Risk ranking of foodborne diseases in Denmark: Reflections on a national burden of disease study

National burden of foodborne disease (FBD) studies are useful for risk ranking and identifying priorities for food safety resource allocation. FBD are caused by microbiological and chemical hazards, which have different incidence and mortality, and lead to health-outcomes varying in severity and duration. Due to their different origins and characteristics, distinct prevention strategies can be implemented. We present the Danish initiative to estimate the burden of FBD caused by pathogens and chemicals. We describe the methodological approaches and data used, present an overview of results for the reference year 2019, and discuss lessons learned throughout more than seven years of the project. Our estimates show that the leading causes of FBD in Denmark include both pathogens and chemicals, suggesting that food safety strategies should be diversified to tackle different issues. The experiences with this national study are useful for other countries planning to implement a burden of FBD study.