R ANKING OF LMF Flow cha chart of f the he steps eps i inv - - PowerPoint PPT Presentation
R ANKING OF L OW OW M OI URE F OOD OODS IN S UPPOR NG OF OISTUR OR OF M ICROB OGICAL R ISK ISK M ANAGE OF OBIOL OLOG GEME MENT Repor ort o of an an FAO/WHO c con onsu sultation p proc ocess ss O BJECTIVES To undertake a scoping
To undertake a scoping systematic review and
To develop and apply a multi-criteria decision
To provide a comprehensive report on the
Catego egory Food
ded Cereals an and Grai ains whole and milled grains , rice and rice products, cereals and cereal products Confections s an and sn snac acks cocoa and chocolate products, other confections/confectionery, snacks, yeast Dried fruits an and veg eget etables dried fruits, dried vegetables, dried/dehydrated mushrooms dried seaweed Dried p ed protei ein p produ ducts dried dairy products, dried egg products, dried meat other than sausages/salamis/jerky (e.g. meat powders, gelatine, fish) Honey an and preserves honey, jams, syrups (e.g. corn syrup) Nuts an and nut p products tree nuts, peanuts and peanut products, mixed and unspecified nuts Seeds f for
consumption
sesame seeds, tahini, halva/helva, other and unspecified seeds Spi Spices, dr dried h her erbs and d te teas as fruit/seed-based, root-based, leaf-based, bark/flower-based mixed/unspecified, tea (e.g. herbal, black teas) Specia ializ lized nutritio ional l product cts lipid based nutrient supplements, dried/powdered nutrient supplements
Dried protein products excluded cured, fermented meat and fish products Retained dried fish / seafood fish flour/meal in review Only products with consistent Aw of <0.85 Excluded powdered infant formula Spices, dried herbs and teas Included tea based on feedback of 45th CCFH Honey and preserves – eventually excluded Lipid based RUF for malnourished populations –
Bacillus cereus, Clostridium botulinum, Clostridium perfringens, Cronobacter spp., pathogenic Escherichia coli Listeria monocytogenes Salmonella spp., Staphylococcus aureus EB an generic E.coli
% ( (count unt) Ou Outbr breaks Cases es Hospit italiz lizatio ions Deaths hs Salmonella spp. 44.9% (96) 43.8%(12415) 88.6% (895) 73.7% (14)
2.3% (5) 1.2% (354) 3.3% (33) 5.3% (1)
25.7% (55) 3.7% (1057) 1.4% (14) 0% (0)
15.0% (32) 0.3% (84) 6.0% (61) 21.1% (4)
4.7% (10) 1.5% (432) 0% (0) 0% (0)
7.5% (16) 49.4% (14006) 0.7% (7) 0% (0)
0% (0) 0% (0) 0% (0) 0% (0) Cronobacter spp. 0% (0) 0% (0) 0% (0) 0% (0) Enterobacteriaceae 0% (0) 0% (0) 0% (0) 0% (0)
Extent of food borne illness – outbreak data International trade – FAOSTAT Consumption Daily consumption (Individual food consumption data) % vulnerable consumers (as above) potential for consumer to increase risk (Expert opinion) Production Prevalence of pathogen (systematic review) Proportion not subject to kill step risk (Expert opinion) Potential for post process contamination risk (Expert opinion)
Crit iteria ia Sub-Crit iteria ia Attr ttribute Source of f info formation /ev /evidence
C1: I Internat ational al T Trad ade
FAOSTAT Trade data (http://faostat3.fao.org/)
C2: B Bur urden o n of f Disease
Systematic/scoping review (Appendix 1) and Published DALY data (Appendix 5)
C3: V Vuln lnerabilit ilitie ies due to F Food C Cons nsump umption C3.1: A Aver erage ge Servi ving
Average g/day FAO/WHO Chronic Individual Food Consumption Database Summary Statistics (CIFOCOSS) (Appendix 6)
C3.2: P Prop ropor
Vuln lnerable le Cons nsume umers
Proportion (0-100%) consumed by vulnerable groups (toddlers and elderly) FAO/WHO Chronic Individual Food Consumption Database Summary Statistics (CIFOCOSS) (Appendix 6)
C3.3: P Pote tenti tial for C Consume umer Mis ishan andlin ling
Proportion (0-100%) of LMF products in a given category with an increased risk as a result of mishandling/poor practices at any time between final retail and consumption (see Appendix 7 for details) Expert opinion
C4: V Vuln lnerabilit ilities due to F Food
Prod
C4.1: I Increa eased ed Ri Risk o k of Contam aminat atio ion
Proportion (0-100%) of LMF products in a given category with an increased risk of contamination post kill step (see Appendix 7for details) Expert opinion
C4.2: P Prop roportion
wit ithout K Kill ill Step
Proportion (0-100%) of LMF in a given category without a kill step prior to retail and distribution (see Appendix 7 for details) Expert opinion
C4.3: P Prevalence nce
Pathogen
Probability that a LMF is contaminated at a level with any pathogens with the potential to cause illness in consumers Systematic/scoping review (Appendix 1)
