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Authors: Marion Nestle

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BOOK: Safe Food: The Politics of Food Safety
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Specialists in risk communication are well aware of the importance of such anxieties in assessment of safety risks. Paul Slovic and his colleagues, for example, have asked people to rank potential hazards according
to the degree of perceived harm. Their findings: people worry most about risks perceived as highly dangerous, particularly to pregnant women and small children (a science-based concept), but they are also concerned about risks perceived as involuntary, unpreventable, unfamiliar, and inequitably distributed—factors based on values. Their studies consistently find people to be less willing to accept risks induced by technology, those poorly understood by science, and those subject to contradictory statements from experts. The more such value-based factors characterize a particular risk, the more the risk generates feelings of anxiety, alarm, dread, and outrage. In fact, risk communication researchers rank such factors on a predictable scale of dread and outrage.
28

With respect to food, acceptance of risk depends far more on perception of the number and intensity of dread-and-outrage factors than it does on the number of cases of illness. Scientists can identify the probable extent of a foodborne illness in the population, for example, but interpreting what that probability means for the health of any one individual is quite another matter. On a population basis, microbial contaminants unquestionably pose the most prevalent foodborne threat to health. The public, however, also ranks chemical pesticides and additives, irradiation, and genetic engineering high on the list of perceived risks, largely because exposures to them are invisible, involuntary, imposed, and uncontrollable. People make clear, predictable, and understandable distinctions between risks they knowingly accept and those they do not. Many people find the benefits of eating raw fish or raw milk cheeses to greatly exceed the small but finite risk of ingesting harmful microbial contaminants; the choice is voluntary, and the foods are familiar. In contrast, the health risks of genetically modified foods (however remote they may be) are hidden and undemocratically applied—witness StarLink—and as a result are far less acceptable.

Because questions of who imposes risks and who takes risks are crucial in assessing whether a risk is acceptable, decisions about food safety take on political dimensions. During the mid-1990s, when the FDA applied a solely science-based approach to approval of genetically engineered foods, Commissioner David Kessler recognized the political implications of excluding value-based considerations when he told a reporter, “Weighing risks against benefits sounds great, but the truth is there is no magic formula, especially when the risks are taken by one group and the benefits by another.”
29

A comparison of the two approaches to assessing risk explains why whenever someone invokes science in discussions of food safety, we can
be reasonably certain that questions of self-interest are at stake but are excluded from debate. Scientists talk about risk as a matter of illness and death. The public wants dread-and-outrage factors to be considered as well. In this book, we will see how the failure of food companies, scientists, and government agencies to recognize the need to address values as well as science in matters of food safety leads to widespread distrust of the food industry and its regulators. When officials and experts dismiss dread-and-outrage concerns as emotional, irrational, unscientific, and indefensible, they raise questions about their own credibility and competence. They fail to recognize their own biases as well as the predictability of public responses to food safety risks. In 1987, Peter Sandman explicitly made this point: “When a risk manager continues to ignore these factors—and continues to be surprised by the public’s response of outrage—it is worth asking just whose behavior is irrational.”
30

The Precautionary Principle: Look Before You Leap

The differences in the two approaches to food safety risk have an additional political dimension. They imply different expectations for the ways in which authorities make decisions about the release of new foods and ingredients. The science-based approach works on the proposition “nothing ventured, nothing gained.” Regulators determine as well as they can whether a food or ingredient is likely to cause harm and permit those that seem reasonably safe to enter the food supply. The FDA uses this approach for food additives characterized as “generally recognized as safe” (GRAS) and also, with some modifications, for genetically engineered foods. If problems occur, the agency deals with them
after
the foods are marketed. This approach requires neither premarket testing nor labeling; it is based on a standard that requires food manufacturers to demonstrate “reasonable certainty of no harm.” This standard, which translates as “safe enough to be acceptable,” leaves plenty of room for subjective opinion and judgment.

An alternative approach is one that has come to be known as the principle of precautionary action, or the “precautionary principle.” This principle, which emerged in Europe as a guideline for environmental protection, can be summarized as “look before you leap,” meaning test the products first, then introduce them into the marketplace. Although this approach may seem so sensible as to be politically neutral, it is nothing of the kind. As the European Commission explains:

Decision-makers are constantly faced with the dilemma of balancing the freedom and rights of individuals, industry and organizations with the need to reduce the risk of adverse effects to the environment or to health. . . . Whether or not to invoke the Precautionary Principle is a decision exercised where scientific information is insufficient, inconclusive, or uncertain and where there are indications that the possible effects on the environment or human, animal or plant health may be potentially dangerous and inconsistent with the chosen level of protection. . . . The appropriate response in a given situation is thus the result of a political decision, a function of the risk level that is “acceptable” to the society on which the risk is imposed.
31

