Toxicants exposures as novel zoonoses: reflections on sustainable development, food safety and veterinary public health

Occurrence and Dietary Risk Assessment of Mycotoxins in Most Consumed Foods in Cameroon: Exploring Current Data to Understand Futures Challenges

Mycotoxins are naturally occurring toxins that contaminate different crops and foodstuffs under certain circumstances during harvesting, handling, storage, and processing. Neither the dietary intake of mycotoxins in Cameroon is well characterized, nor its health effects on the consumers. This review is intended to be the first milestone towards national risk management of mycotoxins. It is noteworthy that mycotoxins contaminate the main staple foods of Cameroonian communities, which are also often used as complementary foods for infants, young children, and people with compromised immune systems (e.g., HIV/AIDS), thus calling for urgent intervention in primary and secondary prevention. Very few data exist on mycotoxin contamination in Cameroonian agricultural commodities and food items. Only 25 studies from 14 different authors have been published in the last decade. On the basis of available data in Cameroon, the Estimated Daily Intake (EDI) of major mycotoxins in foods for Aflatoxins was 0.0018-14.2 µg/kgbw/day in maize, 0.027-2.36 µg/kgbw/day in cassava, and 0.023-0.1 µg/kgbw/day in groundnuts. The estimated daily intake of fumonisins was 0.12-60.6 µg/kgbw/day in maize and 0.056-0.82 µg/kgbw/day in beans. Based on the estimated distribution of human exposure levels by food, maize and cassava are the major sources of exposure and should be prioritized, followed by beans and spices. This estimate will be updated along with improvements on the national database on mycotoxin contamination of Cameroonian foods.

E-WASTE threatens health: The scientific solution adopts the one health strategy

The aggressively extractive advanced technology industry thrives on intensive use of non-renewable resources and hyper-consumeristic culture. The environmental impact of its exponential growth means extreme mining, hazardous labour practices including child labour, and exposure burden to inorganic and organic hazardous chemicals for the environment and current and future human generations. Globally, processes such as in-country reduce, reuse and recycle have so far received less attention than outer-circle strategies like the uncontrolled dumping of e-waste in countries that are unprotected by regulatory frameworks. Here, in the absence of infrastructures for sound hazardous e-waste management, the crude recycling, open burning and dumping into landfills of e-waste severely expose people, animal and the environment. Along with economic, political, social, and cultural solutions to the e-waste global problem, the scientific approach based on risk analysis encompassing risk assessment, risk management and risk communication can foster a technical support to resist transgenerational e-waste exposure and health inequalities. This paper presents the latest public health strategies based on the use of integrated human and animal biomonitoring and appropriate biomarkers to assess and manage the risk of e-waste embracing the One Health approach. Advantages and challenges of integrated biomonitoring are described, along with ad-hoc biomarkers of exposure, effect and susceptibility with special focus on metals and metalloids. Indeed, the safe and sustainable management of novel technologies will benefit of the integration and coordination of human and animal biomonitoring.

Pharmaceutical and personal care products as emerging environmental contaminants in Nigeria: A systematic review

The increasingly broad and massive use of pharmaceuticals (human, veterinary) and personal care products in industrially developing nations makes their uncontrolled environmental and ecological impact a true concern. Focusing on Nigeria, this systematic literature search (databases: PubMed, ScienceDirect, Google Scholar, EMBASE, Scopus, Cochrane library and African Journals Online) aims to increase visibility to the issue. Among 275 articles identified, 7 were included in this systematic review. Studies indicated the presence of 11 personal care products (15.94 %) and 58 pharmaceutical products (84.06 %) in surface and ground water, leachates, runoffs, sludge, and sediments. The 42.86% (3/7) of reviewed studies reported 17 analgesics; 71.42 % (5/7) reported 16 antibiotics; 28.57 % (2/7) reported 5 lipid lowering drugs; 28.57% reported anti-malaria and fungal drugs; 14.29 % (1/7) reported estrogen drugs. Different studies report on sunscreen products, hormone, phytosterol, insect repellent, and β1 receptor. Gemfibrozil (<4-730 ng/L), Triclosan (55.1-297.7 ng/L), Triclocarban (35.6-232.4 ng/L), Trimethoprim (<1-388 ng/L) and Tramadol (<2-883 ng/L) had the highest range of concentrations. Findings confirm the need of i) legislation for environmental monitoring, including biota, ii) toxicological profiling of new market products, and iii) sensitization on appropriate use and disposal of pharmaceuticals and personal care products.

