RISK RANKING BY THE SCIENTIFIC COMMITTEE OF THE BELGIAN FOOD SAFETY AGENCY + IMPLEMENTATION OF RISK RANKING INTO POLICY Symposium Scientific Committee FASFC Brussels 29-11-2013 Dr. X. Van Huffel
Belgian Food Safety Agency: scope & structure Preserving the safety of the entire food chain and the quality of food/feed in order to protect the health of humans, animals and plants Scientific Committee Staff Direction for RA
Definition of risk ranking risk ranking is priority setting of a list of hazards / risks / risk factors based on a set of criteria in a logical order or into groups of similar risk level in order to help the risk manager in his decision process
Examples of risk ranking by Sci Com FASFC 1. Ranking of animal diseases for surveillance purposes (Sci Com advices 26-2009, 5-2010, 10-2010) 2. Ranking of foodborne zoonotic pathogens (Sci Com advice 22-2008 + Cardoen et al., 2009) 3. Ranking of risk factors for emerging infectious animal diseases (Sci Com advice 06-2013) 4. Risk ranking of carcinogenic and/or genotoxic contaminants in food (Sci Com advices 26-2008, 09-2010, 01-2013)
1. Ranking of animal diseases for surveillance purposes (2009-2010) ToR: To draft a prioritized list of animal diseases Classified per animal species (livestock) Purpose: epidemiological surveillance Conditions: Fast (1 month - to be applied during winterscreening of cattle) Method: Pragmatic approach: veterinary expert opinion Criteria / considerations: Public health Animal health Economic Legal Epidemiological Optimal logistic organization (cattle)
1. Ranking of animal diseases for surveillance purposes (2009-2010) Results: * ongoing Brucellosis Leucosis Tuberculosis Aujeszky Avian influenza Brucella melitensis Abortion protocol No surveillance Bovine diseases 1 (via non coagulated blood or serum) Bovine diseases (via other samples) 2 Swine diseases 3,4 Poultry diseases 5 Small ruminant diseases 7,8 Equine diseases High priority Medium priority Low priority Bluetongue, Bovine Viral Diarrhea (BVD), Infectious Bovine Rhinotracheitis (IBR), Q-fever Paratuberculosis, Neosporosis, West- Nile fever, Toxoplasmosis, Leptospirosis, Salmonellosis Parafilariosis / Paratuberculosis, Indicator bacteria (Escherichia coli and Streptococcus bovis) Salmonella, Brachyspira hyodysenteriae Newcastle disease 6 Q fever Bluetongue Equine infectious anemia Toxoplasma, Yersinia enterocolitica, Hepatitis E, Indicator bacteria (Escherichia coli and enterococci), Multiple Resistant Staphylococcus aureus and other Methicillin Resistant Staphylococci West-Nile fever, Indicator bacteria (Escherichia coli and enterococci), multiple resistant Staphylococcus aureus Paratuberculosis, West Nile fever, Visna Maedi, Caprine arthritis and encephalitis Equine viral arteritis, West-Nile fever Mycoplasma bovis, Rift valley fever, Bovine hypodermosis, Epizootic haemorrhagic disease, Crimean Congo hemorrhagic fever Multiple resistant Staphylococcus aureus, Verocytotoxin producing Escherichia coli Nipah virus Chlamydiosis Caseus lymphadenitis, Rift valley fever, Crimean Congo hemorrhagic fever 9 Babesiosis, African Horse Sickness, Hendra virus, Nipah virus, equine encephalitis viruses
2. Ranking of foodborne zoonotic pathogens (2006-2008) ToR: self tasking To draft a list of ranked food- and waterborne zoonotic agents To support decision makers to establish MANCProgram To identify knowledge gaps To identify key research questions Method: Establishment of exhaustive list (51 zoonotic pathogens) Selection of relevant pathogen evaluation criteria (5) Public health (2): severity and occurence of the disease in human population Animal heath (2): occurence of the disease + severity (+ economic and commercial impact of disease) Food: occurence in food (as transmission vehicle) Constitution of help information database for experts Scoring of impact of each zoonotic agent on the 5 criteria Attributing a relative weight to the 5 criteria by risk managers Ranking based on scores Identification of groups of importance (classification and regression tree analysis)
2. Ranking of foodborne zoonotic pathogens (2006-2008) + - Results: Control policy: Salmonella Campylobacter spp Listeria monocytogenes Verocytoxigenic Escherichia coli BSE Zoonotic parasites Toxoplasma gondii Cryptosporidium parvum Echinococcus granulosus Echinococcus multilocularis Fasciola hepatica Giardia intestinalis Overall weighted scores 0 2 4 6 8 10 12 14 16 18 20 12.9 ± 1.23 High importance 6.39 6.33 6.32 6.08 4.82 4.72 4.62 4.15 3.91 3.85 3.79 3.57 2.90 2.81 2.19 8.55 8.45 8.44 8.17 8.11 7.86 7.79 7.73 7.64 7.56 7.48 7.46 7.43 7.26 7.14 7.09 6.98 6.93 10.44 10.28 10.07 9.85 9.83 9.75 9.59 9.55 9.37 9.31 9.25 9.19 8.97 8.87 14.72 13.40 11.95 11.60 9.59 ± 0.45 Significant importance 7.67 ± 0.49 Moderate importance 4.43 ± 1.30 Low importance Salmonella enterica Campylobacter coli and jejuni Listeria monocytogenes Verocytotoxigenic E. coli Toxoplasma gondii Prion protein (BSE) Clostridium botulinum Staphylococcus aureus Cryptosporidium parvum Mycobacterium bovis Echinococcus granulosus