Topic Index

6.8 Historical code - no longer used

When you click on a Sponsored Product ad, you will be taken to an Amazon detail page where you can learn more about the product and purchase it. Preoperative hypoalbuminemia is an independent risk factor for the development of surgical site infection following gastrointestinal surgery: Identifying and exchanging specific contact information for specific products with other countries and developing agreements to cross-train with pertinent foreign officials would improve international information exchange. Surveillance can be defined as: Premises and equipment need to be maintained and cleaned to eliminate any refuge for rodents, wild birds, and other animals that could introduce diseases to the flock.

Exercise is Medicine®: A Global Health Initiative

Sample size calculation in cross-sectional studies

There is a more general WHO disease surveillance programme called Communicable Disease Surveillance and Response, a data mining software developed by the Canadians. A number of international links can also be found at www. Another international electronic tool for food-borne disease information is ProMed, which reports on international health issues multiple times a day. Below are more details on some of the specific international collaborative efforts. Assisting foreign governments in investigation of large or unusual food-borne outbreaks when requested, providing reference laboratory consultations, and assisting in specific disease surveillance projects in other countries.

This includes the training courses. Facilitating the replication of the PulseNet molecular subtyping network internationally in Europe, the Asia Pacific region, and in Central and South America. This includes assisting with technical consultation and participation in training.

Extending a communication network for food-borne epidemiologists in the United States, to include Health Canada and the central hub of EnterNet a cooperative arrangement among European countries. Providing consultation and botulinum antitoxin for suspected cases of botulism to other western hemisphere countries through an agreement with the Pan American Health Organization PAHO. Establishing the Field Epidemiology Training Programmes FETP , which assists foreign governments in establishing epidemiologic competence in disease surveillance and outbreak investigation and control and fosters international collaboration and communication among its trainees.

At present, FETP is active in almost 20 countries. Developing and disseminating the SafeWaterSystem, a point-of-use drinking water disinfections strategy that can be in homes, clinics, and places of food preparation to provide safe water for drinking, washing hands, and preparing food.

Global Salm-Surv is part of WHO's effort to strengthen the capacities of its Member States in the surveillance and control of major food-borne diseases and to contribute to the global effort of containment of antimicrobial resistance in food-borne pathogens.

Since , institutions and individuals in human health, veterinary, and food-related disciplines have participated in Salm-Surv activities, such as regional trainings for microbiologists and epidemiologists, external quality assurance and reference testing, an electronic discussion group, and a web-based databank containing an annual summary of laboratories.

Over the next five years, Global Salm-Surv plans to improve its regional coverage with new training courses in Central Asia, Eastern and Southern Africa, Brazil, and Europe, encourage participation in the External Quality Assurance System and in Focused Regional or National Projects, expand to other food-borne pathogens Campylobacter , produce training manuals in microbiology and epidemiology, and establish regional centers.

For more information see: This has facilitated early interventions in food-borne outbreaks in terms of investigative procedures and public health prevention strategies, thus preventing additional illnesses and possibly saving lives. A feasibility study of PulseNet Europe was completed for three food-borne pathogens Shiga-toxin producing E.

The results of this study were presented and discussed at a workshop held in Paris, France on 16 June PulseNet Europe was successful in obtaining funding from the European Union for Through interactive brainstorming sessions, the benefits and challenges of forming PulseNet Asia Pacific were discussed, an action plan for the establishment of the network was developed, and a Steering Committee for this network was formed at this meeting. Several countries Hong Kong, Japan, Korea, Taiwan and New Zealand have already established PulseNet networks and are beginning to actively perform real-time subtyping of food-borne pathogenic bacteria.

Issues related to funding for establishing and maintaining a central PulseNet database for the Asia Pacific network and for coordinating activities of the network are still to be addressed. The participants expressed overwhelming support for the establishment of PulseNet America Latina. Public health microbiologists from six countries Brazil, Chile, Colombia, Mexico, Uruguay, and Venezuela were trained in the first workshop.

The European Community's RASFF was established to provide control authorities with an effective tool for exchange of information on measures taken to ensure food safety. Whenever a member of the network has information relating to the existence of a serious direct or indirect risk to human health, this information is immediately notified to the Commission under the RASFF. The Commission immediately transmits this information to the members of the network. Without prejudice to other Community legislation, the Member States immediately notify the Commission under the rapid alert system of:.

To assist the members of the network, information is classified under two different headings, Alert Notification and Informational Notifications. Alert Notifications-Alert notifications are sent when the food or feed presenting the risk is on the market and when immediate action is required.

The notification aims at giving all the members of the network the information to verify whether the concerned product is on their market, so that they also can take the necessary measures.

Consumers can be reassured that products subject to an alert notification have been withdrawn or are in the process of being withdrawn from the market. The Member States have their own mechanisms to carry out such actions, including the provision of detailed information through the media if necessary.

