The Risky Habit of Eating

In mid-July, the Food and Nutrition Board’s Food Forum convened a symposium to examine the connections among food safety policy, science, and risk assessment. “What impedes the application of scientific principles to the oversight of food safety?” ask exasperated food scientists. “Why do regulatory agencies dither while people get sick from supper?” wonder impatient consumer advocates. “Why is unsafe food in the marketplace in the first place?” muse others. Dare one ask how dangerous dining is?

That food safety commands the President’s attention has made nearly everyone more aware of the risks of foodborne illness. America’s claim to the world’s safest food supply rings hollow when familiar foods such as sprouts, hamburgers, and eggs send people to hospital. Yes, America has abundant safe food, but we have lost our innocence about our diverse eating environment. FDA Commissioner Jane Henney pointed out to symposium participants that a quarter of the population can be considered “at risk” for foodborne illness and that today we are aware of more than five times the number of pathogens than we knew existed fifty years ago. Our knowledge of who is more susceptible to foodborne disease, what causes foodborne illness, how pathogens thrive, how to make food safer, and how the “bugs” outsmart us has increased vastly, especially in the past two decades. And as our surveillance systems for foodborne illness expand and become more sophisticated, no one should be surprised if we detect disease outbreaks that might have been missed ten years ago. Better information risks making foodborne illness appear rampant. No, knowledge isn’t the culprit; but it starkly revealed the complexity of the farm-to-fork system that improved health and longevity, even as it sheltered stowaway threats. Knowledge holds the key to safer food production, handling, and processing methods, and to treatments and prevention of foodborne illness.

Baffling as it may seem to scientists, food safety policy is driven not only by scientific knowledge, but also by statutory authority, budget constraints, lengthy rule-making and comment periods that make our regulatory system transparent and open to all, and pressure from consumers, politicians, media, food producers, and others. Under Secretary for Food Safety Catherine Woteki provided insightful explanation of several types of decision-making processes that try to accommodate these interests while meeting statutory and regulatory requirements. It’s an imperfect system to be sure, but it draws—not always adequately—on scientific knowledge and input from many interested parties. Major data gaps and insufficient understanding of cause and effect almost guarantee that regulations and policies will be long in coming and imperfect in form. Recent milestones in understanding pathogens, assessing risk, and developing effective interventions mean that new food production techniques, disease detection and treatment, and risk mitigation strategies will follow more quickly. The examples of our understanding of E. coli O157:H7, the foodborne disease active surveillance and pathogen identification systems of FoodNet and PulseNet, respectively, FSIS’ microbial risk assessment for Salmonella enteritidis in shell eggs and egg products, and the use of steam pasteurization in handling carcasses illustrate advances in knowledge contributing to improved food safety policy, regulation, and practice.

Sometimes one hears the lament about why pathogens are in food in the first place. Or worse, why does government or the food industry allow it? Certainly no politician, regulator, food producer or processor—in fact no one—will defend the presence of pathogens in food. Laws are passed to outlaw them or give them “zero tolerance.” Yet some explanation may be useful. A moment’s reflection makes it clear that food—particularly the minimally processed sort—isn’t sterile. Unless we want all our food canned or irradiated, it will contain microorganisms and possibly other hazards, some of which may be harmful but not necessarily harmful to everyone. People understand these ideas at an intuitive level, but become alarmed when told that government or industry is negligent in allowing pathogens to be in food. That is only part of the picture, of course. Foodborne disease is not operating on a level playing field.

Healthy bodies resist most pathogens and detoxify many nasty chemicals. Cooking, some forms of processing, and appropriate handling kill or reduce the presence of disease-causing organisms. But children, elderly people, the immune-compromised and those with certain other illnesses are less able to resist pathogens and toxicants. Some foods are inherently riskier: raw shellfish, undercooked eggs and meat, unrinsed raw fruits and vegetables, unpasteurized milk, to name the obvious ones. One of the big questions is, how risky and to whom?

Enter the risk assessors. Theirs is the job of determining how hazardous particular foods are and what makes them so, who is at greatest risk of getting ill, and what can be done to make illness least likely. Risk managers decide what can and will be done about the risks, and risk communicators ensure that information is disseminated to all parties. Risk assessment and reduction come at a cost. Do the benefits outweigh the costs? None of these questions have simple answers and seldom are adequate data available to provide the quality of risk assessment needed. All food safety agencies are wrestling with these questions and investing in risk assessments in order to set priorities and make better decisions. The $64,000 question of how much risk is okay, however, is anyone’s guess. The smart money knows it isn’t zero. Would the Food Forum like to start the dialogue?

by JOYCE A. NETTLETON
Director, Science Communications