Giacometti Federica, Bonilauri Paolo, Amatiste Simonetta, Arrigoni Norma, Bianchi Manila, Losio Marina Nadia, Bilei Stefano, Cascone Giuseppe, Comin Damiano, Daminelli Paolo, Decastelli Lucia, Merialdi Giuseppe, Mioni Renzo, Peli Angelo, Petruzzelli Annalisa, Tonucci Franco, Piva Silvia, Serraino Andrea
University of Bologna, Department of Veterinary Medical Sciences, Via Tolara di Sopra, 50, Bologna, 40064 Ozzano Emilia, Italy.
Experimental Institute for Zooprophylaxis in Lombardy and Emilia Romagna, Via Pitagora 2, 42100 Reggio Emilia, Italy.
Prev Vet Med. 2015 Sep 1;121(1-2):151-8. doi: 10.1016/j.prevetmed.2015.06.009. Epub 2015 Jun 24.
A quantitative risk assessment (RA) model was developed to describe the risk of campylobacteriosis linked to consumption of raw milk sold in vending machines in Italy. Exposure assessment was based on the official microbiological records of raw milk samples from vending machines monitored by the regional Veterinary Authorities from 2008 to 2011, microbial growth during storage, destruction experiments, consumption frequency of raw milk, serving size, consumption preference and age of consumers. The differential risk considered milk handled under regulation conditions (4°C throughout all phases) and the worst time-temperature field handling conditions detected. Two separate RA models were developed, one for the consumption of boiled milk and the other for the consumption of raw milk, and two different dose-response (D-R) relationships were considered. The RA model predicted no human campylobacteriosis cases per year either in the best (4°C) storage conditions or in the case of thermal abuse in case of boiling raw milk, whereas in case of raw milk consumption the annual estimated campylobacteriosis cases depend on the dose-response relationships used in the model (D-R I or D-R II), the milk time-temperature storage conditions, consumer behaviour and age of consumers, namely young (with two cut-off values of ≤5 or ≤6 years old for the sensitive population) versus adult consumers. The annual estimated cases for young consumers using D-R II for the sensitive population (≤5 years old) ranged between 1013.7/100,000 population and 8110.3/100,000 population and for adult consumers using D-R I between 79.4/100,000 population and 333.1/100,000 population. Quantification of the risks associated with raw milk consumption is necessary from a public health perspective and the proposed RA model represents a useful and flexible tool to perform future RAs based on local consumer habits to support decision-making on safety policies. Further educational programmes for raw milk consumers or potential raw milk consumers are required to encourage consumers to boil milk to reduce the associated risk of illness.
开发了一种定量风险评估（RA）模型，以描述与意大利自动售货机售卖的生乳消费相关的弯曲杆菌病风险。暴露评估基于2008年至2011年期间由地区兽医当局监测的自动售货机生乳样本的官方微生物记录、储存期间的微生物生长、灭活实验、生乳消费频率、食用量、消费偏好以及消费者年龄。差异风险考虑了在规定条件下（所有阶段均为4°C）处理的牛奶以及检测到的最差时间-温度场处理条件。开发了两个单独的RA模型，一个用于煮过的牛奶消费，另一个用于生乳消费，并考虑了两种不同的剂量-反应（D-R）关系。RA模型预测，在最佳（4°C）储存条件下，或者在煮生乳时出现热滥用的情况下，每年都不会出现人类弯曲杆菌病病例，而在生乳消费的情况下，每年估计的弯曲杆菌病病例数取决于模型中使用的剂量-反应关系（D-R I或D-R II）、牛奶时间-温度储存条件、消费者行为和消费者年龄，即年轻消费者（敏感人群有两个截止值，分别为≤5岁或≤6岁）与成年消费者。对于敏感人群（≤5岁）使用D-R II的年轻消费者，每年估计病例数在每100,000人口1013.7例至8110.3例之间；对于使用D-R I的成年消费者，每年估计病例数在每100,000人口79.4例至333.1例之间。从公共卫生角度来看，量化与生乳消费相关的风险是必要的，并且所提出的RA模型是一个有用且灵活的工具，可根据当地消费者习惯进行未来的风险评估，以支持安全政策的决策制定。需要为生乳消费者或潜在的生乳消费者开展进一步的教育计划，以鼓励消费者煮牛奶，降低相关的患病风险。
