Summary - WHO
August 2018Department of Food safety and ZoonosesSummaryClimate change is likely to have considerable impacts on food safety, both direct and indirect, placingpublic health at risk. With changing rainfall patterns and increases in extreme weather events and theannual average temperature we will begin to face the impacts of climate change. These impacts willaffect the persistence and occurrence of bacteria, viruses, parasites, harmful algae, fungi and theirvectors, and the patterns of their corresponding foodborne diseases and risk of toxic contamination.Alongside these impacts, chemical residues of pesticides and veterinary medicines in plant andanimal products will be affected by changes in pest pressure. The risk of food contamination withheavy metals and persistent organic pollutants following changes in crop varieties cultivated,cultivation methods, soils, redistribution of sediments and long-range atmospheric transport, isincreased because of climate changes.Climate sensitive risk factors and illnesses will be among the largest contributors to the global burdenof food-related disease and mortality, including under-nutrition, communicable, non-communicable,and diarrheal- and vector borne diseases.The science on climatechange and food safetyis a rapidly evolvingfield of research. Whileno single document cancomprehensively cover theimplications that climatechange has on food safety,in this first publication,WHO summarises severalconcerns that havebeen highlighted in theliterature. This publicationdoes not attemptto cover all possibleconsequences, nor doesit try to demonstrate thatthe scenarios referencedin this paper will have amore profound effect onfood safety than scenariosnot referenced.WHO/NHM/FOS/RAM/18.4. World Health Organization2018. Some rights reserved.This work is available underthe CC BY-NC-SA 3.0 IGOlicence.The impact of climate change will not be even across different food systems. Some regions areprojected to have an increase in food production; however, generally the projected climate changeis foreseen to have a negative impact on food security, especially in developing countries1. Theeffects of climate change on food security and consequently nutrition are closely linked to effectson food safety and public health and must be considered together. WHO, together with agriculture,environment and other relevant sectors must be ready to support national authorities, particularlyin developing countries and countries most affected, to prepare and respond to these effects. Climate change is expected to lead to modified bacterial, viral and pathogeniccontamination of water and food by altering the features of survival and transmissionpatterns through changing weather characteristics, such as temperature and humidity. Climate-dependent temperature and moisture, fungal growth and formation ofmycotoxins will lead to changes in occurrence patterns. Mycotoxins are produced by certainfungi (moulds) on crops and can cause both acute toxic effects and chronic health problems(including cancer) in humans and livestock.1.Miraglia M., et al 2009. Climate change and food safety: An emerging issue with specil focus on Europe. Food andchemical toxicology, 47, 1009-1021.
Food Safety, Climate Change and the Role of WHO2 Climate change has also been described as a ‘catalyst for the global expansion’ of algalblooms in oceans and lakes, interacting with nutrient loading from fertilizer run-off intowater bodies. This high risk of emerging zoonoses, changes in the survival of pathogens, and alterationsof vector-borne diseases and parasites in animals, may necessitate the increased use ofveterinary drugs, possibly resulting in increased residue levels of veterinary drugs in foodsof animal origin. This poses not only acute and chronic risks to human health, but is directlylinked to an increase in antimicrobial resistance (AMR) in human and animal pathogens. The application of pesticides, and the subsequent residues in food, is an ongoing concernthat is expected to become more prevalent due to climatic changes, with shifts in farmingsystems and farmers’ behaviour to adapt to the changing climate. The increased frequency of inland floods linked to climate change will impactenvironmental contamination and chemical hazards in foods through the remobilisationof contaminated river sediments and subsequent contamination of agricultural andpastureland soil contaminants. Climate change increases the frequency and severity of extreme weather events whichimpacts food security. Where food supplies are insecure, people tend to shift to lesshealthy diets and consume more “unsafe foods” – in which chemical, microbiological andother hazards pose health risks and which contribute to increased malnutrition.WHO role in combatting the impact of climate changeon food safetyThough the challenge of halting and reversing climate change is bigger than any one country,mitigating its health-related impacts is both possible and necessary. Across WHO Member States,health systems should, in collaboration with agriculture, environment and other relevant sectors, beable to prevent, detect and manage the increased foodborne risks associated with climate changeand do so in a way that advances health equity and ensures no one is left behind. There are severalways to do this:Member State health authorities, with support from WHO, should be fully aware ofand prepared for the specific increased foodborne risks associated with climate changethey face and draft national plans (including financing and investment plans) accordingly.Support countries to enhance emergency preparedness, response and capacity buildingto better manage the threat of increased foodborne risks associated with climate change.Provision of scientific risk assessments to provide the evidence basis for the developmentand adoption of food safety standards and guidance on food safety measures, as well asto provide risk assessment on emerging food safety risks.As outlined in the draft thirteenth Global Programme of Work (GPW13), WHO needsto strengthen its work with non-health sectors at country level to address the healthimpacts of climate change. WHO together with all relevant sectors such as agricultureand environment to work on financing of investments in food safety and climate changeand incorporate food safety into its approach to climate change in order to providecomprehensive and effective policy advice, directives and interventions across all sectors.