Informational Notifications-Informational notifications concern a food or feed for which a risk has been identified, but for which the other members of the network do not have to take immediate action, because the product has not reached their market.

These notifications mostly concern food and feed consignments that have been tested and rejected at the external borders of the EU. Consumers can be reassured that products subject to an information notification have not reached the market or that all necessary measures have already been taken. The Commission publishes a weekly overview of alert and information notifications. As it is necessary to strike the balance between openness and the protection of commercial information, the trade names and the identity of individual companies are not published.

This is not detrimental to consumer protection, as a RASFF notification implies that measures have been or are in the process of being taken. WHO is the implementing agency for the contributing institutions located in over 70 countries around the world. GEMS' purpose is to compile data on food contamination and human exposure from different countries for global synthesis, evaluation, and presentation.

In , GEMS began developing a new data structure and protocols for the electronic data submission. The protocols involve encoding and formatting data in a manner compatible with the database maintained at WHO headquarters.

Protocols for aggregate and individual data on contaminant levels in specific food commodities include descriptions of the data fields needed to ensure complete, quality electronic data submissions.

Uniform implementation and wide accessibility of the GEMS system make it a model for expanded, international food surveillance efforts. While there are no all-encompassing international surveillance systems, examples that serve to illustrate the value of such systems have been illustrated. The structure, function, and interactions between each country's government agencies form the start of an eventually global surveillance, regulatory, and protective framework to curtail the transmission of food-borne diseases.

Ultimately, WHO, as the lead international public health organization, could be the focal point of such a global surveillance framework. WHO and FAO, through their collective food safety capability, including the WHO Food Safety Department and the FAO Food Standards Programme, could, with the provision of adequate financial and staffing resources, provide the organizational and scientific capability to support a global food-borne disease surveillance system. The Forum may wish to consider the following points regarding international cooperation on food contamination and food-borne disease surveillance.

Are there other major programmes and international activities that should be brought forward? Are elements missing from these strategies? What strategies should be pursued to better enable international cooperation on food-borne disease surveillance? How best can their role be enhanced in this area? Farming and nature exercise a profound influence over each other. Farming has contributed over the centuries to creating and maintaining a variety of valuable semi-natural habitats.

They shaped an important part of landscapes worldwide and are home to many of the world's richest wildlife. Farming also supports a diverse rural community that is not only a fundamental asset of international culture, but also plays an essential role in maintaining the environment in a healthy state. Farming is an activity whose significance goes beyond simple food production.

Throughout the production chain processes occur that can have an impact on the natural environment and consequently, directly or indirectly, on human health and development. For example, heavy use of pesticides and fertilizers, incorrect drainage or irrigation practices, a high level of mechanization or unsuitable land use can produce environmental degradation. However, abandonment of farming activities can also endanger the environmental heritage through loss of semi-natural habitats as well as biodiversity and landscape associated with them.

Likewise, the effect of agricultural production systems on human health directly farmer's occupational health or indirectly consumer's health through food are increasingly being recognized as an integrated element in the broader evaluation of environmental risks related to agriculture.

The links between the richness of the natural environment and farming practices are complex. While many valuable habitats are maintained by extensive farming, and a wide range of wild species rely on this for their survival, agricultural loss of wildlife can be the result of inappropriate agricultural practices and land use. Discussions on possible future environmental effects of new technologies in food production will necessarily have to take outset in the present situation of agricultural effects on the environment, including derived effects on human health, recognizing that present trends of conventional agriculture are likely to be reflected in the objectives of modern food production.

Agriculture adds to greenhouse gas GHG problems. There are three main sources of GHG emissions from agriculture: N2O nitrous oxide emissions from soils, mainly due to nitrogen fertilization; CH4 methane emissions from intestinal fermentation, CH4 and N2O emissions from manure management.

Measures being considered include: Further development of renewable, agricultural biomass could contribute to reductions in emissions from energy and transport, while benefiting the agricultural sector.

Water pollution by nitrates from agricultural sources, where improved agricultural practices are thought to improve pollution. Pesticides have been proven to have an effect on the environment and ecosystems by reducing biodiversity, especially by reducing weeds and insects which are often important elements of the food chain e.

In addition, human health can be negatively affected through direct exposure and indirect exposure, e. Systems to reduce the need for pesticide use, especially integrated pest management, organic farming or in some cases genetically modified crops are increasingly investigated at national and international level [22].

Soil degradation processes such as desertification, erosion, decline in soil organic matter, soil contamination e. Such degradation processes can result from inappropriate farming practices such as unbalanced fertilization, over abstraction of groundwater for irrigation, improper use of pesticides, use of heavy machinery, or overgrazing.

Measures to prevent soil degradation include support to organic farming, conservation tillage, the protection and maintenance of terraces, safer pesticide use, integrated crop management, management of low-intensity pasture systems, lowering stock density and the use of certified compost. Irrigation can also lead to environmental concerns, such as over-extraction of water from subterranean aquifers, irrigation driven erosion, soil salinization, alteration of pre-existing semi-natural habitats and, secondary impacts arising from the intensification of the agricultural production permitted by irrigation.

