Burden of Disease from Produce and Seafood Contamination

Part of the Environmental Science and Technology Library book series (ENST, volume 24)


Eating fruits and vegetables is beneficial to human health but exposes people to risk if the produce contains hazardous contaminants. Two potential contaminants are human pathogens (e.g., Salmonella, E. coli) and agricultural pesticides (e.g., organophosphates, carbamates), both of which can be reduced with proper food handling and preparation. Foodborne pathogens can cause and/or contribute to an array of human illnesses, including acute gastroenteritis as well as more complex chronic conditions such as organ failure, arthritis, and heart disease. Agricultural pesticide exposure can result in dizziness, nausea, abdominal cramps, diarrhea, tremors, anxiety, confusion, neurological disorders, developmental/reproductive disorders, and death. Because large percentages of fruit, vegetables, grains, and legumes consumed in the United Arab Emirates are produced abroad, pesticide use and other farm management practices in countries exporting to the UAE will affect contamination levels of food consumed in the UAE. Domestically harvested seafood has historically been a primary staple of the Emirati diet. More than 90% of citizens eat fish during at least one meal every week. Consumption of fish provides numerous documented health benefits, including a reduction in risk of chronic heart disease; however, fish can also serve as a vector for pathogenic microorganisms (e.g., Vibrio spp.), heavy metals (e.g., mercury) and other toxins (e.g., dioxin). Estimates of illness resulting from seafood consumption focus on exposure to mercury. Although numerous metals can result in adverse health effects if consumed in seafood, mercury is generally regarded as of greatest concern. Chronic mercury poisoning results in a host of neurological and psychological symptoms, including tremors, motor/cognitive dysfunction, and memory loss. Exposure in utero can result in serious lifetime illness, including mental retardation, sensory loss, developmental delay, cerebral palsy, and seizures. In lieu of estimating foodborne mortality and morbidity cases, our modeling approach directly calculates the probability of exceeding international guidelines for exposure to specific hazardous chemicals in fruit, vegetables, and seafood in the UAE. For fruits and vegetables, the model estimates the number of daily incidents in which UAE residents are exposed to a particular type of pesticide residue above a prespecified benchmark dose, due to eating a particular type of fruit or vegetable. For seafood, the model estimates the number of daily incidents in which UAE residents are exposed to mercury levels above the reference dose maintained by the U.S. Environmental Protection Agency due to eating fish. Results of daily cases in which a UAE resident may be at risk of overexposure to methylmercury from eating seafood and exceeding the reference dose suggest 2,927 women and 11,882 men—with the gender imbalance an artifact of the male-dominated expatriate workforce—could be at risk for health effects. Of all pesticides and crops, chlorpyrifos on tomato has the highest mean ratio (0.26) of average estimated pesticide exposure (0.000078 mg/kg) to its chronic population adjusted dose (cPAD) value (0.0003 mg/kg), making tomatoes the most suitable candidate for a worst-case hypothetical scenario. Considering an atypical but theoretical UAE resident eating 100% tomatoes, and assuming no reduction in pesticide due to washing, peeling, and/or cooking, the model estimates this person has 20.6% (chlorpyrifos) and 1.0% (vinclozolin) chances of exceeding cPAD values each day. Overall, this model estimates 631,074 worst-case daily incidents (cPAD exceedance) contributing to potential chronic illness. Although these probabilities may seem high, daily cPAD incidents are assumed contributory toward potential cases of annual chronic illness; the model assumes (worst-case) no reduction in pesticide due to washing, peeling, and/or cooking for all incidents; and, only very limited human epidemiologic studies exist to objectively link chronic pesticide exposure with adverse health effects—a major reason for the safety factors already built into the cPAD and other benchmarks.


