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Global occurrences of the intentional adulteration of food with a chemical toxicant culled from the literature and news reports from 2009 to 2022 were analyzed in terms of their ability to cause mass public health harm. A total of 76 intentional adulteration events that involved over 27 chemicals and 16 foods were identified. The chemicals used included pesticides, rat poisons, illicit drugs, and commercial chemicals. A total of 253 deaths and 4,887 illnesses were attributed to intentional adulteration events; there were deaths in 20% and illnesses in 50% of the events. Intentional adulteration during manufacturing, which accounted for 21 events (28%), resulted in 205 deaths (81%) and 3,572 illnesses (73%). Intentional adulteration at the food preparation node, which accounted for 17 events (22%), resulted in 39 deaths (15%) and 387 illnesses (8%). On-farm intentional adulteration, eight events (10%) resulted in 843 illnesses (17%) and no deaths. The perpetrators who were identified generally had legitimate access to the food, although in 63% of the cases studied, the perpetrator was not identified. Economically motivated adulteration and revenge resulted in over 80% of the deaths and illnesses.

Global occurrences of the intentional adulteration of food with a chemical toxicant culled from the literature and news reports from 2009 to 2022 were analyzed in terms of their ability to cause mass public health harm. A total of 76 intentional adulteration events that involved over 27 chemicals and 16 foods were identified. The chemicals used included pesticides, rat poisons, illicit drugs, and commercial chemicals. A total of 253 deaths and 4,887 illnesses were attributed to intentional adulteration events; there were deaths in 20% and illnesses in 50% of the events. Intentional adulteration during manufacturing, which accounted for 21 events (28%), resulted in 205 deaths (81%) and 3,572 illnesses (73%). Intentional adulteration at the food preparation node, which accounted for 17 events (22%), resulted in 39 deaths (15%) and 387 illnesses (8%). On-farm intentional adulteration, eight events (10%) resulted in 843 illnesses (17%) and no deaths. The perpetrators who were identified generally had legitimate access to the food, although in 63% of the cases studied, the perpetrator was not identified. Economically motivated adulteration and revenge resulted in over 80% of the deaths and illnesses., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)