Food Safety, Climate Change and the Role of WHOIntroductionOur climate is rapidly changing withdisruptive impacts, and that changeis progressing faster than any seen inthe last 2,000 years.Climate change does not only impactsocial and environmental determinants ofhealth such as clean air, safe drinking water,nutrition and food security, but it also has majorconsequences upon food production systems and foodsafety.Already today an estimated 600 million – almost 1 in 10people in the world – fall ill after eating contaminated foodand 420,000 die every year2- a figure that is expected to growdue to changes in the climate that alter the agricultural andmanufacturing environment, as well as influence human,animal and pest behaviours.The effects of climate change on food safety and publichealth are closely linked to effects on food security andon nutrition, and must be considered together. WHOmust be ready to support national authorities, particularlyin developing countries and countries most affected, toprepare and respond to its effects. This includes providinginformation on the threats that climate change presents tofood safety, coordinating reviews of the scientific evidenceon the links between climate change and food safety, andassisting countries in building capacity to handle foodsafety related impacts of climate change, closely linked withpolicies on malnutrition and food security.Climate change has a profound impact on the availabilityand the safety of the food we consume, and is expected toresult in a significant increase in risk to public health throughits effects on bacteria, viruses, parasites, and chemicals &toxins linked to foodborne diseases. Antimicrobial resistanceand zoonotic diseases, both directly linked to food safety,are also expected to be affected by climate change. Variouschanges driven by climate change influence behaviourswhich impact food safety, including: human, animal andvector behaviours, and changing pathogen, organismand pest survival, growth and transmission behaviours3.Such incidents are more likely to occur in countries wherefood monitoring and surveillance systems are less robust,therefore unable to detect environmental and chemicalcontamination, further increasing the risk to public healththrough the acute and chronic exposure to contaminants.The major effects of climate change: sea level rise, averageglobal temperature rise, warming oceans, extreme weatherevents (droughts, heat waves, intense rainfall, storm surges)and ocean acidification will have a significant impacton these behaviours, with developing countries beingdisproportionately affectedClimate change is expected to cause approximately250,000 additional deaths per year between 2030 and2050; increases in mortality associated with food safety areexpected to contribute to this figure4. This figure must beadded to the approximately 500,000 additional deaths peryear that have been calculated as consequence of changesin diet and body weight due to climate change by 20505.Climate sensitive risk factors and illnesses will be among theimportant contributors to the global burden of disease andmortality, including under-nutrition, communicable, noncommunicable and diarrheal- and vector borne diseases2.Extreme weather events andnatural disastersClimate change increases the frequency and severity ofextreme weather events, including; more common extremetemperatures, heavy precipitation, intense tropical cyclonesand expanded areas affected by drought and floods – forexample, by 2080, 2 to 7 million more people per year, willbe affected by coastal flooding2.During and after a natural disaster such as a flood ortsunami, food safety risks are heightened, as in many cases,proper storing and cooking of food may be impossible dueto the lack of facilities or fuel. Poor sanitation can thencompound the risks, leading to increases in foodbornediseases including hepatitis A, typhoid fever and diarrhoealdiseases, such as cholera and dysentery. Persons sufferingfrom the direct effects of the disaster may already be atrisk of malnutrition, therefore it becomes essential that thefood they consume is safe.By 2020, between 75 and 250 million people areprojected to suffer increased water stress in sub-SaharanAfrica2, however droughts also pose a nutritional risk tothe population through the increased hazard of watercontamination of food and crops, as farmers struggle to findfresh water to irrigate, resorting to unsafe or recycled water.4.2.3.World Health Organization (2014). WHO Estimates of the GlobalBurden of Foodborne Diseases. Geneva. 9789241565165 eng.pdf?ua 1M.C Tirado et al., 2010. Climate change and food safety: A review.Food Research International 43, 1745-1765.35.World Health Organisation, 2014. Quantitative risk assessment ofthe effects of climate change on selected causes of death, 2030s and2050. itativerisk-assessment/en/Marci Springermann et al., 2016. Global and regional health effectsof future food production under climate change: A modellingstudy. 01406736(15)01156-3.pdf
