Environmental Assessments During Foodborne Outbreaks

A Practice from the Kentucky Department for Public Health
For Public Health

At a glance

Use this practice to strengthen statewide capacity for conducting environmental assessments during foodborne outbreak investigations. Kentucky offered standardized training, enhanced data systems, and created pathogen-specific sampling guidance to improve the investigation and prevention of outbreaks.

Chef and food inspector in restaurant kitchen in front of box of vegetables

Background

The Kentucky Department for Public Health identified opportunities to enhance the consistency of environmental assessment practices during foodborne outbreak investigations.

Environmental health staff across 120 Kentucky counties could benefit from more standardized tools, clearer sampling guidance, and streamlined data reporting processes. The state health department met with federal, state, and local staff who participated in outbreak investigations to gather insights and highlight lessons learned. This helped identify ways to improve environmental sampling practices and strengthen documentation submitted to CDC's National Environmental Assessment Reporting System (NEARS). In addition, they saw an opportunity to further integrate environmental assessments into outbreak response workflows for all jurisdictions.

The state health department aimed to strengthen statewide capacity in environmental assessments and enhance collaboration among epidemiology, laboratory, and environmental health programs. They also sought to improve the quality, completeness, and timeliness of outbreak-related environmental data to help prevent future foodborne illness outbreaks.

Key actions

The Kentucky Department for Public Health focused on the following activities:

  • Collecting and reporting environmental assessment data that aligned with NEARS reporting requirements
  • Developing a statewide environmental assessment form to improve data completeness and usability for local health departments
  • Coordinating environmental assessment, sampling, and swabbing training through the Association of Food and Drug Officials (AFDO) and Tennessee Center of Excellence (TNCoE)
  • Creating training for local health departments focused on environmental assessments and environmental sampling
  • Developing pathogen-specific environmental sampling and swabbing resources for local environmental health staff
  • Strengthening partnerships among internal food safety, epidemiology, and laboratory services programs and with local partners to support outbreak response

Using this practice

We selected this practice as an example of environmental public health successfully applied in the field. We based our selection on the following four domains:

  • Effectiveness: Did it solve or help solve the environmental health problem?
  • Feasibility: What conditions and resources are needed to use it?
  • Sustainability: Is it realistically able to continue going forward?
  • Transferability: Could other health departments use it with little to no changes?

Others interested in applying this practice can consider these factors and this program's experience.

Effectiveness

This practice improves the quality, completeness, and consistency of environmental assessment data submitted to NEARS and strengthens outbreak investigation response. Short-term measures include alignment of the electronic environmental assessment form with NEARS, successful data transfer, and reduction in missing data fields. Evaluation is ongoing, with early efforts focused on training delivery and development of standardized tools.

Feasibility

To use this practice, health departments may need the following capacity:

  • Trained environmental health specialists authorized to conduct environmental assessments (see Resources below)
  • Dedicated coordination by a foodborne outbreak and recall coordinator
  • Retail food staff (Kentucky utilized 8 personnel and 5 technical consultants) to support training and oversight
  • Ongoing partnerships with local health departments and training partners
  • Information technology infrastructure, such as REDCap, to manage data from environmental assessments
  • Access to geospatial analysis software, such as ArcGIS, can supplement core NEARS activities but is not necessary.

Sustainability

Sustaining this practice depends on the ability to make training part of workforce development and daily work, the existence and establishment of a data system, the maintenance of the outbreak data system, and the implementation of standardized environmental assessment procedures. Not having enough staff dedicated to the project may delay reduce the potential of this practice.

Long-term sustainability could be strengthened by stable funding and dedicated staff for outbreak investigation.

Transferability

Programs interested in this practice might want to consider the following factors:

Each jurisdiction could adapt the practice to align with its own outbreak investigation manuals, data systems, and policies.

Health departments with IT capacity and a dedicated environmental health workforce may be able to adapt the electronic environmental assessment form and standardized training. Programs can modify these resources to align with jurisdiction-specific NEARS workflows and investigation authority.

Successes and challenges

The practice strengthened coordination across environmental health, epidemiology, and laboratory programs, supporting a more integrated foodborne outbreak response.

Challenges included workforce limitations, time-intensive implementation, and initial hesitancy toward adopting new processes. Funding limitations also restricted the ability to dedicate a full-time staff member exclusively to practice development, contributing to slower implementation and scaling.

Connections to Essential Services

Documenting how programs contribute to the Essential Public Health Services may help health departments in the accreditation process with the Public Health Accreditation Board. The activities in this practice support and align with these services:

  • Assess and monitor (1)
  • Investigate and address hazards (2)
  • Educate (3)
  • Strengthen communities and partnerships (4)
  • Support the workforce (8)
  • Improve or innovate (9)
  • Build public health infrastructure (10)

Resources

Kentucky Department for Public Health

CDC and partners

Citation

In citing this practice in articles, presentations, or elsewhere, we suggest the following citation:

Centers for Disease Control and Prevention. National Center for Environmental Health. Environmental Public Health Practices Gateway. Environmental assessments during foodborne outbreaks: A practice from the Kentucky Department for Public Health. U.S. Department of Health and Human Services, CDC, 2026, https://www.cdc.gov/environmental-health-practice/php/gateway/environmental-assessments-during-foodborne-outbreaks.html.

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Content Source:
National Center for Environmental Health