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As acute gastrointestinal (AGI) disease patients only sometimes seek medical care or submit stool samples for testing, and laboratories cannot detect or identify the pathogen, most cases of foodborne gastroenteritis still need to be identified through public health monitoring. We conducted a population survey and sentinel hospital surveillance to determine the burden of foodborne gastroenteritis caused by non‐typhoidal Salmonella enterica (NTS) and Vibrio parahaemolyticus infection, from July 2018 to June 2019 in Zhejiang province, China, and a model for calculating disease burden established. Using the burden of illness pyramid model, we estimated that there were 140.3 cases of NTS infection and 136.2 cases of V. parahaemolyticus infection. We estimated annual incidence per 100,000 population in Zhejiang province as 236 (95% confidence interval [CI] 208–267) and 206 (95% CI 155–232) cases for foodborne NTS and V. parahaemolyticus gastroenteritis, respectively. The results show that AGI caused by these two pathogens constitutes a substantial burden in the Zhejiang population. The health burden of AGI estimations caused by NTS and V. parahaemolyticus in this study can serve as a strategic framework to direct policy and intervention. [ABSTRACT FROM AUTHOR]

Nickel (Ni) is a silver-white metal with high antioxidative properties, often existing in a bivalent form in the environment. Despite being the fifth most abundant metal on Earth, anthropogenic activities, including industrial processes, have elevated Ni levels in environmental media. This study investigated Ni contamination in various food groups in Zhejiang Province, China, mainly focusing on Ni levels in beans, vegetables, aquatic foods, meat products, cereal products, and fruits. A total of 2628 samples were collected and analyzed. Beans exhibited the highest Ni content in all samples. The overall detection rate of Ni was 86.5%, with variation among food categories. For plant-origin foods, legumes had the highest Ni concentration while for animal-origin foods, shellfish showed the highest median Ni concentration. The results indicate generally acceptable Ni exposure levels among Zhejiang residents, except for children aged 0–6. Beans were identified as the primary contributor to high Ni exposure risk. The paper suggests monitoring Ni contamination in food, especially for vulnerable populations, and provides insights into exposure risks in different age groups. [ABSTRACT FROM AUTHOR]

The intake of paralytic shellfish toxins (PSTs) may adversely affect human health. Therefore, this study aimed to show the prevalence of PSTs from commercially available shellfish in Zhejiang Province, China, during the period of frequent red tides, investigate the factors affecting the distribution of PSTs, and assess the risk of PST intake following the consumption of bivalve shellfish among the Zhejiang population. A total of 546 shellfish samples were collected, 7.0% of which had detectable PSTs at concentrations below the regulatory limit. Temporal, spatial, and interspecific variations in the occurrence of PSTs were observed in some cases. The dietary exposure to PSTs among the general population of consumers only was low. However, young children in the extreme scenario (the 95th percentile of daily shellfish consumption combined with the maximum PST concentration), defined as 89–194% of the recommended acute reference doses, were possibly at risk of exposure. Notably, Arcidae and mussels were the major sources of exposure to toxins. From the public health perspective, PSTs from commercially available shellfish do not pose a serious health risk; however, more attention should be paid to acute health risks, especially for young children, during periods of frequent red tides. [ABSTRACT FROM AUTHOR]

Cadmium (Cd) pollution of food safety is a prominent food safety concern worldwide. The concentration of Cd in six aquatic food categories collected from 2018 to 2022 was analyzed using inductively coupled plasma mass spectrometry, and the Cd exposure levels were calculated by combining the Cd concentration and food consumption data of 18913 urban and rural residents in Zhejiang Province in 2015–2016. The mean Cd concentration was 0.699 mg/kg and the mean Cd exposure of aquatic foods was 0.00951 mg/kg BW/month for the general population. Marine crustaceans were the largest Cd contributor, corresponding to 82.7%. The regional distribution results showed that the average Cd exposure levels of 11 cities did not exceed the provisional tolerable monthly intake (PTMI). According to the subgroups, the Cd mean exposure level of 2–3-year-old children was significantly higher than that of the other age groups but did not exceed the PTMI. Health risk classification assessment demonstrated that the final risk score was six, and the health risk level of Cd exposure in aquatic products in the Zhejiang population was medium. These results demonstrated that the risk of Cd exposure in certain food types or age groups should be given more concern. [ABSTRACT FROM AUTHOR]