In recent decades, the rate of decline and even disappearance of species and related habitats, ecosystems and genes i. Declines in biodiversity are of direct consequence for food security when they affect food related organisms and relatives with relevance for breeding.

Furthermore, intensified agriculture including modern breeding systems has resulted in significant reductions of landraces, adapted to local specificities as well as traditional knowledge. Assessment of agricultural impacts on the environment requires the use of holistic models which are able to integrate multiple sources of information [23].

Previous scientific discussions have concluded that solutions applied at farm level contributed environmental problems but they are not adequate to the task of realizing long-term environmental goals. This requires system innovations at higher levels of aggregation, involving, for example, looking for opportunities to negotiate recycling systems by linking sectors within agriculture and other areas affecting the environment, e.

As a consequence of public discussion, new concepts for policies of agriculture and environment interactions have been developed in many countries including an improved public monitoring and responsibility for sustainability. Secretary-General Kofi Annan in June , is an international work programme designed to meet the needs of decision makers and the public for scientific information concerning the consequences of ecosystem change for human well-being and options for responding to those changes.

The MA focuses on ecosystem services the benefits people obtain from ecosystems , how changes in ecosystem services have affected human well-being, how ecosystem changes may affect people in future decades, and response options that might be adopted at local, national, or global scales to improve ecosystem management and thereby contribute to human well-being and poverty alleviation.

Work on agro-environmental indicators provided information on the current state and changes in the conditions of the environment in agriculture. It also resulted in a better understanding of linkages between the causes and impacts of agriculture on the environment, looking at agricultural policy reform, trade liberalization and environmental measures. This all contributes to monitoring and evaluating the effectiveness of policies addressing agri-environmental concerns. Hazards can take many forms, wholly natural in origin or derived from human activities and interventions.

In the Convention on Biological Diversity CBD, ratified by countries defined a legally binding instrument for biodiversity protection and sustainable use of biological resources. The goal of the Convention on Biological Diversity is "the conservation of biological diversity, the sustainable use of its components and the fair and equitable sharing of the benefit arising out of the utilization of genetic resources.

Biological diversity is closely linked to human interests. Biodiversity is highly important for several quite different reasons: It provides a source of significant economic, aesthetic and cultural benefits. The well-being and prosperity of earth's ecological balance as well as human society depend directly on the extent and status of biological diversity.

Naturalism and nature protection: Some difficulties for environmental protection derive from different interpretations and understanding of the idea of nature.

Especially in the consumer's debate on the creation of genetically modified organisms, the idea of the need to protect nature was often not well defined, mainly because of differences in the understanding of the concept of nature, ranging between concepts of wilderness, human environment, flexibility of natural systems [34] and ideas of naturalism.

Levels of protection may vary as goals range from sustaining ecosystem services to fully preserving endangered species or fragile protected areas. Biotic homogenization that decreases regional biotas and functional diversity would reduce resilience by reducing the available range of species-specific responses to such environmental changes as droughts, contaminants, or invasive species.

The links between environmental protection and human health through the control of direct and indirect health effects of environmental deterioration needs to be factored into these equations, notably with food safety as one of the direct indicators.

Following adoption of hybrid breeding technologies further breeding objectives included methods for the introduction of increased genetic variability using several methods for mutagenesis such as chemical mutagenesis or irradiation as well as various ways of tissue cultures.

The further development resulted in the presently most advanced methods of modern biotechnologies, the production of organism by genetic modification using introduction of defined new or recombinant genetic material by vectors and transformation methods. These organisms are typically named Genetically Modified organisms or GM organisms.

Improved methodology for the development of GM organisms GMOs by homologous recombination may ultimately reduce the potential for unintended effects, including health effects, of the inclusion of new genes randomly in the genome, stemming from present technology. Likewise improved methods for a molecular containment of recombinant genes may reduce problems of unintended gene dispersal. Conflicting assessments and incomplete substantiation of the benefits, risks and limitations of GM food by various scientific, commercial, consumer and public organizations have resulted in national and international controversy regarding their safe use as food and safe release into the environment.

An example is the recent debate on food aid that contained GM material offered to countries in southern Africa in This international debate has often been focused on human health and environmental safety of these new products.

At present, only a few food crops are permitted for food use and traded on the international food and feed markets. These include herbicide- and insect-resistant maize Bt maize , herbicide-resistant soybeans, rape canola oilseed and insect- and herbicide-resistant cotton primarily a fibre crop, though refined cottonseed oil is used as food.

In addition, several government authorities have approved varieties of papaya, potato, rice, squash, sugar beet and tomato for food use and environmental release. Further development of GM crops is likely to produce a range of GM crops with enhanced nutritional profiles. A significant proportion of these traits relates directly to human health, the beta-carotene Vitamin-A precursor rich "golden rice" as the most well-known example.