Produce and seafood contamination Environmental burden of disease United Arab Emirates Marine water quality monitoring Agricultural pathogens Food safety standards Harmful algal blooms (“red tides”) Organophosphate and carbamate pesticides Acetylcholinesterase inhibition Acceptable daily intake Acute population adjusted dose Chronic population adjusted dose Organic methylmercury Reference dose 


  1. Abu Dhabi Food Control Authority (ADFCA). 2006. Pesticides residue group monitoring program 2006. Abu Dhabi: Abu Dhabi Food Control Authority (ADFCA).Google Scholar
  2. Agah, H., M. Leermakers, M. Elskens, S.M.R. Fatemi, and W. Baeyens. 2006. Total mercury and methylmercury concentrations in fish from the Persian Gulf and the Caspian Sea. Water, Air, and Soil Pollution 181(1–4): 95–105.Google Scholar
  3. Ahmad, S., and S.M. Al Ghais. 1996. Metal contents in the tissues of Lutjanus fulviflamma (Smith 1949) and Epinephelus tauvina (Forskal 1775) collected from the Arabian Gulf. Bulletin of Environmental Contamination and Toxicology 57(6): 957–963.CrossRefGoogle Scholar
  4. Al Ashram, O. 2005. Wastes and pollution sources in Abu Dhabi Emirate. Abu Dhabi: Environment Agency–Abu Dhabi, Environment Protection Department.Google Scholar
  5. Al Ghais, S.M. 1995. Heavy metal concentrations in the tissue of Sparus-Sarba Forskal, 1775 from the United Arab Emirates. Bulletin of Environmental Contamination and Toxicology 55(4): 581–587.CrossRefGoogle Scholar
  6. Al Matroushi, M.A. 2005. United Arab Emirates global school-based student health survey 2005. UAE-GSHS-2005. Centers for Disease Control and Prevention/World Health Organization.Google Scholar
  7. Al Yousuf, M.H., M.S. El Shahawi, and S.M. Al Ghais. 2000. Trace metals in liver, skin, and muscle of Lethrinus lentjan fish species in relation to body length and sex. The Science of the Total Environment 256(2/3): 87–94.CrossRefGoogle Scholar
  8. Al Zarooni, M., and W. Elshorbagy. 2006. Characterization and assessment of Al Ruwais refinery wastewater. Journal of Hazardous Materials A136: 398–405.CrossRefGoogle Scholar
  9. Anderson, D.M., P.M. Glibert, and J.M. Burkholder. 2002. Harmful algal blooms and eutrophication: Nutrient sources, composition, and consequences. Estuaries 25(4b): 704–726.CrossRefGoogle Scholar
  10. Badrinath, P., Q.A. Al Shboul, T. Zoubeidi, A.S. Gargoum, R. Ghubash, and O.E. El Rufaie. 2002. Measuring the health of the nation: United Arab Emirates Health and Lifestyle survey 2000. Al Ain: UAE University.Google Scholar
  11. Baker, L.C., and D.J. McGillicuddy. 2006. Harmful algal blooms: At the interface between coastal oceanography and human health. Oceanography 19(2): 94–106.CrossRefGoogle Scholar
  12. Batz, M.B., M.P. Doyle, J.G. Morris Jr., J. Painter, R. Singh, R.V. Tauxe, M.R. Taylor, and D.M. Lo Fo Wong. 2005. Attributing illness to food. Emerging Infectious Diseases 11(7): 993–999.CrossRefGoogle Scholar
  13. Cardoso, C., N. Bandarra, H. Lourenco, C. Afonso, and M. Nunes. 2010. Methylmercury risks and EPA and DHA benefits associated with seafood consumption in Europe. Risk Analysis 30(5): 827–840.CrossRefGoogle Scholar
  14. Codex Alimentarius Commission. 2009. Pesticide residues in food: Maximum residue limits, extraneous maximum residue limits.
  15. Dehghan, M., N. Al Hamad, A. Yusufali, F. Nusrath, S. Yusuf, and A.T. Merchant. 2005. Development of a semi-quantitative food frequency questionnaire for use in United Arab Emirates and Kuwait based on local foods. Nutrition Journal 4(18).
  16. El Shahawi, M.S., and M.H. Al Yousuf. 1998. Heavy metal (Ni, Co, Cr, and Pb) contamination in liver and skin tissues of Lethrinus lentjan fish family: Lethrinidae (toelost) from the Arabian Gulf. International Journal of Food Sciences and Nutrition 49(6): 447–451.CrossRefGoogle Scholar
  17. Environment Agency–Abu Dhabi (EAD). 2006. State of the environment Abu Dhabi: Key findings. Abu Dhabi: Environment Agency–Abu Dhabi (EAD).Google Scholar
  18. Environment Agency–Abu Dhabi (EAD). 2007a. Report on water quality of Abu Dhabi coastal waters. Abu Dhabi: Environment Agency–Abu Dhabi (EAD).Google Scholar
  19. Environment Agency–Abu Dhabi (EAD). 2007b. State of the environment Abu Dhabi: Pollution of groundwater. Abu Dhabi: Environment Agency–Abu Dhabi (EAD).Google Scholar
  20. Eto, K. 1997. Pathology of Minamata disease. Toxicologic Pathology 25(6): 614–623.CrossRefGoogle Scholar
  21. European Commission (EC). 1990. Council directive of 27 November 1990: On the fixing of maximum levels for pesticide residues in and on certain products of plant origin, including fruit and vegetables. 90/642/EEC. Brussels.Google Scholar
  22. European Food Safety Authority (EFSA). 2009. Reasoned opinion of EFSA prepared by the Pesticides Unit on the 2007 annual report on pesticide residues. EFSA Scientific Report 305: 1–106.Google Scholar
  23. Ferguson, C.M., B.G. Coote, N.J. Ashbolt, and I.M. Stevenson. 1996. Relationships between indicators, pathogens, and water quality in an estuarine system. Water Research 30(9): 2045–2054.CrossRefGoogle Scholar
  24. Fleming, L., K. Broad, A. Clement, E. Dewailly, S. Elmir, A. Knap, S.A. Pomponi, S. Smith, H. Solo-Gabriele, and P. Walsh. 2006. Oceans and human health: Emerging public health risks in the marine environment. Marine Pollution Bulletin 53: 545–560.CrossRefGoogle Scholar
  25. Food and Agriculture Organization of the United Nations (FAO). 2003. Crops primary equivalent database: United Arab Emirates, food consumption quantity (2003 data). FAOSTAT.
  26. Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO). 2003. Evaluation of certain food additives and contaminants. Sixty-first report of the joint FAO/WHO expert committee on food additives, Geneva.Google Scholar
  27. Glibert, P.M. 2007. Eutrophication and harmful algal blooms: A complex issue, examples from the Arabian Seas, including Kuwait Bay, and an introduction to the Global Ecology and Oceanography of Harmful Algal Blooms (GEOHAB) programme. International Journal of Oceans and Oceanography 2(1): 157–169.Google Scholar
  28. Glibert, P.M., J.H. Landsberg, J.J. Evans, M.A. Al Sarawi, M. Funaj, M.A. Al Jarallah, A. Haywood, et al. 2002. A fish kill of massive proportion in Kuwait Bay, Arabian Gulf, 2001: The roles of bacterial disease, harmful algae, and eutrophication. Harmful Algae 1: 215–231.CrossRefGoogle Scholar
  29. Glibert, P.M., D.M. Anderson, P. Gentien, E. Graneli, and K.G. Sellner. 2005. The global, complex phenomena of harmful algal blooms. Oceanography 18(2): 136–147.CrossRefGoogle Scholar
  30. Graneli, E., and J.T. Turner. 2006. An introduction to harmful algae. In Ecology of harmful algae, ed. E. Graneli and J.T. Turner, 3–21. Berlin: Springer.CrossRefGoogle Scholar
  31. Gray, G.M., and J.K. Hammitt. 2000. Risk/risk trade-offs in pesticide regulation: An exploratory analysis of the public health effects of a ban on organophosphate and carbamate pesticides. Risk Analysis 20(5): 665–680.CrossRefGoogle Scholar
  32. Hoffmann, S., P. Fischbeck, A. Krupnick, and M. McWilliams. 2008. Informing risk-mitigation priorities using uncertainty measures derived from heterogeneous expert panels: A demonstration using foodborne pathogens. Reliability Engineering and System Safety 93: 687–698.CrossRefGoogle Scholar
  33. Jarup, L. 2003. Hazards of heavy metal contamination. British Medical Bulletin 68: 167–182.CrossRefGoogle Scholar
  34. Jones, K.E., N.G. Patel, M.A. Levy, A. Storeygard, D. Balk, J.L. Gittleman, and P. Daszak. 2008. Global trends in emerging infectious diseases. Nature 451(7181): 990–994.CrossRefGoogle Scholar
  35. Kakande, Y., and M. Kwong. 2009. Inspectors fail half of Sharjah’s restaurants. The National, June 6.
  36. Khaleej Times. 2002. Fruits and vegetables safe from pesticides: Study. November 30.Google Scholar
  37. Khan, S., and V. Salama. 2008. UAE may buy Pakistan farms. The National, May 5.
  38. Kosanovic, M., M.Y. Hasan, D. Subramanian, A.A.F. Al Ahbabi, O.A.A. Al Kathiri, and E.M.A.A. Aleassa. 2007. Influence of urbanization of the western coast of the United Arab Emirates on trace metal content in muscle and liver of wild Red-spot Emperor (Lethrinus lentjan). Food and Chemical Toxicology 45(11): 2261–2266.CrossRefGoogle Scholar
  39. Kuchenmüller, T., S. Hird, C. Stein, P. Kramarz, A. Nanda, and A.H. Havelaar. 2009. Estimating the global burden of foodborne diseases: A collaborative effort. Eurosurveillance 14(18): 1–4.Google Scholar
  40. Lee, C.M., T.Y. Lin, C.-C. Lin, G.A. Kohbodi, A. Bhatt, R. Lee, and J.A. Jay. 2006. Persistence of fecal indicator bacteria in Santa Monica Bay beach sediments. Water Research 40: 2593–2602.CrossRefGoogle Scholar
  41. McKinlay, R., J.A. Plant, J.N.B. Bell, and N. Voulvoulis. 2008. Calculating human exposure to endocrine disrupting pesticides via agricultural and non-agricultural exposure routes. Science of the Total Environment 398: 1–12.CrossRefGoogle Scholar
  42. Mead, P.S., L. Slutsker, V. Dietz, L.F. McCaig, L.F. Bresee, J.S. Shapiro, P.M. Griffin, and R.V. Tauxe. 1999. Food-related illness and death in the United States. Emerging Infectious Diseases 5(5): 607–625.CrossRefGoogle Scholar
