Yufei Liu

Cadmium (Cd) and its compounds are hazardous environmental pollutants with renal toxicity and human carcinogenicity, with ingestion of contaminated foods representing the major mode of exposure. There have been a number of reports evaluating the Cd content in various foods; however, regarding the actual risk posed by dietary cadmium exposure, only a few reports are available in which single point evaluation (less accurate than multiple point evaluation) was employed. In this study, we used a margin of exposure (MOE) model and @RISK software (for multiple evaluation) to evaluate Cd-related health risk in the local Guangzhou residents at varying ages, through a comparison between the estimated monthly exposures and the provisional tolerable monthly intake (0.025 mg/kg body weight (b.w.)), based on the Cd contents in various food categories available locally (a total of 3964 food samples were collected from each of the 13 districts of Guangzhou between 2015 and 2019), which were determined by using inductively coupled plasma mass spectrometry. In this study, Cd was detected in 69.6% of the samples (averaged 0.120 mg/kg), and rice and its products, leafy vegetables, bivalves, and shrimp and crabs contributed most to Cd exposure (8.63, 3.18, 2.79, and 1.48 ng/kg b.w./day, respectively). The MOE values demonstrated the following tendency: the younger age group, the lower MOE, and its 95% confidence range for the (youngest) 3~6 year old group started from 0.92, indicating a health risk of young children, while that for the other age groups were all above 1.0. Our preliminary findings warrant further clarification using biomarker assays in the relevant population.

Chloramphenicol has been used in veterinary medicine, where its residues can remain in food of animal origin, thus potentially causing adverse health effects. This facilitated the ban for its use in food-producing animals globally, but its residues have remained ubiquitous. In this study, food commodities possibly contaminated with chloramphenicol, including livestock meat, poultry, edible viscera, fish, shrimp and crab, molluscs, milk, and eggs, were collected from domestic retail shops in all the 11 districts of Guangzhou and tested for its residue. Probabilistic risk assessment model calculations for its dietary exposure, and the margin of exposure (displayed as mean values and 5th percentile to 95th percentile ranges) were performed by using @RISK software based on a Monte Carlo simulation with 10,000 iterations. The results indicated the detection of chloramphenicol in 248 out of 1454 samples (17.1%), which averaged to a level of 29.1 μg/kg. The highest average value was observed in molluscs (148.2 μg/kg, with the top value as 8196 μg/kg); meanwhile, based on the dietary structure of a typical Cantonese, pond fish, pork, and poultry meat contributed most (about 80%) to the residents’ dietary exposure to chloramphenicol. The margin of exposure for dietary chloramphenicol exposure in Guangzhou residents was 2489, which was apparently below 5000 (the borderline for judging a health risk), particularly low in preschool children (2094, suggesting an increased risk). In conclusion, the study suggests that chloramphenicol exposure in Guangzhou residents is considerable, and its relevant health hazard, especially for preschool children, is worthy of further investigation.

Lead exposure is associated with a wide range of adverse effects on human health. The principal exposure route in the general population is through the diet. In this study, we estimate the dietary lead intake and associated health risks among the residents of Guangzhou, China. Data on lead concentrations were derived from the food safety risk monitoring system, which included 6339 samples from 27 food categories collected in 2014–2017. Food consumption data were taken from a 2011 dietary survey of 2960 Guangzhou residents from 998 households. Dietary lead intake was estimated by age group (3–6, 7–17, 18–59, and ≥60 years), and relevant health risks were assessed using the margin of exposure (MOE) method. The mean and 95th percentiles (P95) of dietary lead intake were respectively 0.7466 and 2.4525 μg/kg body weight per day for preschool children aged 3–6 years; 0.4739 and 1.5522 μg/kg bw/day for school children aged 7–17 years; 0.3759 and 1.1832 μg/kg bw/day for adults aged 18–59 years; and 0.4031 and 1.3589 μg/kg bw/day for adults aged ≥60 years. The MOE value was less than 1 for preschool children at the mean exposure level and for all age groups at the P95 exposure level. Rice and its products, leafy vegetables, and wheat flour and its products were found to be the primary food sources of lead exposure. Our findings suggest that the health risk from dietary lead exposure is low for Guangzhou residents overall, but that young children and consumers of certain foods may be at increased risk. Continued efforts are needed to reduce the dietary lead exposure in Guangzhou.

