Critical review of methods for risk ranking of food-related hazards, based on risks for human health

Quantitative risk ranking of mycotoxins in milk under climate change scenarios

Mycotoxins are toxic fungal metabolites that may occur in crops. Mycotoxins may carry-over into bovine milk if bovines ingest mycotoxin-contaminated feed. Due to climate change, there may be a potential increase in the prevalence and concentration of mycotoxins in crops. However, the toxicity to humans and the carry-over rate of mycotoxins from feed to milk from bovines varies considerably. This research aimed to rank emerging and existing mycotoxins under different climate change scenarios based on their occurrence in milk and their toxicity to humans. The quantitative risk ranking took a probabilistic approach, using Monte-Carlo simulation to take account of input uncertainties and variabilities. Mycotoxins were ranked based on their hazard quotient, calculated using estimated daily intake and tolerable daily intake values. Four climate change scenarios were assessed, including an Irish baseline model in addition to best-case, worst-case, and most likely scenarios, corresponding to equivalent Intergovernmental Panel on Climate Change (IPCC) scenarios. This research prioritised aflatoxin B1, zearalenone, and T-2 and HT-2 toxin as potential human health hazards for adults and children compared to other mycotoxins under all scenarios. Relatively lower risks were found to be associated with mycophenolic acid, enniatins, and deoxynivalenol. Overall, the carry-over rate of mycotoxins, the milk consumption, and the concentration of mycotoxins in silage, maize, and wheat were found to be the most sensitive parameters (positively correlated) of this probabilistic model. Though climate change may impact mycotoxin prevalence and concentration in crops, the carry-over rate notably affects the final concentration of mycotoxin in milk to a greater extent. The results obtained in this study facilitate the identification of risk reduction measures to limit mycotoxin contamination of dairy products, considering potential climate change influences.

A tiered approach of hazard-prioritization and risk-ranking for chemical hazards in food commodities: Application for selected mycotoxins

Chemical hazards in foods, especially naturally occurring food contaminants like mycotoxins, are of serious public health concern. It is important to develop a practical framework to assess and rank health risks of chemical contaminants which can be further utilized by regulatory agencies to prioritize resources for risk assessment and management. In this study, a tiered hazard-prioritization and risk-ranking approach, which included two steps: exposure-based screening and margin of exposure (MOE)-based probabilistic risk ranking; was proposed to efficiently identify and rank chemicals of health concerns. Given the exposure-based hazard prioritization, chemicals with negligible or low health risks were first excluded. The remaining chemicals, imposing a higher health risk, were then ranked to facilitate risk-based decision making. The proposed approach was applied to identify and rank the mycotoxins with substantial health concerns in food commodities randomly sampled in China. A total of 19 mycotoxins were analyzed in 783 food commodities, including infant cookie, noodle, rice flour samples, wheat flour, millet, and rice. Results showed that the mycotoxins in infant foods with the highest health risk were Tenuazonic acid, Deoxynivalenol, and Enniatin B1, but as indicated by the probabilistic MOE estimation, the risks were still in the acceptable range and generally lower than the risks imposed by trace elements (e.g., Arsenic and Cadmium). The health risks of the other 16 mycotoxins were negligible mainly due to their low exposure levels. This study demonstrated that the proposed tiered approach was an efficient and effective tool to quantify and prioritize health risks in support of human health risk management.

Economic Growth, Income Inequality and Food Safety Risk

Food safety risk, as an implicit cost of social and economic development, endangers the health of global residents, including China. To systematically understand the impact of socioeconomic development on food safety risk and to establish a sound modern governance system of food safety in China, this paper uses provincial panel data from 2011 to 2020 to explore the relationship between food safety risk and socio-economic development factors such as economic growth and income inequality by employing a two-way fixed effect model and moderating effect model. The results show that the food safety risk is a Kuznets curve, and the turning point is about RMB 58,104.59 per capita GDP (based on prices in 2011). However, under the moderating effect of income inequality, the turning point of the Kuznets curve of food safety risk will shift to the right, and the curve will be flattened. In other words, income inequality has a negative moderating effect on the "inverted U-shaped" relationship between economic growth and food safety risk. When dealing with food safety problems, the goal of stable and sustained economic growth and common prosperity should be incorporated into policy formulation to enhance the governance effectiveness of food safety risk.