In practice, invocation of the precautionary principle can be used to require companies to demonstrate that foods are safe
before
they are marketed. As we have seen, the EPA followed this principle to some extent when it ruled that StarLink could not enter the human food supply. On the basis of such precautions, the European Union banned American and Canadian beef from cattle treated with growth hormones and delayed introduction of genetically modified crops. Thus, the precautionary principle has implications for international trade as well as domestic food policy and has become a major rallying point for advocates who favor environmental protection or oppose food biotechnology.
32
In January 1998, for example, a group of such advocates met in Wingspread, Wisconsin, to formulate what is now known as the Wingspread statement on the precautionary principle: “When an activity raises threats of harm to human health or the environment, precautionary measures should be taken even if some cause and effect relationships are not fully established scientifically. In this context, the proponent of the activity, rather than the public, should bear the burden of protection.”
33

As a result of such advocacy, international agreements increasingly incorporate the precautionary principle in policy statements. For example, European and United States experts on food biotechnology issued a joint statement in 2000 saying, “When substantive uncertainties prevent accurate risk assessment, governments should act protectively on the side of safety.”
34
Even so mild a statement suggests that companies will have to do more to demonstrate safety in advance. But because testing can
never
prove that a food is perfectly safe, public willingness to accept a new food depends on how well it meets the value concerns summarized in
table 2
. If a food ranks high in dread and outrage, it will
never
appear safe enough, no matter how much effort goes into attempts to prove it harmless.

In their frustration with dread-and-outrage factors, industry leaders and their supporters argue that no matter what they do, they will never be able to satisfy opponents. Instead, they argue, the true purpose of the precautionary principle is to inhibit business. Elizabeth Whelan, who directs the industry-sponsored American Council on Science and Health, explains why the principle so infuriates her and other science-based assessors of food safety risks: “As a corollary to the Precautionary Principle, consumer activists now insist that if the public
perceives
something as risky, that perception should carry the day regardless of whether there truly is a risk or not. In essence these people argue that science should take a back seat to fear—
whether that fear is justified or not
—when it comes to setting policy.”
35

Such comments reveal that much of the controversy about food safety appears as a conflict between a strictly scientific assessment of risk and an approach that also considers a much broader range of issues that affect society. Underlying the controversy, as this book explains, are industry concerns about economic self-interest as opposed to concerns of consumer advocates about the distribution of risk, benefit, and control in matters of public policy. We will see how scientific decisions about food safety cannot be separated from such political and social matters.

ABOUT THIS BOOK

This book traces the interweaving of science, values, and politics through an examination of three broad areas of food safety: bacteria, biotechnology, and bioterrorism. The first part of the book examines the politics of foodborne microbial illness. These chapters describe government attempts to force food producers, particularly those that slaughter and process meat, to take steps to prevent bacterial contamination of their products, and they explain how those industries consistently resist such safety measures. From a science-based approach to risk assessment, food-borne illness is the single most important food safety problem; it is responsible for millions of cases of stomach upset and thousands of deaths each year. Bacteria rank low on the dread-and-outrage scale, however, because meat is familiar, eating it is voluntary, food “poisonings” are common, and most people survive them. Politics enters this picture at the level of responsibility for preventing foodborne illness. We will see how the meat industry exploits the relatively low level of organized public outrage about microbial safety to oppose federal regulations and, instead, to argue that
consumers
bear the principal burden of ensuring safe
food.
Part 1
also describes the fragmentation of government oversight as a basis for developing a more coherent approach to dealing with problems of food safety.

Part 2 shifts the discussion to a different issue: genetically modified foods. By the standards of scientific risk assessment—counting cases of illness and death—such foods appear no less safe than foods developed through traditional plant genetics, but, as the StarLink affair indicates, they present many reasons for distrust and alarm. These chapters describe how the food biotechnology industry, in dismissing dread-and-outrage factors as emotional and unscientific, lobbied for—and won—a largely science-based approach to regulation of its products. The chapters explain how the dismissal of consumer concerns about value issues related to food biotechnology forced advocacy groups to use safety as the only “legitimate” basis of discussion. In the StarLink affair, for example, advocates could not use concerns about corporate control of the food supply as an argument against approval of genetically modified foods. They could, however, use the remote risk of allergenicity as a basis for opposition because of the double negative: it is
not
possible to prove that the StarLink protein is
not
allergenic. These chapters describe the origin of disputes about genetically modified foods that arise from conflicting interests and values.