Food Safety, Climate Change and the Role of WHOThe application of unsafe wateron crops has been, and continuesto be, directly linked to foodborneoutbreaks and illnesses.Food safety:how climate changeimpacts our foodBacteria, viruses and parasiticprotozoaBacteria, viruses and parasitic protozoa were estimatedto have caused over 2 billion illnesses in 2010, resultingin 31 million disability-adjusted life years (DALYs)6. 29% ofthese illnesses were estimated to have been transmitted bycontaminated food5.Climate change is expected to lead to increased bacterial,viral and pathogenic contamination of water and foodby altering the features of survival and transmissionpatterns through changing weather characteristics, such astemperature and humidity. Even increased contaminationof water used for irrigation can impact upon the safetyof crops, and animals who consume the crops, and theirresulting food output.The production of food itself may also be directly affectedby climate change through the alteration of survival and/or multiplication rates of some food-borne pathogens.For example, the multiplication of Salmonella spp., amajor contributor to foodborne disease, estimated to beresponsible for over 50,000 deaths in 20107, is stronglytemperature-dependent. An increase in temperature, orthe duration of high-temperature episodes in particulargeographical areas, may provide better conditions for themultiplication of Salmonella spp. in foodstuffs. As cited byWHO in the 2017 report on protecting health in Europefrom climate change, cases of salmonellosis increase by5–10% for each 1 C increase in weekly temperature whenambient temperatures are above 5 C8. In the same report,citing a study in Kazakhstan, there was a 5.5% increase inthe incidence of salmonellosis with a 1 C increase in themean monthly temperature.Another major source of foodborne disease, vibrio choleraeis estimated to cause over 760,000 illnesses and 24,000deaths every year5. It is commonly associated with theconsumption of contaminated water filtrating organisms,such as mussels and clams. Climate change has beendescribed as a promoter for the global expansion of algalblooms that contaminate these water filtrating organisms9.Mycotoxins and phycotoxinsMycotoxins are compounds naturally produced by a largevariety of fungi (moulds) that can cause acute effects,including death, along with chronic illnesses from long-termexposure, including various forms of cancer. It has beenestimated that 25% of the world’s yearly crop productionis contaminated with mycotoxins. Mycotoxins are knownto occur more frequently in areas with a hot and humidclimate.10 Mycotoxins can be produced before harvest inthe standing crop and many can increase dramatically, evenafter harvest if the post-harvest conditions are favourablefor further fungal growth. The FAO conclude that a changein climatic conditions could result in grain being harvestedwith more than the 12 to 14 percent moisture level requiredfor stable storage11, thus increasing the risk for mycotoxinformation.Human dietary exposure to mycotoxins can occur eitherdirectly, through the consumption of contaminated crops orindirectly, through the consumption of animal derived foodsfrom livestock that have consumed contaminated feed. Theoccurrence of mycotoxin intoxication is common in Africa,with the International Food Safety Authorities Network(INFOSAN)12 documenting several food safety eventsannually, each involving illness or death among particularlyvulnerable populations.The geographical areas subject to aflatoxin growth inmaize and wheat are expected to change with temperatureincreases – it is predicted that aflatoxin contamination andthe associated food safety issues will become prevalent inEurope with a temperature increase of 2 C.13 It has been9.10.6.7.8.The disability-adjusted life year (DALY) is a measure of overalldisease burden, expressed as the cumulative number of years lostdue to ill-health, disability or early death.WHO estimates of the global burden of foodborne diseases. 