Food Safety: Risk - Benefit Assessment. John Gilbert Food and Environment Research Agency York (UK)

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Food Safety: Risk - Benefit Assessment John Gilbert Food and Environment Research Agency York (UK)

Outline of talk 1. Introduction Risk assessment Benefit assessment 2. Examples in food safety area 3. EU projects QALIBRA - FP6 project BRAFO - SSA project 4. EFSA Scientific Colloquim - July 2006 5. Conclusions

Scientific developments Analytical techniques have continued to improve with ever-increasing capability to find smaller and smaller amounts Exposure assessment developing and more refined (probabilistic modeling) Toxicological assessment getting left behind Benefit assessment - very new science, tools only recently being developed

Some examples of risk-benefit Fish consumption - Nitrate from leafy vegetables dioxins vs PUFAs, Hg vs PUFAs & Se Sulfiting agents - adverse effects vs antimicrobial benefits Food supplements and nutrient sources Packaging - azodicarbonamide blowing agent

Benefits of fish consumption (n-3 PUFA) Fish consumption has a beneficial effect on cardio-vascular disease and mortality Increased fish intake by 1 serving/ week might reduce coronary mortality by 4%/annum in Norway (Konig, 2005) Beneficial health effects for the foetus and the child - increased birth wt; positive effects on visual ability; positive neuropsychological development Vitamins A, D, B12, iodine and selenium intake from fish

Dose-response relationship for fish consumption and CHD Is there a dose-response- relationship? Regression of CHD mortality risk versus fish consumption in the general population. The area of each data point is proportional to its statistical weight. CHD, coronary heart disease. Ref: Konig et al 2005

Risks from fish consumption Exposure to dioxins and PCBs - particularly from oily fish Higher levels from contaminated waters and some species Exposure to mercury Large variations in concentration between species Shark, blue marlin and swordfish - high levels

Mercury and selenium content in flesh of local fish Ref: Dewailly et al. 2008 FAC Vol 25 1334

Risk-benefit of green vegetable consumption - EFSA Opinion Benefit Increased consumption of vegetables recommended as beneficial (5 portions a day) Impacts on cancer, obesity, diabetes, cardiovascular disease Risk Acceptable daily intake of nitrate = 3.7 mg/kg b.w./day Equivalent to 222 mg nitrate per day for 60 kg adult Average consumption of mixed vegetables 9400g) contributes 157 mg nitrate/day Source:- EFSA Journal (2008) 689, 1-79

Nitrate levels in lettuce (EFSA Journal 2008 689:1-79) Levels of nitrate in lettuce varieties as influenced by season, production system and region. Thick bars illustrate the number of sample results (left y-axes) and thin bars the 5th, 50 th (crossbar) and 95th percentile values in mg/kg (right y-axes).

Nitrate levels in rucola (EFSA Journal 2008 689:1-79) Levels of nitrate in rucola as influenced by season, production system and region. Thick bars illustrate the number of sample results (left y-axes) and thin bars the 5th, 50th (crossbar) and 95th percentile values in mg/kg (right y-axes).

Food supplements and nutrient sources Micronutrients:- e.g. selenium, calcium, magnesium, chromium, cobalt, copper, silicon, etc Sources:- e.g. metal salts or complexes or incorporated into biological materials (enriched yeasts) Need to assess the source used to deliver the nutrient

The traditional approach to setting an upper level Need to ensure that setting the upper intake level does not produce deficiency.

Packaging - azodicarbonamide blowing agent Issue (risk):- Azodicarbonamide used in plasticol seals in metal jar caps can degrade to semicarbazide (SEM) SEM found in range 0-3.3 ng/g in baby food Maximum SEM exposure = 0.5-0.66 µg/kg/bw day for infant <1 year >21000 margin of safety (Nestmann, 2005)

Benefits of baby food jar closure technology Benefits of commercial baby food - safe, convenient, nutritionally balance food source Hemetic seal provides long shelf-life for pasteurized or sterilized foods Seal integrity provides security

Lessons to be learnt from examples:- Risks easier to assess than benefits - risks healthrelated Risks may be multi-faceted - multiple exposure Benefits may be health related Benefits may also be technological Need common currency to compare risk and benefit

WHO Global Burden of Disease (GBD) project Disability-Adjusted Life Year (DALY) as a single measure to quantify the burden of diseases, injuries and risk factors. DALY is based on years of life lost from premature death and years of life lived in less than full health. Updated for the year 2000-2002 and included a more extensive analysis of the mortality and burden of disease attributable to 26 global risk factors using a consistent analytical framework known as Comparative Risk Factor Assessment (CRA). http://www.who.int/healthinfo/global_burden_disease/about/en/index.html

QALIBRA http://www.qalibra.eu/ QALIBRA is an FP6 project co-ordinated by Matis of Iceland. Duration April 2006 - Sept. 2009. To assess the balance between the risks and benefits associated with a particular food, they must be converted into a common measure of net health impact. QALIBRA has developed methods that can take account of multiple risks, benefits and uncertainties and implement them in web-based software for assessing net health impacts.

QALIBRA Tool QALIBRA aims to develop methods for quantitative risk-benefit analysis of foods to handle:- multiple risks benefits uncertainties Available to stakeholders as web-enabled software the QALIBRA tool.

Application of the QALIBRA tool The analysis includes the following steps: Define two alternative Dietary Scenarios for which Health Effects are to be assessed, and the population they relate to Identify hazardous and beneficial compounds in each diet and their corresponding Health Effects Use Dose-Response relationships to simulate which members of the population experience the Health Effects in each Dietary Scenario Find the sum of the Health Effects in terms of a Common Currency for each Dietary Scenario Calculate the Net Health Impact for the change in Dietary Scenario

QALIBRA tool in schematic form Setup Scenarios Intakes and Health Effects Valuation Calc ulate Exposure Constituent 1 Dose- Response Function 1 Health Endpoint 1 Valuation Health Impact 1 Setup Run Population & Dietary Scenarios Health Effects More Health Effects Select Common Currency Net Health Impact Exposure Constituent 2 Dose- Response Function 2 Health Endpoint 2 Valuation Health Impact 1

BRAFO project http://www.brafo.org/brafo BRAFO is an EU Specific Support Action project to Investigate the Risk Benefit Analysis for Foods co-ordinated by ILSI Europe. Duration:- Sept 2007- December 2010 Risk benefit analyses for the following food groups: fish and soy (natural foods); folic acid and macronutrient replacers (dietary interventions); heat processed compounds.

Interactions between QUALIBRA and Brafo RIVM and CSL participate in Brafo WP3 Exchange of information Potential for Brafo to use & evaluate Qalibra software Proposed steps: Share information about Brafo case studies Qalibra assess feasibility of adapting the software If successful: Brafo case study WPs invited to evaluate software and participate in Qalibra final workshop, Budapest, w/b 8 June 2009

EFSA SCIENTIFIC COLLOQUIUM SUMMARY REPORT Summary Report EFSA Scientific Colloquium 6, 13-14 July 2006 - Tabiano (Province of Parma), Italy

Format of Scientific Colloquim 102 participants (including 21 EFSA staff) Five presentations Discussion Groups;- Nutrient content vs toxic contaminants/constituents Food fortification and functional foods Food preservation vs. microbial hazards

Conclusions Historically in food safety too much focus on 'risk' without considering 'benefit' Many real examples where considering 'benefit' brings balance to the assessment process Need for common currency to undertake risk/benefit (DALY) EU projects and EFSA beginning to tackle very difficult area