Data on exposure assessment for C.parvum in the lettuce and beef chain were linked to data on consumption levels and on hazard characterisation (from dose response models). A semi-quantitative risk assessment was performed using @ risk software for a baseline scenario and some worst-case assumptions.
The general conclusion was that the risk posed by Cryptosporidium in drinkable water is low (mode: 1 in 5 million per year) for the baseline (normal) conditions increasing to (1 in 500 per year) for worst-case scenario. The initial level of contamination is the most relevant risk factor. This can be difficult to control but the level of contamination in the raw water and the resultant risk posed can be reduced by limiting the collection of water from areas likely to be contaminated, in particular unprotected water sources where livestock are kept in the vicinity, or where animal waste or run-off water from agricultural land may contaminate the water. When water is sourced from areas of high risk for contamination (i.e. unprotected water sources) a more stringent physical treatment of the water should be implemented. Once the oocysts are in the raw water, the most important risk factors are the length of storage of water before purification (physical treatments) and the type of treatment, which the water receives.
For the risk calculation on beef, it was assumed that the beef was undercooked. Even for the baseline scenario the risk was high (1 in 400). This must be regarded as an over estimation of risk as in general meat is cooked. The model demonstrated that the main risk factor was contamination of the faeces, though the transmission rate to carcass appears to be low and various operations in the meat processing such as freezing and thawing or any thermal treatment received substantially reduces the viability of the parasite and therefore the risk posed. The general conclusion was that the risk posed by Cryptosporidium on beef was low, as when products are cooked it should effectively inactivate any oocysts present. However, under-cooking or cross contamination from raw too ready to eat foods in the domestic environment is a risk, particularly because of the low infective dose. The most effective risk reduction steps are to ensure the water used in beef processing is either potable or treated to remove parasites and that HACCP (Hazard analysis critical control point systems) based procedures are in place along the meat chain.
For lettuce the baseline model demonstrated that the initial contamination of the lettuce crops was mainly determined by direct contamination with animal manure from the environment (99%) and with the weather, rainfall etc. expected to have a high impact on the transfer factor. If the fertilizers are treated, their contribution is expected to be low compared to that factor (2.0 %). The mean risk of illness per serving for the baseline scenario is 1 in 23,400. The results indicated that the most important factors to control the risk posed by C. parvum on lettuce are the initial contamination of the lettuce crops. This is mainly related to direct contamination from the application of contaminated slurry or manure or water, or accidental contamination from run off water particularly in wet weather. Controls should include treatment of any animal waste or water applied to lettuce to ensure any C. parvum oocysts present are inactivated. Lettuce should be grown in an area protected from accidental incursion from grazing animals and preferably in an area not affected by agriculture run off waters. The other main risk reduction steps are washing, removing outer leafs and length and temperature of storage.
These assessments have highlighted the risk factors posed in each chain and have given an indication of where control measures may be addressed. It has also highlighted the areas where further research is required.