Milk scandal damage limited

A recent scandal involving melamine in milk and infant formula is unlikely to have a widespread health impact in the territory of Hong Kong, according to a new analysis.

Large-scale, urgent screening programmes may not be necessary, write Professor Hugh Lam and colleagues from the Chinese University of Hong Kong, on the website of the British Medical Journal.

The issue arose in September when several Chinese companies were found to have adulterated milk with melamine, a hard synthetic substance often used as a flame retardant. It is believed that the chemical was added to allow substandard milk to pass nutrition tests.

Thousands of children and adults in mainland China exposed to high dose melamine became severely ill with kidney stones and other renal problems. The incident was described by the World Health Organisation as one of the largest food safety events in recent years.

However, Professor Lam states that the exposure to lower dose melamine thought to have occurred in Hong Kong is not associated with severe kidney problems.

In a study, his team screened 3,170 children aged 12 years or less who had consumed milk products containing melamine daily for at least a month. Of these, one child had a kidney stone, seven were suspected of having melamine related kidney deposits, and 208 (6.6 per cent) had blood in their urine.

They conclude that no severe conditions, such as acute kidney failure or urinary tract obstruction, were detected. "None of these children required specific treatment," they write. "These data suggest that large scale and urgent screening programmes may not be informative or cost-effective for populations who have been exposed to low dose melamine.

"The severe acute complications observed on the mainland seem unlikely to occur elsewhere."

Lam, H. S. et al. Renal screening in children after exposure to low dose melamine in Hong Kong: cross sectional study. The British Medical Journal, 2008;337:a2991.

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