Public health risks related to food safety issues in the food ...

Microbial contamination of foods, chemical contamination of foods, food adulteration, misuse of food additives, mislabeling, genetically ... Skiptomaincontent Advertisement SearchallBMCarticles Search Publichealthrisksrelatedtofoodsafetyissuesinthefoodmarket:asystematicliteraturereview DownloadPDF DownloadePub DownloadPDF DownloadePub Reviewarticle OpenAccess Published:30November2019 Publichealthrisksrelatedtofoodsafetyissuesinthefoodmarket:asystematicliteraturereview ZemichaelGizaw  ORCID:orcid.org/0000-0002-6713-19751  EnvironmentalHealthandPreventiveMedicine volume 24,Article number: 68(2019) Citethisarticle 51kAccesses 46Citations 2Altmetric Metricsdetails AbstractBackgroundFoodsafetyinthefoodmarketisoneofthekeyareasoffocusinpublichealth,becauseitaffectspeopleofeveryage,race,gender,andincomelevelaroundtheworld.Thelocalandinternationalfoodmarketingcontinuestohavesignificantimpactsonfoodsafetyandhealthofthepublic.Foodsupplychainsnowcrossmultiplenationalborderswhichincreasetheinternationalizationofhealthrisks.Thissystematicreviewofliteraturewas,therefore,conductedtoidentifycommonpublichealthrisksrelatedtofoodsafetyissuesinthefoodmarket.MethodsAllpublishedandunpublishedquantitative,qualitative,andmixedmethodstudiesweresearchedfromelectronicdatabasesusingathreestepsearching.AnalyticalframeworkwasdevelopedusingthePICo(population,phenomenaofinterest,andcontext)method.Themethodologicalqualityoftheincludedstudieswasassessedusingmixedmethodsappraisaltool(MMAT)version2018.Theincludedfull-textarticleswerequalitativelyanalyzedusingemergentthematicanalysisapproachtoidentifykeyconceptsandcodedthemintorelatednon-mutuallyexclusivethemes.Wethensynthesizedeachthemebycomparingthediscussionandconclusionoftheincludedarticles.Emergentthemeswereidentifiedbasedonmeticulousandsystematicreading.Codingandinterpretingthedatawererefinedduringanalysis.ResultsTheanalysisof81full-textarticlesresultedinsevencommonpublichealthrisksrelatedwithfoodsafetyinthefoodmarket.Microbialcontaminationoffoods,chemicalcontaminationoffoods,foodadulteration,misuseoffoodadditives,mislabeling,geneticallymodifiedfoods(GMfoods),andoutdatedfoodsorfoodspasttheiruse-bydatesweretheidentifiedfoodsafety–relatedpublichealthrisksinthefoodmarket.ConclusionThissystematicliteraturereviewidentifiedcommonfoodsafety–relatedpublichealthrisksinthefoodmarket.Theresultsimplythatthelocalandinternationalfoodmarketingcontinuestohavesignificantimpactsonhealthofthepublic.Thefoodmarketincreasesinternationalizationofhealthrisksasthefoodsupplychainscrossmultiplenationalborders.Therefore,effectivenationalrisk-basedfoodcontrolsystemsareessentialtoprotectthehealthandsafetyofthepublic.Countriesneedalsoassurethesafetyandqualityoftheirfoodsenteringinternationaltradeandensurethatimportedfoodsconformtonationalrequirements. BackgroundFoodsafetyisanimportantissuethataffectsalloftheworld’speople.Manycountriesthroughouttheworldareincreasinglyinterdependentontheavailabilityoftheirfoodsupplyandonitssafety.Hence,peopleallovertheworldincreasinglyvaluefoodsafety;foodproductionshouldbedonesafelytomaximizepublichealthgainsandenvironmentalbenefits.Foodsafetydealswithsafeguardingthefoodsupplychainfromtheintroduction,growth,orsurvivalofhazardousmicrobialandchemicalagents[1,2].Unsafefoodcontainingharmfulbacteria,viruses,parasites,orchemicalsubstancescausesmorethan200diseases—rangingfromdiarrheatocancers.Anestimated600millionintheworldfallillaftereatingcontaminatedfoodand420,000dieeveryyear,resultinginthelossof33milliondisabilityadjustedlifeyears(DALYs).Childrenunder5 