Risk-Benefit Assessment of Feed Additives in the One Health Perspective

Safety and sustainability of animal feeds is a pillar of the safety of the entire food chain. Feed additive assessment incorporates consumer safety as well as animal health and welfare, which, in turn, can affect productivity and hence food security. The safety of feed users and the environment are other important components of the assessment process which, therefore, builds on a One Health perspective. In several instances the assessment entails a balanced assessment of benefits and risks for humans, animals and/or the environment. Three case studies are selected to discuss issues for a consistent framework on Risk-Benefit Assessment (RBA) of feed additives, based on EFSA opinions and literature: (a) Supplementation of feeds with trace elements with recognized human toxicity (cobalt, iodine) - RBA question: can use levels, hence human exposure, be reduced without increasing the risk of deficiency in animals?; (b) Aflatoxin binders in dairy animals - RBA question: can the use reduce the risk for human health due to aflatoxin M1, without unexpected adverse effects for animals or humans?; (c) Use of formaldehyde as preservative in feedstuffs to prevent microbial contamination - RBA question: is the reduction of microbiological risks outweighed by risks for the consumers, farmed animals or the workers? The case studies indicate that the safety of use of feed additives can involve RBA considerations which fit into a One Health perspective. As in other RBA circumstances, the main issues are defining the question and finding “metrics” that allow a R/B comparison; in the case of feed additives, R and B may concern different species (farm animals and humans). A robust assessment of animal requirements, together with sustainability considerations, might be a significant driving force for a RBA leading to a safe and effective use.

A Survey on One Health Perception and Experiences in Europe and Neighboring Areas

A questionnaire survey was promoted under the COST Actions “Network for Evaluation of One Health-NEOH” and “European Network for Neglected Vectors and Vector-Borne Infections-EURNEGVEC”, from June 2016 to April 2017, to collect information on the existence of One Health (OH) collaboration and implementation of OH initiatives in 37 EU COST Countries. The questionnaire was to be answered by key respondents representing the three major OH components: (i). Animal Health; (ii). Human Health/Public Health; (iii). Environmental Health. A target respondent rate of nine respondents/country was aimed for, representing the following categories: (i). ministries; (ii). academia-research; (iii). private sector and NGOs, associations and scientific societies. The questionnaire, composed of 27 questions organized in six sections, was circulated to target respondents by Committee Members of the two COST actions. A total of 171 respondents from 34 countries completed the questionnaire, mainly belonging to academic and research institutions (55.5%), and to Animal Health/Animal Science fields (53.8%). Although the majority (57.9%) declared they had heard about OH, few respondents (10.7%) provided a complete definition. The “human” and “animal” elements prevailed over other key elements of OH definition (ecosystem, intersectoral, transdisciplinary, holistic, collaboration). Overall, 62.6% respondents declared to take part in OH initiatives. Antimicrobial resistance, avian influenza and environmental pollution were cited as the top three OH issues over the past 5 years. Limitations and gaps in intersectoral collaboration included communication and organizational problems resulting in poor networking, differing priorities and a lack of understanding between sectors. Regarding control and monitoring of zoonotic diseases, respondents from different sectors preferentially selected their own directorates/ministries while actually in most countries both Ministry of Health and Ministry of Agriculture are engaged. According to respondents, the level of awareness of OH amongst the general public is limited. Similarly, a dearth of opportunities of collaborations at different institutional and/or professional levels was described. Our survey provided an overview of how respondents in COST countries perceived and experienced OH and current limits to OH implementation. Identifying how initiatives are currently working and knowing the promoting and hindering factors allowed suggesting strategies to promote efficiency and effectiveness of OH implementation in the future.

