湖北省袋泡茶、坚果、植物油、玉米粉中黄曲霉毒素污染情况调查

目的了解湖北省9个地市州袋泡茶、坚果、植物油、玉米粉中4种黄曲霉毒素的污染状况。方法 2013年从湖北省9个地市州的农贸市场、超市、商场和网购随机抽取674份四类食品(袋泡茶、坚果、植物油、玉米粉)作为研究对象,采用免疫亲和层析净化高效色谱法测定AFB_1、AFB_2、AFG_1和AFG_24种黄曲霉毒素含量。结果 674份样品中AFB_1、AFB_2、AFG_1、AFG_2总阳性率分别为29.67%、12.06%、29.50%、8.53%;九市州之间,四类食品(袋泡茶、坚果、植物油、玉米粉)的黄曲霉毒素的总阳性率差异无统计学意义(χ~2=1.408,P=0.994);四类食品阳性率差异有统计学意义(χ~2=561.038,P=0.000),坚果最高(91.41%);坚果样品超标率为1.95%,最大值11.2μg/kg。黄曲霉毒素B_2、G_1和G_2因无国家限量标准未评价其超标率。结论湖北省市售袋泡茶、坚果及籽类和植物油存在4种黄曲霉毒素联合污染的状况,污染以黄曲霉毒素B_1、G_1为主。     

市售食品中黄曲霉毒素B_1、B_2、G_1、G_2污染情况分析

目的了解市售谷物、坚果和食用油等7类食品中的黄曲霉毒素B1、B2、G1、G2污染情况。方法建立高效液相色谱-串联质谱法检测黄曲霉毒素B_1、B_2、G_1、G_2。结果共检测266份样品,黄曲霉毒素的总检出率为4.5%,最高总含量为72.8μg/kg。在7类样品中,以花生油、玉米粉和花生受污染情况较为严重,其中,花生油的检出率为75.0%,明显高于其他类食品。所采集的266份样品黄曲霉毒素总检出率为:黄曲霉毒素B_1(4.5%)黄曲霉毒素G_1(0.8%)黄曲霉毒素B_2(0.4%)黄曲霉毒素G_2(0.0%)。4种黄曲霉毒素中以黄曲霉毒素B_1的污染情况最为严重,共检出1份花生样品含量为58.4μg/kg,为黄曲霉毒素B_1含量超标样品。结论黄曲霉毒素在食品中的污染情况仍然存在,相关管理部门应加强监控,以保证消费者的身体健康。     

高效液相色谱法测定食品中黄曲霉毒素B1

黄曲霉毒素B_1(简称AFB_1)是一种毒性与致癌性强的物质,它主要是黄曲霉和寄生曲霉的代谢产物,温特曲霉也产生黄典霉毒素,但产量较少。黄曲霉毒素主要污染粮油及其制品。如花生、花生油、玉米、大米、棉籽、啤酒和酱油等。 黄曲霉毒素根据其荧光颜色Rf(相对荧光)值及结构等分别命名为B_1、B_2、G_1、G_2、M_1、M_2、P_1、Q_1、霉醇、GM等。其基本结构都有二呋喃和氧杂萘邻酮,凡二呋喃环末端有双键者毒性较强并有致癌性如B_1、G_1和M_1。 黄曲霉毒素B_1是一种较强的致癌物,以往食品中AFB_1的测定多采用薄层色谱,柱液相色谱等方法,但操作较繁,误差较大,灵敏度也不够理想。本文参考有关文献在食品预处理后进行衍生,用高效液相色谱测定,效果较好。采用Sep-Pak C_(18)小柱浓缩AFB_1,提高了方法灵敏度,并对色谱分离条件进行了改     

咸阳市2014年市售部分食品中真菌毒素污染状况分析

目的了解咸阳市市售部分食品真菌毒素的污染状况。方法分层随机抽取样品,不同样品进行有针对性指标的检测,将监测结果与国家标准限值进行对照,并进行统计学分析。结果共抽检样品63份,合格率为100.0%。不同食品中污染的主要真菌毒素不同,小麦粉和燕麦中分别为DON和3A-DON;玉米粉中为伏马菌毒素B1和玉米赤霉烯酮;花生油和玉米粉中为黄曲霉毒素(AFB1、AFB2);调料粉中为黄曲霉毒素(AFB1、AFB2、AFG1)。不同食品间真菌毒素检出率比较:谷物及其制品与花生油之间,差异无统计学意义(P0.05);调料粉与谷物及其制品和花生油之间,差异均有统计学意义(P0.05)。谷物及其制品和调料粉中,散装包装和定型包装,差异均无统计学意义(P0.05)。结论本市该6种食品真菌毒素污染状况相对较好,但根据检出率监测结果看,需要引起关注,应加强对这几类食品的监督管理,引导公众正确消费。     