Ranking food products based on estimating and combining their microbiological, chemical and nutritional risks: Method and application to Ready-To-Eat dishes sold in France

Microbiological (M), chemical (C), and nutritional (N) risks associated with food products are usually assessed and managed independently by experts in public services or food companies. This can render difficult the comparison of food products in term of overall risk for the consumer. The objective of this study was to suggest a relatively simple method to (i) classify food products based on their M, C and N risks, and (ii) aggregate these risks and rank the food products accordingly. The method was developed and applied to 17 ready-to-eat (RTE) dishes available on the French market. With regard to food safety, the individual M and C risks were characterized considering likelihood and severity as recommended by the Codex Alimentarius. With regard to nutrition/health, the N risk was estimated based on the tendency of the dish to contribute to nutrient adequacy and to a healthy eating pattern. Finally, the outranking method PROMETHEE was applied to aggregate the three M, C, N risks and rank the food dishes. Food products were ranked relatively to each other, not in absolute terms. When we attributed the same weight to M, C and N risks, the RTE dish "Duck Parmentier" had the highest risk score while "Papillote of chicken, potatoes and small vegetables" and "Vegetarian plate vegetables and quinoa" had the lowest. However, this overall ranking changed according to the weight assigned to individual M, C and N risks, at least for food products whose scores varied according to risk types, such as"sushi discovery" (high M and C risks, low N risk). Since the risk ranking method developed here was built with assumptions and hypotheses related to the specific case study, more applications are needed to assess whether it can be generic. Nevertheless, this method is well grounded, objective, transparent, relatively fast and easy to set up. It might lead to further development of decision tools, particularly for consumers. This study paves the way towards food product multi-risk ranking.

Prioritization of vegetable-borne biological hazards in Argentina using a multicriteria decision analysis tool

Vegetables, especially those eaten raw, have been implicated in several foodborne disease outbreaks. Since multiple vegetable matrices and hazards are involved, risk managers have to prioritize those with the greatest impact on public health to design control strategies. In this study, a scientific-based risk ranking of foodborne pathogens transmitted by leafy green vegetables in Argentina was performed. The prioritization process included hazard identification, evaluation criteria identification and definition, criteria weighting, expert survey design and selection and call for experts, hazard score calculation, hazard ranking and variation coefficient, and result analysis. Regression tree analysis determined four risk clusters: high (Cryptosporidum spp., Toxoplasma gondii, Norovirus), moderate (Giardia spp., Listeria spp., Shigella sonnei), low (Shiga toxin-producing Escherichia coli, Ascaris spp., Entamoeba histolytica, Salmonella spp., Rotavirus, Enterovirus) and very low (Campylobacter jejuni, hepatitis A virus and Yersinia pseudotuberculosis). Diseases caused by Norovirus, Cryptosporidium spp. and T. gondii do not require mandatory notification. Neither viruses nor parasites are included as microbiological criteria for foodstuff. The lack of outbreak studies did not allow to accurately identify vegetables as a source of Norovirus disease. Information on listeriosis cases or outbreaks due to vegetable consumption was not available. Shigella spp. was the main responsible for bacterial diarrhea, but it has not been epidemiologically associated with vegetable consumption. The quality of the available information for all hazards studied was very low and low. The implementation of good practice guidelines throughout the entire vegetable production chain could prevent the presence of the identified hazards. The current study allowed the identification of vacancy areas and could help reinforce the need for performing epidemiological studies on foodborne diseases potentially associated with vegetable consumption in Argentina.

Methodology for risk-based monitoring of contaminants in food - A case study in cereals and fish

In this study, a methodology was developed that can be used as input for risk-based monitoring plans for chemical contaminants in food products. The novel methodology was applied to a case study in which cereals and fish were evaluated simultaneously for the possible presence of mycotoxins and heavy metals. The methodology was based on hazard quotients that were estimated by dividing the daily intake - using concentrations of the contaminants in the different food products and consumption of the respective products combined per product group - by the health based guidance value (HBGV) or reference points used for assessing potential health concerns (RPHC). The most relevant hazard-product combinations were further ranked based on the volume of import of the ingredients, per import country and a defined contaminant prevalence level per country. For fish, the hazard quotients were around ten times lower compared to the highest hazard quotients in cereals. Consumption of molluscs, mackerel-type fish and herring-type fish contaminated with mercury contributed most to the HBGV or RPHC. The top 25 hazard-product combinations for various age groups included: aflatoxin B1 in combination with wheat, rice (products), maize (products), and pasta, zearalenone in combination with wheat (products), T2/HT2-toxin in combination with rice (products), and DON in combination with wheat (products). The methodology presented showed to be useful in identifying the most relevant hazard-food-age group combinations and the most relevant import countries linked to these that should be included in the monitoring. As such, the method can help risk managers in establishing risk-based monitoring programs.