Cadmium and its compounds are human carcinogens with severe organ toxicity, and their contamination of agricultural soil in China has been frequently reported; however, the dietary exposure to cadmium in residents and the relevant health risk have seldom been reported. In this study, the concentration of cadmium in various types of food collected from 2013 to 2015 were analyzed using graphite furnace atomic absorption spectrometry, and the dietary exposure to cadmium assessed based on a dietary survey in 2976 Guangzhou residents. In total, 3074 out of 4039 food samples had cadmium levels above the limit of detection. The mean ± standard deviation (50th, 95th percentile) cadmium content in all samples was 159.0 ± 112.7 (8.6, 392.4) μg/kg, with levels ranging from 1.0 to 7830 μg/kg. Using the mean cadmium concentrations, the average monthly dietary exposure of Guangzhou residents to cadmium was 14.4 (μg/kg body weight (BW), accounting for 57.6% of the provisional tolerable monthly intake (PTMI). Rice, laver, vegetables, and live aquatic products were the main sources of cadmium intake, on average accounting for 89% of the total value. The dietary cadmium exposure in high consumers (95th percentile food consumption) was 41.0 μg/kg·BW/month, accounting for 163% of the PTMI. Additionally, dietary cadmium exposure at mean consumption but high cadmium food concentration (95th percentile) was 32.3 μg/kg·BW/month, corresponding to 129% of the PTMI. The level of dietary exposure to cadmium in most Guangzhou residents was within the safety limit, thus increased health risk from dietary cadmium exposure is low at present. However, continued efforts by local governments to monitor the levels of cadmium in the four main food categories contributing to exposure are necessary.

Foodborne outbreaks caused by a mixed infection of Vibrio parahaemolyticus and norovirus have rarely been described. We reported a mixed outbreak of Vibrio parahaemolyticus and norovirus causing acute gastroenteritis in 99 staff members of a company in Guangdong, China, in May 2013, following consumption of roasted duck, an uncommon non-seafood vehicle for such mixed infection, in one meal served in the company's catering service. Epidemiological and laboratory findings indicated that a single asymptomatic food handler was the source of both pathogens, and the high rate of infection of both pathogens was exacerbated by the setting’s suboptimal food hygiene practice.

To investigate a survey about acceptance of central slaughtering of live poultry in residents of Guangzhou. We conducted a telephone survey by sampling residents with fixed-line telephone and with normal hearing, whose age is more than 15 years, by Mitofsky-Waksberg two-stage method during Jan 6(th) to 8(th), 2014. 358 residents finished the telephone questionnaire by 12 320 health hot line. We investigated the acceptance rate of city-wide central slaughtering permanently. We compared the difference between the respondents and the 2010 Guangzhou census data by Cohen's effect sizes (w) and weighted by population age and sex. We used χ(2) test to compare the acceptance rate of central slaughtering in residents with different characteristic. We used multiple logistic regression analysis to analyze the factors. The difference in gender and age was small between respondents and the 2010 Guangzhou census data (w value was 0.13, 0.28, respectively), but that in education and marital status was large (w value was 0.52, 0.31, respectively). 49.0% (95% CI: 43.7%-54.3%) accept city-wide central slaughtering permanently. The acceptance rate of city-wide central slaughtering permanently in those who bought fresh, chilled and frozen poultry in their family in previous year was 54.3% (133/245), 60.0% (57/95) and 59.8% (49/82), respectively. It was more than those who didn't buy fresh, chilled and frozen poultry (38.1% (43/113), 44.9% (118/263) and 45.7% (126/276); χ(2) values were 8.15, 6.40 and 5.03; P values were 0.004, 0.011 and 0.025, respectively). The acceptance rate of city-wide central slaughtering permanently in those who deem fresh poultry taste better than live poultry was 64.9% (24/38). It more than those who deem not (47.0%, 151/320) (χ(2) = 4.22, 6.02, P = 0.040, 0.014, respectively). The acceptance rate of city-wide central slaughtering permanently in the male (OR = 2.68, 95% CI: 1.64-4.37) and those who deem getting sick due to buying live birds from LPM (OR = 1.72, 95% CI: 1.05-2.82), who can accept only fresh poultry carcass supply (OR = 2.39, 95% CI: 1.33-4.30), Who bought live poultry in their family in previous year (OR = 0.29, 95% CI: 0.11-0.74), who will decrease the consumption after ban on live poultry sale (OR = 0.50, 95% CI: 0.30-0.83) was 58.6% (109/186), 59.0% (92/156), 60.7% (139/230), 44.9% (132/295), 36.6% (68/186), respectively. In the early stage of avian influenza A(H7N9) epidemic in Guangzhou, the rate of acceptance of central slaughtering permanently in residents was not so high. Who deem getting sick due to buying live birds from LPM, who could accept only fresh poultry carcass supply and the male more accept city-wide central slaughtering permanently.