Toxicological Risk Analysis in Data-Poor Countries: A Narrative Approach to Feed an "Awareness Raising-Community Empowerment" Vortex

Background and objectives: With globalization of culture and products, choices and behaviors associated with the unawareness of toxicological risk factors result in human and environmental toxic exposures along with health disparities. Toxic exposures are risk factors for malnutrition and diseases, impairing the chances of being healthy and having a healthy adulthood for current and next generation(s). Increasing research funds, infrastructures, analytical data and risk assessment is a reality well worth attention in sub-Saharan Africa. These countries are still unprotected nowadays and are particularly exposed and data-poor in respect to risk factors (e.g., neurotoxicants, immunotoxicants and endocrine disruptors). This paper presents how-based on scientific literature-low-resource countries may achieve more with less. As one of the world's most important emerging markets, Africa can, and should, assess the benefits and risks of modernity versus tradition and ask for safe and quality products at affordable prices while producing safe and nutritious foods. Materials and Methods: Exempla and experiences of risk analysis based on participant observation in field anthropological research, consumer safaris and reportages in the field of food safety, environmental health and consumer products are discussed in terms of "narrative prevention" and its power to highlight previously unrecognized/overlooked real-life risk scenarios. Knowledge return initiatives are discussed in light of their power to feed awareness raising, informed choice and empowerment of communities. Results: In some cases, data exist but remain too sparse, unknown or underused; in other cases, the information is totally neglected. When there is international scientific evidence, a diagnostic risk assessment is feasible. Despite significant resource constraints, properly science-driven targeted reportages in data-poor countries can bridge the gaps between international scientific knowledge and the implementation of relevant findings in an "awareness-empowerment vortex". When a clear message promoting healthy choices and behaviors is given, African communities are ready to respond. Conclusions: Poor skills are an avoidable consequence of low national income. Narrative prevention does not replace scientific research but stimulates scientific research and toxicological risk analysis during the ongoing risk transition in Africa. While African populations increasingly aspire to improve life expectancy in health, increasing exposure to such new health risk factors in sub-Saharan Africa needs top-down choices for diseases prevention, One Health, as well as public awareness and empowerment towards everyday habits and health protective choices.

Public Health Burden of E-waste in Africa

BACKGROUND

Environmental impacts from informal e-waste recycling are increasing in Africa. E-waste handling and disposal exposes people to highly toxic cocktails of heavy metals, brominated flame retardants, non-dioxin-like polychlorinated biphenyls (PCB), polycyclic aromatic hydrocarbons (PAH), polychlorinated dibenzo-p-dioxins (PCDD), polychlorinated dibenzofurans (PBDF) and dioxin-like polychlorinated biphenyls (DL-PCB). Most of these compounds are endocrine disrupters, and most are neuro- and immune-toxic as well.

OBJECTIVES

Informal e-waste recycling in African countries is a serious public health threat. The present paper reviews the extent of e-waste exposure in Africa and related impacts on people, animals and the environment.

METHODS

Four electronic databases (PubMed, Science Direct, Scopus, Google Scholar) were searched for publications related to e-waste and human health in Africa. Search terms included 'e-waste in Africa', 'e-waste in developing nations', 'public health and e-waste', 'environment and e-waste', and 'e-waste and health'.

DISCUSSION

Elevated levels of e-waste pollutants in water, air, soil, dust, fish, vegetable, and human matrices (blood, urine, breast milk) indicate that not only are e-waste workers at risk from exposure to e-waste, but the general population and future generations as well. Headache, cough and chest pain, stomach discomfort, miscarriage, abnormal thyroid and reproductive function, reduction of gonadal hormone, and cancer are common complaints of those involved with the processing of e-waste.

CONCLUSIONS

The evidence presented from the reviewed studies illustrates the extent of the human health and environmental risks posed by e-waste in Africa. There is a need for a regulatory framework including specific legislation, infrastructure and protocols to safely recycle and dispose of e-waste in sub-Saharan African countries.

COMPETING INTERESTS

The authors declare no competing financial interests.