重庆市涪陵区农村家庭粮油及调味食品中黄曲霉毒素B_1污染调查

目的调查重庆市涪陵区李渡社区和义和镇农户家的粮油、调味食品类中黄曲霉毒素B_1(AFB_1)污染情况,为粮油及调味食品中AFB_1污染水平的监测提供基础数据。方法 2013-2016年在该地区采集粮油、调味食品共8种,用酶联免疫吸附法(ELISA)检测AFB_1含量,依据GB 2761-2011《食品中真菌毒素限量》进行评价。结果调查的685件样品中:大米168件,超标2件,最大值超标6.4倍;玉米102件,超标3件,最大值超标9.2倍;辣椒123件,超标9件,最大值超标11.0倍;豆瓣82件,超标2件,最大值超标6.6倍;菜油、花生油和酱油210件样品未检出超标件。结论农户家粮油、调味食品均受到AFB_1污染,但污染程度较轻。     

免疫亲和柱净化-HPLC光化学柱后衍生荧光法测定植物油中的黄曲霉毒素

目的建立免疫亲和柱净化-HPLC光化学柱后衍生荧光检测法,用于测定植物油中黄曲霉毒素B_1、B_2、G_1、G_2。方法样品用乙腈-水(20+80,体积比)混合液提取,提取液经免疫亲和柱净化,净化液经C18色谱柱分离,用光化学柱后衍生器衍生、荧光检测器进行检测,采用外标法进行定量。结果在优化的条件下,4种黄曲霉毒素能达到很好的分离效果,黄曲霉毒素B_1、G_1在0.2~20.0 ng/ml范围内线性关系良好,检出限为0.04μg/kg;黄曲霉毒素B_2、G_2在0.1~10.0 ng/ml范围内线性关系良好,检出限为0.02μg/kg,4种黄曲霉毒素的回收率为82.5%~95.3%,RSD为2.4%~5.9%。结论该方法快速、简单、准确、灵敏、重现性好,是测定植物油中的黄曲霉毒素B_1、B_2、G_1、G_2的可靠方法。     

食品中黄曲霉毒素B_1的测定方法

黄曲霉毒素是部分黄曲霉菌所产生的代谢产物,具有较强毒性的物质。在天然被污染的食品中一般以黄曲霉毒素B_1最多,而其他如黄曲霉毒素B_2、G_1、G_2、只有一小部分,在某些情况下甚至检不出来。食品中以花生、玉米等最易污染黄曲霉毒素。为了食品卫生检验工作的需耍,我们参考了有关资料,建立了食品中黄曲霉毒素B_1的测定方法。     

植物油中黄曲霉毒素B_1的污染状况调查分析

目的为了初步调查分析市售植物油中黄曲霉毒素B_1的污染状况。方法随机抽取市售花生油、玉米油、葵花籽油、菜籽油、大豆油、调和油共246份的植物油作为研究对象,采用高效液相色谱法进行黄曲霉毒素B_1测定。结果调查分析的6类植物油中,黄曲霉毒素B_1只在花生油和菜籽油中有检出,超标样品全部为花生油。花生油黄曲霉毒素B_1的平均含量为16.2μg/kg,最高浓度为288μg/kg,其检出率及超标率分别为88.1%和11.9%。散装花生油与定型包装花生油黄曲霉毒素B_1检出率差异无统计学意义(χ~2=0.649,P0.05);但超标率差异有统计学意义(χ~2=9.469,P0.05)。结论市售植物油黄曲霉毒素B_1的总体污染水平不高,但花生油的检出率和超标率较高,散装花生油较易受到黄曲霉毒素B_1的污染,其超标率高于定型包装花生油。     