Microbiological and chemical analysis of food collected under official control in the Emilia-Romagna region of northern Italy, 2014-2019

This study analyzed data from six years (2014-2019) of official controls in the Emilia-Romagna region (northern Italy) to investigate the frequencies of human pathogens and chemical hazards in foods during production and distribution. Campylobacter spp. was the most prevalent pathogen, isolated in 4.4% of the 1,078 food samples examined, followed by Salmonella spp. (2.8%), Shiga toxin-producing Escherichia coli (STEC) (1.9%) and Listeria monocytogenes (0.9%). Salmonella serotyping showed that the isolates belonged to the serotypes most commonly isolated from humans in Emilia-Romagna. These serotypes were: S. Infantis (34.8%), mostly isolated from chicken, monophasic S. Typhimurium (1,4, (Anonymous, 2013),12:i:-) (12.6%), S. Bredeney (8.9%) and S. Derby (8.6%). No Clostridium botulinum, Yersinia spp. and Shigella spp. were isolated. No positivity was detected for hepatitis A virus, while 5.1% samples taken in the production phase of the food chain were found to be contaminated with norovirus. The chemical analyses identified environmental contaminants within legal limits (heavy metals, 0.6% positive overall; mycotoxins, 0.4% positive overall), analytes subjected to monitoring (perfluoro-alkyl substances (PFASs), 6.2% positive overall; inorganic arsenic, no positives overall) and process contaminants and additives within legal limits (acrylamide, 9.6% positive overall; permitted or non-permitted additives, 0.9% positive overall). Only one sample showed dioxins and polychlorinated biphenyls (PCBs) at levels higher than the legal limits. The monitoring by competent authorities (CA) of food contamination can generate useful data that can be used as a basis for estimating the exposure to different food contaminants over time and for evaluating the effects of control measures on the contamination of food.

Progress in Fluorescence Biosensing and Food Safety towards Point-of-Detection (PoD) System

The detection of pathogens in food substances is of crucial concern for public health and for the safety of the natural environment. Nanomaterials, with their high sensitivity and selectivity have an edge over conventional organic dyes in fluorescent-based detection methods. Advances in microfluidic technology in biosensors have taken place to meet the user criteria of sensitive, inexpensive, user-friendly, and quick detection. In this review, we have summarized the use of fluorescence-based nanomaterials and the latest research approaches towards integrated biosensors, including microsystems containing fluorescence-based detection, various model systems with nano materials, DNA probes, and antibodies. Paper-based lateral-flow test strips and microchips as well as the most-used trapping components are also reviewed, and the possibility of their performance in portable devices evaluated. We also present a current market-available portable system which was developed for food screening and highlight the future direction for the development of fluorescence-based systems for on-site detection and stratification of common foodborne pathogens.

Risk ranking of chemical hazards in foods: comparison of aggregating methods using infant formula as an example

The aim of this study was to rank several chemical hazards present in one food item, namely infant formula. We first identified the substances potentially present in infant foods according to the results of the French infant Total Diet Study and to the available scientific literature. Second, we built three criteria to rank the hazards: severity, contribution to the total exposure, and risk characterisation. Each criterion was scored using quantitative or semi-quantitative scales. Third, in order to rank the chemical hazards, two approaches of aggregation of the three criteria were deployed. On the one hand, a multi-criteria decision analysis outranking method and on the other hand a semi-quantitative risk-matrix type method. We then tested these approaches on follow-on formulae for the 7-12 months population, for which contamination data from the French infant Total Diet study were available. The results of both methods showed that the six prioritised substances are the same even if not in the exact same order (acrylamide, inorganic arsenic, furan, chromium VI, lead and PCDD/Fs) demonstrating the robustness of these approaches.

Risk ranking of food categories associated with Salmonella enterica contamination in the central region of Mexico

To prevent and control foodborne diseases, there is a fundamental need to identify the foods that are most likely to cause illness. The goal of this study was to rank 25 commonly consumed food products associated with Salmonella enterica contamination in the Central Region of Mexico. A multicriteria decision analysis (MCDA) framework was developed to obtain an S. enterica risk score for each food product based on four criteria: probability of exposure to S. enterica through domestic food consumption (Se); S. enterica growth potential during home storage (Sg); per capita consumption (Pcc); and food attribution of S. enterica outbreak (So). Risk scores were calculated by the equation Se*W₁ +Sg*W₂ +Pcc*W₃ +So*W₄ , where each criterion was assigned a normalized value (1-5) and the relative weights (W) were defined by 22 experts' opinion. Se had the largest effect on the risk score being the criterion with the highest weight (35%; IC95% 20%-60%), followed by So (24%; 5%-50%), Sg (23%; 10%-40%), and Pcc (18%; 10%-35%). The results identified chicken (4.4 ± 0.6), pork (4.2 ± 0.6), and beef (4.2 ± 0.5) as the highest risk foods, followed by seed fruits (3.6 ± 0.5), tropical fruits (3.4 ± 0.4), and dried fruits and nuts (3.4 ± 0.5), while the food products with the lowest risk were yogurt (2.1 ± 0.3), chorizo (2.1 ± 0.4), and cream (2.0 ± 0.3). Approaches with expert-based weighting and equal weighting showed good correlation (R²  = 0.96) and did not show significant differences among the ranking order in the top 20 tier. This study can help risk managers select interventions and develop targeted surveillance programs against S. enterica in high-risk food products.