Understanding Seasonal Changes to Improve Good Practices in Livestock Management

Background and Aim: Food quality control techniques based on process control methods are increasingly adopted in livestock production systems to fulfill increasing market's expectations toward competitiveness and issues linked to One Health pillars (environment, animal, and human health). Control Charts allow monitoring and systematic investigation of sources of variability in dairy production parameters. These parameters, however, may be affected by seasonal variations that render impractical, biased or ineffective the use statistical control charts. A possible approach to this problem is to adapt seasonal adjustment methods used for the analysis of economic and demographic seasonal time series. The aim of the present work is to evaluate a seasonal decomposition technique called X-11 on milk parameters routinely collected also in small farms (fat, protein, and lactose content, solids-not-fat, freezing point, somatic cell count, total bacterial count) and to test the efficacy of different seasonal removal methods to improve the effectiveness of statistical control charting.

Method: Data collection was carried out for 3 years on routinely monitored bulk tank milk parameters of a small farm. Seasonality presence was statistically assessed on milk parameters and, for those parameters showing seasonality, control charts for individuals were applied on raw data, on X-11 seasonally adjusted data, and on data smoothed with a symmetric moving average filter. Correlation of seasonally influenced parameters with daily mean temperature was investigated.

Results: Presence of seasonality in milk parameters was statistically assessed for fat, protein, and solids-non-fat components. The X-11 seasonally-adjusted control charts showed a reduced number of violations (false alarms) with respect to non-seasonally adjusted control chart (from 5 to 1 violation for fat, from 17 to 1 violation for protein, and from 9 to none violation for solids-non-fat.). This result was achieved despite stricter control chart limits: with respect to raw data charts, the interval of control chart allowed variation (UCL–LCL) was reduced by 43% for fat, by 33.1% for protein, and by 14.3% for solids-not-fat.

Conclusions: X-11 deseasonalization of routinely collected milk parameters was found to be an effective method to improve control chart application effectiveness in farms and milk collecting centers.

From Invention to Innovation: Risk Analysis to Integrate One Health Technology in the Dairy Farm

Current Hazard Analysis Critical Control Points (HACCP) approaches mainly fit for food industry, while their application in primary food production is still rudimentary. The European food safety framework calls for science-based support to the primary producers’ mandate for legal, scientific, and ethical responsibility in food supply. The multidisciplinary and interdisciplinary project ALERT pivots on the development of the technological invention (BEST platform) and application of its measurable (bio)markers—as well as scientific advances in risk analysis—at strategic points of the milk chain for time and cost-effective early identification of unwanted and/or unexpected events of both microbiological and toxicological nature. Health-oriented innovation is complex and subject to multiple variables. Through field activities in a dairy farm in central Italy, we explored individual components of the dairy farm system to overcome concrete challenges for the application of translational science in real life and (veterinary) public health. Based on an HACCP-like approach in animal production, the farm characterization focused on points of particular attention (POPAs) and critical control points to draw a farm management decision tree under the One Health view (environment, animal health, food safety). The analysis was based on the integrated use of checklists (environment; agricultural and zootechnical practices; animal health and welfare) and laboratory analyses of well water, feed and silage, individual fecal samples, and bulk milk. The understanding of complex systems is a condition to accomplish true innovation through new technologies. BEST is a detection and monitoring system in support of production security, quality and safety: a grid of its (bio)markers can find direct application in critical points for early identification of potential hazards or anomalies. The HACCP-like self-monitoring in primary production is feasible, as well as the biomonitoring of live food producing animals as sentinel population for One Health.

Engaging One Health for Non-Communicable Diseases in Africa: Perspective for Mycotoxins

The role of mycotoxins-e.g., aflatoxins, ochratoxins, trichothecenes, zearalenone, fumonisins, tremorgenic toxins, and ergot alkaloids-has been recognized in the etiology of a number of diseases. In many African countries, the public health impact of chronic (indoor) and/or repeated (dietary) mycotoxin exposure is largely ignored hitherto, with impact on human health, food security, and export of African agricultural food products. Notwithstanding, African scientific research reached milestones that, when linked to findings gained by the international scientific community, make the design and implementation of science-driven governance schemes feasible. Starting from Nigeria as leading African Country, this article (i) overviews available data on mycotoxins exposure in Africa; (ii) discusses new food safety issues, such as the environment-feed-food chain and toxic exposures of food producing animals in risk assessment and management; (iii) identifies milestones for mycotoxins risk management already reached in West Africa; and (iv) points out preliminary operationalization aspects for shielding communities from direct (on health) and indirect (on trade, economies, and livelihoods) effects of mycotoxins. An African science-driven engaging of scientific knowledge by development actors is expected therefore. In particular, One health/One prevention is suggested, as it proved to be a strategic and sustainable development framework.

