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Fresh vegetables are increasingly recognized as a source of foodborne outbreaks in many parts of the world. The purpose of this study was to conduct a quantitative microbial risk assessment for Escherichia coli O157:H7, Salmonella, and Listeria monocytogenes infection from consumption of leafy green vegetables in salad from salad bars in The Netherlands. Pathogen growth was modeled in Aladin (Agro Logistics Analysis and Design Instrument) using time-temperature profiles in the chilled supply chain and one particular restaurant with a salad bar. A second-order Monte Carlo risk assessment model was constructed (using @Risk) to estimate the public health effects. The temperature in the studied cold chain was well controlled below 5 degrees C. Growth of E. coli O157:H7 and Salmonella was minimal (17 and 15%, respectively). Growth of L. monocytogenes was considerably greater (194%). Based on first-order Monte Carlo simulations, the average number of cases per year in The Netherlands associated the consumption leafy greens in salads from salad bars was 166, 187, and 0.3 for E. coli O157:H7, Salmonella, and L. monocytogenes, respectively. The ranges of the average number of annual cases as estimated by second-order Monte Carlo simulation (with prevalence and number of visitors as uncertain variables) were 42 to 551 for E. coli O157:H7, 81 to 281 for Salmonella, and 0.1 to 0.9 for L. monocytogenes. This study included an integration of modeling pathogen growth in the supply chain of fresh leafy vegetables destined for restaurant salad bars using software designed to model and design logistics and modeling the public health effects using probabilistic risk assessment software.

Quantitative microbial risk assessments do not usually account for the planning and ordering mechanisms (logistics) of a food supply chain. These mechanisms and consumer demand determine the storage and delay times of products. The aim of this study was to quantitatively assess the difference between simulating supply chain logistics (MOD) and assuming fixed storage times (FIX) in microbial risk estimation for the supply chain of fresh-cut leafy green vegetables destined for working-canteen salad bars. The results of the FIX model were previously published (E. Franz, S. O. Tromp, H. Rijgersberg, and H. J. van der Fels-Klerx, J. Food Prot. 73:274-285, 2010). Pathogen growth was modeled using stochastic discrete-event simulation of the applied logistics concept. The public health effects were assessed by conducting an exposure assessment and risk characterization. The relative growths of Escherichia coli O157 (17%) and Salmonella enterica (15%) were identical in the MOD and FIX models. In contrast, the relative growth of Listeria monocytogenes was considerably higher in the MOD model (1,156%) than in the FIX model (194%). The probability of L. monocytogenes infection in The Netherlands was higher in the MOD model (5.18×10(-8)) than in the FIX model (1.23×10(-8)). The risk of listeriosis-induced fetal mortality in the perinatal population increased from 1.24×10(-4) (FIX) to 1.66×10(-4) (MOD). Modeling the probabilistic nature of supply chain logistics is of additional value for microbial risk assessments regarding psychrotrophic pathogens in food products for which time and temperature are the postharvest preventive measures in guaranteeing food safety.

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