Diet and Health: Diseases and Food 303Food Safety and Foodborne Diseases
Whilst attention to such non-communicable diseases is of vital importance, food
safety, foodborne diseases and other communicable diseases remain uppermost
within food and public health policy, partly due to consumer campaigns about
risks and to heightened media awareness of poor food processing standards. Food
safety problems include risks from:^106
- veterinary drug and pesticide residues;
- food additives;
- pathogens (i.e. illness-causing bacteria, viruses, parasites, fungi and their tox-
ins); - environmental toxins such as heavy metals (e.g. lead and mercury);
- persistent organic pollutants such as dioxins;
- unconventional agents such as prions associated with BSE.
In particular, companies have had to respond to new public awareness about food
safety issues, and new regimes of traceability have been implemented to enable
companies to track food ingredients in order to eliminate subsequent legal or
insurance liability consequences. In this respect, food companies are anxious to
present themselves as guardians of the public health.^107 The attention food safety
receives is predictably higher in affluent countries when, on the evidence, the bur-
den of ill health is far greater in the developing world, due to lack of investment
and infrastructure, including drains, housing, water supplies and food control sys-
tems. The World Health Report 2002 pointed out that, in developing countries,
water supply and general sanitation remain the fourth highest health-risk factor,
after underweight, unsafe sex and blood pressure.^108 In developing countries which
are building their food export markets, there is too often a bipolar structure, with
higher standards for foods for export to affluent countries than for domestic mar-
kets. There ought to be a cascading down into internal markets of these higher
standards.^109
Environmental risks to health are a significant problem on the global scale
and, in Western countries in the 1990s, new strains of deadly bacteria such as E.
coli 0157 captured policy attention, an estimated 30 per cent of people having suf-
fered a bout of foodborne disease annually. The US, for instance, reports an annual
76 million cases, resulting in 325,000 hospitalizations and 5000 deaths.^110 The
WHO estimates that 2.1 million children die every year from the diarrhoeal dis-
eases caused by contaminated water and food,111,112 asserting that each year world-
wide there are ‘thousands of millions’ of cases of foodborne disease.^113
In early industrializing countries, a grand era of engineering made dramatic
health improvements in public health. Part of that investment included the intro-
duction of effective monitoring and hygiene practice systems, such as the estab-
lishment of local authority laboratories and training, the packaging of foods and
processes such as milk pasteurization. Today, public health proponents are actively