Local food protection and safety infrastructure and capacity: A Maryland case study

INTRODUCTION:: In Maryland, county Food Protection Programs (FPP), housed within Environmental Public Health (EPH) Divisions, maintain responsibility for regular inspection of all food service facilities (FSF). With growing concerns about how our food supply is protected, it is important to determine the state and effectiveness of our food safety systems. This research elucidates the roles, responsibilities, strengths, and weaknesses of Food Safety and Protection Programs in Maryland. Methods: A 16-question survey tool, which addressed facets of the local food protection infrastructure, including FSF inspections, staffing, budget, and foodborne illness surveillance, was distributed to all 24 county FPP. Results: The number of FSF in Maryland increased 97% from 2001 to 2006 and counties had an average inspection completion rate of 73%, with a 4% increase over the time period. Statewide, there were 4.1 EPH full-time employees (FTE) per 10 000 population and 1.6 FPP FTE per 10 000 population. EPH Division budgets increased 63% statewide, from $19.5 million in 2000 to $31.9 million in 2007. FPP budgets also increased 59% over the period, from $6.2 million in 2000 to $9.8 million in 2007. Conclusions: This study offers new quantitative measures of the demands, capacities, and performance of Food Protection and Safety Programs in Maryland. This assessment of local EPH and FPP capacity also offers insight into the strengths and weaknesses of the local food protection and safety infrastructure. Importantly, it reveals an infrastructure and dedicated food protection workforce that inspects the food supply and responds to foodborne illness outbreaks. Yet, resources vary substantially from county to county, impacting which services can be provided and how well they can be performed. This can, in turn, impact the potential risk of foodborne illness and the public's overall health.