Other examples with health implications are removing allergens and anti-nutrients, altering fatty-acid profiles and increasing the anti-oxidant content. All new products related to such potential health benefits will naturally need to be scrutinized through thorough environmental and food safety risk assessments. An analysis of risks and effects of food production practices using modern methods of biotechnology needs to reflect on all developments in the area, based on knowledge of modern biology and keeping in mind that the definition of modern biotechnology is often not very standardized.

Integrated pest management IPM needs to be seen in the light of modern biotechnology because of the use of advanced bio-technological methods: Definitions of IPM cover a range of approaches: Suitable pest control methods should be used in an integrated manner and pesticides should be used on an "as needed basis" only, and as a last resort component of an IPM strategy.

In such a strategy, the effects of pesticides on human health, the environment, sustainability of the agricultural system and the economy should be carefully considered.

According to FAO, IPM programmes are designed to generate independence and increased profits for farmers, and savings on foreign imports for governments. IPM enables farmers to make informed decisions to manage their crops. Sometimes also organic farming is discussed as a modern technology for food production, where farmers adhering to this idea are aiming for similar objectives like IPM but more clearly pronounce the ideas of integrity, self determination and co evolution.

Principles of the environmental risk assessment, ERA: In many national regulations the elements of the ERA for GM food organisms include the biological and molecular characterizations of the genetic insert, the nature and environmental context of the recipient organism, the significance of new traits of the GMO for the environment, and information on the geographical and ecological characteristics of the environment in which the introduction will take place.

The risk assessment focuses especially on potential consequences on the stability and diversity of ecosystems, including putative invasiveness, vertical or horizontal gene flow, other ecological impacts, effects on biodiversity and the impact of presence of GM material in other products.

Internationally the concept of familiarity was developed also in the concept of environmental safety of transgenic plants. Familiarity can also be used to indicate appropriate management practices including whether standard agricultural practices are adequate or whether other management practices are needed to manage the risk OECD, Currently the Cartagena Protocol on Biosafety to the Convention on Biological Diversity is the only international regulatory instrument which deals specifically with the potential adverse effects of genetically modified organisms known as Living Modified Organisms LMOs under the Protocol on the environment.

The Biosafety Protocol covers transboundary movements of any genetically modified foods that meet the definition of LMO. The Protocol establishes a harmonized set of international rules and procedures designed to ensure that countries are provided with the relevant information, through the information exchange system called "Biosafety Clearing-House". This Internet-based information system enables countries to make informed decisions before agreeing to the import of LMOs.

It also ensures that LMO shipments are accompanied by appropriate identification documentation. Furthermore, the scope of its consideration of human health issues is limited, given that its primary focus is biodiversity, in line with the scope of the Convention itself.

Potential unintended effects of GMOs on non target organisms, ecosystems and Biodiversity: Potential risks for the environment include unintended effects on non target organisms, ecosystems and biodiversity. Insect resistant GM crops have been developed by expression of a variety of insecticidal toxins from the bacterium Bacillus thuringiensis Bt.

Detrimental effect on beneficial insects or a faster induction of resistant insects depending on the specific characteristics of the Bt proteins, expression in pollen and areas of cultivation have been considered in the environmental risk assessment ERA of a number of insect protected GM crops. These questions are considered an issue for monitoring strategies and improved pest resistance management, which inherently can affect food safety in the longer term.

Under certain agro-ecological situations, such as a high weed pressure, the use of herbicide tolerant crops has resulted in a reduction in quantity of the herbicides used, in other cases no herbicide reductions or even the need of increased herbicide uses have been reported.

Out-crossing of transgenes has been reported from fields of commercially grown GM plants including oilseed rape and sugar beet, and has been demonstrated in experimental releases for a number of crops including rice and maize.

Out-crossing could result in an undesired transfer of genes such as herbicide resistance genes to non-target crops or weeds creating new weed management problems. The consequences of out-crossing can be expected in regions where a GM crop has a sympatric distribution and synchronized flowering period, that is highly compatible with a weedy or wild relative species as demonstrated e. The possibility that certain genetically engineered fish and other animals may escape, reproduce in the natural environment and introduce recombinant genes into wild populations is a concern of a report of a recent US Academy of Science study [46].

Genetically engineered insects, shellfish, fish and other animals that can easily escape, are highly mobile and form feral populations easily, are of concern, especially if they are more successful at reproduction than their natural counterparts.

For example, it is possible that transgenic salmon with genes engineered to accelerate growth released into the natural environment could compete more successfully for food and mates than wild salmon, thus endangering wild populations. The use of sterile all-female genetically engineered fish could reduce interbreeding between native populations and farmed populations, a current problem with the use of non-engineered fish in ocean net-pen farming.

Sterility eliminates the potential for spread of transgenes in the environment, but does not eliminate all potential for ecological harm. Monosex triploidy is the best existing method for sterilizing fish and shellfish, although robust triploidy verification procedures are essential.