Risk–Benefit assessment of foods: Development of a methodological framework for the harmonized selection of nutritional, microbiological, and toxicological components

Investigating the impact of diet on public health using risk–benefit assessment (RBA) methods that simultaneously consider both beneficial and adverse health outcomes could be useful for shaping dietary policies and guidelines. In the field of food safety and nutrition, RBA is a relatively new approach facing methodological challenges and being subject to further developments. One of the methodological aspects calling for improvement is the selection of components to be considered in the assessment, currently based mainly on non-harmonized unstandardized experts’ judgment. Our aim was to develop a harmonized, transparent, and documented methodological framework for selecting nutritional, microbiological, and toxicological RBA components. The approach was developed under the Novel foods as red meat replacers—an insight using Risk-Benefit Assessment methods (NovRBA) case study, which attempted to estimate the overall health impact of replacing red meat with an edible insect species, Acheta domesticus. Starting from the compositional profiles of both food items, we created a “long list” of food components. By subsequently applying a series of predefined criteria, we proceeded from the “long” to the “short list.” These criteria were established based on the occurrence and severity of health outcomes related to these components. For nutrition and microbiology, the occurrence of health outcomes was evaluated considering the presence of a component in the raw material, as well as the effect of processing on the respective component. Regarding toxicology, the presence and exposure relative to reference doses and the contribution to total exposure were considered. Severity was graded with the potential contribution to the background diet alongside bioavailability aspects (nutrition), the disability-adjusted life years per case of illness of each hazard (microbiology), and disease incidence in the population, potential fatality, and lifelong disability (toxicology). To develop the “final list” of components, the “short list” was refined by considering the availability and quality of data for a feasible inclusion in the RBA model. The methodology developed can be broadly used in food RBA, to guide and reinforce a harmonized selection of nutritional, microbiological, and toxicological components and will contribute to facilitating RBA implementation, enabling the generation of transparent, robust, and comparable outcomes.

Risk-based Decision Making Definition: A Scoping Review of Food, Agricultural, Environmental, and Medical Literature

Risk-based decision making (RBDM) is a term that is used frequently as an aspirational goal in many fields, including health, engineering, environmental science, regulatory and, more recently, food safety. When RBDM is used in the literature, many different types of criteria are used to characterize a decision process as being "risk-based." Like the parable about the blind men and the elephant, everyone is confident they know what RBDM means even though there is no universal definition. The use of RBDM is gaining wide acceptance and implies a level of rigor and focus that many decisionmakers and stakeholders are interested in adopting. However, without one clear definition, there are questions about what a RBDM approach really means. This study summarizes peer-reviewed and gray literature that uses the term "RBDM" from the last 50 years in the agricultural, environmental, and medical areas. The criteria discussed were identified and organized into themes. A foundational definition is proposed to represent the most fundamental use of RBDM in the literature, and three themes covering the additional concepts presented in some of the literature were identified and added as themes within the definition. Results from this research will inform practitioners interested in following the principles of RBDM, and will help guide researchers who are interested in advancing this approach. The most immediate use will be to guide the development of a roadmap for a risk-based food safety system for low- and middle-income countries and to aid the global food safety community in moving toward RBDM.

Addressing biohazards to food security in primary production

This review addresses ways to prepare for and to mitigate effects of biohazards on primary production of crops and livestock. These biohazards can be natural or intentional introductions of pathogens, and they can cause major economic damage to farmers, the agricultural industry, society, and international trade. Agroterrorism is the intentional introduction of animal or plant pathogens into agricultural production systems with the intention to cause socioeconomic harm and generate public fear. Although few acts of agroterrorism are reported, the threat of agroterrorism in Europe is real. New concerns about threats arise from the rapid advancements in biotechnology and emerging technologies. FORSA, an analytical framework for risk and vulnerability analysis, was used to review how to prepare for and mitigate the possible effects of natural or intentional biohazards in agricultural production. Analyzing the effects of a biohazard event involves multiple scientific disciplines. A comprehensive analysis of biohazards therefore requires a systems approach. The preparedness and ability to manage events are strengthened by bolstered farm biosecurity, increased monitoring and laboratory capacity, improved inter-agency communication and resource allocation. The focus of this review is on Europe, but the insights gained have worldwide applications. The analytical framework used here is compared to other frameworks. With climate change, Covid-19 and the war in Ukraine, the supply chains are challenged, and we foresee increasing food prices associated with social tensions. Our food supply chain becomes more fragile with more unknowns, thereby increasing the needs for risk and vulnerability analyses, of which FORSA is one example.