The concluding chapter takes up a third area: food bioterrorism—the deliberate poisoning or contamination of the food supply to achieve some political goal. Questions about food bioterrorism take us into the realm of emerging food safety hazards that might be used as biological weapons: mad cow disease, foot-and-mouth disease, and anthrax. From a science-based perspective, these problems are of uncertain or low overall risk to human health, but they rank high as causes of dread and outrage. The terrorist attacks of September 2001 increased the level of anxiety, particularly about the country’s vulnerability to bioterrorism in general, and to food bioterrorism in particular. In concluding this discussion, I offer suggestions for ways in which the government, the food industry, and consumers might engage in political action to deal with this and the other food safety issues raised in this book. Finally, a short appendix briefly summarizes some of the basic scientific concepts that underlie the debates about food safety issues.

With this introduction, we can now begin our discussion by examining the historical and modern reasons why government attempts to keep harmful bacteria out of food have proved so controversial and why they raise issues of politics as well as of science.

PART ONE
RESISTING FOOD SAFETY

FRIENDS AND COLLEAGUES, KNOWING THAT I WAS WRITING
about harmful bacteria in food, wondered why anyone would care about things so invisible, tasteless, unpronounceable, and, for the most part, innocuous. Like most people, they view occasional episodes of food “poisoning” as uncomfortable (sometimes
very
uncomfortable), but certainly more a matter of random bad luck than of decades of industry and government indifference, dithering, and outright obstructionism. They accept at face value the endlessly intoned mantra of industry and government: the United States has the safest food supply in the world.

Whether this assertion is true is a matter of some debate. Safety is relative. The most authoritative estimate of the yearly number of cases of foodborne disease in the United States defies belief: 76 million illnesses, 325,000 hospitalizations, 5,000 deaths. As the chapters in
part 1
explain, such numbers undoubtedly
underestimate
the extent of the problem. Although the most frequent causes of these illnesses are viruses and species of bacteria—
Campylobacter, Salmonella, Shigella
, and
Escherichia coli
(
E. coli
)—most episodes are never reported to health authorities and their cause is unknown.
1
From a science-based perspective, the risks and costs of foodborne illness are extremely high.

Furthermore, although outbreaks of foodborne illness have become more dangerous over the years, food producers resist the attempts of government agencies to institute control measures, and major food industries oppose pathogen control measures by every means at their disposal. They lobby Congress and federal agencies, challenge regulations
in court, and encourage local obstruction of safety enforcement. We will see, for example, that the culture of opposition to food safety measures so permeates the beef industry that it led, in one shocking instance, to the assassination of federal and state meat inspectors.

To explain this culture of resistance, we need to understand that current problems of food safety are not new but are
different
. A century ago, the main sources of foodborne illness were milk from infected cows and spoiled meat from sick animals. Public health measures that we now take for granted—water chlorination and milk pasteurization, for example—eliminated typhoid fever, cholera, and most lethal diarrheal diseases. The food supply depended on local production and was largely decentralized. Fish, for example, were caught wild from the sea. Even though cattle were transported to common areas for slaughter and kept in close quarters—conditions ripe for spreading infections—federal inspection and veterinary care kept most sick animals from entering the food supply.

Today, centralized food production has created even more favorable conditions for dissemination of bacteria, protozoa, and viruses. We call these organisms by collective terms: microbes, microorganisms, or “bugs.” If harmful, they are pathogens. Many pathogens infect the animals we use for food without causing any visible signs of illness. Infected animals excrete pathogenic microbes in feces, however, and pass them along to other food animals, to food plants, and to us. If the pathogens survive cooking, stomach acid, and digestive enzymes, they can multiply, produce toxins, upset digestive systems, and do worse. Their effects are especially harmful to people with immature or weakened immune systems—infants, young children, the elderly, and those ill from other causes. Even from this brief description, it should be evident that people involved with every stage of food production, from farm to fork, must take responsibility for food safety to prevent animal infections (producers), avoid fecal contamination (processors), and destroy pathogens (food handlers and consumers).

Sharing of responsibility, however, also permits sharing of blame. As these chapters explain, producers blame processors for foodborne illness, and processors blame producers; government regulators blame both, and everyone blames consumers. The role of government in food safety demands particular notice. Current laws grant regulatory agencies only limited authority to prevent microbial contamination before food gets to consumers. Federal oversight of food safety remains unshakably
rooted in policies established almost a century ago, in 1906. Congress designed those policies to ensure the health of
animals
, in an era long before most of the current microbial causes of foodborne illness were even suspected, let alone recognized. Although food safety experts have complained for years about the gap between hazards and oversight practices, attempts to give federal agencies the right to enforce food safety regulations have been blocked repeatedly by food producers and their supporters in Congress, sometimes joined by the agencies themselves, and more recently by the courts. Some progress has occurred, driven by the appearance in common foods of new and more deadly pathogens such as
E. coli
O157:H7, an exceptionally virulent strain of an otherwise normal and relatively harmless bacterial inhabitant of the human digestive tract. The multimillion-dollar costs of product recalls, legal counsel, and liability payments, and the associated costs of damaged reputation and loss of sales, have made the need for more forceful government oversight of food safety apparent to all but the staunchest protectors of food industry self-interest.