Gene transfer between bacteria belonging to different species, genera or even families has been demonstrated in soil and other systems. Such gene transfer goes on between ordinary microorganisms in all ecosystems, and has also been demonstrated from GM microorganisms to other microorganisms, e. The transfer of antibiotic genes to microorganisms present in foods and of clinical importance is an unwanted event relative to food safety, while the very low frequency of such transfer most probably leads to very low levels of concern.

Only a limited number of releases of GM microorganisms e. Pseudomonas and Rhizobia have been permitted mainly to explore the spread and the fate of microorganisms in nature. In some cases released GM bacterial populations have been found to persist in the soil for years. Regional specificity in safety assessments: Contradictory findings as relates benefits or disadvantages for the same GM crop may reflect different agro-ecological conditions in different regions.

For example, the use of herbicide resistant crops and the consequent herbicide use could potentially be detrimental in a small sized agricultural area, which has extensive crop rotation and low levels of pest pressure. However, the moderate herbicide use related to these GM plants could be beneficial in other agricultural situations where it might represent a decrease in herbicide use.

Presently, no conclusive evidence on environmental advantages or costs can be generalized from the use of GM crops. Consequences may vary significantly between different GM traits, crop types and different local conditions including ecological and agro-ecological characteristics. In , the UK government asked an independent consortium of researchers to investigate how growing genetically modified GM crops might affect the abundance and diversity of farmland wildlife compared with growing conventional varieties of the same crops.

The researchers stress that the differences they found do not arise just because the crops have been genetically modified. They arise because these GM crops give farmers new options for weed control where they use different herbicides and apply them differently. Monitoring of human health and environmental safety: In the future specific GM organisms may gain approvals for widespread production where the approval may not always include the possibility to enter them also in the human food supply.

Examples could be plants or animals used for drug production. In such situations, it will be important to consider whether or not to apply post-market monitoring for unexpected environmental spread of the GM animals or animals and their transgenes in the event that these would pose food safety hazards. A prerequisite for any kind of monitoring are tools to identity or trace GMOs or products derived from GMOs in the environment or food-chain.

Detection techniques such as PCR are in place in a number of countries to monitor the presence of GMOs in foodstuffs, to enable the enforcement of GM labelling requirements and for the monitoring of effects on the environment. Attempts to standardize analytical methods for tracing GMOs have been initiated e. The need to assess indirect effects of the use of GMOs in food production has been emphasized by many countries. For example, the production of chemicals or enzymes from contained GM micro-organisms e.

A further example of beneficial human environmental outcomes of the use of GM crops is the reduction in the use, environmental contamination and human exposure to pesticides demonstrated in some areas. This has been demonstrated especially through the use of pesticide resistant Bt cotton, which has been shown to decrease pesticide poisoning in farm workers [51].

Out-crossing of GM plants with conventional crops or wild relatives, as well as the contamination of conventional crops with GM material, can have an indirect effect on food safety and food security by contamination of genetic resources [52]. The Codex guidelines for the safety assessment of GM foods include the analysis of potential unintended effects, where effects on the environment may result in unintended, indirect effects on human health. Crop breeding strategies are highly dependent upon preservation of diversity of crops and wild relatives.

Many methods of conventional and modern biotechnology can interfere with diversity of organisms which have relevance for further breeding. In crops these methods can often concentrate on the further improvement of few elite lines only.

The majority of locally adapted land races e. Also the system for the protection of intellectual property rights interferes with crop diversity. There is growing scientific and public concern about a rapid decline of diversity, e. On the other hand modern methods of biotechnology can be beneficial for enabling diversity in scenarios where possibilities of conventional breeding are difficult because of sterility and pests, e.

Historically, plant genetic resources were freely provided by developing countries to gene-banks world-wide. Now international policy attaches importance to national ownership of such resources. An important aspect for the future potential of agricultural research is access to genetic resources for researchers on terms that recognize the contributions made by farmers to the conservation and sustainable utilization of these resources.

The International Treaty on Plant Genetic Resources adopted at a conference by the Food and Agriculture Organization in November , provides the legal framework for dealing with the resources on which food security and sustainable agriculture depend. The Treaty gives a directive on the conservation and sustainable use of plant genetic resources for food and agriculture making provision for the fair and equitable sharing of the benefits arising out of their use, in harmony with the United Nations Convention on Biological Diversity CBD.

The Treaty also addresses farmers' rights. The Treaty establishes a Multilateral System of Facilitated Access and Benefit-sharing MLS for key crops, emphasizing the interdependency of countries in terms of plant genetic resources for food and agriculture. The developing countries rich in genetic resources are encouraged to place germplasm in the MLS. The users of the material will sign a Material Transfer Agreement, incorporating the conditions for access and benefit sharing through a fund established under the Treaty.

