Presented by Nguyen Viet Hung, Hoang Van Minh, Hoang Thi Thu Ha, Kohei Makita, Fred Unger, Lucy Lapar and Delia Grace at the inception workshop for the 'Reducing Disease Risks and Improving Food Safety in Smallholder Pig Value Chains in Vietnam' project, Hanoi, 14 August 2012.

1. Reducing disease risks and improving food safety
in smallholder pig value chains in Vietnam
Risk assessment component:
planned activities
Nguyen Viet Hung (Hanoi School of Public Health) - Presenter
Hoang Van Minh (Hanoi Medical University)
Hoang Thi Thu Ha (National Institute for Disease and Epidemiology)
Kohei Makita (Rakuno Gakuen University)
Fred Unger (International Livestock Research Institute)
Lucy Lapar (International Livestock Research Institute)
Delia Grace (International Livestock Research Institute)

2. Objectives
• 1. To assess impacts of pork-borne diseases on human
health and the livestock sector and identify critical
points/opportunities for risk management
• 2. To develop and test incentive-based innovations to
improve management of human and animal health risks
in smallholder pig value chains.
• 3. To sustainably improve capacity to assess and
manage risks in smallholder pig value chains by
engaging stakeholders and co-generating evidence.

3. Project framework
Risk profiling 1
2 Microbial Risk Assessment
t 3
m
Chemical Risk Assessment
en Action research 1
s s
Risk assessment
se
as
Action research 2
Animal Health Risk Assessment
R i sk Interventions
Action research 3
Economics (eg health, CBA)
…………………
Rapid assessment
Economic assessment
Value chain
…
Incentive-based interventions
Randomized Control Trials (RCT)
….
4
Engaging stakeholders and co-generating evidence, Advocacy, C ommunication, OM

4. Risk analysis
• Risk analysis describes how risks are dealt
within the society, including 3 components
Hazard vs. Risk
• Risk assessment (RA): is there a
Risk Risk
problem? How adverse the problem is?
Assessment Management
• Risk management: how to reduce risk
Risk
Communication
• Risk communication: Communication of
risks to managers, stakeholders, public
officials, and the public.
Source: Codex (1999)

5. Quantitative Microbial Risk Assessment (QMRA)
within Risk Analysis framework
Q M R A
1.Hazard Identification
Describe environment, pathogens, Health effects
2.Dose-response Analysis
Relationships between exposure (dose) &
frequency of infection/illness (response)
3.Exposure Assessment
Size & nature of the population, route, amount and
duration of the exposure
4.Risk Characterization
Integrate the information from 3 and 4 to express
i t ac nu mm C
public health outcomes, taking into account the
o
variability and uncertainty of the estimations.
uqca a a D
t
i
Risk management

6. Quantitative Risk assessment
Food safety risk analysis: Codex vs. informal
marketing system
Participatory methods
Risk Risk
Assessment Management
Risk
Communication

7. Concept of participatory risk analysis
Bonfoh B. (2010) Revue Africaine de Santé et de Productions Animales.
Adapting quantitative risk assessment to the context of food safety in informal
markets: incorporation of information collected using participatory methods;
engagement of stakeholders; use of “appropriately imprecise” data (that is,
collected at least cost for the purpose).

8. Where is participatory used in the conventional RA
Q M R A
1.Hazard Identification
Describe environment, pathogens, Health effects
2.Dose-response Analysis
Relationships between exposure (dose) &
frequency of infection/illness (response)
3.Exposure Assessment
Size & nature of the population, route, amount and
duration of the exposure Participatory
methods
4.Risk Characterization
Integrate the information from 3 and 4 to express
fit well
i t ac nu mm C
public health outcomes, taking into account the
o
variability and uncertainty of the estimations.
uqca a a D
t
i
Risk management

9. Activities
•Risk profiling and priority hazard identification
•Risk assessment
•Economic assessment of disease burden on
humans and CBA

10. 1. Risk Profiling and priority hazard
identification
• Broad and qualitative summary of relevant information on a specific
food safety issue or animal disease.
• Hazard, impact on human and/or animal health, population affected,
incidence and prevalence, epidemiology of transmission, stakeholder
concerns, relative importance of the hazard, and options for
management, etc.
• Recommendations whether or not to further address the problem and
the recommendation to whether or not to commission risk
assessments. This needs to be done in collaboration with national
stakeholders to reflect priorities.
• Rough analysis (sample collection and analysis)
• Design: desk study based on systematic literature review + sampling

