Effect Measure

Salad days

The sanitary revolution of the 19th century began with providing clean water and food to urban residents. Piped water supplies brought an essential, health giving commondity to city dwellers starting around the beginning of the 19th century (i.e., the 1800s) and the result was an improvement in overall health and longevity. But the same mechanism that brought a healthy substance efficiently to large numbers of people could also be the means to distribute poison to the community and the periodic outbreaks of waterborne diseases was the result. A water supply is a long lever and small changes at the central end can move large numbers of lives at the other end.

Until recent decades, food was different. Most foods were locally grown, produced and distributed. If a farm sold contaminated produce people got sick but the number and geographic scope was limited. That’s no longer true. Food production is now a huge industrial operation, with a reach longer and broader than even the largest water systems.

Most people think US government agencies are looking out for them. They are right that government agencies have been given responsibility for looking after food safety. But the system is a dysfunctional and weird patchwork of jurisdictions:

A dozen federal agencies now have some food safety oversight. The Agriculture Department is responsible for meat, poultry and some egg products, while the F.D.A. is responsible for just about everything else.

And odd, conflicting rules determine which agency has authority. The F.D.A. is responsible for the safety of eggs still in their shells; the Agriculture Department is responsible once the shells are broken. If a packaged ham sandwich has two pieces of bread, the F.D.A. is in charge of inspecting it – one piece of bread, and Agriculture is in charge. A sandwich-making factory regulated by the Agriculture Department will be inspected every day, while one inspected by the F.D.A. is likely to be inspected every five years.

Neither agency has the power to recall contaminated food (with the exception of tainted infant formula) or to fine companies for food-safety lapses. And when the cause of an outbreak is unknown, it’s unclear which agency should lead the investigation. (Eric Schlosser, Op Ed piece, New York Times; h/t easyhiker)

One hundred years ago, the scandal generated by Upton Sinclair’s depiction of conditions in slaughterhouses in his novel The Jungle led to the Pure Food and Drug Act of 1906. Now, increasingly fresh produce is the culprit.

Several factors have contributed to the rise in outbreaks: greater consumption of fresh produce, especially cut fruits and vegetables; wider distribution; improved electronic reporting of outbreaks; and an aging population more susceptible to food-borne illness. Produce presents a special food safety challenge because, unlike meat, which can be rid of bacteria through proper cooking, it is meant to be consumed raw. There is no “kill step,” as food safety experts put it. (WaPo)

Produce is an FDA responsibility, but the agency’s budget for the Center for Food Safety and Applied Nutrition has fallen 37% between 2003 and 2006.

That has meant fewer inspectors and less frequent inspections. In 2005, the FDA conducted 4,573 inspections of domestic food-processing operations. For 2006, the agency said, it hopes to conduct 3,400. There are more than 12,000 such plants in the nation. (WaPo)

The budget constrains are significant but aren’t the only reason we are in trouble with food safety. The “system” is broken, or more accurately, never worked. Right now produce manufacturing is largely self-regulated. What’s needed is a complete overhaul of food safety regulation in the US, with a single agency in charge. And the people in charge have to be committed to food safety.

The current chief of staff at the Agriculture Department used to be the beef industry’s chief lobbyist. The person who headed the Food and Drug Administration until recently used to be an executive at the National Food Processors Association. (Schlosser Op Ed,NYT)

Fox guarding the chicken coop, so to speak.

The new Congress has an opportunity to take this on if it is also willing to take on the food industry. Schlosser reports that a good bill has been introduced by Democrats Rose DeLauro in the House and Dick Durbin in the Senate.

There is a saying that watching the legislative process is a bit like watching sausage being made. You’d rather not know. Let’s see if these guys can clean up their act so that neither would be such a nauseating sight.

Comments

  1. #1 Regular reader
    December 12, 2006

    Just one more example of two huge problems with the Bush administration -
    1. they have abdicated all responsibility of government regulation as a favor to their wealthy friendss who run so many large companies

    2. they have no respect for or understanding of, science

    compassionate conversatives my A _ _.