2012—2015年陕西省市售食品中黄曲霉毒素的污染调查

目的了解2012—2015年陕西省市售食品中黄曲霉毒素的污染状况。方法2012—2015年,在陕西省10个地市随机采集八大类食品,包括谷物及其制品(大米、玉米粉)、豆及豆制品(黄豆)、植物油(花生油、玉米油)、坚果及籽类(花生、开心果、杏仁等)、调味品(酱油、辣椒及花椒制品)、酒类(啤酒)、茶叶制品及特殊膳食用食品(婴幼儿辅食),采用超高效液相色谱仪对4种黄曲霉毒素进行了检测,并以GB 2761—2011《食品安全国家标准食品中真菌毒素限量》为标准进行评价。结果1007份样品中,有108份检出黄曲霉毒素,检出率为10.7%,平均值为2.34μg/kg。只有5份花生样品黄曲霉毒素B_1超标,超标率为13.5%。结论陕西省市售食品中黄曲霉毒素含量总体处于安全水平,但花生样品有潜在危险性,超标率较高。     

福建省本地稻谷及糙米常见真菌毒素污染状况研究

目的了解福建省本地稻谷及糙米中常见真菌毒素的污染情况,发现可能存在的风险。方法用同位素内标稀释超高效液相色谱-串联质谱技术,测定福建省内2018—2019年150份未脱壳稻谷和119份糙米中16种常见真菌毒素的含量。结果稻谷150份和糙米119份各有1份样品黄曲霉毒素B_1超过GB 2761-2017限量指标,超标率分别为0.7%和0.8%;脱氧雪腐镰刀菌烯醇(DON)、黄曲霉毒素B_2(AFTB_2)、赭曲霉毒素A(OTA)、玉米赤霉烯酮(ZEN)、伏马毒素B_1(FB_1)和B_2(FB_2)有检出,但含量低;糙米储存4个月前后的黄曲霉毒素B_1(AFB_1)、脱氧雪腐镰刀菌烯醇(DON)、伏马毒素B_1(FB_1)和玉米赤霉烯酮(ZEN)的检出率比较可见,储存4个月后糙米玉米赤霉烯酮(ZEN)检出率与检测值高于储存前;脱氧雪腐镰刀菌烯醇(DON)和伏马毒素B_1(FB_1)的检测值高于储存前的检测值。结论黄曲霉毒素B_1(AFB_1)是福建省本地稻谷及糙米最重要的污染物;糙米的储存、加工周期长,真菌毒素污染情况受储存条件影响大,应加强糙米等杂粮中真菌毒素污染的监测。     

Aflatoxins and ochratoxin A in food and risks to human health

OBJECTIVES: The presence of mycotoxins in food has been associated with several human diseases, and health authorities have taken actions to decrease the ingestion of these compounds in the diet. A study was carried out to assess aflatoxins and ochratoxin A concentrations found in food, and to evaluate the potential risk to human health resulting from mycotoxin exposure. METHODS: Between July 1998 to December 2001, 366 food samples were analyzed, including peanuts and its products, nuts, maize, oat and/or wheat products, rice and beans. Samples were processed and the extracted mycotoxins were detected and separated using thin layer chromatography, and then quantified with fluorescence. RESULTS: Aflatoxins were detected in 19.6% of the samples: raw peanuts and its products, pop corn, maize and Brazilian nuts (>2mg/kg). Peanuts and its products showed the highest levels of aflatoxin contamination (34.7%) with up to 1280 mg/kg of AFB1+AFG1 and 1706 mg/kg of total aflatoxins. Of the positive samples, AFB1 was detected in 98.5%, AFB2 in 93%, AFG1 in 66.7%, and AFG2 in 65.4%. Ochratoxin A was not detected (<25 mg/kg) in any sample analyzed. CONCLUSION: It was found that contamination levels mainly seen in peanuts and its products exceed Brazilian regulated standards, and they can be a potential risk to regular consumers of these products. Food producers' awareness allied to monitoring programs is essential to reduce human exposure to these compounds and prevent ensuing chronic diseases.     

