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Reducing disease risks and improving food safety in smallholder pig value chains in Vietnam
Risk assessment component: planned activitiesNguyen Viet Hung (Hanoi School of Public Health) - PresenterHoang Van Minh (Hanoi Medical University) Hoang Thi Thu Ha (National Institute for Disease and Epidemiology)Kohei Makita (Rakuno Gakuen University) Fred Unger (International Livestock Research Institute) Lucy Lapar (International Livestock Research Institute) Delia Grace (International Livestock Research Institute)
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Objectives
• 1. To assess impacts of pork-borne diseases on human health and the livestock sector and identify critical points/opportunities for risk management
• 2. To develop and test incentive-based innovations to improve management of human and animal health risks in smallholder pig value chains.
• 3. To sustainably improve capacity to assess and manage risks in smallholder pig value chains by engaging stakeholders and co-generating evidence.
• 1. To assess impacts of pork-borne diseases on human health and the livestock sector and identify critical points/opportunities for risk management
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Project framework
Risk profiling
Risk assessment
Microbial Risk Assessment
Chemical Risk Assessment
Economics (eg health, CBA)
Value chain
Rapid assessment
Economic assessment
Animal Health Risk Assessment
…
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Interventions
Action research 1
Action research 2
Action research 3
…………………
Engaging stakeholders and co-generating evidence, Advocacy, Communication, OM
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2 3
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Incentive-based interventionsRandomized Control Trials (RCT)
Risk assessment
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Risk analysis• Risk analysis describes how risks are dealt within the society, including 3 components
• Risk communication: Communication of risks to managers, stakeholders, public officials, and the public.
• Risk management: how to reduce risk
• Risk assessment (RA): is there a problem? How adverse the problem is?
Source: Codex (1999)
Risk Assessment
Risk Management
Risk Communication
Hazard vs. Risk
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3.Exposure Assessment Size & nature of the population, route, amount and
duration of the exposure
1.Hazard IdentificationDescribe environment, pathogens, Health effects
2.Dose-response Analysis Relationships between exposure (dose) & frequency of infection/illness (response)
4.Risk Characterization Integrate the information from 3 and 4 to express public health outcomes, taking into account the
variability and uncertainty of the estimations.
Q M R A
Risk management
Quantitative Microbial Risk Assessment (QMRA) within Risk Analysis framework
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Quantitative Risk assessmentFood safety risk analysis: Codex vs. informal
marketing system
Participatory methods
Risk Assessment
Risk Management
Risk Communication
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Concept of participatory risk analysisBonfoh B. (2010) Revue Africaine de Santé et de Productions Animales.
Adapting quantitative risk assessment to the context of food safety in informal markets: incorporation of information collected using participatory methods; engagement of stakeholders; use of “appropriately imprecise” data (that is, collected at least cost for the purpose).
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3.Exposure Assessment Size & nature of the population, route, amount and
duration of the exposure
1.Hazard IdentificationDescribe environment, pathogens, Health effects
2.Dose-response Analysis Relationships between exposure (dose) & frequency of infection/illness (response)
4.Risk Characterization Integrate the information from 3 and 4 to express public health outcomes, taking into account the
variability and uncertainty of the estimations.
Q M R A
Risk management
Where is participatory used in the conventional RA
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Participatory methodsfit well
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Activities
•Risk profiling and priority hazard identification
•Risk assessment
•Economic assessment of disease burden on humans and CBA
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1. Risk Profiling and priority hazard identification
• Broad and qualitative summary of relevant information on a specific food safety issue or animal disease.
• Hazard, impact on human and/or animal health, population affected, incidence and prevalence, epidemiology of transmission, stakeholder concerns, relative importance of the hazard, and options for management, etc.
• Recommendations whether or not to further address the problem and the recommendation to whether or not to commission risk assessments. This needs to be done in collaboration with national stakeholders to reflect priorities.
