『保健医療科学』 2023 第72巻 第3号 p.191 －202（2023年8月）
特集：身の回りに潜む健康リスクと我が国の安全管理への取組
＜総説＞
食品に含まれる健康ハザード
―発生状況の把握と対策が期待されるもの―
温泉川肇彦
生活環境研究部
Health hazards in foods:
Concerns regarding their occurrence and safety measures
YUNOKAWA Toshihiko
Department of Environmental Health, National Institute of Public Health
抄録
日本における食中毒の発生状況は，この四半世紀の間，減少傾向が続いている．一方で，これまで食中毒事例として十分に認識されていなかったアニサキスによる事例は増加しており，これは患者を診断した医師が保健所に食中毒を届出る制度と関係していると考えられる．日本の食中毒の届出制度は，食中毒患者を診察した医師が保健所に届出ることによる受け身の監視制度のため，その事例が食中毒であると認識されないと届出がされず，統計上は食中毒と計上されず，その対策も進まないおそれがある．
アニサキス以外では，ヒスタミンも報告様式の病因物質のリストに含まれていないため，医療機関からの報告が過少になっている可能性がある．そのほか，非タンパク質分解性のボツリヌス菌は冷蔵での増殖と毒素産生の可能性があるが，食品包装の技術の向上・多様化により，魚介製品等の賞味期限が延ばされる傾向があり，それらの実情に合わせたリスク評価も必要であると思われる．
また，E型肝炎もこの 10年で事例が増加しているが，食中毒として報告されるものは数件と少ないため，原因食品等の調査が十分実施されているか，また，発生を防止するための対策が十分に検討さ
れているか懸念される．
キーワード：環境リスク，レギュラトリーサイエンス，リスク・コミュニケーション
Abstract
Outbreaks of food poisoning in Japan have been on a continuous downward trend over the past quarter century.
On the other hand, outbreaks due to Anisakis have increased in the last decade, probably because doctors did not recognize these outbreaks as food poisoning, and did not report them to the public health department before that time. As a result, they were not included in the statistics. This may be related to the passive surveillance system, in which doctors notify the health department when they recognize a patient with food poisoning.
Therefore, if a cause is not included in the etiological agents section of the report form, it may not be recognized as a causative agent of food poisoning. In such a case, not only would it not be reported as food poisoning and recorded in the statistics, but food safety measures against the causative agent might also not be adequately taken.
If the administrative authorities in charge of food safety do not receive reports of cases of these original food borne illnesses, there is a risk that the administrative authorities will not take measures such as providing guidance to food-related businesses, and that no progress will be made in improving their foodborne illness countermeasures.
Other than anisakiasis, for example, histamines are also not included in the list of etiologic agents in its reporting form, and may be underreported by medical institutions.
Non-proteolytic Clostridium botulinum has the potential to grow and produce toxins under refrigeration. However, due to improved and diversified food packaging technologies, the shelf life of fish and shellfish products that may contain the bacteria tends to be extended. There are concerns about whether the risk assessment is sufficient to meet the actual conditions of these products.
In addition, although the number of hepatitis E cases has increased over the past 10 years, only a few cases are reported as food poisoning. There are concerns about whether the outbreaks are being investigated sufficiently to pursue the causative foods, etc., and whether measures to prevent their occurrence are being adequately considered.
keywords: food poisoning, histamines, non-proteolytic Clostridium botulinum, hepatitis E, HACCP