View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Elsevier - Publisher Connector Kaohsiung Journal of Medical Sciences (2012) 28, S10eS16 Available online at www.sciencedirect.com journal homepage: http://www.kjms-online.com REVIEW ARTICLE Major food safety episodes in Taiwan: Implications for the necessity of international collaboration on safety assessment and management Jih-Heng Li a,b,*, Wen-Jing Yu b,c, Yuan-Hui Lai d, Ying-Chin Ko e,f a School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan b Ph.D. Program in Toxicology, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan c Food and Drug Administration, Department of Health, Taiwan d Department of Public Affairs and Management, Kainan University, Taoyuan, Taiwan e Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan f Center of Excellence for Environmental Medicine, Kaohsiung Medical University, Taiwan Received 30 September 2011; accepted 16 December 2011 Available online 7 July 2012 KEYWORDS Abstract The major food safety episodes that occurred in Taiwan during the past decade are Assessment and briefly reviewed in this paper. Among the nine major episodes surveyed, with the exception of management; a U.S. beef (associated with CreutzfeldteJakob disease)-related incident, all the others were Food safety; associated with chemical toxicants. The general public, which has a layperson attitude of zero Taiwan; tolerance toward food safety, may panic over these food-safety-associated incidents. Zero tolerance However, the health effects and impacts of most incidents, with the exception of the mela- mine incident, were essentially not fully evaluated. The mass media play an important role in determining whether a food safety concern becomes a major incident. A well-coordinated and harmonized system for domestic and international collaboration to set up standards and regulations is critical, as observed in the incidents of pork with ractopamine, Chinese hairy crab with nitrofuran antibiotics, and U.S. wheat with malathion. In the future, it can be antic- ipated that food safety issues will draw more attention from the general public. For unknown new toxicants or illicit adulteration of food, the establishment of a more proactive safety assessment system to monitor potential threats and provide real-time information exchange is imperative. Copyright ª 2012, Elsevier Taiwan LLC. All rights reserved. * Corresponding author. School of Pharmacy, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung City 80708, Taiwan. E-mail address: [email protected] (J.-H. Li). 1607-551X/$36 Copyright ª 2012, Elsevier Taiwan LLC. All rights reserved. http://dx.doi.org/10.1016/j.kjms.2012.05.004 Major food safety episodes in Taiwan S11 Introduction become chaotic. Related to the case of the incident of U.S. pork with ractopamine, the Department of Health intended Although food bears the presumption of safety, and the to set up a maximum ractopamine residue level in pork in ultimate goal of the food industry and national policy- August 2007, only to find that the Council of Agriculture had makers is to ensure that all food should be “safe and banned the use of ractopamine as a feed additive in wholesome,” complete freedom from risk has not yet been October 2006. at hand [1,2]. In fact, along with the more and more With respect to the classification of toxicants in these globalized food trade, food safety has become one of our episodes, only one (the U.S. beef incident) was caused by major concerns. For example, two recent issues of illicit a biologic agent (prion). The other eight incidents were all adulteration of food, the 2008 melamine incident and the associated with chemical toxicants, which included mala- 2011 plasticizer incident, not only caused unwanted health chite green and nitrofuran antibiotics (illicit additives used effects but also resulted in tremendous social and economic for antibacterial purposes, three cases), melamine and costs [3e6]. Apart from illicit adulteration, food safety plasticizer (illicit adulteration, two cases), malathion and issues can also arise from a variety of causes, such as food ractopamine (legal with residue limits in the source country allergy, anaphylactoid reaction, foodedrug interactions but illegal in Taiwan, two cases), and arsenic (a false alarm, and metabolic food reactions [1]. one case). A few of the chemicals that caused the food In Taiwan, as in many other countries, major food safety safety incidents may be questioned in terms of their incidents have occurred during the past decade. Reviewing potential to result in a real health threat. Taking nitrofuran the causes of these incidents will not only provide us with antibiotics as an example, people who consumed clues to understand the risk factors that contributed to nitrofuran-contaminated Chinese hairy crabs or trout may their occurrences but will also prevent us from experi- be concerned with the liability of getting cancer. However, encing similar situations in the future. As these incidents nitrofuran antibiotics (e.g., nitrofurantoin) are still used have not been systematically reviewed previously, the clinically as a medication for treating urinary tract infec- major food safety incidents that occurred in Taiwan in the tion in humans. If large doses of nitrofuran antibiotics are past decade are therefore scrutinized in this paper and not a concern with respect to patients developing cancers, their causes and effects are discussed. then it is debatable whether trace amounts of nitrofuran antibiotics in Chinese hairy crabs or trout would cause cancers [28]. Definition of a major food safety incident One should also be reminded that mass communication media play an important role in deciding whether a food In this paper, a major food safety incident is defined as safety incident is regarded as a major or significant issue. a food-safetyerelated issue that was reported by Taiwan’s The fried oil with arsenic incident is a good example. It is major press media, such as Apple Daily, China Times, now known that the fried oil, after confirmation testing, United Daily, and Liberty Times, for more than 1 week, was found not to contain an excessive concentration of thereby drew the attention of the general public and had arsenic. Although it is always in the spirit of news media to a substantial impact on society. Such major food safety report news with exclusivity and rapidity, truth seeking incidents are responded to by the incumbent governmental should also be one of the core values when pursuing agencies, with announcements of decision-making and/or breaking news. action measures. The major food safety incidents were identified and analyzed according to their chemical and toxicologic characteristics, health effects, and social Effects and impacts of major food safety impacts, as well as possible solutions to the problems. episodes The effects and impacts of these food safety episodes are Occurrence and development of major food also depicted in Table 1. With the exception of the safety episodes in Taiwan poisonous milk (melamine) incident, the health effects and impacts of most incidents are yet to be evaluated, although The major food safety episodes that occurred in Taiwan in people in Taiwan have already become panicky. The the past decade are summarized in Table 1 [6e27]. Among melamine incident represents one of the largest deliberate the nine major food safety incidents, the food involved can food adulteration events [3,4]. It has been shown that the be classified into five categories: (1) aquaculture products: incident affected about 300,000 Chinese infants and young grouper fish, trout, and Chinese hairy crab (three inci- children and caused six deaths. The tragedy also indicated dents); (2) farmed cattle meat: beef and pork (two inci- that food safety incidents should be managed internation- dents); (3) milk products and beverages (two incidents); (4) ally, and as early as possible. Worldwide collaboration crop: wheat (one incident); and (5) fried oil (one incident). between food safety authorities is needed so that infor- In most cases, the jurisdiction of food safety issues falls mation exchange and tracking and recalling of affected into the responsibility of more than one incumbent products can be efficiently executed to ensure food safety government agency in Taiwan. For instance, both the [29]. A similar situation was the plasticizer incident, which Department of Health and the Council of Agriculture are was also a case of illicit adulteration and depended on the gatekeepers of food safety in Categories (1), (2) and international collaboration for information exchange, (4). If the regulations and standards of one agency are not tracking and recalling of affected products to lessen the in harmony with those of another agency, the situation may health effects and impacts [6]. However, as exposure to S12 Table 1 Major food safety episodes in Taiwan. Incident Main hazard involved Occurrence and Development of the Incident Effects and Impacts U.S. beef CreutzfeldteJakob disease Imports of U.S. beef were banned when the mad The level of beef safety became a worldwide (CJD), a prion-related disease. cow disease (bovine spongiform encephalopathy), a concern. The safety level of beef in Taiwan was variant form of human CJD, was reported in the U.S. downgraded to those in the United States and in December 2003 [7]. The imports, conditionally Canada [11]. The general public, by the influence of reopened in April 2005[8], were soon banned again mass media, panicked over the possibility of in July 2005 but resumed conditionally in January contracting CJD if they consumed U.S. beef. In 2006 [9]. The regulations regarding the import of January 2010, lawmakers, reflecting the public U.S. beef and derived products were amended in concern that Taiwanese officials lacked sufficient 2009 [10]. protective measures, voted to ban the American ground beef and offal [12]. Grouper fish with Malachite green, a carcinogenic On September 1, 2005, Hong Kong media reported The results aroused the public’s concerns.