Fresh-Cut Vegetables Processing: Environmental Sustainability and Food Safety Issues in a Comprehensive Perspective

The fresh-cut industry supplies the food market with healthy fresh fruit and vegetables and, in that way, may contribute to improve the nutritional status of the general population. On the other hand, over the last few years increasing concerns have been raised regarding the environmental impact of the fresh-cut industry, human health risks from exposure to disinfection by-products found in fresh-cut products and chlorine-based disinfection treatments during produce processing. This review provides a comprehensive view of the main interlinked aspects related to food safety and environmental impact of processing of fresh-cut vegetables. Advantages and downsides of the mainstream disinfection strategy, based on the use of chlorine-related disinfecting agents, along with some alternative treatments close to a wide commercial application, are discussed. Limitation in the application of these strategies to processing of organic fresh-cut produce are also highlighted, examining the specific environmental and food safety problems in the organic sector. Areas where lack of available information hinders at present a clear understanding of priorities of research and action are pointed out. Innovative conceptual tools are proposed to address these multiple and interlinking issues and to overcome limitations of currently available technologies. A comprehensive and multidisciplinary approach is suggested to move toward a more safe and environmentally sustainable production of fresh-cut products.

Detection, quantification, and characterization of Salmonella enterica in mango, tomato, and raw chicken purchased in the central region of Mexico

To estimate human exposure to Salmonella enterica, it is essential to understand the pathogen distribution and characteristics. Prevalence and concentration of S. enterica were determined in mango, tomato, and raw chicken samples purchased in three states (Aguascalientes, Querétaro, and Guadalajara) located in the central region of Mexico during two seasons. In addition, S. enterica isolates were characterized by absence/presence of 13 virulence genes (chromosomal, prophage, and plasmid) and resistance to 14 antibiotics. A total of 300 samples of mango, 272 of tomato, and 354 of raw chicken were analyzed. The mean of the prevalence (24.9%) and concentration (-0.61 Log MPN/g) of S. enterica in chicken was higher than in mango (1.3%, -1.7 Log MPN/g) and tomato (1.1%, -1.7 Log MPN). Among S. enterica isolates (284), there were 7 different virulotypes, belonging 68.7% of isolates to V2; there was high variability in the presence of mobile genetic elements. The occurrence of specific mobile elements ranged from 81.4% to 11.3% among isolates. Among the isolates, 91.5% were resistant to at least one antibiotic with ampicillin being the most frequent; 54.9% of isolates were multidrug resistant. Data from this study can be used for quantitative microbial risk assessment of S. enterica related to mango, tomato, and raw chicken consumption in the central region of Mexico. PRACTICAL APPLICATION: Data on the prevalence and concentration of Salmonella enterica obtained in this study can be used to estimate the exposure assessment for the consumption of mango, tomato, and chicken in the central region of Mexico. In addition, the characteristics of the S. enterica isolates could be used to select representative strains for future studies to evaluate the intraspecies variability.

Methods to perform risk-based inspections of food companies

Risk‐based monitoring programs are increasingly applied for cost‐effective monitoring of food safety. Such programs ideally consist of three steps: risk‐ranking, risk‐based inspections, and cost‐effective monitoring. Various methods have been described to perform the first step of risk‐based monitoring. However, once the risk‐ranking has been completed, identifying the hazard‐food combinations to monitor, the frequency of inspection needs to be established based on a prioritization of food business operators (FBOs). The aim of this paper is to provide an overview of methods available for risk‐based inspections. Literature shows that FBO's food safety compliance can be assessed based on company size, historical monitoring data, and socio‐economic factors influencing compliance behavior. Non‐compliance can either be intentional or unintentional. The latter can be assessed by evaluating the food safety culture of a company. Various models—ranging from qualitative (e.g., focus groups) to quantitative (e.g., scoring)—can be used for this purpose. These models usually include an evaluation of the organizational structure (e.g., management control, communication, commitment), the technical food safety environment (e.g., hygienic design, zoning), and employee characteristics (e.g., knowledge, risk awareness). Intentional non‐compliance can be assessed using food fraud vulnerability tools. These tools incorporate factors influencing the likelihood of food fraud at the company, that is, opportunity, motivation, and (lack of) control measures. The literature indicates that either self‐assessment tools or risk matrices are applied. There is no global consensus on the methods to apply for risk‐based inspections. Depending on time and budget available as well as preferred output, one of the presented methods may be applied for prioritizing FBOs.

Interactions between risk assessors and risk managers during three major food incidents in Europe

Risk analysis consists of risk assessment (RA), risk management (RM), and risk communication (RC). In most countries, RA and RM of food safety are separated to achieve a high scientific integrity, and typically occur in sequential order. However, in case of a food safety incident, even though being separate processes, RA and RM are performed simultaneously due to great time pressure and expected high impacts. The aim of this study was to analyze and evaluate the observed interactions between RA and RM processes, during three major food incidents in Europe, and to provide suggestions for possible improvement. Based on the differences observed between the three cases, strengths and weaknesses of each system have been identified. The enterohemorrhagic Escherichia coli (EHEC) crisis in 2011 in Germany, the horsemeat scandal in 2013 in Ireland, and the fipronil incident in 2017 in the Netherlands were used as case studies. Timelines of these incidents and crisis management procedures in place in each of the three countries provided the basis for further analysis. First, results showed that details of the communication processes between RA and RM bodies were frequently lacking in crisis management protocols. Second, RA, RM, and RC processes differed for each incident, due to differences in estimated risk for public health, but also due to differences in the organization within a country. Based on our results, we recommend that crisis management protocols should contain a section on communication between RA, RM, and on communication between member states in the EU.

