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ABSTRACT
Objective: The aim of this study was to assess the mean of histamine concentration in food poisoning.
Design: Systematic review and meta-analysis of reports published between 1959 and 2013.
Study selection: Main criteria for inclusion of studies were: all report types that present outbreaks of “histamine poisoning' or “scombroid syndrome” from food, including histamine content and type of food. Health status of people involved must be nonpathological.
Results: Fifty-five (55) reports were included, these studies reported 103 incidents. All pooled analyses were based on random effect model; histamine mean concentration in poisoning samples was 1107.21 mg/kg with confidence interval for the meta-mean of 422.62–2900.78 mg/kg; heterogeneity index (I2) was 100% (P < 0.0001); prediction interval was 24.12–50822.78 mg/kg. Fish involved in histamine poisoning was mainly tuna or Istiophoridae species. No clues of association between concomitant conditions (female sex, alcohol consumption, previous medication, and consumption of histamine releasing food) and histamine poisoning, were highlighted.
Conclusions: This is the first systematic review and meta-analysis that analyzes all the available data on histamine poisoning outbreaks evaluating the histamine concentration in food involved. Histamine mean concentration in poisoning samples was fairly high. Our study suffers from some limitations, which are intrinsic of the studies included, for instance the lack of a complete anamnesis of each poisoning episode.
Protocol registration: Methods were specified in advance and have been published as a protocol in PROSPERO database (18/07/2012 -CRD42012002566).
Contributions of authors
CB building protocol, study selection, data extraction and writing review; EC bibliographic search; FC building protocol, study selection, data extraction and analysis and writing review; PC: building protocol, supervising of all phases and writing review.
Declarations of interest
This systematic review is a phase of a research commissioned from a food industry.
Sources of support
Internal sources
Università degli Studi di Milano (Italy): EC work in this systematic review was rewarded by a salary.
External sources
Generale Conserve company, Italy: sponsored research about histamine poisoning in tunafish.
Acknowledgments
The authors thank Angela Moccia for her contributtion as information expert.
Funding
The authors thank Generale Conserve for funding this systematic review.