Streptococcus spp. Echinococcus multilocularis Yersinia enterocolitica Mycobacterium avium Fasciola hepatica Giardia intestinalis Rotavirus Coxiella burnetii Helicobacter spp. Bacillus anthracis Leptospira spp. Clostridium perfringens Hepatitis A virus Brucella melitensis Francisella tularensis Taenia saginata Arcobacter butzleri Avian influenza virus H5N1 Trichinella spp. Yersinia pseudotuberculosis Norovirus Brucella abortus Central European tick-borne virus Campylobacter (vibrio) fetus Sarcocystis bovihominis Anisakis simplex Vibrio cholerae Hepatitis E virus Sarcocystis suihominis Taenia spp. (other than saginata) Vibrio parahaemolyticus Dioctophyma renale Corynebacterium bovis Corynebacterium ulcerans Aeromonas spp. Clonorchis sinensis Lymphocytic choriomeningitis virus Balantidium coli Diphyllobothrium Linguatula serrata
3. Ranking of risk factors for (re)emerging infectious animal diseases (2013) ToR: self tasking To identify and rank risk factors for (re)emerging infectious animal diseases Forecasting To make recommendations (surveillance, biosafety, legislation, research) Method: Establishment of list of 34 potentially (re)emerging animal diseases Establishment of list of 33 risk factors Scoring of effect of risk factor on disease by 50 experts Delphi survey Ranking of diseases based on scores
3. Ranking of risk factors for (re)emerging infectious animal diseases (2013) Results: ranked risk factors Policy: towards a monitoring of measurable risk factors (emerging risk forecasting system)? RF Forecasting event Early warning
4. Risk ranking of carcinogenic and/or genotoxic contaminants in food ToR: self tasking To draft a list of ranked carcinogenic/genotoxic contaminants in food (ranking according risks for public health) To make suggestions for FASFC control programme Method: Establishment of non-exhaustive list of carcinogenic/genotoxic contaminants based on IARC classification Create subgroups (5): process contaminants, environmental contaminants, residues from pesticides and pharmaceutical drugs, naturally occurring contaminants, residues from the migration of contact materials Consider different approaches: ALARA, dose-response relationship, margin of exposure (MOE), threshold of toxicological concern (TTC) 2 case studies: process contaminants and environmental contaminants
4a. Risk ranking of process contaminants (2010) List: acrylamide (AA), benzene, chloropropanols, ethylcarbamate (EC), formaldehyde, furan, heterocyclic amines (HAA), nitro-pah, nitrosamines, polycyclic aromatic hydrocarbons (PAH), semicarbazid (SEM) Risk assessment: IARC classification, toxicity, exposure, MOE Ranking: 3 classes (high, medium, low concern) Results: Control policy + + +
4a. Risk ranking of process contaminants (2010) Control policy + - - + Control policy + - - - -
4b. Risk ranking of environmental contaminants (2013) List: 18 environmental contaminants Risk assessment: IARC, tox. reference values, exposure, MOE, % of TDI, other effects (ED) Ranking: 3 classes (high, medium, low concern) Results + Control policy: High concern: arsenic, lead Medium concern: benzene, cadmium, methylmercury, dioxins and dioxine-like PCB s, non-dioxine-like PCB s, polycyclic aromatic hydrocarbons (PAHs), toxaphene Low concern: 2-nitro-anisole, nitro-pah s, polybrominated biphenyls (PBB), forbidden pesticides (chlordane, DDT, ), hexachlorobenzene (HCB), hexachlorocyclohexane (HCH), lindane, polychlorophenols
Conclusions Risk ranking is frequently applied by Sci Com Different approaches can be used: from pragmatic (quick) to more elaborated and time-demanding studies Results of RR: to be interpreted in relation to used methodology, timeframe, local (epidemiological) context, Degree of implementation of risk ranking results into control policy depend on different risk management considerations such as: Availability of financial ressources Aim of control program: detection of disease/contamination versus prevalence determination or knowledge building Existence of tests, standards, action limits and control measures Economical considerations Stakeholders attitude Political factors
Acknowledgment Members of the SciCom s of FASFC V. Baeten, D. Berkvens, C. Bragard, J.-P. Buts, A. Clinquart, P. Daenens, E. Daeseleire, G. Daube, J. Debevere, B. De Meulenaer, L. De Zutter, P. Delahaut, K. Dewettinck, J. Dewulf, K. Dierick, R. Ducatelle, P. Gustin, L. Herman, P. Hoet, A. Huyghebaert, H. Imberechts, J. Lammertijn, A. Legrève, P. Lheureux, G. Maghuin- Rogister, C. Matthys, L. Pussemier, K. Raes, C. Saegerman, B. Schiffers, M.-L. Scippo, M. Sindic, N. Speybroeck, W. Stevens, W. Steurbaut, E. Thiry, M. Uyttendaele, T. van den Berg, J. Van Hoof, C. Van Peteghem, G. Vansant External experts: members of the workgroups: G. Ducoffre, F. Pasmans, S. Quoilin, S. Ribbens, J. Tytgat,, L. Vandaele, C. Vleminckx The scientific experts who participated in the scoring exercises Scientific experts of the Staff Direction for Risk Assessment of FASFC S. Cardoen, W. Claeys, P. Depoorter, X. Van Huffel, C. Verraes, V. Vromman, O. Wilmart