Food and pharmaceuticals. Lessons learned from global contaminations with melamine/cyanuric acid and diethylene glycol.

Recently, contamination of pharmaceuticals with diethylene glycol (DEG) and food with melamine and cyanuric acid has demonstrated the impact of globalization on drug and food safety. By examining the details of these outbreaks, some important lessons can be learned. Toxicoses from contaminated food and drugs are often identified only when large numbers of people or animals are affected and numerous deaths result. Populations most at risk are those repeatedly exposed to a single product. Toxicoses may be complex, involving synergism among relatively nontoxic co-contaminants. Although some contamination may occur inadvertently, practices of deliberate contamination of food and drug ingredients may be widespread but escape detection in poorly regulated markets. If this deliberate contamination is motivated by personal financial gain, it is likely to recur and be concealed. The contaminated raw material produced in a poorly regulated market may cross national boundaries and be used in manufacturing processes for numerous products, sometimes in more well-regulated markets. Once in the production chain, contaminated raw materials may be widely disseminated. It is not clear that regulatory organizations have the capacity to identify significant contaminations despite their best efforts. The veterinary and medical communities, in cooperation with regulatory agencies, should develop cooperative programs designed to detect and limit these global outbreaks. Although addressing regional or national outbreaks remains an important role for regulatory agencies, the veterinary and medical communities must develop proactive global approaches to this global problem.