C2: B Burden of D Dis isease Code Category Name Total DALYs in
from 1990 to 2014 Normalised Impact (v2) [Dis-Value] Cat Cat 1 1 Cereals and Grains 72.53 45.9 Cat Cat 2 2 Confections and Snacks 60.26 35.4 Cat Cat 3 3 Dried Fruits and Vegetables 32.78 12.2 Cat Cat 4 4 Dried Protein Products 136.44 100.0 Cat Cat 5 5 Nuts and Nut Products 118.51 84.8 Cat Cat 6 6 Seeds for Consumption 18.42 0.0 Cat Cat 7 7 Spices, Dried Herb and Tea 80.71 52.8
C1: I Intern rnati tional T Trade Code Category Name Export value [US$ billions/year] Normalised Impact (v1) [Dis-Value] Cat Cat 1 1 Cereals and Grains 118. 118.59 594 100.0 Cat Cat 2 2 Confections and Snacks 58.124 48.5 Cat Cat 3 3 Dried Fruits and Vegetables 15.211 12.0 Cat Cat 4 4 Dried Protein Products 22.800 18.4 Cat Cat 5 5 Nuts and Nut Products 20.338 16.3 Cat Cat 6 6 Seeds for Consumption 1.150 0.0 Cat Cat 7 7 Spices, Dried Herb and Tea 14.938 11.7
C3.1: Aver erage S ge Serving C3.2 2 - Vulnerabl ble e Cons nsume umers C3.3 3 - Consume umer M Mishandling ng Cod
Category Name Average g/day Normalised Impact (v3.1) [Dis-Value] Proportion (0-100%) consumed by vulnerable groups: toddlers and elderly Normalised Impact (v3.2) [Dis-Value] Proportion (0-100%)
given category with an increased risk as a result of mishandling/poor practices at any time between final retail and consumption* Normalised Impact (v3.3) [Dis-Value] Cat at 1 1 Cereals and Grains 185. 85.0 100. 00.0 14.9 10.6 20 75.0 Cat at 2 2 Confections and Snacks 67.4 36.1 12.7 0.0 5 0.0 Cat at 3 3 Dried Fruits and Vegetables 21.1 10.9 16.0 15.9 5 0.0 Cat at 4 4 Dried Protein Products 1.1 0.0 33. 33.5 100. 00.0 25 25 100. 00.0 Cat at 5 5 Nuts and Nut Products 2.1 0.5 19.8 34.1 5 0.0 Cat at 6 6 Seeds for Consumption 5.5 2.4 12.7 0.0 5 0.0 Cat at 7 7 Spices, Dried Herb and Tea 4.4 1.8 13.9 5.8 15 50.0
*scores based on experts' opinion
C4.1 1 - Incre reased R Risk of
Contam aminat atio ion C4.2 .2 - Prop ropor
Kill Step C4.3 .3 - Prevalence nce o
hogens Cod
Category Name Proportion (0- 100%) of LMF products in a given category with an increased risk of contamination post kill step* Normalised Impact (v4.1) [Dis-Value] Proportion (0-100%)
given category not subject to a kill step (see definition below) prior to retail and distribution* Normalised Impact (v4.2) [Dis-Value] Presence of contamination (log10 cfu/g) Normalised Impact (v4.3) [Dis-Value] Cat at 1 1 Cereals and Grains 14.55 15.2 85 85 100. 00.0 3.94 29.0 Cat at 2 2 Confections and Snacks 40 40 100. 00.0 20 13.3 2.21 13.1 Cat at 3 3 Dried Fruits and Vegetables 10 0.0 70 80.0 4.84 37.3 Cat at 4 4 Dried Protein Products 20 33.3 10 0.0 2.54 16.2 Cat at 5 5 Nuts and Nut Products 10.5 1.7 50 53.3 0.78 0.0 Cat at 6 6 Seeds for Consumption 10 0.0 75 86.7 2.07 11.8 Cat at 7 7 Spices, Dried Herb and Tea 10 0.0 75 86.7 11. 11.67 100. 00.0
Code Cat Category N Nam ame C1 C1 - International Tr Trade ( (v1) C2 C2 - Burd rden o
Disea ease ( e (v2) C3 C3 - Food Consump mption (v3) C4 C4 - Food d Product ction (v4) Overall Impact ( t (V) ) [dis-va value] Ranking
rder Cat Cat 1 1 Cereals and Grains 100.0 45.9 57.9 50.0
Cat Cat 2 2 Confections and Snacks 48.5 35.4 15.7 29.7
Cat Cat 3 3 Dried Fruits and Vegetables 12.0 12.2 11.6 44.4
Cat Cat 4 4 Dried Protein Products 18.4 100.0 56.5 14.0
Cat Cat 5 5 Nuts and Nut Products 16.3 84.8 15.1 18.1
Cat Cat 6 6 Seeds for Consumption 0.0 0.0 1.0 34.5
Cat Cat 7 7 Spices, Dried Herb and Tea 11.7 52.8 9.8 76.5
Norma malised W Weights W1 = 16.7% W2 = 37.0% W3 = 18.5% W4 = 27.8% 100.0%
The overall normalised impact (V) of a LMF category a is thus given by the following formula: V(a (a) = = w1 v1(a (a) + + w2 v v2(a (a) + + w3 v v3(a (a) + + w4 v v4(a (a) (w (w1
1 +
+ w2
2 + w
+ w3
3 +
+ w4
4 =
= 1) 1)
Sensitivity analysis – robustness of ranking Using these criteria Cereals and grains or dried protein
The ranking was quite robust to changes of priorities,
Significant variability in the quality and quantity of data
Disease data -outbreak data, DALUS calculated based
Ranking – only as good as the data available at the
Very diverse categories – may need to be sub-divided
Sub- ranking with a focus on risk – relative ranking Considered factors influencing prevalence and level of
Given diversity of industry not appropriate to focus on
Scenario based approach – type of spice, level of
n=10 (25g analytical samples), c=0 Noted low levels of contamination – considered
tion of 0.5