Estimating the burden of disease of exposure to chemical contaminants in food in Denmark

Abstract

Abstract Background Recent global estimates have shown that dietary exposure to chemical contaminants cause over 56,000 deaths and 9 million healthy life years lost each year. However, the contribution of causative agents varies greatly between world regions and countries due to local food consumption and contamination. To prioritize public health interventions to reduce disease burden, national-level risk ranking evidence is needed. The overall aims of this project are to estimate the burden of disease (BoD) of selected chemical hazards in foods consumed in Denmark, and to identify the relative contribution of foods. Methods We identified chemicals on the basis of their presumed public health impact. The final list of chemicals was defined in agreement with the Danish Veterinary and Food Administration, and included: methylmercury, inorganic arsenic, cadmium, acrylamide, dioxin/dioxin-like PCBs and lead. We estimated BoD in terms of disability adjusted life years (DALY) in a model combining exposure assessment with dose response models to derive probabilities of health effects, taking an incidence-based approach. Data were collected from the Danish National Survey of Diet and Physical Activity, food monitoring, literature, and national statistics. Results We estimated that methylmercury, inorganic arsenic, cadmium and acrylamide lead to a BoD of 514 DALY (95% uncertainty interval: 185, 990) in 2016 (preliminary results). Estimates for lead and dioxin/dioxin-like PCBs are pending. Methylmercury exposure from fish was the greatest contributor to overall burden (478 DALY), and acrylamide from potato products the second (30 DALY). The health outcomes leading to highest burden were intellectual disability and cancer. Conclusions Our estimates will assist public health managers identifying the chemical contaminants in foods with the highest impact on public health in Denmark. Future research should focus on estimating the effect of mitigation strategies on the disease burden. Key messages We provide national quantitative evidence of the health impact of chemical exposures from foods. Information on the relative contribution of foods and population groups affected may focus mitigation.