Overview and Disclaimer

Welcome to the Risk-Risk Analysis tool. This tool accompanies the manuscript titled “Implementing a risk-risk analysis framework to evaluate the impact of food intake shifts on risk of illness: a case study with infant cereal” published in Food Additives & Contaminants: Part A. (DOI: /10.1080/19440049.2021.1885752>10.1080/19440049.2021.1885752) (link will open in a new tab).

Manuscript Abstract
In food safety, process pathway risk assessments usually estimate the risk of illness from a single hazard and a single food and can inform food safety decisions and consumer advice. To evaluate the health impact of a potential change in diet, we need to understand not only the risk posed by the considered hazard and food but also the risk posed by the substitution food and other potential hazards. We developed a framework to provide decision-makers with a multi-faceted evaluation of the impact of dietary shifts on risk of illness. Our case study explored exposure to inorganic arsenic (iAs) and aflatoxins through consumption of infant cereals and the risk of developing lung, bladder and liver cancer over a lifetime. The estimated additional Disability-Adjusted Life Year (DALY) in the U.S. from exposure to iAs and aflatoxin based on available contamination and consumption patterns of infant rice and oat cereal is 4,921 (CI 90%: 414; 9,071). If all infant cereal consumers shift intake (maintaining equivalent serving size and frequency) to only consuming infant rice cereal, the predicted DALY increases to 6,942 (CI 90%: 326; 12,931). If all infant cereal consumers shift intake to only consuming infant oat cereal, the predicted DALY decreases to 1,513 (CI 90%: 312; 3,356). Changes in contaminant concentrations or percent consumers, that could occur in the future, also significantly impact the predicted risk. Uncertainty in these risk predictions is primarily driven by the dose-response models. A risk-risk analysis framework provides decision-makers with a nuanced understanding of the public health impact of dietary changes and can be applied to other food safety and nutrition questions.

Access to the tool is provided to facilitate model use in the risk-risk analysis presented. The “Input Model Parameter” section (left) includes all the inputs to the model that a user can change to explore potential changes in outputs and risk estimates. The “Main” tab includes the estimated number of illnesses per year and DALYs for the total US population as well as the model output as a shift in consumption. Additional graphs for both inputs and outputs are provided in the corresponding tabs “Additional graphs for inputs” and “Additional graphs for outputs”, respectively. The last tab “Risk as a function of iAs concentration in Rice” includes a visualization of the estimated risk as a function of the concentration of inorganic arsenic in rice where the user can select different output statistics. Please refer to the manuscript “Implementing a risk-risk analysis framework to evaluate the impact of food intake shifts on risk of illness: a case study with infant cereal” (link will open in a new tab) for a full description of the methods, results, limitations and conclusions of the analysis.

Responsibility for the interpretation and use of the model and of the accompanying documentation lies solely with the user. Third parties' use of or acknowledgment of the system and its accompanying documentation, including through the suggested citation, does not in any way represent that FDA or JIFSAN endorses such third parties or expresses any opinion with respect to their statements.

Suggested citation

Sofia M. Santillana Farakos, Régis Pouillot, Judith Spungen, Brenna Flannery, Jane M. Van Doren, and Sherri Dennis. 2021.
Implementing a risk-risk analysis framework to evaluate the impact of food intake shifts on risk of illness: a case study with infant cereal.
Food Additives & Contaminants: Part A. https://doi.org/10.1080/19440049.2021.1885752 (link will open in a new tab).