Can food be a risk?

Food is much more than personal fuel—food creates community. We welcome friends and family into our homes with a meal. We celebrate important occasions with feasts. We carry food to those in mourning. We receive food as daily comfort. We don’t think of food as a risk.

But there is risk.

When we consider factors that spread disease, ticks or rats spring to mind more quickly than scrambled eggs or a juicy hamburger. What could be more wholesome than those fresh sprouts at the salad bar? But foods bring risk… In the United States alone, millions are diagnosed each year with food poisoning, with 325,000 affected so severely that they require hospitalization. (Many thousands of others probably go undiagnosed.) While treatments are usually effective, food poisoning in the United States kills more than a thousand people annually.

The problems of food safety are not only serious—they are growing. Two crucial factors in this unfolding story are the increasingly industrialized production of food and the emergence of new infectious agents.

“Industrialization” of foods refers to a range of innovations in food production, preservation, and transportation that radically changed eating habits during the twentieth century. For the first time in human history, seasonal foods became available year-round. Commercially prepared foods took precedence over home-made. Food of all sorts became cheap.

As the industrialization of food continues to expand in the twenty-first century, new problems are emerging. Consider the complex networks by which food is distributed. The contamination of a prepared food in one factory can sicken hundreds of people in widely separated areas, concealing both the outbreak and its source. Globalization and the expansion of world trade further complicate epidemiologic detective work—an outbreak of food poisoning in Canada may trace back to an abattoir in Argentina or a greenhouse in South Africa.

A second major factor in food safety has been the emergence of new infectious diseases. Diseases carried by foods are part of a larger picture of emerging infections. Among the emerging food-borne infectious agents, the prion may be the most fascinating. Prions are the cause of such diseases as scrapie and bovine spongiform encephalopathy (“mad cow” disease). While prions are not life forms by conventional definition, they slowly catalyze lethal reactions in our food animals—and in us. Epidemiologists made some of the key observations on the infectious nature of prion diseases, and the tools of epidemiology will be necessary to monitor the future impact of these diseases.

Infectious agents are not our only worry. With industrialization comes an increased reliance on pesticides, leading to more pesticide exposures for those handling and eating food, with the potential for producing subtle and longterm problems. The ubiquity and chronic nature of pesticide exposures, together with their potential to produce diverse health effects, make their study by epidemiologists particularly challenging.

In coming to grips with new problems, epidemiologists have the advantage of new tools. Better integration and monitoring of medical information systems allow earlier detection of suspicious clusters of acute infections. Once identified, such clusters can be traced with molecular genetic assays that allow the “fingerprinting” of specific strains of organisms, and thus the precise identification of cases. Once an outbreak has been identified, public health actions may be required that cross national borders. The swift international response to the SARS (severe acute respiratory syndrome) epidemic has shown that effective cross-border interventions are possible.

Meanwhile, the public is becoming more aware of the emerging problems of food-borne diseases and the hidden costs of our cheap food. The essays of Wendell Berry bear witness to the ecologic virtues embodied in the small farm and lost with industrialized farming. Community farmers’ markets are thriving as people rediscover the benefits of locally grown foods. Even so, these are small drops compared with the vast ocean of agribusiness. The spectrum of food-borne illnesses is increasingly complex, and the economic and social consequences are ever more far-reaching.

… Make no mistake: this topic should be compelling to anyone who eats.