In return, the owners of the genetic resources would get a share of the benefits arising from their use and development in the way of information, technology transfer and capacity building. Agency for International Development reported that between and the year the world lost 22 percent of its high-potential agricultural land. That's , square miles, an area equal in size to Alaska. The loss is alarming because, as population pressures mount, agricultural production will have to expand onto medium- and low-potential lands that are not only less productive but also more fragile and susceptible to degradation.

Soil is degraded mainly through deforestation, agricultural activities, overgrazing, and overexploitation. Biophysical manifestations include erosion and loss of moisture-holding capacity. But more important, and more complex, are the social and economic aspects. Indeed, some view land degradation as a socioeconomic rather than biophysical problem. For example, population growth increases demand for land on which to grow crops, which often leads to deforestation, shorter fallow periods, and continuous cropping.

Short-sighted economic policies often make the problem worse by encouraging farmers to clear new land for cultivation rather than to protect land already under cultivation. Insecure land tenure arrangements discourage farmers from making long-term investments needed for resource conservation. The Impacts of trade liberalization: The implementation or reform of agricultural and trade policy creates a complicated set of environmental effects - some negative, some positive, and in some cases linked to food safety issues.

The effect of freer agricultural trade on environmental quality depends on a number of factors, such as the mix of post-reform commodities, level of output, changes in production inputs, land use, technical change, and the capacity of the natural resource base to assimilate production impacts.

The additional effect of such changes related to food safety will in many cases relate to the existence of food safety systems and experience related to the new or increase food commodity production.

Freer trade improves market access for goods previously governed by quantity restrictions such as quotas and other non-tariff barriers and aligns domestic prices closer to world prices. Resource reallocation occurs as prices adjust to market conditions and reflect the availability of resources such as arable land, labour, and other farming inputs.

As prices change, farmers respond by altering their crop mix and their input use, buying or selling land, and investing in new machinery. In addition, trade and health considerations are intimately connected. The use of international standards for traded food, focusing on food safety, but in the future also most likely on environmental issues, will have the potential to improve not only internationally traded food but also local food, and thereby the health of local consumers.

This in turn would then favour both health and social and economic development - a true win-win situation. This Facility will hopefully provide the means for developing countries to strengthen their systems to comply with international standards to the benefit of both exported and locally consumed food.

International agreements related to nature and food production are summarized in a report from FAO on ethical issues in food and agriculture. They include the value of food, the value of enhanced well-being, the value of human health, the value of natural resources, and the value of nature, whereas the Convention on Biological Diversity recognizes that nature itself is to be valued for what it is.

The summary of these objectives shows that all principle arguments usually discussed in a risk benefit evaluation of food biotechnology, especially enhanced productivity for increased food production, equity, health and nature protection, interfere with each other, thus requiring a high level of ethical consideration. There is international agreement that risk assessment, risk management and risk communication are central elements in the management of possibly emerging risks of new technologies for food production where risk assessment needs to be done based on "sound science".

But discussions on the use of precaution by some countries referred to as the precautionary principle and the need to respect legitimate factors other than the scientific assessment of risk have turned out to be controversial [60].

Science and Ethics Rome, The experts agreed that risk assessment is based on science, but scientific evidence and analysis cannot always provide immediate answers to questions posed. Much scientific evidence is tentative, as the established processes of science include checking and re checking outcomes in order to obtain the required level of confidence. Decisions usually are defended as based on "science," and sometimes on economic costs and benefits as well, which offer seemingly objective, verifiable evidence that the policy choice is "correct.

The emphasis on science and the exclusion of ethical argument as the basis for decisions may polarize the scientific debate. A cross sectoral group of scientists, NGOs and industry formulated the safety first approach asking for interactive negotiation between research, industry, government and consumers to formulate safety standards.

These standards would make safety a criterion in discussions on developments from the beginning and not at the end before product notification and include post market monitoring, training and stewardship. Products produced with different methods of modern biotechnology are already produced for local or international markets.

Crops, animals or microorganism have been improved according to agricultural objectives where these organisms may display specific characteristics in regard to safety or usefulness in different agro- ecological, socio-economic or cultural areas. A globalized market for food production will most likely trade products of these organisms internationally and the safety measures of the Biosafety Protocol will be of importance in risk prevention. However, possibilities of the protocol are restricted to transboundary movements of LMOs and direct effects on diversity.

Furthermore, sufficient technical capacities for coherent analysis may be difficult to achieve in many developing countries and the need for coordinated local as well as international information exchange on complex parameters will require sophisticated technical and scientific capacities. The capacity of the Codex Alimentarius Commission to continue its work on internationally agreed principles and guidelines for a food safety risk analysis framework will be key to a truly global development in this area of integrating the different areas of assessment of new agricultural technologies and ensuring that human health considerations will remain at the core.

This will ultimately need measures for capacity building in some countries as well as the intensive engagement of international bodies in coordinated monitoring activities, data collection and data analysis. An engaged cooperation of international organizations, especially UN-bodies will be essential for a successful and equitable development in this direction. The malicious contamination of food for political, financial and other purposes is a real and current threat, and deliberate contamination of food at one location could have global public health implications.