  2. #2 Lea
    December 12, 2006

    Isnt it becoming obvious that we can no longer depend on any government agency to look out for our health and well being? It is to me. That leads one to the thought that greater personal responsibility needs to be implemented by the individual. Plain common sense and an ounce of contemplation concerning the particular subject that has captivated our attention would help.
    It is fine and dandy to criticize everything from soup to crackers and it helps us vent our anger over the utter stupidity of our government agencies. However, it will not solve the dilemma that has been created, whether consciously or unconsciously. The government is on a collision course with its self and we the people are the ones who will bear the brunt of their misguided and absolute self serving vanity.
    Greed has become the motivating factor in our world. The Bird Flu book revere recommended, How might bird flu arrive in the US? Posted on: December 5, 2006 7:32 AM, even mentions greed. In addition, only one-third done with the book, and I am very thankful for revere sharing it with us. I have only been on the Bird Flu bandwagon for seven months now and the book has helped put it into greater perspective.
    With all this said, I am one of those who really does care about their fellow human being, regardless how stupid they are. Although, my level of compassion is quickly fading. Simply because that is just my own preconceived notions about how people should act, think and be. You know, the basics, do what is right and all that ethical stuff.
    So, we take better care of the body and what goes into it as the world grows in population. We thoroughly wash all our produce, cook the feces out of the meat, clean up our thoughts and look out for others who share our own interests. What more can be done?

  3. #3 revere
    December 12, 2006

    Lea: I’m not of your mindset. There have been times in the recent past where at least some government agencies and many public servants had the public interest at heart. It can happen again. My contribution is to criticize those who have abandoned us. The great enemy here is cynicism, which is exactly what the greedy want. If you think there is nothing that can be done you will do nothing.

  4. #4 DeLuca
    December 12, 2006

    I’m all for taking care of myself but when I need to eat away from home, I’d like to know that the item I am willing to pay for is safe for consumption. I can’t very well wash the lettuce in my taco in the ladies room. In fact, the rest rooms are so dirty that I can’t even urinate there most times

  5. #5 M. Randolph Kruger
    December 12, 2006

    Regular Reader….Is there ANYTHING that you wont blame on the Bush Administration? As for Revere’s comments about government agencies abandoning us, I think that happened just about the 1940′s. I cant think of any agency that when pressured by politicians didnt cave even though they were being chastised by the people at the time.

    Healthcare is now finished in this country as Revere has put it, “Every drop has been wrung out.” Now what? Cant fix it anymore because everyone is hitting retirement age and no way to pay for it. Back to traditional insurance. If you can afford it then great. If not, you are going to be on your own. Lets blame that on Bush too as he is the scapegoat of the left for any and all ills of the world.

    I challenge anyone to tell me of any government agency that has done anything for anyone in the last 40 years. I spent 10 years just getting the EPA to come and test an old military site…. OFF THE SCALE FOR HEAVY METALS, CYANIDE, DIOXIN AND THINGS WITH LATITINE CHAINS SO LONG THAT THE NAMES WERE 48 CHARACTERS LONG. The only showed up during the BUSH administration, not Clinton when I presented them with a soil analysis that they immediately discounted.

    Waiting on that agency.

  6. #6 gbruno
    December 12, 2006

    A few years back i read about a DNA matching method that could trace contaminated veges back to a single farm in (CentralAmerica?) what has happened to this method? It seemed like a terrific idea.
    Living in Sydney Australia, I get threadworms from salad rolls several times a year. I guess staff dry-wiping isnt reliable.. I have never got thread worms in SEAsia….
    Obviously I’m too lazy to make my own salads. I tried a ‘mixed greens’ bag from my local greengrocers, and 24 hours later, threadworms It is a worry because hepatitis might be along for the ride. It can be difficult to determine the culprit if multiple salads are eaten within a few days.
    But anecdotally big M has never been a problem, big S has, despite plastic gloves on the server.
    My local cafe “Lou Jacks” on King St Newtown is clean, no problems. Check it out, the bacon avocado rolls are fine.

  7. #7 JMG3Y
    December 12, 2006

    IMO, the emergence of these outbreaks is due to a number of factors but one is not the food system being worse with increasing scale. Rather, the increasing scale increases the likelihood of detection of a contamination event. While E. coli O157:H7 is an emergent agent, salmonellae, listeria, campylobacter and others have likely been with us for a very long time. Processing a food ingredient in larger batches simply increases the number of cases associated with a given attack rate and the greater the number of cases, the more likely that the outbreak will be detected. This increases the likelihood that the contamination event will be detected if it is associated with a large plant compared to a small local plant at the same organism concentration.