Risk Analysis in Healthcare Organizations: Methodological Framework and Critical Variables

Purpose

A risk assessment matrix is a widely used tool for analyzing, assessing and setting priorities in risk management in many fields. This paper overviews critical variables, advantages, disadvantages, strengths and weaknesses of this tool, according to the ISO 31000 risk management framework.

Results

Risk assessment is one of the key stages in the Risk Management Process and involves specific steps: identifying hazards, analyzing and evaluating all possible risks. Several methods are developed to assess risks in the literature. A risk matrix method, also called “decision matrix risk assessment (DMRA) technique”, is a systematic approach used to determine the risk level and to compare different risks and define which threats need to be controlled first. The actors involved in risk assessment are called on to manage different issues related to the choice of the most appropriate methodological approach, the assessment of the adequacy of the existing control measures, the articulation of risk consequence domains, the definition of the impact-consequences, the explanation of risk likelihood scales and the development of a risk matrix.

Conclusion

We highlighted a number of recommendations in order to address these issues, especially useful when healthcare organizations provide insufficient guidance on how to use risk matrices as well as what to do in response to the existing criticisms on their use.

Risk-benefit in food safety and nutrition - Outcome of the 2019 Parma Summer School

Risk-benefit assessment is the comparison of the risk of a situation to its related benefits, i.e. a comparison of scenarios estimating the overall health impact. The risk-benefit analysis paradigm mirrors the classical risk analysis one: risk-benefit assessment goes hand-in-hand with risk-benefit management and risk-benefit communication. The various health effects associated with food consumption, together with the increasing demand for advice on healthy and safe diets, have led to the development of different research disciplines in food safety and nutrition. In this sense, there is a clear need for a holistic approach, including and comparing all of the relevant health risks and benefits. The risk-benefit assessment of foods is a valuable approach to estimate the overall impact of food on health. It aims to assess together the negative and positive health effects associated with food intake by integrating chemical and microbiological risk assessment with risk and benefit assessment in food safety and nutrition. The 2019 Parma Summer School on risk-benefit in food safety and nutrition had the objective was to provide an opportunity to learn from experts in the field of risk-benefit approach in food safety and nutrition, including theory, case studies, and communication of risk-benefit assessments plus identify challenges for the future. It was evident that whereas tools and approaches have been developed, more and more case studies have been performed which can form an inherent validation of the risk-benefit approach. Executed risk-benefit assessment case studies apply the steps and characteristics developed: a problem formulation (with at least 2 scenarios), a tiered approach until a decision can be made, one common currency to describe both beneficial and adverse effects (DALYs in most instances). It was concluded that risk-benefit assessment in food safety and nutrition is gaining more and more momentum, while also many challenges remain for the future. Risk-benefit is on the verge of really enrolling into the risk assessment and risk analysis paradigm. The interaction between risk-benefit assessors and risk-benefit managers is pivotal in this, as is the interaction with risk-benefit communicators.

An expert-based risk ranking framework for assessing potential pathogens in the live baitfish trade

As global trade of live animals expands, there is increasing need to assess the risks of invasive organisms, including pathogens, that can accompany these translocations. The movement and release of live baitfish by recreational anglers has been identified as a particularly high‐risk pathway for the spread of aquatic diseases in the United States. To provide risk‐based decision support for preventing and managing disease invasions from baitfish release, we developed a hazard identification and ranking tool to identify the pathogens that pose the highest risk to wild fish via this pathway. We created a screening protocol and semi‐quantitative stochastic risk ranking framework, combining published data with expert elicitation (n = 25) and applied the framework to identify high‐priority pathogens for the bait supply in Minnesota, USA. Normalized scores were developed for seven risk criteria (likelihood of transfer, prevalence in bait supply, likelihood of colonization, current distribution, economic impact if established, ecological impact if established and host species) to characterize a pathogen's ability to persist in the bait supply and cause impacts to wild fish species of concern. The generalist macroparasite Schizocotyle acheilognathi was identified as presenting highest overall threat, followed by the microsporidian Ovipleistophora ovariae, and viral haemorrhagic septicaemia virus. Our findings provide risk‐based decision support for managers charged with maintaining both the recreational fishing industry and sustainable, healthy natural resources. Particularly, the identification of several high‐risk but currently unregulated pathogens suggests that focusing risk management on pathogens of concern in all potential host species could reduce disease introduction risk. The ranking process, implemented here for a single state case study, provides a conceptual framework for integrating expert opinion and sparse available data that could be scaled up and applied across jurisdictions to inform risk‐based management of the live baitfish pathway.

