HBsAg prevalence in Indonesia 10% (3.4-20.3%) It assumes that 10% of the population carries the hepatitis B virus. Potency: 0.01 x 90% + 0.3 x 10% = 0.039 cancers per year/100 000 people per ng aflatoxin B1/kg body weight per day 3.2 ng/kg bw per day x 0.039 cancers/year per 100,000 population per ng aflatoxin/kg bw per day = 0.1248 cancers/year per 100,000 people. Estimated cancers/year in Indonesia 222.192.000 people/100.000 people x 0.1248 = 227 persons * Peanut sauce: pecel/gado-gado/ketoprak, food consumption data 2007; average body weight 60kg; 50 g peanuts per portion Lower estimate? A-PDF Split DEMO : Purchase from www.a-pdf.com to remove the watermark Estimated cancers/year due to peanut and peanut sauce consumption*
Peanuts and peanut-based products? Peanuts Pecel Gado-gado Karedok Ketoprak Sate (chicken) Sate (lamb/goat) Batagor Siomay Peanut butter Others: gula kacang, enting-enting gepuk, enting-enting kacang, rempeyek kacang, tahu telor, otak-otak, nasi uduk, etc. Check the indonesian food recipes How big the portion? How much the consumption? How often? Who is the consumer? What is the level of aflatoxin? Food recipe database More than I thought
How about other products that might contain aflatoxin? Corn How big the portion? Rice How much the consumption? Wheat How often? Who is the consumer? Oilseeds What is the level of aflatoxin? Spices Tree nuts (e.g. coconut) We should include them Milk I have other beside peanut Dried products foods that might products Etc contain aflatoxin
Uncertainty in the estimates of cancer risk due to aflatoxin Dietary intake data? We should include other peanut based products Use of average body weight. At present study we use 60 kg. It might be lower than this weight Other foods that might contain low aflatoxin, but give more exposure due to high intake of the foods? Range of aflatoxin level in suspected foods? Prevalence of Hepatitis B in Indonesia? Many versions
Aflatoxin control should include all stakeholders M1 B1 Aflatoxin M1, the hydroxylated metabolite of B1, has a potency approximately one order of magnitude less than that of B1.
AFLATOXIN CONTROL: Risk based approach On farm Pre-harvest Harvest Post harvest Consumption Think about consequence, exposure and probability Aflatoxin control should be food chain approach Considering risk factors for aflatoxin production (e.g. temperature, moisture, humidity) for management strategies throughout the food chain. Standard setting should be achievable Think a priority Need awareness raising to build a commitment Strengthening a partnership
Regulation should be food chain approach and not fragmented On farm Pre-harvest Harvest REGULATIO N Food safety objective? Performace objective throughout food chain? PC, PrC, MC? Post harvest Consumption
Can we achieve the standard (FSO)? Primary Production Performance criteria Storage Performance objective? Manufactures Performance objective? Transport MPL for aflatoxin at consumption level in Indonesia 30 (µ/kg (Total) 20 (µ/kg (B 1 ) Control measures Retail Cooking Food safety objective Public health burden? Exposure Consumption
Assess your standard and food control for the estimated cancer level* Consumption of aflatoxin containing food Codex ML National ML Aflatoxin exposure Aflatoxin exposure Estimated cancer level Estimated cancer level Epidemiological data: Prevalence of Hepatitis B Monitored level Aflatoxin exposure Estimated cancer level *A need for a sound scientific assessment of the impact of aflatoxin levels in foods on human health
Intervention and management option should be based on the risk assessment throughout the food chain* On farm Ho Ʃ R + Ʃ I Po or FSO Pre-harvest Harvest Post harvest Consumption Hazard level at initial step Reduction when applicable Increase (growth and toxin production) Level at step in the food chain Level at consumption level *Adapted from ICMSF (2002)