Risk Surveillance and Assessment of Food Safety in Shanghai

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Risk Surveillance and Assessment of Food
Safetyin Shanghai
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Resume

• Name Chunfeng Wu
• Position
• Shanghai Municipal Center for Disease Control
  and Prevention
• Education
• 19992004 Bachelor of Medical Sciences
• Public Health College, Fudan University
• 2008 Reading for MPH in Fudan
  University

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Work Experience

• 2004.7
• Work in Department of Food Hygiene and
  Food-borne Disease Control
• 2008.5.222008.6.11
• Go to Sichuan province to provide
• health and epidemic prevention
• after Wenchuan Earthquake
• 2008.8.242008.9.2
• Participate in a workshop held by U.S. CDC
• Epi-Ready Team Foodborne Illness Response
  Strategies

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Framework of our jobs
Food-borne Disease Surveillance
Food Contamination Monitoring
Risk Assessment
Research
Evaluate
Prevention, Intervention
Food-borne Outbreaks Investigation and Response
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• Food-borne Diseases Surveillance
• Food Contamination Monitoring
• Others

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Food-borne Disease Surveillance

• In order to estimate the incidence of food-borne
  diseases in Shanghai
• Refer to the theory of FoodNet
• Establish the surveillance in the beginning of
  2006

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FoodNet

• The project consists of active surveillance for
  foodborne diseases and related epidemiologic
  studies

Covers population of 37.6 million or 13.8 of the
United States population
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Burden of Illness Pyramid Cases reported
through passive surveillance represent fraction
of actual number of cases in community
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Food-borne Disease Surveillance
School
Drugstore
The Current Surveillance Pyramid
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(No Transcript)
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Community symptom surveillance

• Select 4 communities every district
• Sample 120 residents every community
• Face to face investigation every month
• Collect the data of food-borne diarrhea symptom
• Deduce the incidence of food-borne diseases in
  general population

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Hospital pathogen surveillance

• Select 6 hospitals every district
• Report all the cases in Enteric Diseases Clinic
• obtain specimen such as stool
• test Salmonella/E coli/Vibrio/Shigella
• Collect chemical food poisoning cases in
  emergency room
• Conclude the main causes of food-borne disease

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No formal surveillance

• Drugstore surveillance
• 2 stores every district
• Explore the status of antidiarrhoeal drug and
  enteric antiseptics
• One kind of data to estimate the burden
• School surveillance
• 4 schools every district
• Determine the proportion of student absence for
  diarrhea
• Incidence in a particular population

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Passive surveillance

• Report the food-borne outbreaks online
• In a prescriptive time
• Hospital district CDC municipal
  CDC

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During 1990 and 2000 in Shanghai, 68.8 foodborne
outbreaks caused by bacterial, 23.9 caused by
chemical
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63.7 bacterial food-borne outbreaks caused by
Vibrio parahaemolyticus
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Food Contamination Monitoring

• Determine the level of food contamination and its
  dynamic trend
• According to Global Environment Monitoring System
  - Food Contamination Monitoring and
  Assessment
• (GEMS/Food) and national monitoring programme
• Establish the monitoring in 2002

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Sample the monitoring sites such as supermarkets
based on population distribution and
living standard
urban
2007
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• Consumers routine purchases were imitated in
  those places for sampling food
• commissariat and commissariat products
• vegetable and vegetable products
• fruits and fruit products
• meat and meat products
• aquatic products
• milk and milk products
• Etc.
• About 100 kinds and 5,000 pieces of food sample
  every year

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Food contamination

• Chemical contamination
• Heavy metal 
• Pesticide
• Veterinary drugs
• Food additive
• Etc.

• Bacterial contamination
• Salmonella
• Listeria monocytohenes
• Vibrio parahaemolyticus
• E coli O157
• Staphylococcus
• Etc.

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Others

• Risk assessment
• Finish the assessment of lead and cadmium
• The main sources of lead and cadmium were rice,
  tint vegetables, fish and shrimp
• Overall, the dietary lead and cadmium intakes
  were safe in Shanghai residents
• Dietary cadmium intake was on a high level in
  children in whom P90 of cadmium intake is over
  PTWI

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• My study
• Quantitative risk assessment of heavy metal in
  aquatic product  
• Finished gathering the data of aquatic product
  consumption
• testing the concentration of lead and cadmium
• Next to do
• Monte Carlo simulation ?
• software _at_RISK 5.0 analysis ?

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Primary results
Status of Pb in aquatic product(mg/Kg)
0.81
0.9
0.8
0.7
0.6
0.41
0.39
mean
0.5
P90
0.27
0.4
max
0.24
0.19
0.2
0.3
0.13
0.092
0.091
0.078
0.2
0.036
0.1
crustacean  
0
Marine fish
mollusc 
Fresh water fish
Pb concentration in mollusc is higher than in
fresh water fish
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Status of Cd in aquatic product(mg/Kg)
0.91
1
0.9
0.8
0.7
0.55
0.6
mean
0.5
P90
0.4
max
0.3
0.18
0.15
0.16
0.079
0.2
0.081
0.031
0.022
0.015
0.013
0.1
0
crustacean  
Marine fish
Fresh water  fish
mollusc 
Cd concentration in mollusc and crustacean is
much higher than in marine and fresh water fish
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Current situation

• Food Safety Lawhad brought into effect from Jun
  1st
• CDC has responsibility of food-borne outbreaks
  investigation
• FDA do this job now, we have little experience
  to deal with the field epidemiological
  investigation

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• 2010 World Expo will be held in Shanghai

• will be held from May to Oct
• 7075 millions
• person-times will visit

• bacteria proliferate befittingly
• pesticide using increase

food contaminated incident food-born
e outbreaks

• food consumption increase
• more people will eat in restaurants

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Development

• Increase the quality and sensitivity of
  surveillance and monitoring
• Practice food-borne outbreaks investigation and
  response
• Accumulate experiences of risk assessment
• Enrich the methods of intervention

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Activities

• Be familiar with Epidemiological methods and
  applications in food-borne outbreaks
  investigation and response
• Understand more about FoodNet, PulseNet
• How California conduct and act?
• Know some fast-testing methods of food
  contamination
• Participate in some jobs or workshops of
  exposure assessment , especially the use of
  model and software
• Learn to do intervention such as health education
  and communication

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Thank you very much!