烟台市售食品黄曲霉毒素污染状况及膳食暴露评估

目的 了解烟台市售食品黄曲霉毒素污染状况及居民膳食来源暴露风险水平。方法 免疫亲和层析高效液相色谱法测定样品中黄曲霉毒素,点评估方法估算人群黄曲霉毒素暴露量。结果 检测的市售食品中AFB1检出率为4.19%（19/453）,超标率为0.22%（1/453）,均值为0.86 μg/kg。AFB2、AFG1、AFG2和AFM1检出率分别为2.13%（9/423）、1.65%（7/423）、0.95%（4/423）和41.90%（44/105）,均值分别为0.29、0.64、0.33和 0.03 μg/kg。食品中存在AFB1、AFB2、AFG1和AFG2多重污染情况。AFB1的检出均值占到黄曲霉毒素(AFB1、AFB2、AFG1和AFG2)均值总和的47.18%。AFB1、AFB2、AFG1、AFG2和AFM1的日膳食暴露量分别为4.326、1.733、3.143、2.423和0.168 ng/（kg·bw·d）。AFB1、AFB2、AFG1、AFG2和AFM1的膳食暴露贡献率分别占到总体的36.69%、14.70%、26.65%、20.55%和1.42%。谷类及其制品的膳食暴露贡献最大,食用植物油的贡献次之。结论 AFB1总体检出率和均值均高于AFB2、AFG1和AFG2,是主要的污染品种。谷类及其制品和食用植物油是主要的AFB1、AFB2、AFG1和AFG2膳食暴露来源。乳制品是主要的AFM1的膳食暴露来源。烟台市居民AFB1和AFM1膳食暴露导致肝癌发病率为0.101/10万人和0.004/10万人。     

玉米中四种黄曲霉毒素的关系

目的了解我国玉米中黄曲霉毒素B1（AFB1）、黄曲霉毒素B2（AFB2）、黄曲霉毒素G1（AFG1）和黄曲霉毒素G1（AFG1）污染的关系。方法用统计方法分析玉米中任意两种毒素污染率、污染浓度的相关性;计算AFB1与总黄曲霉毒素（AFs）的数量关系,分析AFB1在AFs中的构成1结果AFB1检出率最高,AFB1没有单独污染,均伴随AFB1。任两种毒素浓度呈正相关（P=0．000）,AFB1、AFB1、AFG1与AFG1的相关系数均大于0．951任两种毒素检出率有相关性（P=0．000）,AFB1和AFBz相关性最强1随AFB1浓度区间增高,AFB1检出率增高,AFG1和AFG1检出率先升高后降低;AFB1与AFs浓度比升高,AFs高于4μg／kg时,浓度比超过0．51结论AFB1和AFBz污染密切相关,AFBz伴随AFB1,二者污染率和浓度呈正向变化。当AFB1浓度较高时,对AFG1和AFG1呈现抑制作用1按照AFs限量是AFB1的两倍,当玉米中AFs限量在4μg／kg以上时,同时制定AFB1和AFs限量,与仅制定AFB1限量相比,不增加管理效力。     

中国部分地区玉米中4种黄曲霉毒素污染调查

目的了解中国玉米中黄曲霉毒素B1(AFB1)、黄曲霉毒素B2(AFB2)、黄曲霉毒素G1(AFG1)和黄曲霉毒素G2(AFG2)的污染状况。方法从吉林、河南、湖北、四川、广东、广西采集玉米样品,用HPLC测定黄曲霉毒素含量。结果共测定279份玉米,黄曲霉毒素阳性率为75.63%,阳性样品平均浓度为44.04μg/kg,浓度范围0.20～888.30μg/kg。四川、湖北、广西、河南、广东和吉林样品的阳性率依次为90.48%、93.75%、87.50%、36.96%、91.84%和52.17%,平均浓度依次为107.93、70.98、39.65、8.06、3.70和1.15μg/kg。4种毒素中AFB1阳性率和平均浓度最高,分别为74.55%和39.64μg/kg;AFB2、AFG1和AFG2的阳性率和平均浓度依次降低,阳性率分别为58.42%、41.22%和19.71%,平均浓度分别为3.81、3.47和0.51μg/kg。结论玉米的黄曲霉毒素污染比较普遍;调查的各地样品均有不同程度污染,总体上南方地区高于北方;4种毒素中以AFB1污染为主。     

Inhibition of aflatoxin production and growth of Aspergillus parasiticus by Cuminum cyminum, Ziziphora clinopodioides, and Nigella sativa essential oils