Development and application of a comparative risk assessment method for ranking chemical hazards in food

The aim of this study was to develop a comparative risk assessment method to prioritise the public health risks posed by chemical hazards in food. Through a literature review, and in light of expert opinions, a bottom-up, semi-quantitative scoring method was applied to screen the ranking metrics and assign a score. In addition, a metrics system and a ranking model were constructed. The fuzzy comprehensive analysis model was used to assess typical chemical hazards in a specific food, as well as to rank risks in many foods. Data were collected from the National Food Surveillance System in China, the Food Consumption of Chinese Residents Database, government reports, public websites and databases of authoritative organisations. The comparative risk assessment method was applied to case studies on ranking chemical hazards in different kinds of food. According to application testing, the method truly reflects the overall risk and ranking of chemical hazards in food.

Swans and elephants: A typology to capture the challenges of food supply chain risk assessment

As a result of internal or external shocks, food supply chains can transition between existing regimes of assembly and planned activity to situations that are unexpected or unknown. These events can occur without warning, causing stress, shift, even collapse, and impact on business/supply chain viability.

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Black elephants and black swans are of concern in food supply chains.

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Black swans can evolve to grey and white swans with appropriate risk mitigation.

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If supply chain controls become lax, white swans can revert to grey swans.

The Rise of Climate-Driven Sediment Discharge in the Amazonian River Basin

The occurrence of hydrological extremes in the Amazon region and the associated sediment loss during rainfall events are key features in the global climate system. Climate extremes alter the sediment and carbon balance but the ecological consequences of such changes are poorly understood in this region. With the aim of examining the interactions between precipitation and landscape-scale controls of sediment export from the Amazon basin, we developed a parsimonious hydro-climatological model on a multi-year series (1997–2014) of sediment discharge data taken at the outlet of Óbidos (Brazil) watershed (the narrowest and swiftest part of the Amazon River). The calibrated model (correlation coefficient equal to 0.84) captured the sediment load variability of an independent dataset from a different watershed (the Magdalena River basin), and performed better than three alternative approaches. Our model captured the interdecadal variability and the long-term patterns of sediment export. In our reconstruction of yearly sediment discharge over 1859–2014, we observed that landscape erosion changes are mostly induced by single storm events, and result from coupled effects of droughts and storms over long time scales. By quantifying temporal variations in the sediment produced by weathering, this analysis enables a new understanding of the linkage between climate forcing and river response, which drives sediment dynamics in the Amazon basin.

Evaluation of Multicriteria Decision Analysis Algorithms in Food Safety: A Case Study on Emerging Zoonoses Prioritization

Decision making in food safety is a complex process that involves several criteria of different nature like the expected reduction in the number of illnesses, the potential economic or health-related cost, or even the environmental impact of a given policy or intervention. Several multicriteria decision analysis (MCDA) algorithms are currently used, mostly individually, in food safety to rank different options in a multifactorial environment. However, the selection of the MCDA algorithm is a decision problem on its own because different methods calculate different rankings. The aim of this study was to compare the impact of different uncertainty sources on the rankings of MCDA problems in the context of food safety. For that purpose, a previously published data set on emerging zoonoses in the Netherlands was used to compare different MCDA algorithms: MMOORA, TOPSIS, VIKOR, WASPAS, and ELECTRE III. The rankings were calculated with and without considering uncertainty (using fuzzy sets), to assess the importance of this factor. The rankings obtained differed between algorithms, emphasizing that the selection of the MCDA method had a relevant impact in the rankings. Furthermore, considering uncertainty in the ranking had a high influence on the results. Both factors were more relevant than the weights associated with each criterion in this case study. A hierarchical clustering method was suggested to aggregate results obtained by the different algorithms. This complementary step seems to be a promising way to decrease extreme difference among algorithms and could provide a strong added value in the decision-making process.

A Systematic Review of Beef Meat Quantitative Microbial Risk Assessment Models

Each year in Europe, meat is associated with 2.3 million foodborne illnesses, with a high contribution from beef meat. Many of these illnesses are attributed to pathogenic bacterial contamination and inadequate operations leading to growth and/or insufficient inactivation occurring along the whole farm-to-fork chain. To ensure consumer health, decision-making processes in food safety rely on Quantitative Microbiological Risk Assessment (QMRA) with many applications in recent decades. The present study aims to conduct a critical analysis of beef QMRAs and to identify future challenges. A systematic approach, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, was used to collate beef QMRA models, identify steps of the farm-to-fork chain considered, and analyze inputs and outputs included as well as modelling methods. A total of 2343 articles were collected and 67 were selected. These studies focused mainly on western countries and considered Escherichia coli (EHEC) and Salmonella spp. pathogens. Future challenges were identified and included the need of whole-chain assessments, centralization of data collection processes, and improvement of model interoperability through harmonization. The present analysis can serve as a source of data and information to inform QMRA framework for beef meat and will help the scientific community and food safety authorities to identify specific monitoring and research needs.

