QUANTITATIVE MICROBIAL RISK ASSESSMENT -- Copyright -- Contents -- PREFACE -- CHAPTER 1 MOTIVATION -- Prevalence of Infectious Disease -- Prior Approaches -- Scope of Coverage -- Potential Objectives of a QMRA -- Site-Specific Assessment -- Ensemble of Sites -- Secondary Transmission -- Outbreaks versus Endemic Cases -- References -- CHAPTER 2 MICROBIAL AGENTS AND TRANSMISSION -- Microbial Taxonomy -- Eukaryotes -- Prokaryote -- Viruses -- Prions -- Clinical Characterization -- Microorganisms of Interest -- Viruses -- Bacteria -- Protozoa -- Transmission Routes -- Inhalation -- Dermal Exposure -- Oral Ingestion -- References -- CHAPTER 3 RISK ASSESSMENT PARADIGMS -- Chemical Risk Assessment: National Academy of Sciences Paradigm -- Ecological Risk Assessment -- Approaches for Assessing Microbial Risks -- Background -- The QMRA Framework -- Hazard Identification -- Dose-Response Assessment -- Exposure Assessment -- Risk Characterization -- Risk Management -- Development of the QMRA Framework and Processes -- QMRA and the Safety of Water -- QMRA, Food Safety, and the HACCP System -- References -- CHAPTER 4 CONDUCTING THE HAZARD IDENTIFICATION (HAZ ID) -- Identifying and Diagnosing Infectious Disease -- Health Outcomes Associated with Microbial Infections -- Sensitive Populations -- Women during Pregnancy, Neonates, and Young Babies -- Diabetes -- The Elderly -- The Immunocompromised -- Databases for Statistical Assessment of Disease -- ICD Codes -- Waterborne and Foodborne Outbreaks -- Epidemiological Methods for Undertaking HAZ ID -- Controlled Epidemiological Investigations -- HAZ ID Data Used in the Risk Assessment Process -- Recommendations for Updating Quantitative Data for HAZ ID Information -- References -- CHAPTER 5 ANALYTICAL METHODS AND THE QMRA FRAMEWORK: DEVELOPING OCCURRENCE AND EXPOSURE DATABASES -- Introduction.

Approaches for Developing Occurrence and Exposure Databases -- Overview of Methodological Issues -- Sampling Water -- Sampling Surfaces and Food -- Sampling Aerosols -- Specific Techniques for Bacteria, Protozoa, and Viruses -- Bacteria -- Protozoa -- Viruses -- Molecular Techniques -- Probes (FISH) -- Typing -- Metagenomics -- PCR and Quantitative PCR -- References -- CHAPTER 6 EXPOSURE ASSESSMENT -- Conducting the Exposure Assessment -- Characterizing Concentration/Duration Distributions -- Random (Poisson) Distributions of Organisms -- Estimation of Poisson Mean in Count Assay (Constant and Variable Volumes) -- Count Assay with Upper Limits -- Estimation with Quantal Assay -- Goodness of Fit to Poisson: Plate Assay -- Goodness of Fit: MPN -- Confidence Limits: Likelihood -- Implications for Risk Assessment -- Consumption Distributions -- Systematic Subpopulation Differences -- Afterword -- Appendix -- Microsoft Excel -- MATLAB -- R -- References -- CHAPTER 7 PREDICTIVE MICROBIOLOGY -- Objective -- Basic First-Order Processes and Deviations -- Biological and Physical Bases for Deviations -- Physical Removal -- Types of Decay Processes -- General Forms of Decay and Reasons for Nonlinearity -- Spontaneous/Endogenous -- Chemical Agents -- Thermally Induced -- Ionizing and Nonionizing Radiation -- Predation and Antagonism -- Types of Growth Processes -- Mathematical Modeling of Growth Curves -- Substrate Dependency -- Structured Growth Models -- Incorporation of Decay into Growth Models -- Systems Biology Approaches -- Dependence of Growth Parameters on Other Environmental Variables -- Interacting Populations -- Data Sources -- References -- CHAPTER 8 CONDUCTING THE DOSE-RESPONSE ASSESSMENT -- Plausible Dose-Response Models -- Framework for Mechanistic Dose-Response Relationships -- Exponential Dose-Response Model -- Beta-Poisson Dose-Response Model.

Simple Threshold Models -- Negative Binomial Dose Distributions -- Variable Threshold Models -- Other Mixture Models -- Biological Arguments for One-Hit Models -- Empirical Models -- Fitting Available Data -- Types of Data Sets -- Potential Impacts of Immune Status -- Relationship between Dose and Severity (Morbidity and Mortality) -- Morbidity Ratio (PD:I) -- Mortality Ratio -- Reality Checking: Validation -- Validation: 1993 Milwaukee Outbreak -- Use of Indicators and Other Proxy Measures in Dose-Response -- Indicator Methods -- Molecular Methods -- Advanced Topics in Dose-Response Modeling -- Dose-Response-Time Models -- Physiological Models -- Appendix -- References -- CHAPTER 9 UNCERTAINTY -- Point Estimates of Risk -- Terminology: Types of Uncertainty -- Sources of Uncertainty -- Sources of Variability -- Variability that is Uncertain -- Approaches to Quantify Parametric Uncertainty -- Likelihood -- Bootstrap -- Other Methods -- Applications -- Exposure Assessment -- Dose-Response Assessment -- Combining Parametric Uncertainty from Multiple Sources -- Propagation Methods -- Monte Carlo Analyses -- Overall Risk Characterization Example -- Second-Order Methods -- Model Uncertainty and Averaging -- References -- CHAPTER 10 POPULATION DISEASE TRANSMISSION -- Introduction: Models for Population and Community Illnesses -- Basic SIR Model -- Incubation Period -- Duration of Illness -- Secondary Cases -- Impact of Immunity -- Outbreak Detection -- References -- CHAPTER 11 RISK CHARACTERIZATION AND DECISION MAKING -- Introduction -- Valuing Residual Outcomes -- Classical Economics -- DALYs and QALYs -- Decision Making -- Cost-Benefit Analysis -- Multivariate Approaches -- Other Aspects Entering into a Decision -- Equity and Justice Aspects -- References -- INDEX.