    Another factor is improving technology. Advances in laboratory detection technology now enables genetic-level strain comparisons for isolates of the same phenotype. Where before the phenotype had to be unusual to trigger outbreak detection (e.e., S. muenchen in the “weed”) in the noise, now outbreaks of more common serovars can be detected through Pulsnet. And over the last decade the surveillance intensity has increased through active rather than passive programs. If I recall correctly, something on the order of only 1 out of every 38 clinical foodborne salmonella cases were detected by the surveillance system in the ’80′s.

    Although they do not make their programs public for several reasons, large firms generally do considerably more testing than any regulatory mandates require. National firms simply cannot afford HACCP failures because of their impact on name brands. On the other hand, smaller firms cannot afford to implement the same level of scrutiny because they don’t have the product volume to spread the monitoring costs across.

    So, IMO the growing public perceptions that “local food” is safer than “industrial food” or that “organic” or “natural” food is safer than conventionally produced food are wrong for multiple reasons.

  8. #8 revere
    December 13, 2006

    Randy: CDC pre-Gerberding, especially in 60s and 70s, NIOSH and OSHA in the Carter years, NIH, EPA 1970-1980, HEW during Carter, and those are just some of the ones I know about. None of them were perfect but they served us reasonably well and we were better off than if they hadn’t existed.

    gbruno: DNA fingerprinting is still used but doesn’t always tell the tale. Under the right conditions it is great, but the circumstances have to be just right.

    JMG3Y: Whether it is a true increase or just better recognition isn’t certain but the increase in scale means that missteps have much more severe consequences. That is the “long lever” I was talking about. If you screw up in a local source some people get sick but you don’t get multistate outbreaks all over the country, which is a change.

  9. #9 M. Randolph Kruger
    December 13, 2006

    I love it Revere when you bring up the original cut and run-Carter. He eviscerated the miltary, the Russians invaded Afghanistan, we got the Energy Department, that created regulations but no energy, astronomical high taxes and a 21% interest rate.

    NIH well they did have huge budget then and all sorts of research went directly from the universities to….you guessed it Big Pharma. EPA yep regulated us into making damned sure no jobs were being created but hey check out those snowy egrets and even with the regulations the water is still crap.
    HEW -Well now all you people just learn to get along and we are going to make sure that you get paid for having babies that created a permanent subculture in this country that cant read, write or by gosh hold a job or even qualify for one. Now thats healthy, well educated and by golly make your car payments with the welfare money. You get to eat steak on food stamps while some working mom struggles with two kids to pay the rent.

    OHSA’s regluations tripled and the FAA’s 7110.65 regulations went from a small 200 page document to over 1000 for controllers to follow…Of course neither did anything to increase safety. It did make the unions stronger than ever and then we had the controllers strike because their workload increased by 30% in just a year for regulations and traffic. It was inevitable and the first legacy that he passed on to Reagan. Does anyone remember the Iran Hostage Crisis? Hmmm We paid six BILLION dollars in cash the day for them. Can I get those hostages to go please?

    Sure some of the stuff they came up with was nice. Most of it was anal and as with all regulations voted in there wasnt one red cent voted for regulators.People still cleave fingers off at meat packers, a brick dropped from a building at six stories still drives you into the ground even if you are wearing a hard hat.. Just not as messy. Just like it did before you had to wear the hard hat. Eye injuries still happen on production lines. But they dont have all those regulations in China, so lets move the business there!

    Lets talk about medical stuff too while we are at it. The ever increasing dependency of this society on S. Security, Medicare, aid to dependent children etc have created a net that is going to be jerked out from under us all. In 8 years every dollar going into the kitty will be taken up 100% by the giveaway programs. You pay into S. Security but what do you do when you get nothing back? If you invested 100 a month for 25 years you would have gotten back by now a whopping 69% return on your money. I’ll take that over S. Security any day.

    Universal Health Care? No way to pay for it. Reagan forced them to take S. Security off the budget. The Democrats will try to put it back because it will give them all cover for whats coming. No way to fund it any longer as in 10 years it starts sucking red ink and collapses in 15. Medically that means that there will be no money for research, care or anything else. Hey it will be just turn around money as they will tax you upon your taxed S. Security that you already paid in. How can it be income if you already paid it in? Then you will be charged sales taxes on the already taxed money that you were taxed on.