Deoxynivalenol (DON) together with its acetylated derivatives cause detrimental effects on human health, and the purpose of this study was to assess the prevalence of DON and its acetylated derivatives from grains and grain products in Zhejiang province, China, and to assess the risk of DON and its acetylated derivatives due to multiple consumptions of grains and grain products among the Zhejiang population. Food samples numbering 713 were collected, and the LC-MS/MS method was used to determine the toxins. The levels of toxins from grains and grain products were relatively low: DON was the toxin at the highest levels. The food frequency questionnaire was used to collect food consumption data. The result of exposure assessments showed that the population was overall at low levels of toxin exposure. The probable mean group daily intake of toxins was 0.21 μg/kg bw/day, which was far from the group provisional maximum tolerable daily intake of 1 μg/kg bw/day, but 0.71% of participants were at high exposure levels. Rice and dried noodles (wheat-based food) were the main sources of toxin exposure, and reducing the consumption of rice and dried noodles while consuming more of other foods with lower levels of toxins is recommended. [ABSTRACT FROM AUTHOR]

Background: Foodborne diseases are a growing public health problem and contribute significantly to the global burden of disease and mortality. Bacteria are the most common foodborne pathogens. We aimed to explore characteristics of bacterial foodborne disease outbreaks (FBDOs) in Zhejiang Province and to provide data support for foodborne disease prevention and control. Methods: Descriptive statistical methods were used to analyze the data reported by centers for disease control (CDCs) at all levels in Zhejiang Province through Foodborne Disease Outbreaks Surveillance System (FDOSS) during 2010–2020. Results: CDCs in Zhejiang Province reported 517 bacterial FBDOs in 11 years, resulting in 7031 cases, 911 hospitalizations, and 3 deaths. Vibrio parahaemolyticus had the highest number of outbreaks, accounting for 58.41% of the total bacterial outbreaks, followed by Salmonella (18.38%). In all settings, restaurants (37.14%), staff canteens (11.99%), and households (11.80%) were responsible for the large number of outbreaks. Aquatic products (42.08%), meat and meat products (23.56%), cereals (10.81%), and flour products (9.27%) were the most common single foods reported. Further analysis showed that the settings and food vehicles of outbreaks caused by different pathogens were different. Conclusions: Bacterial outbreaks are the most common type of FBDOs in Zhejiang Province. By analyzing the epidemiological characteristics of common pathogenic bacteria, we can identify the etiology, food, and setting that the government needs to focus on, and issue relevant targeted policies to reduce the number of FBDOs. [ABSTRACT FROM AUTHOR]

Foodborne diseases are an increasing concern to public health; climate and socioeconomic factors influence bacterial foodborne disease outbreaks. We developed an "exposure–sensitivity–adaptability" vulnerability assessment framework to explore the spatial characteristics of multiple climatic and socioeconomic environments, and analyzed the risk of foodborne disease outbreaks in different vulnerable environments of Zhejiang Province, China. Global logistic regression (GLR) and geographically weighted logistic regression (GWLR) models were combined to quantify the influence of selected variables on regional bacterial foodborne diseases and evaluate the potential risk. GLR results suggested that temperature, total precipitation, road density, construction area proportions, and gross domestic product (GDP) were positively correlated with foodborne diseases. GWLR results indicated that the strength and significance of these relationships varied locally, and the predicted risk map revealed that the risk of foodborne diseases caused by Vibrio parahaemolyticus was higher in urban areas (60.6%) than rural areas (20.1%). Finally, distance from the coastline was negatively correlated with predicted regional risks. This study provides a spatial perspective for the relevant departments to prevent and control foodborne diseases. [ABSTRACT FROM AUTHOR]

Acute gastrointestinal illness (AGI) is a prevalent public health concern worldwide. This study investigated the magnitude, distribution and burden of self-reported AGI among residents of Zhejiang Province, China. A face-to-face household survey was conducted using a multi-stage stratified random sampling method in 10 counties in Zhejiang Province between July 2018 and June 2019. In total, 12,021 participants were recruited. The prevalence of AGI 28 days after standardization was 1.8% (95% confidence interval (CI), 1.6–2.1), with an incidence rate of 0.24 episodes of AGI per person-year and an estimated 14 million cases of AGI in Zhejiang Province. Univariate and multivariable analyses showed a higher AGI prevalence among people who performed housework and were unemployed in summer and autumn among respondents living in western or northern cities (p < 0.05). More than 50% of AGI cases were attributed to the consumption of contaminated food. The disease burden caused by AGI in Zhejiang Province was approximately 975 million Chinses yuan (CNY). These results indicated that the disease burden of AGI in Zhejiang Province should be addressed and highlights the need for an improved active surveillance system of foodborne diseases to assess the impact of AGI on society and health. [ABSTRACT FROM AUTHOR]

