World Health Organization estimates of the global and regional disease burden of four foodborne chemical toxins, 2010: a data synthesis.

Herman Gibb,Esther Brandon,Henk Van Loveren,Janis Baines,Bas Bokkers,David Bellinger,John Pitt,Marcel Mengelers,Philippe Verger,Brecht Devleesschauwer,Gabriel Adegoke,Felicia Wu,P Michael Bolger,Reza Afshari,Arie H Havelaar,Marco Zeilmaker,Julie Cliff,Janine Ezendam,Yan Liu

doi:10.12688/f1000research.7340.1

Abstract

Background Chemical exposures have been associated with a variety of health effects; however, little is known about the global disease burden from foodborne chemicals. Food can be a major pathway for the general population's exposure to chemicals, and for some chemicals, it accounts for almost 100% of exposure. Methods and Findings Groups of foodborne chemicals, both natural and anthropogenic, were evaluated for their ability to contribute to the burden of disease. The results of the analyses on four chemicals are presented here - cyanide in cassava, peanut allergen, aflatoxin, and dioxin. Systematic reviews of the literature were conducted to develop age- and sex-specific disease incidence and mortality estimates due to these chemicals. From these estimates, the numbers of cases, deaths and disability adjusted life years (DALYs) were calculated. For these four chemicals combined, the total number of illnesses, deaths, and DALYs in 2010 is estimated to be 339,000 (95% uncertainty interval [UI]: 186,000-1,239,000); 20,000 (95% UI: 8,000-52,000); and 1,012,000 (95% UI: 562,000-2,822,000), respectively. Both cyanide in cassava and aflatoxin are associated with diseases with high case-fatality ratios. Virtually all human exposure to these four chemicals is through the food supply. Conclusion Chemicals in the food supply, as evidenced by the results for only four chemicals, can have a significant impact on the global burden of disease. The case-fatality rates for these four chemicals range from low (e.g., peanut allergen) to extremely high (aflatoxin and liver cancer). The effects associated with these four chemicals are neurologic (cyanide in cassava), cancer (aflatoxin), allergic response (peanut allergen), endocrine (dioxin), and reproductive (dioxin).

Highlights

Chemicals in food are a worldwide health concern[1]
In September 2006 the World Health Organization (WHO) organized a consultation to develop a strategy to estimate the global burden of foodborne disease[13]
At its first meeting, the Chemical and Toxins Disease Task Force (CTTF) identified groups of chemicals and toxins that are of highest priority in estimating the burden of foodborne disease

Summary

Introduction

Chemicals in food are a worldwide health concern[1]. The Dutch National Institute for Public Health and the Environment (RIVM) found that chemicals in food contributed as much as infectious agents to the foodborne burden of disease in the Netherlands[12]. In September 2006 the World Health Organization (WHO) organized a consultation to develop a strategy to estimate the global burden of foodborne disease[13]. The FERG includes three hazard-based task forces: Enteric Disease Task Force, Parasitic Disease Task Force, and the Chemical and Toxins Disease Task Force (CTTF). A Country Studies Task Force, a Source Attribution Task Force, and a Computational Task Force were subsequently added to FERG. The CTTF reports the estimates of the burden of disease of four chemicals. Food can be a major pathway for the general population’s exposure to chemicals, and for some chemicals, it accounts for almost 100% of exposure

Methods

Results

Discussion

Conclusion