  43. Menon, P. 2009. Red tide closes two Dubai beaches. The National, April 7.
  44. Mohamed, A. A. 2009. Abu Dhabi Food Control Authority pesticides monitoring program, 2006–2008. Presentation, Dubai International Food Safety Conference, February 6, Dubai.Google Scholar
  45. Morinigo, M.A., R. Cornax, M.A. Munoz, P. Romero, and J.J. Borrego. 1990. Relationships between Salmonella spp and indicator microorganisms in polluted natural waters. Water Research 24(1): 117–120.CrossRefGoogle Scholar
  46. Mozaffarian, D., and E.B. Rimm. 2006. Fish intake, contaminants, and human health: Evaluating the risks and benefits. Journal of the American Medical Association 296(15): 1885–1899.CrossRefGoogle Scholar
  47. Musaiger, A.O., and N.M. Abuirmeileh. 1998. Food consumption patterns of adults in the United Arab Emirates. Journal of the Royal Society for the Promotion of Health 118(3): 146–150.CrossRefGoogle Scholar
  48. National Center for Health Statistics. 2000. Data table of weight-for-age charts: Children 2 to 20 years. Centers for Disease Control and Prevention.
  49. National Research Council. 1999. From monsoons to microbes: Understanding the ocean’s role in human health. Washington, D.C.: The National Academies Press.Google Scholar
  50. Polo, F., M.J. Figueras, I. Inza, J. Sala, J.M. Fleisher, and J. Guarro. 1998. Relationship between presence of Salmonella and indicators of faecal pollution in aquatic habitats. FEMS Microbiology Letters 160: 253–256.CrossRefGoogle Scholar
  51. Ragsdale, N.N. 2000. The impact of the Food Quality Protection Act on the future of plant disease management. Annual Review of Phytopathology 38: 577–596.CrossRefGoogle Scholar
  52. Sambidge, A. 2008. “Red tide” forces desalination plant closure., November 17.
  53. Setrakian, L. 2009. Filthy rich: Dubai choking on sewage. ABC News, February 1.
  54. Steenland, K. 1996. Chronic neurological effects of organophosphate pesticides. British Medical Journal 312(7042): 1312–1313.CrossRefGoogle Scholar
  55. Stewart, J.R., R.J. Gast, R.S. Fujioka, H.M. Solo-Gabriele, J.S. Meschke, L.A. Amaral-Zettler, E. del Castillo, et al. 2008. The coastal environment and human health: Microbial indicators, pathogens, sentinels, and reservoirs. Environmental Health 7(Suppl. 2): S3.CrossRefGoogle Scholar
  56. U.S. Department of Agriculture (USDA). 2009. International maximum residue limit database. Foreign Agricultural Service.
  57. U.S. Environmental Protection Agency (EPA). 1997. Reference dose tracking report. Office of Pesticide Programs.
  58. U.S. Environmental Protection Agency (EPA). 1999. Recognition and management of pesticide poisonings, ed. J.R. Reigart, and J.R. Roberts. Office of Prevention, Pesticides and Toxic Substances.
  59. U.S. Environmental Protection Agency (EPA). 2002. Integrated risk information system: Methylmercury (CASRN 22967-92-6).
  60. U.S. Environmental Protection Agency (EPA). 2009. Pesticide reregistration status.
  61. UAE Federal Government. 1999. Protection and development of the environment. Federal Law 24.Google Scholar
  62. UAE Federal Government. 2004. UAE Ministerial Decree 193, concerning ban on importing and circulation of some harmful pesticides for health and environment.Google Scholar
  63. UAE Ministry of Economy. 2008. United Arab Emirates: Population and vital statistics 2008.Google Scholar
  64. UAE Ministry of Environment and Water. 2006. United Arab Emirates: National report. Report submitted to International Conference on Agrarian Reform and Rural Development.Google Scholar
  65. World Health Organization. 2006. WHO initiative to estimate the global burden of foodborne diseases: A summary document. Geneva: World Health Organization.Google Scholar
  66. World Health Organization. 2007. Exposure to mercury: A major public health concern.
  67. World Health Organization. 2009a. Child growth standards: Length/height for age.
  68. World Health Organization. 2009b. Growth reference: height for age (5–19 years).

Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  1. 1.Gillings School of Global Public HealthUniversity of North Carolina–Chapel HillChapel HillUSA
  2. 2.Environment Agency–Abu DhabiAbu DhabiUnited Arab Emirates
  3. 3.Health Authority–Abu DhabiAbu DhabiUnited Arab Emirates

Personalised recommendations