Wild mushroom poisoning has been recognized as a global problem threatening human health. In this study, we aimed to explore characteristics of wild mushroom poisoning in Zhejiang province, China. From 2016 to 2018, 429 cases of wild mushroom poisoning were reported, and among them, there were 2 deaths and 84 hospitalizations, with the incidence of 0.2526 per 100,000 and the case fatality rate of 0.47%. Digestive symptoms were found in all cases. Systemic symptoms and signs, neurological symptoms, and urinary symptoms were found in 28.90% (124/429), 11.66% (50/429), and 4.90% (21/429) of the cases, respectively. The proportion of cases with incubation period <6 h was 85.78%, and those with ≥6 h accounted for 14.22%. The peak period of poisoning occurred from June to October annually. Quzhou (Moran's I = 1.242, p <.05) and Lishui (Moran's I = 0.759, p <.05) with mild climate, more mountains, and abundant rainfall were "hot spots" for the incidence of wild mushroom poisoning, showing a state of high‐incidence aggregation. Epidemiological analysis showed that there were seasonal, high‐incidence areas and high‐risk groups in wild mushroom poisoning. The government should give early warning to high‐incidence areas and strengthen publicity to high‐risk groups before wild mushrooms mature every summer and autumn. In addition, we recommend that ordinary people not pick wild mushrooms outdoors for consumption, because it is difficult to distinguish whether wild mushrooms are poisonous and do not buy wild mushrooms of unknown sources. [ABSTRACT FROM AUTHOR]

3- And 2-monochloropropanediol fatty acid esters (3- and 2-MCPD esters) are contaminants of processed vegetable oils. In this study, vegetable oils and related products available 486 food samples from Zhejiang market were collected and analysed for 3- and 2-MCPD esters during 2016–2018. Food consumption data were taken from a food consumption survey of urban and rural residents in Zhejiang province performed in 2008 using data from 9646 subjects. Levels of 3-MCPD esters in foods ranged from not detected to 8.3 mg/kg, and the highest mean levels were found in vegetable oils with levels of 0.76 mg/kg. Esters of 2-MCPD levels ranged from not detected to 4.0 mg/kg, and the highest mean levels were found in instant noodles containing 0.40 mg/kg. The dietary intake of 3-MCPD was 0.62 μg/kg bw per day (mean) and 2.29 μg/kg bw per day (P97.5), and 2-MCPD esters intakes were 0.26 μg/kg bw per day (mean) and 0.87 μg/kg bw per day (P97.5). Vegetable oils were the main food source of dietary 3- and 2-MCPD esters intake. These findings suggested that the dietary exposure levels of 3-MCPD esters may pose a potential risk to the health for high consumers (P97.5) aged 4–17 when compared to the tolerable daily intake. [ABSTRACT FROM AUTHOR]

Aluminium was measured in 2580 samples of 15 food groups and dietary exposure was estimated. Samples were purchased and analysed during 2010 to 2014. High aluminium levels were found in jellyfish (mean 4862 mg/kg), laver (mean 455.2 mg/kg) and fried twisted cruller (mean 392.4 mg/kg). Dietary exposure to aluminium was estimated for Zhejiang residents. The average dietary exposure to aluminium via 15 food groups in Zhejiang Province was 1.15 mg/kg bw/week, which is below the provisional tolerable weekly intake of 2 mg/kg bw /week. Jellyfish is the main Al contributor, providing 37.6% of the daily intake via these 15 food groups. This study provided new information on aluminium levels and assessment of aluminium (Al) dietary exposure in Zhejiang Province of China. [ABSTRACT FROM PUBLISHER]

The purpose of this study was to assess the risk of aflatoxins due to multiple food consumption among the Zhejiang population. Ultra-high-performance liquid chromatography coupled with tandem mass spectrometry method was used to determine aflatoxins in 792 samples. Aflatoxins were detected in 27.1% of the samples at levels between 0.07 and 262.63 μg kg−1, and aflatoxins B 1 was the most frequently detected among different types of samples. 0.8% of peanut oil, 3.39% of nut products as well as 1.1% of condiments contaminated with aflatoxins B 1 exceeded China national tolerance limits. Peanut oil had the highest incidence of aflatoxin, with a range from 0.17 to 22.50 μg kg−1. Using bags conferred limited advantages in reducing aflatoxin contents. Moreover, peanut and rice were the main contributors to dietary exposure to aflatoxins among Zhejiang residents. Finally, the margin of exposure values obtained by rice consumption were far from the safe margin of 10,000, indicating a potential risk to public health. The results pointed out the need for further prioritization of aflatoxins B 1 risk-management actions in Zhejiang. [Display omitted] • This is the first risk assessment of aflatoxins in multiple foodstuffs in Zhejiang. • The highest incidence of aflatoxins occurred in peanut oil. • One peanut oil, six nuts and one condiment sample exceeded the Chinese maximum limit for aflatoxins B 1. • A potential risk associated with total aflatoxins and aflatoxins B 1 in rice was established. [ABSTRACT FROM AUTHOR]