Aflatoxins are highly toxic and carcinogenic metabolites produced by Aspergillus parasiticus on food and agricultural commodities. Natural products may control the production of aflatoxins. The aims of this study were to evaluate the effects of the essential oils (EOs) of Cuminum cyminum, Ziziphora clinopodioides, and Nigella sativa on growth and aflatoxins production by A. parasiticus. Minimal inhibitory concentrations (MICs) and minimal fungicidal concentrations (MFCs) of the EOs were determined and compared with each other. Determination of aflatoxins (AFB(1), AFB(2), AFG(1), and AFG(2)) was performed by immunoaffinity column extraction using reverse phase-high performance liquid chromatography. The major oil components were α-pinene (30%) in C. cyminum, pulegone (37%) in Z. clinopodioides, and trans-anthol (38.9%) in N. sativa oils. In broth microdilution method, C. cyminum oil exhibited the strongest activity (MIC(90): 1.6; MFC: 3.5?mg/mL), followed by Z. clinopodioides (MIC(90): 2.1; MFC: 5.5?mg/mL) and N. sativa (MIC(90): 2.75; MFC: 6.25?mg/mL) oils against A. parasiticus (p<0.05). Aflatoxin production was inhibited at 0.25?mg/mL of C. cyminum and Z. clinopodioides oils, of which that of C. cyminum was a stronger inhibitor. C. cyminum EO caused significant reductions in values of 94.2% for AFB(1), 100% for AFB(2), 98.9% for AFG(1), 100% for AFG(2), and 97.5% for total aflatoxin. It is concluded that the EOs of C. cyminum, Z. clinopodioides, and N. sativa could be used as natural inhibitors in foods at low concentrations to protect from fungal and toxin contaminations by A. parasiticus.     

The effect of bread making steps on the degradation of aflatoxins produced as a result of single inoculation with Aspergillus flavus and combined inoculation with Aspergillus flavus and Aspergillus ochraceus

This study aimed to determine the effect of bread making steps on the stability of aflatoxin. Sakha 8 wheat and Gemaiza 5 wheat cultivars, were used in the present study. They were inoculated with a dense spore suspension of toxigenic fungal species of Aspergillus flavus and a non toxigenic species of Aspergillus ochraceus singly and combined. Aflatoxin concentration was determined in the whole wheat grain, after milling, after fermentation, and after bread-baking process. Results showed that the highest reduction percentage for the total aflatoxins (81, G1 and G2), was in Sakha 8 (32.96%) (single treatment), Gemaiza 5 (19.54%) (single treatment ), Gemaiza 5 (18.65%) (combined treatment), and finally in Sakha 8 (16.49%) (combined treatment). There was no significant difference (p < 0.05) in aflatoxins content between Sakha 8 and Gemaiza 5 treated singly and in a combined way before and after milling process. In the mean time, the percentage of AFB1, AFG1 and AFG2 were reduced by 31.98%, 44.53% and 35.35%, respectively, while the total aflatoxins concentration were reduced by 41.17% after baking. Results also showed the presence of a significant difference at p < 0.05 among the whole grain, after milling and after baking concerning AFG1, AFG2 and the total aflatoxins content. No significant difference was found in case of AFB1.     

Microbial contamination of seven major weaning foods in Nigeria

Five million children aged less than five years die annually due to diarrhoea. The aim of the study was to identify some possible contributing factors for persistent diarrhoea. Seven weaning foods, including a locally-made food, were evaluated by estimating the microbial load using the most probable number method and aflatoxin levels (AFM1, AFG1, AFG2, and AFB2) by immunoaffinity column extraction and high-performance liquid chromatography (HPLC) with detection of fluorescence. The results showed that the locally-made weaning food had the highest microbial count (2,000 cfu/g) and faecal streptococcal count (25 cfu/g). Moulds isolated were mainly Aspergillus niger, A. flavus, A. glaucus, Cladosporium sp., and Penicillium sp. The home-made weaning food recorded the highest fungal count (6,500 cfu/g). AFM1 of the weaning foods was 4.6-530 ng/mL. One weaning food had AFB1 level of 4,806 ng/g. Aflatoxin metabolites, apart from AFM1 and AFB1 present in the weaning foods, were AFG1 and AFG2. There were low microbial counts in commercial weaning foods but had high levels of aflatoxins (AFM1, AFG1, AFG2, AFB1, and AFB2). Growth and development of the infant is rapid, and it is, thus, possible that exposure to aflatoxins in weaning foods might have significant health effects.     