Contaminants in Foods of Animal Origin in Cameroon: A One Health Vision for Risk Management "from Farm to Fork"

Foods of animal origin represent an important share in the diet of Cameroonian populations. Cameroon is known to be a food basket in the west and central Africa sub-region, and an important supplier of foods on the international markets. In the meantime, food importation is continuously increasing to meet the high demand of a more westernized segment of the population. Cereals, fish, sea products, eggs, honey, shrimps, chicken, and feed ingredients are important share in the international trade of agricultural products. Few controls are made on the quality and safety of these products. Certain safety standards do exist but are still yet to be enforced. Inspections done so far by regulatory authorities are partial and do not cover important hazards that require laboratory analysis. The increasing awareness of population, the burden of new types of disease, as well as the recurrence of food scandals have recently launched a scientific and population debate on the contribution of foods items, especially those of animal origin, to the toxic exposure of food producing animals and humans. This paper critically reviews the occurrence of toxicants in most consumed foods of animal origin in Cameroon. This study included the most consumed food of animal origin, identified during the national household budget survey and contributing to 8.1% of the total diet of an individual. Data evaluated suggest an important contamination by toxic metals, mycotoxins, veterinary drugs’ residues, and pesticides. The current national legal framework is briefly analyzed to explore possible intervention measures in the frame of the One Health approach.

Framework to Define Structure and Boundaries of Complex Health Intervention Systems: The ALERT Project

Health intervention systems are complex and subject to multiple variables in different phases of implementation. This constitutes a concrete challenge for the application of translational science in real life. Complex systems as health-oriented interventions call for interdisciplinary approaches with carefully defined system boundaries. Exploring individual components of such systems from different viewpoints gives a wide overview and helps to understand the elements and the relationships that drive actions and consequences within the system. In this study, we present an application and assessment of a framework with focus on systems and system boundaries of interdisciplinary projects. As an example on how to apply our framework, we analyzed ALERT [an integrated sensors and biosensors’ system (BEST) aimed at monitoring the quality, health, and traceability of the chain of the bovine milk], a multidisciplinary and interdisciplinary project based on the application of measurable biomarkers at strategic points of the milk chain for improved food security (including safety), human, and ecosystem health (1). In fact, the European food safety framework calls for science-based support to the primary producers’ mandate for legal, scientific, and ethical responsibility in food supply. Because of its multidisciplinary and interdisciplinary approach involving human, animal, and ecosystem health, ALERT can be considered as a One Health project. Within the ALERT context, we identified the need to take into account the main actors, interactions, and relationships of stakeholders to depict a simplified skeleton of the system. The framework can provide elements to highlight how and where to improve the project development when project evaluations are required.

Elements of kitchen toxicology to exploit the value of traditional (African) recipes: The case of Egusi Okra meal in the diet of HIV+/AIDS subjects

The Egusi Okra soup is a traditional African meal that is considered of high nutritional value and protective against weight loss. We introduce the concept of "kitchen toxicology" to analyse the recipe of the Egusi Okra soup and highlight possible mitigation measures for toxic and/or antinutritional effects in the wide spectrum of health and nutritional needs of HIV+/AIDS subjects. In particular, we focus on toxicants (environmental contaminants, process contaminants, substances leaching from food contact materials) dysregulating the immune status, as well as on interactions between nutrients, contaminants, and/or antinutrients which may lead to secondary/conditioned nutritional deficiencies or imbalances; in their turn, these can modulate the ability to cope with toxicants, and increase nutritional requirements. Recommendations are given for practices preserving the Egusi Okra soup from such risk factors, identifying points of particular attention during meal preparation, from purchase of raw ingredients through to food handling, cooking, storage, and consumption. The Egusi Okra soup is discussed in the context of a diet that is asked to mitigate complications (weight loss, opportunistic infections) and support antiretroviral therapy in African countries with high HIV/AIDS prevalence. The paper discusses how nutritional interventions benefit of the integration of kitchen toxicology practices in everyday life. Toxicological risk assessment is crucial to understand the history and status of the person exposed to or affected by infectious diseases.