9789241565165 eng.pdf?ua 1Protecting health in Europe from climate change: 2017update. WHO. http://www.euro.who.int/ ropeFromClimateChange.pdf?ua 1411.12.13.H. W. Paerl and J. Huisman. (2009). Climate change: a catalyst forglobal expansion of harmful cyanobacterial blooms. EnvironmentalMicrobiology Reports. (Vol. 1, Issue 1). Retrieved from: 2229.2008.00004.x/fullM. Perracia et al., 1999. Toxic effects of mycotoxins inhumans. Bulletin of WHO, 77. AO, Climate change and food security, A framework document,2008. 3dbc6ff34de4807e4.pdfFAO/WHO International Food Safety Authorities Network(INFOSAN) http://www.who.int/foodsafety/areas work/infosan/en/R. Assunção, C. Martins, S. Viegas, C. Viegas, L.S. Jakobsen, S.Pires and P. Alvito (2018) Climate change and the health impact ofaflatoxins exposure in Portugal – an overiew. Retrieved from https://doi.org/10.1080/19440049.2018.1447691
Food Safety, Climate Change and the Role of WHO5estimated that an increase of onedegree in global mean temperaturewill reduce average global yieldsof wheat by six percent14. Thisdecrease in food availability canresult in an increased risk to publichealth from mycotoxin intoxication, inparticular in (developing) countries wheresmall-scale farmers and families sell locally,and eat what they grow, thereby being forced tosell and consume contaminated crops to survive.Zoonosis and other animal diseasesOther important mycotoxins are produced by species of themould genus Fusarium, with the main staple food affectedbeing maize (corn). Fusarium occurrence is linked todrought stress, with dry season maize in southern and eastAfrica often containing large amounts of this toxin, withoutvisual damage to the maize. However, Fusarium is muchless common in (northern) temperate zones. It is predictedthat with an increase in extreme weather events, zones thatare currently temperate with a relatively low occurrenceof Fusarium will become prone to the occurrence of thefungus and formation of toxins.While in the aquaculture sector, a warming of theenvironment and oceans will lead to disease organismsthriving, which may result in increased incidences ofmass fish deaths, or an increase in the use, and potentialfor misuse, of chemicals to control diseases, leading tothe possibility of increased residues in fish and seafoodproducts, subsequently impacting public health.Climate change has also been described as a ‘catalyst forthe global expansion’ of algal blooms, interacting withincreased nutrient loading from fertilizer run-off into waterbodies. A number of these algae produce toxic compounds,the so-called phycotoxins that exert adverse effects onhuman consumers of seafood containing these toxins. Forexample, water-filtrating organisms, such as mussels andclams, are prone to contamination with these toxins. Thesymptoms that these toxins may cause after consumptionare, for example, Paralytic Shellfish Poisoning and DiarrheicShellfish Poisoning.Ciguatera fish poisoning (CFP) is a pantropical illness causedby the bioconcentration of algal toxins, known as ciguatoxins(CTXs), in marine food webs. Ciguatera fish poisoning isamong the world’s most common seafood-toxin diseases.Growth, distribution and abundance of CFP-associateddinoflagellates are largely temperature driven and expectedto shift in response to climate induced changes as oceantemperatures rises15. This can be observed in the geographicregions in which CFP outbreaks have been reported, whichappear to have been expanding geographically over the lasttwo decades.1614. C., Zhao, B., Liu, S. Piao, D.B, Lobell, and S., Asseng (2017)Temperature increase reduces global yields of major crops in fourindependent estimates. United States of America. Retrieved fromhttp://www.pnas.org/content/114/35/932615. Steven et al., 2015. Ecological modelling 316, 194-210. Effectsof ocean warming on growth and distribution of dinoflagellatesassociated with ciguatera fish poisoning in the Caribbean.16. Friedman M. A. et al., 2017. An Updated Revie
Climate change is likely to have considerable impacts on food safety, both direct and indirect, placing public health at risk. With changing rainfall patterns and increases in extreme weather events and the annual average temperature we will begin to face the impacts of climate change. These impacts will
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