• Rough analysis (sample collection and analysis)
• Design: desk study based on systematic literature review + sampling
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Food-borne disease Diseases of pigParasiticCysticercus cellulosaeTrichinella spiralisToxoplasma gondiiFasciola spp
BacterialBacillus cereusBrucella suisCampylobacter spp.Salmonella enetericaStaphylococcus aruesShiga toxin producing E. coliYersinia enterocolitica
ChemicalAntibiotic residuesAflatoxinsSteroids/growth promoters
EctoparasitesEndoparasites (gut, lung, liver)Respiratory (bacterial, viral)Gastrointestinal (bacterial viral)ReproductiveSkeletalFoot-and-mouth disease Classical swine feverPorcine reproductive and respiratory syndrome
Non-food borne zoonosesJapanese encephalitisErysipeloidStreptococcus suisLeptospira spp
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Farm to fork (Microbiological Risk Assessment Series No2-2002, No7-2008)
Nf Np Nr
Pathogen concentration (N)
Pf Pp Pr
Infection risk (P)
FarmMarketSlaughter
houseCon-
sumption
Exposure assessment
Exposure assessment
Exposure assessment
Exposure assessment
Risk
Risk
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Piglets source -sow-feed-contamination
FARM & TRANSPORT
Weaners source -new pig in batch-feed-contamination
Finishers source-new pigs in batch-feed-contamination
Transport & lairage-mixing of pigs-contamination of transport
Slaughter-Scalding-Dehairing-Singeing-Polishing-Evisceration-Trimming-Chilling
Randomly sampling
PROCESSING:(different pig meat products)
PREPARATION & CONSUMPTION(Different end-products)
-transmission-cross-contamination
-transmission-cross-contamination
-transmission-cross-contamination
-transmission-cross-contamination-inactivation
-transmission-cross-contamination-inactivation-growth
An overview of the modules within the farm-to-consumption for risk assessment
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Understanding a value chain
Quantifying a value chain
Quantifying contamination and growth
Quantifying risk mitigation in a value chain
Building into risk characterization model
Understanding a logic of exposureFault tree
Participatory &interviews
A survey,literature
Participatory &interviews
Participatory &interviews
Modeling process in exposure assessment
Dose-response modelLiterature
Day 2-1
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Chemical risk assessment
• Heavy metals (lead, mercury, arsenic, cadmium …)• Polychlorinated dibenzo-p-dioxins (PCDDs), • Polychlorinated dibenzofurans (PCDFs) and dioxin-like polychlorinated
biphenyls (DL-PCBs), hexachlorobenzene (HCB), polychlorinated naphthalenes (PCNs),
• Polycyclic aromatic hydrocarbons (PAHs), polychlorinated diphenyl ethers (PCDEs), polybrominated diphenyl ethers (PBDEs), 16 polycyclic aromatic hydrocarbons (PAHs) (naphthalene, acenaphthylene, acenaphthene, fluorene, phenanthrene, anthracene, fluoranthene, pyrene, benz[a]anthracene, chrysene, benzo[b]fluoranthene, benzo[k]fluoranthene, benzo[a]pyrene, dibenz[a,h]anthracene, benzo[g,h,i]perylene, and indeno[1,2,3-c,h]pyrene), antibiotics, etc.
• February 2012, officials in Vietnam found beta-Agonists, a banned lean meat enhancing drug in some pig-rearing households in Dong Nai.
• Environmental health risk assessment framework.
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Sampling (1)
• At farm: environmental impact• Slaughter house• Market• Consumption • Predictive microbiology (microbial growth)• Combined assessment on consumption, market,
SH etc.. with interview of the value chain actors…• Modeling
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Sampling (2)
• Pork foodstuffs, way of preparation, and eating habits identified by the survey.
• Raw and cooled, in the case of (iv), prepared pork meat samples will be collected at four points for testing: i) Small scale slaughterhouse, ii) Market (wet market and supermarket), iii) Consumer handling (undercooking and cross-contamination) and iv) Consumption (exposure to pathogens).
• Environmental samples (farm, water, soil)
• Variability, seasonal bias amples will be collected in two different seasons on a distribution of 8 months.
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Challenges
• Difficulties to follow farm to folk: do we need to trace pork from farm to fork?
• Chemical risk assessment: what will be the key hazard (technique for hazard ranking?)
• Risk factor vs. Phylogeny study to identify etiology of diseases
• Uncertainty