Analysis of Food Safety and Security Challenges in Emerging African Food Producing Areas through a One Health Lens: The Dairy Chains in Mali

Challenges posed by changes in livestock production in emerging food producing areas and demographic development and climate change require new approaches and responsibilities in the management of food chains. The increasingly recognized role of primary food producers requires the support of the scientific community to instruct effective approaches based on scientific data, tools, and expertise. Mali is an emerging food producing area, and this review covers (i) the dairy farming scenario and its environment, (ii) the role of dairy production in food security, including the greatly different animal rearing systems in the Sahel and tropical regions, (iii) risk management pillars as modern infrastructures, effective farmer organizations, and institutional systems to guarantee animal health and safety of products, and (iv) feasible interventions based on good practices and risk assessment at the farm level (e.g., sustainable use of fertilizers, feeds, veterinary drugs, and pesticides) to protect consumers from food safety hazards. Social innovation based on the empowerment of the primary food producers emerges as crucial for sustainable and safe food production. Sustainable policies should be supported by the mobilization of stakeholders of One Health, which is a science-based approach to linking human health and nutrition with the health and management of food producing animals and environmental safety. In the context of the complex, multifaceted scenario of Mali dairy production, this article presents how a cost-effective animal health and food safety scheme could be established in the dairy production chain. Because milk is a major commodity in this country, benefits could be derived in food security, public health, the resilience of the farming system, animal husbandry, and international trade.

Health risks from lost awareness of cultural behaviours rooted in traditional medicine: An insight in geophagy and mineral intake

The term geophagy is applied to the recurrent intentional eating of soil with multifactorial motivation. Geophagists are generally defined by gender (women), age (children), physical status (e.g. pregnancy, lactation, postpartum), social status (people exposed to significant nutritional deficiencies), and culture, but lost awareness of traditional medical meaning of this practice is changing these consumption patterns and increasing health risks. Moreover, although the holistic anthropological perspective recognizes soil consumption as mineral supplementation under certain circumstances, we should consider how the living environment has changed and is changing, along with diet, nutrition requirements, and habits. Therefore, benefits-to-risks ratio of cultural behaviours initiated centuries ago based on traditional medical practices requires deep revision and assessment. Knowledge on minerals metabolism, bioavailability and interactions is required to properly assess the role of geophagy in a balanced and safe intake of micronutrients. Most important, the risk of unbalanced intake of minerals may be serious since the mineralogy and chemistry of geophagic clays are uncontrolled, variable, and difficult to standardize. In addition, other factors (radioactive materials, organic chemicals and soil pathogens) complicate the risk assessment for population groups consuming soil. Since the geophagic practice is expected to persist despite economic development, the paper discusses the multifaceted spectrum of geophagy to highlight critical aspects for risk management.

The One Health Perspective in Trace Elements Biomonitoring

Health risks in both animals and humans are associated with chronic exposures to levels of trace elements (TE) eliciting toxic and/or antinutritional effects, including excess exposures to some essential elements. Interferences with essential TE may also lead to secondary nutritional deficiencies and/or imbalances. Although research is still required, biomarkers of exposure, including bioavailability, for TE are established tools for human biomonitoring that can also be applied to animal surveillance. Biomarkers of effect as well as, where available, of susceptibility and bioavailability are necessary to understand whether an ongoing exposure may pose a current or future health concern. In the field of animal health the use of biomarkers is less developed and less widespread than in human health; however, under a One Health perspective, animal biomonitoring can provide important information on the interfaces among humans, animals, and the environment, supporting the prevention and management of health risks. Therefore, a transfer of knowledge from human biomonitoring to farm or free-ranging animals is critical in a risk assessment framework from farm to humans. Advantages and critical aspects in designing and conducting integrative biomonitoring activities in humans and animals were critically reviewed focusing on biomarkers of exposure, effect, susceptibility, and bioavailability for toxic and essential TE. Highlighted aspects include TE metabolism, bioaccessibility, and interactions. Farm or free-ranging animals may provide noninvasive matrices suitable for evaluating animal welfare, environmental stressors, food safety, and potential risks for human health, as proposed by the interdisciplinary concept of One Health.