    You’ll be doing good to eat and those decisions are going to have to be made… all bad ones. We all live in our own little words and I am sure that MIH will tell you live on many year round. I go to places that would make a maggot puke and to very, very inhumble abodes with movers and shakers. It gives me a deep and abiding reverence of how bad things could get and good they can be. Government intervention in a problem is generally well meant but also and equally screwed up when they do.

    Bird flu might not be so bad if it comes as it will eliminate all these problems for about six hundred years.

  10. #10 albatross
    December 13, 2006

    More to the point, whether it’s possible or not for government agencies to protect us, we often have little ability to change their behavior in the short term. What can we do to minimize our risk? My sister worked for several years as a county health inspector, and her budget and staff simply wouldn’t allow the level of scrutiny you would hope for–most restaurants were seeing an inspector once every 2-3 years, though they also did repeated inspections of places they knew had problems. Her take was that some restaurant chains (Mc Donalds was one) had internal inspection and controls that were much tougher than what the county required, simply for protection of brand reasons.

    Do you think mad cow is a serious threat to the food supply? My impression is that the agriculture department is at least as interested in protecting the US beef industry as protecting US consumers.

  11. #11 revere
    December 13, 2006

    Randy: LOL. Vintage. Of course I get the front page.

    albatross: I agree with you about mad cow and am not confident it isn’t here to some extent (i.e., in the beef supply). We can do better in public health.

  12. #12 tan06
    December 13, 2006

    Many similarities in the US situation as compared to the Netherlands. Globalization appears not only to mean food is imported and exported to the other side of the world – with all concomitant risks – but also the health care systems are looking alike more and more. Like a collegue of mine who is a respected psychotherapist in the field, I am stepping out of an overregulated system that is destroying our profession. He told me he had crying collegues from the States at a conference last month, in about the same situation. The paper work is inundating us and the Sovjet year planning of last century is coming up in all Western systems now as if it ever worked. Like what is left of the Sovjet Union we will be wrecked as a result of the same administrative systems in this century. And the most painful part IMHO is, that as soon as the system undermines the relation of effort/professional work done linked to outcome/payment for the work done, the motivation of the people who are the fundaments of a functioning society is gone; not for a decade, but for a generation or two/three. See it in Russia. There after the Perestrojka was the upcoming of some of the people whose motivation was left intact during the communist system, criminals: easy money taken from the undertakers.
    Also the selling out of big companies in Hedge funds isn’t going to get us anywhere (as I posted once before, John Perkins ‘Confessions of an Economic Hit Man’).
    As for the food issue here I was waiting last night for my ‘tram’transport home at the local shopping center and I really couldn’t count the mice running over there. One person almost fell from the stairs stepping on a mouse.
    I imagine those mice are running over the food I’m going to buy in the supermarket over there next Saturday and I am determined to clean all food, especially the raw vegetables, as thoroughly as I can.
    It will be a massive visit of new ‘pets’ in the houses in times of a pandemic. Empty supermarkets and the mice and rats looking for new sources to get their little families fed.

  13. #13 M. Randolph Kruger
    December 13, 2006

    http://www.channel4.com

    Black Plague-”Along the circuitous trade routes of the 14th century, the plague cut short the lives of millions. In Constantinople in 1347, it struck down thousands of Byzantines, including Andronicus, son of the Greek emperor John VI Cantacuzenus. In Cairo in 1348, up to two-fifths of the population died. In the Nile Delta village of Bilbais, corpses were piled so high along the roads that bandits took to hiding behind them during ambushes.

    Aswan, Antioch, Damascus, Jerusalem, Tunis and even Mecca followed by 1349, one-third of the Islamic world had perished.”

    That was when the population of the earth was only 2.5 billion or so. Think about the stacks if it were starting at the 6.5 billion. We would end up with only about 3 or so billion.

    Incidentally, on the heels of the Plague came the remaining two-thirds of the Muslims who fought all the way into the S. of France and they held it for almost 200 years. The similarities are striking… Started in what was then China and then moved in every direction in a horrendous method and in waves. Just about every country/city that it touched it was if someone had laid the hand of death on people. One day there, the next gone. If indeed those mice are amplifying the bug in their bodies I can only wonder what it would do once it got a foothold. Yep, wash that stuff off Tan06. V accinate the cats and turn them loose.