Live poultry traders (LPTs) have greater risk to avian influenza due to occupational exposure to poultry. This study investigated knowledge, attitudes and practices of LPTs relating to influenza A (H7N9). Using multi-stage cluster sampling, 306 LPTs were interviewed in Guangzhou by a standardized questionnaire between mid-May to June, 2013. Hierarchical logistic regression models were used to identify factors associated with preventive practices and attitudes towards various control measures implemented in live poultry markets against H7N9. Only 46.1% of the respondents recognized risks associated with contacts with bird secretions or droppings, and only 22.9% perceived personally

To identify the source of infection, route of transmission and risk factors related to a cluster of acute gastroenteritis cases in a university of Guangzhou. Cases were identified according to the definition. Descriptive epidemiological approaches and case-control study designs were employed in the analysis. All the samples were tested for norovirus by RT-PCR. Positive samples were subjected to both nucleotide sequence and homology analysis. A total of 141 cases related to norovirus gastroenteritis were identified in January 8 to 21, 2013, with the attack rate as 8.5 per thousand (141/16,600). The peak in morbidity was seen on January 8 to 9. No clustering was found in different classes or dormitories. Results from the case-control study revealed that early cases were infected in Restaurant A (OR = 3.46, 95% CI: 1.07-11.16) and the cold shredded chicken set meal (OR = 17.82, 95% CI: 4.46-78.17) served at lunch (OR = 4.34, 95% CI: 1.18 -17.37) on January 7 was under suspicion. A total of 266 samples, including rectal swabs from the patients and kitchen wokers, leftover food and environmental swabs, were collected. Twenty-one samples (collected from 17 persons) were positive for norovirus by RT-PCR. About 29.6% (8/27) of the kitchen workers in the Restaurant A were tested positive for the virus. The pathogen was identified as the new norovirus genotype II.4 variant, termed Sydney 2012. The virus strains isolated from the patients among student and staff and the kitchen workers were 100% identical in their nucleotide sequence. This was the first reported acute gastroenteritis outbreak caused by the new norovirus genotype II.4 variant, Sydney 2012, which showed that the food was contaminated by the asymptomatic kitchen workers who carried the virus.

We conducted both quick surveillance and evaluation programs within one week after the novel H7N9 influenza cases had been released by the Ministry of Health (MOH), to get the basic information on H7N9 virus in Guangzhou. We sampled live birds from food markets and the natural habitat of birds to detect H7N9, H5 and H9 viruses. We interviewed workers from both markets and natural habitats. We also reviewed records on pneumonia patients with unknown causes from the surveillance system, to find clues related to the identification of severe pneumonia. We sampled 300 specimens from 49 stalls in 13 food markets and a natural habitat but none showed H7N9 positive result. A chopping block was detected positive of carrying H5 avian influenza virus, while another 4 specimens including a chicken cage, a duck cage, a chopping block and a pigeon cage were detected positive of carrying H9 avian influenza virus. In the past month, no sick, dead birds or ILI cases among the workers were discovered. 21.2% (7/33) of the stalls did not follow the set regulations for prevention. 10.3% (4/39) of the stalls had the cages cleaned, 4 days after the inspection. 3.7% (2/54) of the workers wore masks and 40.7% (22/54) of them wore gloves during the slaughtering process. 102 bird feces specimens were tested negative on H7N9 virus. No pneumonia cases with unknown reason were identified. From April 3(rd) to 17(th), we found 26 severe pneumonia cases but with negative results on influenza A (H7N9). According to the data and information from 1) lab tests, 2) pneumonia cases with unknown reasons under the surveillance system, 3) the identification of severe pneumonia cases, and 4) preventive measures and actions taken by the workers, we inferred that no H7N9 virus or related cases were found prior to April in Guangzhou. However, the risk of H7N9 epidemic does exist because of the following reasons:1) improper market management process, 2) negligent behavior of the workers and 3) potential trend of the national situation, suggesting strategies related to poultry markets management, health education and preventive measures against the avian influenza need to be strengthened.