Member States of WHO have expressed concern that chemical, biological or radionuclear agents might be introduced into food and other media to deliberately to harm civilian populations and have requested the Organization to provide tools and support to increase their capacity to respond.

In response, WHO has prepared various guidelines, including guidance to prevent and respond to intentional contamination of food. While all food safety emergencies, including intentional and unintentional incidents, may be managed by the existing food safety infrastructure, sensible preventive measures coupled with basic preparedness are needed to address threats posed by deliberate contamination.

Countries should integrate consideration of acts of food sabotage into existing programmes for assuring the safety of their food supplies. Strengthening of food safety infrastructure will serve to increase countries' capacity to reduce the burden of all food-borne illness caused by chemical and microbial agents and to respond to all contamination incidents.

Improved linkages with existing communicable disease control systems will also ensure that surveillance, preparedness and response systems include the necessary metrics to identify food-borne outbreaks in a timely manner and provide relevant information to facilitate an effective and rapid response.

In order to respond effectively and rapidly, countries require alert, preparedness and response systems to public health threats from actual or threatened intentional contamination of the food supply. Coordination with WHO, FAO and other international and regional organizations regarding incidents involving intentional contamination should be considered as an integral part of strengthening of national systems to respond to all food safety emergencies.

Threats from criminals and other anti-social groups who target the safety of the food supply are already a reality. During the past two decades, WHO Member States have expressed increasing concern about the possibility that chemical and biological agents and radionuclear materials might deliberately be used to harm civilian populations. In recent years, the health ministries of several countries have increased their state of alert for intentional malevolent use of agents that may be spread through air, water or food.

In , the World Health Assembly in recognizing these threats against civilian populations, requested WHO to provide tools and support to countries in strengthening their national systems to respond to the deliberate use of biological, chemical or radionuclear agents [65]. It also requested WHO to continue to issue international guidance and technical information on recommended public health measures to deal with potential incidents.

All countries must have basic systems to prevent or deter deliberate contamination of their food supplies and, if an incident occurs, to respond rapidly to minimize potential health, economic and other adverse effects of such contamination.

However, specific countermeasures should be seen as only one aspect of a broader, comprehensive food safety programme, in national and global contexts. The WHO Global Food Safety Strategy [67] comprises a preventive approach to food safety, with increased surveillance and more rapid response to outbreaks of food-borne illness and chemical contamination incidents. This approach could substantially expand the abilities of countries to protect the safety of their food supplies against natural and accidental threats, while providing a framework for addressing intentional contamination of food.

The chemical agents in question are man-made or natural toxins, and the biological agents referred to are pathogenic microorganisms, including viruses, bacteria and parasites, that may be communicably infectious or non-infectious.

Radionuclear agents are defined in this context as radioactive chemicals capable of causing injury when present at unacceptable levels. This paper covers all foods, including water used in the preparation of food, as well as bottled water.

As with all health and safety problems, prevention is usually the most desirable option. Prevention is considered first line of defence against intentional contamination. The key to prevention is awareness of this potential threat and the implementation of basic security and precautionary measures.

Working in cooperation with government, the food industry is in the best position to rapidly address such threats throughout the food supply system from production to consumption. Government food safety authorities may provide necessary guidance and other coordination functions to assist industry, as in the case of product tracing and recall. As production methods and quality programmes are often proprietary, the food industry has both the knowledge and the capacity to reduce the likelihood of deliberate contamination of food, from the raw materials to product distribution.

Governments should support industry in strengthening existing food safety management systems, to include consideration of deliberate contamination. Governments also have a role in promoting preventive food safety, through various voluntary and regulatory mechanisms [68].

It is important to note that a number of the preventive activities described in this paper relate to 'industrialized' food production systems. Although industrialized production probably also present the most likely targets for intentional contamination, it is very likely that more traditional production systems, including systems with short distribution lines, present problems that need separate consideration.

Food can be contaminated deliberately by chemical, biological or radionuclear agents at any point in the food chain. Food safety management programmes offer opportunities for the prevention, detection and control of food sabotage.

Understanding the relationships between the production system, ingredients, people, utensils, equipment and machinery can help in identifying where critical failures of the system might occur. Methods of sabotage and the extent of a threat might be identified as a part of this analysis and would provide the basis for a risk analysis. Typical food safety management programmes within the food industry, include good agricultural and manufacturing practices and 'hazard analysis and critical control point' HACCP systems.

Newer systems based on a scientific assessment of the risk are now increasingly being used to develop risk reduction options along the food supply continuum from farm to table. Governments should work closely with industry to incorporate prevention and response to intentional contamination into food safety management programmes. Not all countries have the infrastructure needed to assist industry, especially small and less developed businesses, to apply such programmes throughout the food production, processing and preparation continuum.

Capacity building for such competence is vital for the prevention of both intentional and unintentional contamination of food. The generic actions that may be taken by governments to assist industry in this respect include:. Prevention of intentional contamination does not always require high technology or great expense.

