IARC Sci Publ. 2012(158):119-29.
The economic impacts of mycotoxins to human society can be thought of in two ways: (i) the direct market costs associated with lost trade or reduced revenues due to contaminated food or feed, and (ii) the human health losses from adverse effects associated with mycotoxin consumption. Losses related to markets occur within systems in which mycotoxins are being monitored in the food and feed supply. Food that has mycotoxin levels above a particular maximum allowable level is either rejected outright for sale or sold at a lower price for a different use. Such transactions can take place at local levels or at the level of trade among countries. Sometimes this can result in heavy economic losses for food producers, but the benefit of such monitoring systems is a lower risk of mycotoxins in the food supply. Losses related to health occur when mycotoxins are present in food at levels that can cause illness. In developed countries, such losses are often measured in terms of cost of illness; around the world, such losses are more frequently measured in terms of disability-adjusted life years (DALYs). It is also useful to assess the economics of interventions to reduce mycotoxins and their attendant health effects; the relative effectiveness of public health interventions can be assessed by estimating quality-adjusted life years (QALYs) associated with each intervention. Cost-effectiveness assessment can be conducted to compare the cost of implementing the intervention with the resulting benefits, in terms of either improved markets or improved human health. Aside from cost-effectiveness, however, it is also important to assess the technical feasibility of interventions, particularly in low-income countries, where funds and infrastructures are limited.
（i）与受污染食品或饲料导致的贸易损失或收入减少相关的直接市场成本，以及（ii）因食用霉菌毒素产生的不良影响造成的人类健康损失。与市场相关的损失发生在对食品和饲料供应中的霉菌毒素进行监测的系统内。霉菌毒素含量超过特定最大允许水平的食品要么被直接拒售，要么以较低价格出售用于其他用途。此类交易可在地方层面或国家间贸易层面进行。有时这会给食品生产商带来巨大经济损失，但此类监测系统的好处是降低了食品供应中霉菌毒素的风险。当食品中存在能导致疾病的霉菌毒素水平时，就会发生与健康相关的损失。在发达国家，此类损失通常以疾病成本来衡量；在全球范围内，此类损失更常以伤残调整生命年（DALYs）来衡量。评估减少霉菌毒素及其相关健康影响的干预措施经济学也很有用；可通过估计与每种干预措施相关的质量调整生命年（QALYs）来评估公共卫生干预措施的相对有效性。可以进行成本效益评估，以比较实施干预措施的成本与由此产生的效益，效益方面可以是改善市场或改善人类健康。然而，除了成本效益外，评估干预措施的技术可行性也很重要，特别是在资金和基础设施有限的低收入国家。
