Table 2.

Three selected hazards found in pork in Kohima, Nagaland, displayed in a qualitative risk assessment framework.

	Hazard identification & characterization	Exposure assessment	Risk characterization
Enterobacteriaceae	Bacteria of this group representing hazards for human health include Salmonella spp., Klebsiella spp. and toxigenic E. coli. These cause a range of symptoms from diarrhoea to urinary tract and soft tissue infection and septicaemia. General morbidity to infection with clinical symptoms is moderate, mortality is low.	In the questionnaire survey, pork consumers from Nagaland indicated that boiling of meat was the common method of preparing meat (98%). Ninety-eight % of questionnaire respondents cook pork between 30 and 190 min. This means that pork is generally well cooked which will kill Enterobacteriaceae. However there are chances for cross contamination, which is most problematic for hazards where the infectious dose is very low: notably pathogenic E. coli strains.	Because of thorough cooking, we consider the risk of ingestion of harmful Enterobacteriaceae from cooked pork was low with potentially severe health consequences. The risk of ingesting Enterobacteriaceae on other aliments which have been cross-contaminated through pork can be estimated higher. However we did not directly investigate these processes in this study. The uncertainty of these estimates is high.
Taenia solium (Cysticercus cellulosae)	Infection with the larval stage (cysticerci) of the tapeworm T. solium can lead to establishment of a tapeworm in the gut. Through the ingestion of tapeworm eggs, human cysticercosis, a serious disease, develops: Inside the body, cysticerci can develop in a number of tissues; muscle tissue can be affected as well as the eyes and the central nervous system. Neurocysticercosis [16] including epilepsy [17] is the most severe form of the disease.	Proof of highly frequent presence of the parasite was found manifold within this study: through lingual palpation and detection of viable cysticerci in meat. Also, 57% of consumers reported white, rice grain like cysts in the meat they purchased. Based on this, prevalence of T. solium stages in pork designated for human alimentation can be estimated as high. Thorough cooking will kill cysticerci and only 1% pork consumers in the study indicated they would eat raw meat. It is common practice in Nagaland to consume smoked pork products (indicated by 43% of consumers).	The risk of ingestion of viable cysticerci from cooked meat has to be considered low, because meat tends to be thoroughly cooked. The direct health impacts can be estimated as low and the indirect health impacts as severe with moderate associated uncertainties. Regarding the possibility of infection through cysticerci in raw/smoked meat products, the uncertainties are higher.
Antibiotic residues	Antibiotic residues favour the development of antibiotic resistance in bacteria and can cause allergies in sensitive persons who consume meat containing residues. Prevalence of such incidents is low when searching the literature for case descriptions; but this can only be stated with a high level of uncertainty.	Of the pork samples tested in this study, 4.5% were positive and thus contained traces of antibiotic residues. Good hygiene practices and heat treatment do not eliminate the residues and thus, the consumer is not able to influence or mitigate this risk.	We considered the risk of ingestion of antibiotic residues in pork with a direct impact on consumer’s health (anaphylactic reaction) as very low but severe. We considered indirect health impacts as moderate. Uncertainty of these estimates was moderate.