Increased awareness of the problem and enhanced vigilance are among the effective measures that can be taken. Awareness can be heightened by auditing food safety management programmes. In the event of an incident, information from early surveillance could be shared with the food industry to facilitate prompt action to address consumer concerns and contain and mitigate the threat.

The knowledge and capacity to prevent deliberate sabotage of food lies mainly with the food industry and must be applied throughout the food chain. Potential contamination with chemical and biological agents and radionuclear materials and interruption of food supplies need to be considered in the development and review of food safety management programmes, which may vary from rudimentary to well developed.

Opportunities for deliberate contamination of food can be minimized by increasing the security for both people and premises.

All segments of the food industry should consider improving security and response plans for their establishments.

For example, sources of raw materials and storage facilities and transport systems could be safeguarded; access to all critical areas in production, processing, transport and storage could be controlled and documented to minimize opportunities for contamination. Regarding personnel, employers could consider screening their staff to ensure that their qualifications and background are compatible with their work and responsibilities.

Would you like to tell us about a lower price? If you are a seller for this product, would you like to suggest updates through seller support? Learn more about Amazon Prime. This text is intended for those who wish to understand the complex relationships between diet and risks of important diseases, such as cancer and cardiovascular disease.

It is aimed both at researchers engaged in the unraveling of these complex relationships and at readers of the rapidly multiplying and often confusing scholarly literature on the subject.

The book starts with an overview of research strategies in nutritional epidemiology-still a relatively new discipline that combines the vast knowledge compiled by nutritionists during the 20th century with the methodologies developed by epidemiologists to study the determinants of diseases with multiple etiologies and long latent periods.

A major section is devoted to the methods of dietary assessment using data on food intake, biochemical indicators of diet, and measures of body composition and size. The reproducibility and validity of each approach and the implications of measurement error are considered in detail. The analysis, presentation, and interpretation of data from epidemiologic studies of diet and disease are explored in depth.

Particular attention is paid to the important influence of total energy intake on findings in such studies. To illustrate methodological issues in nutritional epidemiology, relationships of dietary factors to the incidence of lung and breast cancer, heart disease, and birth defects are examined in depth. The first edition of Nutritional Epidemiology, published in , was widely praised and quickly established itself as the standard reference in this field.

The second edition, published in , added new chapters on the analysis and presentation of dietary data, nutritional surveillance, and folic acid and neural tube defects. This new edition, in addition to substantial updating of existing chapters, includes new chapters on assessment of physical activity, nutrition and genetic epidemiology, and the role of nutritional epidemiology in policy.

This book will benefit epidemiologists, nutritionists, dietitians, policy makers, public health practitioners, oncologists, and cardiovascular and other clinical specialists. Read more Read less. Prime Book Box for Kids. Add both to Cart Add both to List. These items are shipped from and sold by different sellers.

Buy the selected items together This item: Ships from and sold by Amazon. The Essentials by Robert H. Ships from and sold by inventoryrecoveryva. Customers who bought this item also bought. Page 1 of 1 Start over Page 1 of 1. Clean, Green, and Lean: Advanced Nutrition and Human Metabolism. Sponsored products related to this item What's this?

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For those attempting to measure dietary intakes in an epidemiologic context, Willett's book will be essential reading. The volume as a whole makes a valuable contribution, since it is comprehensive and summarizes significant developments from the last ten years; a compilation of information about nutrition epidemiology has long been lacking.

Willett's book will be most useful to advanced students, practitioners, and researchers. Nutritional Epidemiology was written specifically for researchers actively engaged in studies of diet and disease. It is a clear, coherent, and eminently readable expose of a very complex, multifaceted new discipline. Willett in his third edition of Nutritional Epidemiology provides a practical and straightforward discussion of how to conduct and interpret studies of diet in relation to chronic disease risk, which is unparalleled in breadth and depth.

He incorporates many recent advances, encourages rigorous and thoughtful conduct and interpretation of study results and often challenges conventional interpretations from medical and nutritional sciences. This outstanding book is essential reading for graduate students and researchers in the field. It is also a useful resource for any nutritional scientists, epidemiologists, and health professionals who use results of epidemiological studies to make policies that promote healthy eating.

Willett condenses a vast and rapidly expanding literature, from the history of nutritional epidemiology to future directions. New chapters on physical activity and genetics, as well as discussion of new methodologies-and thoughtful analysis of recent debates on measurement error-make this required reading for anyone working in nutrition and health research, and a welcome up-to-date text for graduate teaching.

New chapters on physical activity, genetics, and policy provide much needed updates on the methods used by today's researchers. Overall, the book is a nearly comprehensive introduction to the basic principles of studying diet and long-term health and disease.

Monographs in Epidemiology and Biostatistics Book 40 Hardcover: Oxford University Press; 3 edition November 7, Language: Related Video Shorts 0 Upload your video.

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