A Quantitative Risk Assessment of the Human Health Impacts Due to Macrolide Use in Swine
We used a retrospective modeling approach instead of the traditional farm to fork model; back calculating (Cm) the number of human macrolide resistant C. coli mfections caused by eating contaminated pork, due to specific macrolide use in swine. We used the estimated number of culture confirmed human infections (Ct). As a measure of human health risk, we then calculated the expected number among the (Cm) cases that experience an adverse treatment outcome (prolonged illness) due to macrolide resistance, using estimates for fluoroquinolone. We divided the model into Release, Exposure and Consequence assessment sections according to FDA guidance 152 and utilized @Risk software with 20,000 iterations for simulation. The results show the human health risks are negligible. For example, the predicted annual risk, for preventton and growth promotion uses is only 1 in 92 million per U.S. resident, with a 5% chance it could be as high as 1 in 52 million. Our model focuses on the impact of resistance on human treatment. It assumes that macrolide resistance C. coli infection reduces treatment efficacy. However, it is possible that risks less than our estimates.