A common approach for ranking of microbiological and chemical hazards in foods based on risk assessment - useful but is it possible?

This article compares and contrasts microbial and chemical risk assessment methodologies in order to evaluate the potential for a common framework for ranking of risk of chemical and microbiological hazards, and developments needed for such a framework. An overview of microbial (MRA) and chemical (CRA) risk assessment is presented and important differences are highlighted. Two microbiological and two chemical hazard-food combinations were ranked based on both a margin of exposure and a risk assessment approach. The comparisons illustrated that it is possible to rank chemical and microbiological hazard-food combinations with traditional approaches from each domain and indicated that the rank order but not the absolute measures is similar using either approach. Including severity in the assessment using DALY reduced differences between hazards and affected the outcome more than which approach was used. Ranking frameworks should include assessment of uncertainty as an integral part of the ranking, and be based on assessment of risk, not safety, and expressed in a common health metric such as disease burden. Necessary simplifications to address data gaps can involve the use of default scenarios. Challenges include comparisons of case-based vs. non-case-based health-endpoints, e.g. biomarker concentration, and integration of the severity of health effects into ranking.

Emerging Point-of-care Technologies for Food Safety Analysis

Food safety issues have recently attracted public concern. The deleterious effects of compromised food safety on health have rendered food safety analysis an approach of paramount importance. While conventional techniques such as high-performance liquid chromatography and mass spectrometry have traditionally been utilized for the detection of food contaminants, they are relatively expensive, time-consuming and labor intensive, impeding their use for point-of-care (POC) applications. In addition, accessibility of these tests is limited in developing countries where food-related illnesses are prevalent. There is, therefore, an urgent need to develop simple and robust diagnostic POC devices. POC devices, including paper- and chip-based devices, are typically rapid, cost-effective and user-friendly, offering a tremendous potential for rapid food safety analysis at POC settings. Herein, we discuss the most recent advances in the development of emerging POC devices for food safety analysis. We first provide an overview of common food safety issues and the existing techniques for detecting food contaminants such as foodborne pathogens, chemicals, allergens, and toxins. The importance of rapid food safety analysis along with the beneficial use of miniaturized POC devices are subsequently reviewed. Finally, the existing challenges and future perspectives of developing the miniaturized POC devices for food safety monitoring are briefly discussed.

Risk ranking of chemical and microbiological hazards in food

Risk ranking is a versatile tool used to prioritise activities performed by public health regulatory bodies. It also allows efficient communication between all stakeholders in the process of risk analysis. However, risk ranking methods are still not optimal. Because of the different approaches employed in the risk assessment of microbiological agents and chemicals, it is difficult to rank them together using the same metrics. In our work, we first discuss differences and commonalities between chemical and microbiological risk assessment to provide a starting point for consideration of a common risk ranking platform. In the second part, we perform risk ranking of contaminants and regulated chemicals using the recently developed Risk Thermometer tool. In this approach, chemicals are not ranked solely on the basis of the margin of exposure between a reference value and the exposure, but also by considering the severity of the critical health effects used. The results show that ranking using both methods provides different results from the use of either method alone. Overall, specific chemical groups (i.e. heavy metals, pesticides, etc.) do not generally rank higher or lower, but individual compounds are scattered in the rankings from low to high. Risk ranking methods demand further development to gain wide acceptability and recognition.

Risk ranking of foodborne parasites: State of the art

In a time of increasing threats and decreasing financial resources, monitoring and controlling all possible foodborne hazards at the same time and to the same extent has become more challenging than ever. Therefore, attention is increasingly being paid to the so-called "risk ranking" methods that enable decision makers to focus on the most important foodborne hazards - even when time is limited and knowledge incomplete. In this review paper, we provide an overview of the most common quantitative methods and metrics used for ranking the risks associated with foodborne parasites and present the state of the art on risk ranking exercises for foodborne parasites. A number of risk ranking metrics and methods are available, ranging from simple approaches that can be used to assess the health or economic impact of a foodborne parasitic disease, to more complicated but more comprehensive multi-criteria assessments. For health impact assessment, measures of population health such as disease occurrence and number of deaths; Disability-Adjusted Life Years (DALYs) measuring the healthy life years lost; and Quality-Adjusted Life Years (QALYs) measuring the number of life years lived in optimal health, are described. For economic impact assessment, applied approaches that measure the cost-of-illness from a societal perspective and stated preference methods are outlined. Finally, Multi-Criteria Decision Analysis (MCDA), which can be used to integrate multiple metrics and criteria into a single ranking, is described. These risk ranking methods for foodborne parasites are increasingly performed to aid priority setting at global, regional, and national levels. As different stakeholders have their own prioritization objectives and beliefs, the outcome of such exercises is necessarily context-dependent. Therefore, when designing a risk ranking exercise for foodborne parasites, it is important to choose the metrics and methods, as well as what to rank, in the light of the predefined context of the question being addressed and the target audience.