Estimated cancers/year due to and A-PDF SplitDEMO:Purchasefromwww.A-PDF.comtoremovethewatermark consumption*

HBsAg prevalence in 10% (3.4-20.3%) It assumes that 10% of the population carries the hepatitis B virus.

Potency: 0.01 x 90% + 0.3 x 10% = 0.039 cancers per year/100 000

people per ng aflatoxin B1/kg body weight per day

3.2 ng/kg bw per day x 0.039 cancers/year per 100,000 population per ng aflatoxin/kg bw per day = 0.1248 cancers/year per 100,000 people.

Estimated cancers/year in Indonesia 222.192.000 people/100.000 people x 0.1248 = 227 persons

* Peanut sauce: /gado-gado/, food Lower consumption data 2007; average body weight estimate? 60kg; 50 g per portion Peanuts and peanut-based products?

•• Peanuts Peanuts How big the portion? •• Pecel Pecel How much the consumption? •• Gado-gado Gado-gado How often? • Who is the consumer? • Karedok What is the level of aflatoxin? •Ketoprak•Ketoprak •• Sate Sate (chicken)(chicken) More than I •• Sate Sate (lamb/goat)(lamb/goat) thought •• Batagor ••Siomay •• Peanut Peanut butterbutter •• Others: Others: gulagula kacang,kacang, enting-entingenting-enting ,gepuk, enting-entingenting-enting kacang,kacang, rempeyekrempeyek kacang,kacang, tahutahu telor,telor, otak-otak,otak-otak, nasinasi uduk,uduk, Food recipe etc.etc. database •• Check Check thethe indonesianindonesian foodfood recipesrecipes How about other products that might contain aflatoxin?

•Corn•Corn How big the portion? •• Rice Rice How much the consumption? •• Wheat Wheat How often? •• Oilseeds Oilseeds Who is the consumer? •Spices•Spices What is the level of aflatoxin? •• Tree Tree nutsnuts (e.g.(e.g. coconut)coconut) We should •Milk•Milk include them I have other •• Dried Dried productsproducts beside peanut foods that might products •Etc•Etc contain aflatoxin Uncertainty in the estimates of cancer risk due to aflatoxin

• Dietary intake data? We should include other peanut based products • Use of average body weight. At present study we use 60 kg. It might be lower than this weight • Other foods that might contain low aflatoxin, but give more exposure due to high intake of the foods? • Range of aflatoxin level in suspected foods? • Prevalence of Hepatitis B in Indonesia? Many versions Aflatoxin control should include all stakeholders

M1 B1

Aflatoxin M1, the hydroxylated metabolite of B1, has a potency approximately one order of magnitude less than that of B1. AFLATOXIN CONTROL: Risk based approach

OnOn farmfarm • Think about consequence, exposure and probability • Aflatoxin control should be food chain Pre-harvestPre-harvest approach • Considering risk factors for aflatoxin production (e.g. temperature, moisture, HarvestHarvest humidity) for management strategies throughout the food chain. • Standard setting should be achievable PostPost harvestharvest • Think a priority • Need awareness raising to build a commitment ConsumptionConsumption • Strengthening a partnership Regulation should be food chain approach and not fragmented

OnOn farmfarm

Pre-harvestPre-harvest

HarvestHarvest

PostPost harvestharvest REGULATIO N Food safety objective? ConsumptionConsumption Performace objective throughout food chain? PC, PrC, MC? Can we achieve the standard (FSO)?

Performance objective? MPL for aflatoxin at PrimaryPrimary consumption level in ProductionProduction Indonesia 30 (µ/kg (Total) Storage Performance Storage 20 (µ/kg (B1) objective? ManufacturesManufactures Performance criteria TransportTransport

Control RetailRetail Food safety measures objective CookingCooking

Public health burden? Exposure ConsumptionConsumption Assess your standard and food control for the estimated cancer level*

Codex ML Aflatoxin Estimated exposure cancer Consumption of level aflatoxin containing food National ML Aflatoxin Estimated exposure cancer level Monitored level Aflatoxin Estimated exposure cancer level Epidemiological data: Prevalence of Hepatitis B

*A need for a sound scientific assessment of the impact of aflatoxin levels in foods on human health Intervention and management option should be based on the risk assessment throughout the food chain*

OnOn farmfarm Ho – Ʃ R + Ʃ I ≤ Po or FSO

Pre-harvestPre-harvest

Hazard level Level at step at initial step HarvestHarvest in the food chain Reduction when Level at PostPost harvestharvest applicable consumption Increase level (growth and ConsumptionConsumption toxin production)

*Adapted from ICMSF (2002)