Pathogen-produce pair attribution risk ranking tool to prioritize fresh produce commodity and pathogen combinations for further evaluation (P3ARRT)

Foodborne disease outbreaks and cases associated with fresh produce have increased over the past decade. In developing approaches to prevent or reduce illnesses from consumption of contaminated produce, new tools are needed to identify and prioritize appropriate efforts. The purpose of this study was to develop a semi-quantitative risk ranking tool (Pathogen-Produce Pair Attribution Risk Ranking Tool, or P3ARRT) to rank the relative public health impact of pathogen-produce commodity combinations, based on explicit data-driven criteria. To identify candidate pathogen-commodity pairs, a database was created that included all published reports of fresh produce-associated outbreaks in the United States. A total risk score was calculated for each pathogen-commodity pair as the summation of nine criteria scores multiplied by the respective criteria weighting. A total of 53 pathogen-produce commodity pairs were included in the risk ranking, and based on scenario and sensitivity analyses, enterohemorrhagic E. coli in leafy greens consistently ranked first, followed by Salmonella spp. in tomatoes, and Salmonella spp. in leafy greens. The P3ARRT model provides a systematic, transparent, and customizable tool with which to prioritize produce pathogen-commodity pairs for further, more rigorous risk assessment modeling and evaluation efforts. The tool is available to the public at .