue brief investigates the benefits of state and local retail food regulatory programs participating in state- and region-wide networks aimed at achieving conformance with the Voluntary National Retail Food Regulatory Program Standards. The goal of this study was to unveil the benefits of working in collaboration with other jurisdictions when working towards achieving conformance with the Retail Program Standards and to highlight best practices that resulted from being a part of these networks. NACCHO and the Conference for Food Protection (CFP) led and authored this study.
Learn more and access the brief at bit.ly/RPSNissuebrief.
Analysis of Factors Impacting the Implementation of Effective Intervention Strategies
This study identified and assessed the implementation of risk factor interventions currently employed by local retail food regulatory programs enrolled in the Voluntary National Retail Food Regulatory Program Standards (Retail Program Standards), with a focus on Standard 9. The study, conducted in 2021 by the National Association of County and City Health Officials (NACCHO) and the Conference for Food Protection (CFP) assessed how most jurisdictions targeted risk factors interventions, identified success factors and challenges, and developed recommendations to support the implementation of targeted interventions. The qualitative research uncovered that most jurisdictions targeted risk factors based on violations most frequently cited during retail food regulatory inspections and that the risk factor most often targeted was poor personal hygiene. Read the study at https://bit.ly/riskfactorstudy. To access a short summary of the findings, go to www.retailfoodsafetycollaborative.org/tools/analysis-of-factors-impacting-the-implementation-of-effective-intervention-strategies/.
Analysis of Factors Influencing the Implementation of Risk-Based Inspections
To aid the expansion of state, local, tribal, and territorial (SLTT) regulatory programs using risk-based inspections (RBIs) to advance smarter food safety, NACCHO and CFP conducted a study in 2021 to identify, better understand, and assess the application of RBI methods currently employed by local retail food regulatory programs while seeking to identify the overarching barriers preventing application of RBI methods.
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.
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 is the streamlined and easy-to-read third edition describing the overall approach to foodborne disease outbreaks.
- CIFOR Toolkit was developed to help implement the third edition of the Guidelines. The Toolkit contains worksheets and keys to success designed to help agencies identify which recommendations work best for their jurisdictions.
- 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.
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:
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 protected] 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 Chelsea Gridley-Smith for more information.
NACCHO's Foodborne Illness Outbreak Response Community of Practice (CoP) brings together food safety professionals from across the country to share tips and best practices across jurisdictions. The CoP will convene through regular conference calls and webinars, and the group will be limited in size to ensure active participation from all. To request to join, go to https://virtualcommunities.naccho.org/communities/allcommunities, and search for the CoP.
Environmental Health Program
Director of Environmental Health
Environmental Health Program
Senior Program Analyst, Environmental Health
Environmental Health Program
Program Analyst, Environmental Health
Environmental Health Program
Program Analyst, Environmental Health
Environmental Health Program
Program Analyst, Environmental Health
Environmental Health Program
Environmental Health Program
Senior Program Assistant, Environmental Health