yearsofagecarry40%ofthefoodbornediseaseburden,with125,000deathseveryyear.Diarrhealdiseasesarethemostcommonillnessesresultingfromtheconsumptionofcontaminatedfood,causing550millionpeopletofallilland230,000deathseveryyear[3].Foodsafetyisbeingchallengednowadaysbytheglobaldimensionsoffoodsupplychains[1,4,5].Foodsintheinternationalmarketmaybefraudedasdifferentpartiessuchasmanufacturers,co-packers,distributors,andothersalongthechainofdistributioninvolveinthenationalorinternationaltrade[6,7,8].Foodsafetyinthefoodmarketisoneofthekeyareasoffocusinpublichealth,becauseitaffectspeopleofeveryage,race,gender,andincomelevelaroundtheworld.Thelocalandinternationalfoodmarketingcontinuestohavesignificantimpactsonfoodsafetyandhealthofthepublic.Foodsupplychainsnowcrossmultiplenationalborderswhichincreasetheinternationalizationofhealthrisks[9,10,11,12,13,14].Thissystematicreviewofliteraturewas,therefore,conductedtoidentifycommonpublichealthrisksrelatedtofoodsafetyissuesinthefoodmarket.Thisreviewprovidesevidencetoimprovefoodsafetyinthefoodmarketusingrisk-basedfoodsafetystrategies.Healthcareproviders,researchers,andpolicymakersmayusetheresultsofthissystematicliteraturereviewtoprotectthepublicfromunduehealtheffectsduetoconsumptionoffoodswithpoorqualityandsafety.MethodsResearchquestionWhatfoodsafety–relatedpublichealthrisksarecommonlyfoundinthefoodmarket?AnalyticalframeworkWedevelopedthecomponentsoftheanalyticalframeworkusingthePICo(population,phenomenaofinterest,andcontext)method.Thepopulationforthisreviewwasthepublicovertheglobe.Thephenomenonofinterestforthisreviewwaspublichealthrisksassociatedwithfoodsafety.Thecontextwasthefoodmarket(suchasrestaurants,foodstores,supermarkets,shops,foodprocessingplants,andstreetvending).Thereviewerssattogethertodiscussandrefinetheframework.CriteriaforconsideringstudiesforthisreviewAllpublishedandunpublishedquantitative,qualitative,andmixedmethodstudiesconductedonfoodsafety–relatedhealthrisksforthegeneralpublicinthefoodmarketwereincluded.Governmentalandotherorganizationalreportswerealsoincluded.ArticlespublishedotherthanEnglishlanguage,citationswithnoabstractsand/orfulltexts,duplicatestudies,andstudieswithpoorqualitywereexcluded.SearchstrategyWesearchedpublishedarticles/orreportsfromMEDLINE/PubMed,EMBASE,CINAHL,AccessMedicine,Scopus,WebofScience,GoogleScholar,WHOLibrary,FAOLibraries,andWTOLibrary.WealsosearchedthesisanddissertationsfromWorldcatandProQuest.Weusedathreestepsearching.Inthefirststep,weconductedaninitiallimitedsearchofMEDLINEandanalyzedthetextwordscontainedinthetitleandabstract,andoftheindextermsusedtodescribearticles.Secondly,wesearchedacrossallincludeddatabasesusingallidentifiedkeywordsandindexterms.Thirdly,referencesofallidentifiedarticlesweresearchedtogetadditionalstudies.Thesearchtermweusedintheinitialsearchingispresentedasfollows.((((("publichealth"[MeSHTerms]OR("public"[AllFields]AND"health"[AllFields])OR"publichealth"[AllFields])AND("risk"[MeSHTerms]OR"risk"[AllFields]OR"risks"[AllFields]))OR(("publichealth"[MeSHTerms]OR("public"[AllFields]AND"health"[AllFields])OR"publichealth"[AllFields])ANDhazards[AllFields]))OR(("publichealth"[MeSHTerms]OR("public"[AllFields]AND"health"[AllFields])OR"publichealth"[AllFields])ANDproblems[AllFields]))AND((("foodsafety"[MeSHTerms]OR("food"[AllFields]AND"safety"[AllFields])OR"foodsafety"[AllFields])OR("foodquality"[MeSHTerms]OR("food"[AllFields]AND"quality"[AllFields])OR"foodquality"[AllFields]))OR(("food"[MeSHTerms]OR"food"[AllFields])AND("hygiene"[MeSHTerms]OR"hygiene"[AllFields]))))AND(((("food"[MeSHTerms]OR"food"[AllFields])ANDmarket[AllFields])OR(("food"[MeSHTerms]OR"food"[AllFields])ANDtrade[AllFields]))OR(("foodsupply"[MeSHTerms]OR("food"[AllFields]AND"supply"[AllFields])OR"foodsupply"[AllFields])ANDchain[AllFields]))AssessmentofmethodologicalqualitySearchresultsfromdifferentelectronicdatabaseswereexportedtoEndnotereferencemanagertoremoveduplication.Twoindependentreviewers(ZGandBA)screenedoutarticlesusingtitlesandabstracts.Thereviewersfurtherinvestigatedandassessedfull-textarticlesagainsttheinclusionandexclusioncriteria.Thereviewerssattogethertoresolvedisagreementsduringthereview.Themethodologicalqualityoftheincludedstudieswasassessedusingmixedmethodsappraisaltool(MMAT)version2018[15].Thismethodexplainsthedetailofeachcriterion.Theratingofeachcriterionwas,therefore,doneasperthedetailexplanationsincludedinthemethod.Almostalloftheincludedfull-textarticlesfulfilledthecriteriaandalltheincludedfull-textarticleswerefoundtobebetterquality.DataextractionInordertominimizebias,wethereviewersindependentlyextracteddatafrompapersincludedinthereviewusingJBImixedmethodsdataextractionform[16].Thedataextractionformwaspilotedonrandomlyselectedpapersandmodifiedaccordingly.Eligibilityassessmentwasperformedindependentlybythetworeviewers.Informationlikeauthors,yearofpublication,studyareas,typeofstudies,andfocusofthestudyormainmessageswereextracted.SynthesisoffindingsTheincludedfull-textarticleswerequalitativelyanalyzedusingemergentthematicanalysisapproachtoidentifykeyconceptsandcodedthemintorelatednon-mutuallyexclusivethemes.Wethensynthesizedeachthemebycomparingthediscussionandconclusionoftheincludedarticles.Emergentthemeswereidentifiedbasedonmeticulousandsystematicreading.Codingandinterpretingthedatawererefinedduringtheanalysis.ResultsThesearchprocessThesearchstrategyidentified2641titlesandabstracts(1890fromPubMedand751fromothersources)asof13June2019.Weobtained1992titleandabstractsafterweremovedduplicates.Followingassessmentbytitleandabstract,705articleswereretrievedformoreevaluationand344articleswereassessedforeligibility.Finally,81articleswereincludedforsystematicliteraturereviewbasedontheinclusioncriteria(Fig.1). Fig.1StudyselectionflowdiagramFullsizeimageInthisreview,81of1992(4%)full-textarticlesmatchedtheinclusioncriteria.Theoverwhelmingmajority,74of81(91%)oftheincludedfull-textarticlesareresearcharticles;2(3%)areshortcommunications;2(3%)areregulatorypapers,1(1%)isfieldinspection;1(1%)isresearchnote;andtheother1(1%)isthesis.Oftheincludedfull-textarticles,30of81(37%)areconductedinAsia;4of81(5%)areconductedinmultiplecountriesinthesameregionoracrossregions;and1of81(1%)isnotregionspecific(Fig.2). Fig.2Regionswheretheincludedfull-textarticlesconductedFullsizeimageAlltheincludedfull-textarticlesarepublishedbetween1991and2018(35(43%)between2011and2015;16(20%)between2000and2005;16(20%)between2006and2010;12(15%)between2016and2018;andtherest2(2%)before2000).Foodsafety–relatedpublichealthrisksidentifiedfromthesearchprocessTheanalysisof81full-textarticlesresultedinsevencommonpublichealthrisksrelatedwithfoodsafetyinthefoodmarket.Microbialcontaminationoffoods,chemicalcontaminationoffoods,foodadulteration,misuseoffoodadditives,mislabeling,GMfoods,andfoodspasttheiruse-bydatesweretheidentifiedfoodsafety–relatedhealthrisksinthefoodmarket(Table1). Table1Commonfoodsafety–relatedpublichealthrisksidentifiedfromthesearchprocessFullsizetableTable2showsfoodsafety–relatedpublichealthrisksinthefoodmarketbycountryname(countriesarecategorizedintodevelopedanddevelopingbasedontheUnitedNations(UN)2019list).Among21full-textarticlesincludedformicrobialcontaminationoffoods,13(62%)werefromdevelopingcountries.Thismaysuggestmicrobialcontaminationoffoodsinthefoodmarketisacommonpublichealthriskindevelopingcountriesthanthedeveloped.Eight(53%)of15articlesretrievedforchemicalcontaminationoffoodsinthefoodmarketwerefromdevelopingcountries.Thevastmajority,8of9(89%)full-textarticlesretrievedforfoodadulterationwerefromdevelopingcountries,whichmayindicateadulterationoffoodsispracticedmoreofindevelopingcountries.Similarly,8of11(73%)ofthefull-textarticlesincludedformisuseoffoodadditiveswerefromdevelopingcountries,whichmayshowmisuseoffoodadditivesisacommonproblemindevelopingcountries.Formislabeling,14of17(82%)and8of17(47%)ofthefull-textarticleswerefromdevelopedanddevelopingcountriesrespectively.Fouroutofsix(67%)offull-textarticlesretrievedforfoodspastuse-bydateswerefromdevelopingcountries.Thismayshowsellingofoutdatedfoodsiscommonindevelopingcountriesthanthedeveloped. Table2Foodsafety–relatedpublichealthrisksinthefoodmarketbycountryname(countriesarecategorizedintodevelopedanddevelopingbasedontheUnitedNations(UN)2019list)FullsizetableFigure3showscomparisonoffoodsafetyissuesindevelopedanddevelopingcountries.Atotalof37and50articleswereincludedinthisreviewfromdevelopedanddevelopingcountriesrespectively.Thecomparisonoffoodsafetyissuesamongdevelopedcountriessuggeststhatmislabeling(38%),microbialcontaminations(22%),andchemicalcontamination(19%)arethecommonestfoodsafetyissuesinthefoodmarket.Similarly,thecomparisonoffoodsafetyissuesamongdevelopingcountriessuggeststhatmicrobialcontaminations(26%),chemicalcontaminations(16%),foodadulteration(16%),misuseofadditives(16%),andmislabeling(16%)arethecommonestfoodsafetyissuesinthefoodmarket. Fig.3ComparisonoffoodsafetyissuesindevelopedanddevelopingcountriesFullsizeimageMicrobialcontaminationoffoodsInthisreview,21of81(26%)full-textarticlesreportedthepresenceofpathogenicmicroorganismsindifferentfooditemsinthefoodmarket.ThesestudiesidentifieddifferentdiseasescausingbacteriamainlySalmonellaspp.,Escherichiacoli,Klebsiellaspp.,Shigellaspp.,Enterobacterspp.,Proteusspp.,Citrobacterspp.Staphylococcusaureus,Campylobacterspp.,Listeriaspp.,Vibrio,Alklegensspp.,Bacilluscereus,Pseudomonasspp.,Clostridiumperfringens,Arcobacterspp.,andEnterococcusspp.Moreover,differentfungussuchasBlastomyces,Fusariumspp.,Mucorspp.,Aspergillusniger,Fusariumavenaceum,Penicilliumdigitatum,Rhizopusstolonifer,Saccharomycesspecies,Fusariumsolani,Aspergillusflavus,Saccharomycesdairensis,andSaccharomycesexiguuswereidentifiedfromdifferentfooditemsfromfoodstoresorshops.Theincludedstudiesalsoreportedthatsomeofthemicroorganismsareresistanttodifferentantimicrobials(Table3).Theresultsalsoshowthattotalcoliforms,fecalcoliforms,anddifferentfunguswerecommonlyreportedindevelopingcountriesthandevelopedcountries.Ontheotherhand,differentCampylobacterspecieswerereportedindevelopedcountriesthandevelopedcountries. Table3Summaryoffull-textarticleswhichreportedmicrobialcontaminationoffoodsasapublicriskinfoodmarketingFullsizetableChemicalcontaminationoffoodsFifteen(19%)ofthefull-textarticlesincludedinthisreviewreportedthatcontaminationoffoodswithhazardouschemicalsisamajorpublichealthconcernassociatedwiththefoodmarket.Heavymetals(likecadmium,nickel,lead,copper,zinc,iron,mercury,andmanganese),pesticideresiduals(likedichlorvos,dimethoate,parathion-methyl,pirimiphos-methyl,andparathion),persistentorganicpollutants(likedichlorodiphenyltrichloroethanemetabolites,polychlorinatedbiphenyls,perfluorooctanoicacid,endosulfans,andaldrin),organiccompounds(likepatulin,chloroform,formalin,andurea),volatileorganiccompounds(likeethylbenzene,o-xylene,andbenzene),hydrocarbons(likebenzo[a]pyreneandtoluene),andotherchemicalcompounds(likecalciumcarbideandcyanide)arechemicalcontaminantsidentifiedbythefull-textarticlesincludedinthisreview.Inmostcases,theconcentrationofchemicalsexceededthetolerablelimitforconsumablefooditems(Table4). Table4Summaryoffull-textarticleswhichreportedchemicalcontaminationoffoodsasapublicriskinfoodmarketingFullsizetableFoodadulterationIn9(11%)offull-textarticlesincludedinthisreview,foodadulterationhasbeendiscussedasamajorpublichealthriskassociatedwithfoodsafetyissuesinthefoodmarket.Mostofthefoodstuffsinthemarketareadulteratedinvaryingdegrees.Chemicals(likeureafertilizer,artificialcolorflavors,textiledye,formalin,chlorofluorocarbon;DDTpowder,sodiumbicarbonate,neutralizers,detergents,hydrogenperoxide,causticsoda,sodiumchloride,boricacid,ammoniumsulfate,sorbitol,metanilyellow,ultramarineblue,rhodamineB.,maleicanhydride,copperchlorophyll,dimethyl/diethylyellow,argemoneoil,burntmobil,andburntoil);itemswhicharenotthegenuinecomponentoffoods(likepotatosmash,cow’sfatandintestineinghee,waterinmilk,sugarinhoney,etc.);poor-qualityproducts;andphysicalorinertagents(likesawdustandbrickpowder)arethecommonestadulterantsaddedtodifferentfooditems(Table5). Table5Summaryoffull-textarticleswhichreportedfoodadulterationasapublicriskinfoodmarketingFullsizetableMisuseoffoodadditivesInthissystematicreviewofliterature,11of81(14%)full-textarticlesshowedthatmisuseoffoodadditivesinthefoodmarketendangerspublichealth.Asreportedintheincludedfull-textarticles,eventhoughsomefoodcolorantsandsweetenersarepermittedtousesuchassunsetyellowFCF(SSYFCF),tartrazine,erythrosine,newcoccine,ponceau,andsaccharin(somemaynotbepermittedbasedoncountriesfoodregulation),theirconcentrationexceededtheprescribedlimit.Moreover,useofnon-permittedcolorantsandsweetenerssuchasrhodamineB,metanilyellow,orangeII,malachitegreen,auramine,quinolineyellow,amaranth,carmoisine,Sudandyes,andcyclamate(somemaybepermittedbasedoncountriesfoodregulation)isalsocommonlyreportedintheincludedstudies(Table6). Table6Summaryoffull-textarticleswhichreportedmisuseoffoodadditivesasapublicriskinfoodmarketingFullsizetableMislabelingMislabelingoffoodproductshasbeenmentionedasamajorpublichealthriskassociatedwithfoodsafetyinthefoodmarketin17of81(21%)full-textarticlesincludedinthisreview.Allofthe17studiesreportedthatsignificantproportionoffoodsamplescollectedfromsupermarkets,foodstores,shops,andrestaurantsweregeneticallyidentifiedasentirelydifferentspeciesfromthatidentifiedontheproductlabels,andthereforewereconsideredasmislabeled.Thestudieswitnessedthatseafoodisthemostcommonlymislabeledfoodproduct(Table7). Table7Summaryoffull-textarticleswhichreportedmislabelingasapublicriskinfoodmarketingFullsizetableGeneticallymodifiedfoodsInthissystematicreviewofliterature,4of81(5%)oftheincludedfull-textarticlesdiscussedthatGMfoodsarebecominganincreasingpublichealthrisk.Hypertension,stroke,diabetes,obesity,lipoproteinmetabolismdisorder,Alzheimer’s,Parkinson’s,multiplesclerosis,hepatitisC,end-stagerenaldisease,acutekidneyfailure,cancersofthethyroid/liver/bladder/pancreas/kidney,myeloidleukemia,diarrhea,vomiting,difficultyinbreathing,respiratoryproblems,hormonalimbalancesandsusceptibilitytoinfectionorimmunosuppression,allergenicorrashes,andchemicaltoxicityarehealthproblemsreportedintheincludedfull-textarticles(Table8). Table8Summaryoffull-textarticleswhichreportedgeneticallymodifiedfoodsasapublicriskinfoodmarketingFullsizetableFoodspasttheiruse-bydatesSix(7%)oftheincludedfull-textarticlesrevealedthatoutdatedorfoodspasttheiruse-bydatesarebeingsoldinfoodstores,shops,andrestaurantswhicharecontributinghugepublichealthandenvironmentalproblems(Table9). Table9Summaryoffull-textarticleswhichreportedfoodspasttheiruse-bydatesasapublicriskinfoodmarketingFullsizetableDiscussionThisreviewidentifiedthatmicrobialcontamination,chemicalcontamination,adulteration,misuseoffoodadditives,mislabeling,geneticallymodifiedfoods,andoutdatedfoodsarecommonpublichealthrisksrelatedwithfoodsafetyissuesinthefoodmarket.Inthefoodmarket,foodcanbecomecontaminatedinonecountryandcausehealthproblemsinanother.Thesefoodsafetyissuescauseexposureofconsumerstobiological,chemical,andphysicalhazards[91,92,93,94,95]sothatendangerhealthofthepublic.Theoriginoffoodhazardscanbedescribedasachainwhichcommencesonthesourceandcontinueswithtransportation,furtherprocessingsteps,merchandisingeventsandfinallyendswiththeconsumer[96,97,98,99,100].Overall,thisreviewsuggestedthatfoodsafety–relatedpublichealthrisksaremorecommonindevelopingcountriesthandevelopedcountries.Thiscanbejustifiedthatfoodsgeteasilycontaminatedwithmicrobesduetothepoorhygieneandsanitationindevelopingcountries[101,102,103,104].Moreover,hencetheregulatoryservicesareweakindevelopingcountries,mostfoodsellersmaynotcomplywithfoodhygieneandsafetyrequirementsorstandards[105,106,107].Indevelopingcountries,thelegislationenforcementisstillweakaboutadministratingtheconcentrationofharmfulcontaminantsinthefood[108,109].Inaddition,thereisinadequateinformationandtechnologytodetectfakeandfraudproducts[110,111,112].Thisreviewidentifiedthatmicrobialcontaminationoffoodsinthefoodmarketiscommonlyreportedinmanystudies.Differentbacterialspeciesandfunguseswerethecommonestdiseasescausingpathogensidentified[17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,113].Failuretoapplyfoodsafetystrategiesineverystageofthefoodsupplychain,forexamplebadfoodhandlingpractices,poorproductionprocess,pooragriculturalpractices,poortransportationsystem,poormarketingpractices,andpoorsanitationleadtomicrobialcontaminationoffoods[114,115,116,117,118].Moreover,fraudoffoodssuchasadulteration,mislabeling,andsellingofspoiledorexpiredfoodsarealsocausingmicrobialcontamination[36,119,120,121,122].Microbialcontaminationoffoodscausesmillionsofdiseasesandthousandsofdeaths[123].Thisreviewalsoshowsthattotalcoliforms,fecalcoliforms,anddifferentfunguswerecommonlyreportedindevelopingcountriesthandevelopedcountries.Thismightbeduetothefactthatfecalcontaminationoffoodsandtheenvironmentiscommonindevelopingcountriesduetopoorsanitationcondition[124,125,126].Moreover,thetemperatureandairsystemoffoodstorageareasarenotwellregulatedindevelopingcountries.Thissituationcreatesfavorableconditionformolds.Ontheotherhand,differentCampylobacterspecieswerereportedindevelopedcountries.Thismightbeduetothefactthatadvancementofmoleculartechniquestoidentifythesemicroorganisms.Developingcountrieslackspecializedcultivationtechniquestoculturetheseorganisms[127].Thestandardculture–basedtechnique,whichisapredominantdetectionmethodindevelopingcountries,isnoteffectiveforCampylobacterspecies[128,129,130].Contaminationoffoodswithhazardouschemicalshasbeenreportedasamajorpublichealthconcernassociatedwiththefoodmarketinindividualstudiesincludedinthisreview[37,38,39,40,41,42,43,44,45,46,48,131,132,133].Thephasesoffoodprocessing,packaging,transportation,andstoragearesignificantcontributorstofoodcontamination[109].Foodcontaminantsincludeenvironmentalcontaminants,foodprocessingcontaminants,unapprovedadulterantsandfoodadditives,andmigrantsfrompackagingmaterials.Environmentalcontaminantsareimpuritiesthatareeitherintroducedbyhumanoroccurringnaturallyinwater,air,orsoil.Foodprocessingcontaminantsincludethoseundesirablecompounds,whichareformedinthefoodduringbaking,roasting,canning,heating,fermentation,orhydrolysis.Thedirectfoodcontactwithpackagingmaterialscanleadtochemicalcontaminationduetothemigrationofsomeharmfulsubstancesintofoods.Useofunapprovedorerroneousadditivesmayresultinfoodcontamination[134,135,136,137,138].Chemicalcontaminationoffoodsisresponsiblemillionsofcasesofpoisoningwiththousandsofhospitalizationsanddeathseachyear[139].Nineofthefull-textarticlesincludedinthisreviewreportedthatfoodadulterationisamajorpublichealthriskassociatedwithfoodsafetyissuesinthefoodmarket.Chemicals,itemswhicharenotthegenuinecomponentoffoods,poor-qualityproducts,andphysicalorinertagentsarethecommonestadulterantsadded[47,49,50,51,52,53,54,55,56].Foodadulterationinvolvesintentionalorunintentionaladditionofuseless,harmful,unnecessarychemical,physical,andbiologicalagentstofoodwhichdecreasesthequalityoffood.Italsoincludesremovalofgenuinecomponentsandprocessingfoodsinunhygienicway[119,140].However,removalofgenuinecomponentsoffoodisnotconsideredinthisreview.Foodisadulteratedtoincreasethequantityandmakemoreprofit,whichiseconomicallymotivatedadulteration[141,142,143].Chemicalswhicharebeingusedasadulterantshaveawiderangeofseriouseffectsonthehealthofconsumersincludingcancer[119,144,145,146,147].Inthissystematicreviewofliterature,11ofthefull-textarticlesreportedthatmisuseoffoodadditivesinthefoodmarketendangerspublichealth[57,58,59,60,61,62,63,64,65,66,67].Foodadditiveisanysubstancenotnormallyconsumedasafoodbyitself;notnormallyusedasatypicalingredientofthefood(whetherornotithasnutritivevalue);andaddedintentionallytofoodforatechnologicalpurposeintheproductionprocessforthepurposeofmaintainingafood’snutritionalquality,forexamplebypreventingthedegradationofvitamins,essentialaminoacids,andunsaturatedfats;extendingtheshelflifeofaproduct,forexamplebypreventingmicrobialgrowth;andmaintainingandimprovingaproduct’ssensoryproperties,suchastexture,consistency,taste,flavor,andcolor;Beingabletoprovideproducts[148,149].Substancesgenerallyrecognizedassafe(GRAS)canbeusedasfoodadditives[150,151];however,misuseofsubstancessuchasusingmorethanthemaximumallowableconcentration;usingnon-permittedsubstances;andblendingofpermittedandnon-permittedsubstancestogethercauseshealthhazards[152,153].Mislabelingoffoodproductshasbeenmentionedasamajorpublichealthriskassociatedwithfoodsafetyinthefoodmarketin17ofthefull-textarticlesincludedinthisreview[68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,154].Mislabelingoffoodproductsincludesfalseadvertising,deliberatelyoraccidentallyleavingoutingredients,notlistingpotentialhealtheffects,andclaimingafoodcontainsingredientsthatitdoesnotforfinancialgainwiththeintentofdeceivingtheconsumerregardingwhatisactuallyinthepackage[155].Theseactsoffraudhaveincreasedovertimeasdifferentpartiessuchasmanufacturers,co-packers,distributors,andothersalongthechainofdistributioninvolveinthenationalorinternationaltrade.Mislabelingleadstocross-contamination,poorfoodquality,degradationofnutrients,andevenadverseeffectsonhumanhealth,seriousfinancial,andlegalconsequences[69,154].Inthissystematicreview,weidentifiedthatGMfoodsarebecominganincreasingpublichealthrisk.Theincludedfull-textarticlesreportedthatawiderangeofhealthconsequencesassociatedwithconsumptionofGMfoods[83,84,85,86].PossiblehazardsofGMfoodsincludethepotentialforpleiotropicandinsertionaleffects(silencingofgenes,changesintheirlevelofexpressionor,potentially,theturningonofexistinggenesthatwerenotpreviouslybeingexpressed),effectsonanimalandhumanhealthresultingfromtheincreaseofanti-nutrients,potentialeffectsonhumanhealthresultingfromtheuseofviralDNAinplants,possibletransferofantibiotic-resistantgenestobacteriaingastrointestinaltract,andpossibleeffectsofGMfoodsonallergicresponses[156,157,158,159,160,161].However,thehealtheffectsofgeneticallymodifiedfoodsarestilldebatable.Differentlab-animal-basedstudiesreportedthatthereisnosafetydifferencebetweenGMandnon-GMfoodsorthehealthconcernsarenotconfirmedwell[162,163,164,165].Someothersarguethatdespitetheadvancesinfoodcropagriculture,thecurrentworldsituationisstillcharacterizedbymassivehungerandchronicmalnutrition,representingamajorpublichealthproblem.BiofortifiedGMcropshavebeenconsideredanimportantandcomplementarystrategyfordeliveringnaturallyfortifiedstaplefoodstomalnourishedpopulations[164].Thisreviewrevealedthatfoodspasttheiruse-bydatesinthefoodmarketaremajorthreatsforconsumers.Thismalpracticeismorecommoninlessdevelopedcountriesandruralmarkets[36,67,87,88,89,90].Growthofmicroorganismsinexpiredfoodsisverycommon.Mostofthesemicroorganismsarepathogenicandsomemicroorganismsproducetoxicsubstancesastheydevelop[36,121,166,167,168,169].LimitationofthereviewWeentirelyreliedonelectronicdatabasestosearchrelevantarticles.Wedidnotincludearticlesavailableinhardcopy.Webelievedwecouldgetmorerelevantarticlesifwehadaccesstohardprints.ConclusionThissystematicliteraturereviewidentifiedcommonfoodsafety–relatedpublichealthrisksinthefoodmarket.Theresultsimplythatthelocalandinternationalfoodmarketingcontinuestohavesignificantimpactsonhealthofthepublic.Thefoodmarketincreasesinternationalizationofhealthrisksasthefoodsupplychainscrossmultiplenationalborders.Therefore,effectivenationalfoodcontrolsystemsareessentialtoprotectthehealthandsafetyofthepublic.Countrieshavetoimplementandenforcerisk-basedfoodcontrolstrategies.Countriesneedalsoassurethesafetyandqualityoftheirfoodsenteringinternationaltradeandensurethatimportedfoodsconformtonationalrequirements.Moreover,foodproducersandretailsectorshavetorespectthenationalfoodsafetyguidelineandhavetoworktoprotectthesafetyoftheircustomersAdditionalfile1.ListoffulltextarticlesincludedinthereviewThefulltextarticlesincludedinthisreviewareattachedasasupplementaryfile(seesupplementaryfile). Availabilityofdataandmaterials Alltheextracteddataareincludedinthemanuscript. 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ReprintsandPermissionsAboutthisarticleCitethisarticleGizaw,Z.Publichealthrisksrelatedtofoodsafetyissuesinthefoodmarket:asystematicliteraturereview. EnvironHealthPrevMed24,68(2019).https://doi.org/10.1186/s12199-019-0825-5DownloadcitationReceived:13August2019Accepted:16October2019Published:30November2019DOI:https://doi.org/10.1186/s12199-019-0825-5SharethisarticleAnyoneyousharethefollowinglinkwithwillbeabletoreadthiscontent:GetshareablelinkSorry,ashareablelinkisnotcurrentlyavailableforthisarticle.Copytoclipboard ProvidedbytheSpringerNatureSharedItcontent-sharinginitiative KeywordsPublichealthrisksPublichealthhazardsPublichealthproblemsFoodsafetyFoodqualityFoodhygieneFoodmarketing DownloadPDF DownloadePub Advertisement EnvironmentalHealthandPreventiveMedicine ISSN:1347-4715 Contactus Generalenquiries:[email protected]