福建省市售花生及花生制品中4种黄曲霉毒素污染调查

目的:了解福建省花生中黄曲霉毒素B1(AFB1)、黄曲霉毒素B2(AFB2)、黄曲霉毒素G1(AFG1)和黄曲霉毒素G2(AFG2)的污染状况。方法:从福建省九个地区采集花生和花生制品,用高效液相色谱测定黄曲霉毒素含量。结果:共测定62份花生,40份花生酱,20份花生油。以国家标准规定的黄曲霉毒素B1限值20μg/kg计,超标率分别为17.7%、37.5%和0。4种毒素中AFB1阳性率和平均浓度最高,AFB2、AFG1和AFG2的阳性率和平均浓度依次降低。结论:福建省花生和花生制品的黄曲霉毒素污染比较普遍,4种毒素中以AFB1污染为主。     

Ionic liquid functionalized zinc oxide nanorods for solid-phase microextraction of aflatoxins in food products

Aflatoxins (AFs) in food and agricultural products pose serious health hazards to consumers. As a result, exports are restricted and farmers lose much needed income. One major challenge faced in controlling AFs in developing countries in particular is lack of simple and cost-effective methods of analysis. To address this problem, a solid-phase microextraction (SPME) technique was developed based on 1-hexyl-3-methylimidazolium hexafluorophosphate functionalized zinc oxide nanorods for the extraction of AFB1, AFB2, AFG1 and AFG2 in food products prior to HPLC analysis. The SPME was performed using 10 mg of the adsorbent at pH 7 and vortexing for 1 min at 500 rpm, and desorbed by sonication for 2 min in 1 mL acetonitrile. The technique showed excellent linearity (correlation coefficients, ≥0.997). LOD and LOQ were determined respectively to be 0.07 and 0.73 μg/kg for AFB1, 0.01 and 0.12 μg/kg for AFB2, 0.04 and 0.44 μg/kg for AFG1 and 0.02 and 0.18 μg/kg for AFG2. The intra- and inter-day relative standard deviations were in the ranges of 3.9–4.7% and 6.9–8.4%, respectively. The acquired recovery of blank samples of the pepper and groundnut samples spiked with mixed analytes at 5 and 10 μg/kg spiking levels were in the range of 88.6–99.8%. The SPME was employed for the analysis of the considered analytes from real chili pepper and processed groundnut samples. Overall, the technique is easy, fast, cost-effective and environmentally friendly and can be used for the analysis of AFs in various food and agricultural products.     

Associations of serum aflatoxin B1-lysine adduct level with socio-demographic factors and aflatoxins intake from nuts and related nut products in Malaysia

Aflatoxins are one of the major risk factors in the multi-factorial etiology of human hepatocellular carcinoma. Therefore, the information on aflatoxins exposure is very important in the intervention planning in order to reduce the dietary intake of aflatoxins, especially among the children. This study investigated the relationship between aflatoxin B(1) (AFB(1)) lysine adduct levers in serum and socio-demographic factors and dietary intake of aflatoxins from nuts and nut products in Penang, Malaysia. A cross-sectional field study was conducted in five districts of Penang. A survey on socio-demographic characteristics was administered to 364 healthy adults from the three main ethnic groups (Malay, Chinese and Indian). A total of 170 blood samples were successfully collected and tested for the level of AFB(1)-lysine adduct. 97% of the samples contained AFB(1)-lysine adduct above the detection limit of 0.4 pg/mg albumin and ranged from 0.20 to 23.16 pg/mg albumin (mean±standard deviation=7.67±4.54 pg/mg albumin; median=7.12 pg/mg albumin). There was no significant association between AFB(1)-lysine adduct levels with gender, district, education level, household number and occupation when these socio-demographic characteristics were examined according to high or low levels of AFB(1)-lysine. However, participants in the age group of 31-50 years were 3.08 times more likely to have high AFB(1) levels compared to those aged between 18 and 30 years (P=0.026). Significant difference (P=0.000) was found among different ethnic groups. Chinese and Indian participants were 3.05 and 2.35 times more likely to have high AFB(1) levels than Malay. The result of AFB(1)-lysine adduct suggested that Penang adult population is likely to be exposed to AFB(1) but at a level of less than that needed to cause direct acute illness or death.