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Oral Communication of Géraldine Boué on the Research unit's thematic Risk-Benefit assessment:

Methodological Lessons Learnt from Developing a Risk-benefit Assessment Applied to Infant Milk-based Diet

Géraldine Boué, Enda Cummins, Sandrine Guillou, Jean-Philippe Antignac, Bruno Le Bizec and Jeanne-Marie Membré

The objective of this study was to develop a conceptual and methodological framework to assess quantitatively the overall impact of food on human health, including microbiological, chemical and nutritional dimensions. This methodology was developed using a case study related to infant milk-based diet (breast milk and infant formulas) taking into account the following selected factors: Cronobacter sakazakii, Cryptosporidium, arsenic, dioxin-like polychlorinated biphenyls and docosahexaenoic acid. Five probabilistic mathematical models were developed to quantify risks / benefits associated with these factors. In this communication main outputs obtained on the case-study will be presented as well as lessons learnt in terms of “Risk-Benefit Assessment” methodology. Probabilistic techniques enabled the consideration of the variability (heterogeneity between individuals of the same population) and the uncertainty linked to the lack of knowledge and data. Separation of variability and uncertainty, using second-order Monte Carlo simulation, strengthened the evaluation by enabling a more accurate interpretation of results and by providing more comprehensive information to policy makers. The DALY metric was used in this study to compare the health effects originated from different factors. Although very attractive in integrating the whole complex RBA issue within a simple figure, this metric might not be an intuitive metric to communicate results to stakeholders (too integrative to be understood). Finally, a multi-criteria table was built to incorporate in a transparent and comprehensive manner the various outputs of the risk-benefit assessment (e.g. DALY, number of case, individual probability of illness, etc.), a promising technique to facilitate decision-making. The methodological framework developed in the present study can be considered as a robust basis for risk-benefit assessment in foods and results obtained will enable to progress on the evaluation of infant milk-based diet.