Purpose: Towards developing a Draft Code of Hygienic Practice for LMF, the Codex Committee on Food Hygiene (CCFH) asked the FAO and WHO to provide advice on which foods should be the highest priorities and on risk management options. FAO and WHO initiated a series of activities to provide guidance, including knowledge synthesis activities, and culminating in a 3-day expert workshop in May 2014.
Methods: A multi-criteria decision analysis (MCDA) model was developed interactively with subject matter experts over 3 days to rank seven LMF product categories based on a number of criteria relating to public health and international trade. Swing weights were elicited from experts during the meeting, sensitivity analyses were conducted, and further data collection was used to parameterize attributes. The ranking was finalized interactively with experts via web-conference following the meeting.
Results: Expert-selected model attributes related to disease burden, pathogen contamination, food production characteristics, annual trade impacts, food consumption patterns, and population vulnerabilities. Cereals and Grains scored highest overall, and particularly for international trade and food consumption criteria. Dried protein products ranked second and stood out in terms of disease burden due to a couple of very large outbreaks associated with dried dairy products. Dried spices and herbs ranked third and had high criteria values associated with food production characteristics and outbreak disease burden.
Significance: The MCDA ranking, risk management recommendations, and related materials were presented to CCFH and guided discussion in determining priorities for future risk management efforts.