For the most part, the events described in this part of the book are
political
and outside the daily experience of most people in our society. Most of us do not worry much about the possibility that foods in our supermarkets might be contaminated and dangerous, and we act on the basis of what Nicols Fox calls the “unspoken contract” among food producers, government regulators, and the public to ensure that food is safe.
2
On a daily basis, most of us think the risks are so small, so familiar, and so voluntary that we can ignore them. Microbial risks generate little dread and virtually no outrage.

I most clearly recognized the extent of our collective denial about the hazards of food pathogens in the summer of 1999 when I served as a member of an American Cancer Society committee developing dietary guidelines for cancer survivors—people diagnosed with cancer and treated for it. Because surgery, radiation, and chemotherapy can cause a temporary decline in immune function, our committee wanted to stress the importance of preventing microbial infections during periods of treatment and recovery. This advice, we realized, firmly precludes even a taste of raw cookie dough, not to mention avoidance of a host of other foods: Caesar salads, homemade ice cream, and anything else made with raw or partially cooked eggs; rare or medium-cooked hamburger and beef tartare; sushi and other raw seafood; raw
milk and cheeses made from it; freshly squeezed juices; unpeeled vegetables and unwashed salad greens and berries; and raw sprouts. For people with weakened immune systems, eating uncooked and unpasteurized foods means taking a risk, and not just of minor discomfort but perhaps of hospitalization, long-term disability, or death.
3

But what about those of us with healthy immune systems? As these chapters explain,
everyone
takes a risk when eating uncooked foods, but the extent of that risk is uncertain. In the absence of better oversight of safety at the production end, federal agencies now advise us to follow safety guidelines that used to be reserved for travelers to developing countries. Such advice converts the act of eating to a matter of risk management rather than of nourishment or pleasure, and must be understood as a political act in itself. Because federal policies cannot ensure that food is safe before people bring it home, government agencies shift the burden of responsibility to consumers.
Of course
all of us should learn to prepare foods properly, but the industry can and should do its share as well.

As these chapters explain, for reasons of history, inertia, turf disputes, and just plain greed, government oversight of food safety has long tended to provide far more protection to food producers than to the public. Only in recent years, when foodborne illness began to raise serious issues of liability, have food companies and federal agencies been forced to consider measures—albeit grudgingly—to prevent microbial pathogens in food.

Like the events related to the StarLink affair, those recounted in these chapters reflect certain recurrent themes. With respect to government, one theme is the fragmented, overlapping, and ultimately obstructive distribution of authority between two federal agencies: the Food and Drug Administration (FDA) and the Department of Agriculture (USDA). Another is the historic closeness of working relationships among congressional agriculture committees, federal regulatory agencies, and food producers. We will see how food producers repeatedly deny responsibility for foodborne illness, invoke science to promote self-interest and divert public attention from harm caused by their products, and express outright hostility to federal oversight. From the standpoint of consumer advocacy, an additional theme bears on the ways in which food safety relates to much broader societal concerns. As Eric Schlosser discussed so compellingly in
Fast Food Nation
(Houghton Mifflin, 2001), much of the actual work in the food
industry—in agriculture, slaughterhouses, processing plants, and places where food is served—is carried out by immigrants, teenagers, and other groups paid the minimum wage. People can only produce safe food if they know how to do so, if they follow the rules, and if they are themselves in good health. Thus, the production of safe food also depends on the adequacy of fundamental social support systems such as public education and health care.

In this part of the book,
chapter 1
sets the stage by reviewing the origins of the present system of governmental oversight of food safety.
Chapters 2
and
3
review some of the landmark incidents leading to the current “crisis” over bacterial pathogens. They also explain how government agencies attempted to deal with such crises in the face of resistance by food producers and processors. In
chapter 4
, I discuss some political alternatives for improving oversight of our food safety system.

For the most part, these chapters focus on the actions of producers and processors of meat—in this case, beef. Unlike the producers of most other foods, the beef industry makes little attempt to hide its self-interested political activities. Beef industry pressures on Congress and federal regulators are more transparent than those of other food industries, and are better documented. Nevertheless, many of the food safety issues raised by beef production are similar to matters that affect poultry, eggs, seafood (especially the farmed variety), and pork, as well as to those that affect fruits and vegetables inadvertently contaminated as they move from farm to table, sometimes from one country to another.

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