11. Food-borne disease Diseases of pig
Parasitic Ectoparasites
•Cysticercus cellulosae Endoparasites (gut, lung, liver)
•Trichinella spiralis Respiratory (bacterial, viral)
•Toxoplasma gondii Gastrointestinal (bacterial viral)
•Fasciola spp Reproductive
Skeletal
Bacterial Foot-and-mouth disease
•Bacillus cereus Classical swine fever
•Brucella suis Porcine reproductive and respiratory syndrome
•Campylobacter spp.
•Salmonella eneterica Non-food borne zoonoses
•Staphylococcus arues •Japanese encephalitis
•Shiga toxin producing E. coli •Erysipeloid
•Yersinia enterocolitica •Streptococcus suis
•Leptospira spp
Chemical
•Antibiotic residues
•Aflatoxins
•Steroids/growth promoters

12. Exposure
assessment
Infection risk (P)
Pf Pp Pr
Slaughter Market Con-
Farm Risk
house sumption
Nf Np Nr
Pathogen concentration (N) Exposure
assessment
Farm to fork (Microbiological Risk Assessment Series No2-2002,
No7-2008)

13. An overview of the modules within the farm-to-consumption for risk assessment
FARM & TRANSPORT
Piglets source Weaners source Finishers source Transport & lairage
-sow -new pig in batch -new pigs in batch -mixing of pigs
-feed -feed -feed -contamination of transport
-contamination -contamination -contamination
-transmission -transmission -transmission
-cross-contamination -cross-contamination -cross-contamination
Slaughter
PROCESSING: -Scalding
Randomly
(different pig meat products) -Dehairing
sampling -Singeing
-Polishing
-transmission -Evisceration
-cross-contamination -Trimming
-inactivation -Chilling
-growth
-transmission
PREPARATION & CONSUMPTION -cross-contamination
(Different end-products) -inactivation

14. Modeling process in exposure assessment
Fault tree Understanding a logic of exposure
Participatory &
interviews Understanding a value chain
Participatory &
Quantifying a value chain
interviews
A survey, Quantifying contamination and growth
literature
Participatory &
interviews Quantifying risk mitigation in a value chain
Literature Dose-response model
Building into risk characterization model
Day 2-1

15. Chemical risk assessment
• Heavy metals (lead, mercury, arsenic, cadmium …)
• Polychlorinated dibenzo-p-dioxins (PCDDs),
• Polychlorinated dibenzofurans (PCDFs) and dioxin-like polychlorinated
biphenyls (DL-PCBs), hexachlorobenzene (HCB), polychlorinated
naphthalenes (PCNs),
• Polycyclic aromatic hydrocarbons (PAHs), polychlorinated diphenyl
ethers (PCDEs), polybrominated diphenyl ethers (PBDEs), 16 polycyclic
aromatic hydrocarbons (PAHs) (naphthalene, acenaphthylene,
acenaphthene, fluorene, phenanthrene, anthracene, fluoranthene,
pyrene, benz[a]anthracene, chrysene, benzo[b]fluoranthene,
benzo[k]fluoranthene, benzo[a]pyrene, dibenz[a,h]anthracene,
benzo[g,h,i]perylene, and indeno[1,2,3-c,h]pyrene), antibiotics, etc.
• February 2012, officials in Vietnam found beta-Agonists, a banned lean
meat enhancing drug in some pig-rearing households in Dong Nai.
• Environmental health risk assessment framework.

16. Sampling (1)
• At farm: environmental impact
• Slaughter house
• Market
• Consumption
• Predictive microbiology (microbial growth)
• Combined assessment on consumption, market,
SH etc.. with interview of the value chain actors…
• Modeling

17. Sampling (2)
• Pork foodstuffs, way of preparation, and eating habits
identified by the survey.
• Raw and cooled, in the case of (iv), prepared pork meat
samples will be collected at four points for testing: i) Small
scale slaughterhouse, ii) Market (wet market and
supermarket), iii) Consumer handling (undercooking and
cross-contamination) and iv) Consumption (exposure to
pathogens).
• Environmental samples (farm, water, soil)
• Variability, seasonal bias amples will be collected in two
different seasons on a distribution of 8 months.

18. Challenges
• Difficulties to follow farm to folk: do we need to trace
pork from farm to fork?
• Chemical risk assessment: what will be the key hazard
(technique for hazard ranking?)
• Risk factor vs. Phylogeny study to identify etiology of
diseases
• Uncertainty