Am J Epidemiol 2004; 159:1200.
Copyright © 2004 by the Johns
Hopkins Bloomberg School of Public Health
BOOK REVIEWS |
When Food Kills: BSE, E. coli, and Disaster Science
Food Safety Office, Centers for Disease Control and Prevention, Atlanta, GA 30333
By T. Hugh Pennington
ISBN 0198525176, Oxford University Press, New York, New York (Telephone: 800-445-9714, Fax: 919-677-1303, Website: http://www.oup.com/us, E-mail: orders{at}oup-usa.org), 2003, 226 pp., $39.50 (hardcover)
In this timely publication, When Food Kills: BSE, E. coli, and Disaster Science, Scottish professor T. Hugh Pennington, Chair of Bacteriology at Aberdeen University, recounts in detail the events surrounding two major outbreaks that took place in the United Kingdom. The first is the Escherichia coli O157:H7 outbreak that occurred in central Scotland in 1996. The second is the bovine spongiform encephalopathy (BSE) outbreak, which was initially recognized in cattle in 1986 and then appeared 10 years later in humans as variant Creutzfeld-Jakob disease. As the head of the Pennington Group inquiry into the 1996 outbreak of E. coli O157:H7 and as an expert witness and commentator during the "mad cow" disaster, Pennington provides some first-hand accounts of what happened, what went wrong, and how the United Kingdom responded. Along with these histories, he provides an inventory of outbreaks of botulism, typhoid, and Salmonella that have occurred in the United Kingdom, as well as some civil disasters ranging from railway accidents to oil drilling incidents. Using these infectious-disease and non-infectious-disease events, Pennington attempts to elaborate on the reasons why such disasters happen and the sometimes unfortunate role politics and mismanagement can play in official responses to them. The author discusses failures in policy-making and failures in the application of science by industry and government regulators alike. He also clearly recognizes the important role of risk perception and the influence of the mass media in spurring policy-makers and the public to undertake basic prevention measures.
Because of its breadth, this book contains information that would be of some interest to many different audiences. However, it is difficult to recommend the entire work to any one group. It might make a good addition to a library for students of disasters because of the variety of events that are chronicled, ranging from communicable disease outbreaks to mining catastrophes. Microbiologists might find the chapters on E. coli O157:H7, other strains of E. coli, BSE, and other transmissible spongiform encephalopathies of scientific and historical interest. However, the lay reader may be disappointed. At times, Pennington’s writing is reminiscent of the "outbreak thriller" genre. At other times, his writing can be highly technical; and at still other times, his writing gets lost in narrative detail that seems more like digression than insightful analysis. Often there is no clear transition between topics or chapters, so that much of the "disease detective" appeal of the narrative is lost. Epidemiologists will be particularly disappointed, because Pennington’s sleuthing often involves examination of microbiologic evidence and environmental evidence but no presentation of epidemiologic data.
The book’s title and chapter headings are enticing; but these reviewers, expecting a more detailed look into "disaster science," were disappointed. For example, in the chapter "Inspectorates Have Limits," we simply learn that the inspectors were not doing their inspections properly rather than learn about the theoretical or practical limits of a purely regulatory approach to food safety. The book promises to make connections between catastrophes as disparate as Three Mile Island, the space shuttle Challenger disaster, and classic outbreaks of foodborne disease; however, in the end, these readers found many of the events mentioned to still appear as unrelated disasters. Pennington seemingly gets lost in the detailed historical narrative and fails to adequately describe the underlying dynamics explaining the occurrence of the various disasters. While this volume identifies problems such as interagency coordination, poorly written and/or enforced statutes, and conflict of interest in science-based policy-making—all familiar themes—the book does not identify principles, theories, or hypotheses that might point to broader societal solutions for disaster prevention and response.
In summary, this book provides a nice historical perspective on E. coli O157:H7 and BSE but is not necessarily recommended for either the scientist or the layperson in the United States. There is no analysis of the epidemiologic aspects of the disasters detailed in this volume. Perhaps the book would be inherently more appealing to a British audience, who might recognize the cast of characters from the various United Kingdom disasters detailed. No doubt some of the appeal of the book is a "behind-the-scenes" discussion of events that the reader may otherwise have read about only in newspapers. Some of this appeal will be lost on US readers unfamiliar with catastrophes like the mudslide in Aberfan, Wales (where 144 people perished in 1966) and the Piper Alpha North Sea oil platform explosion (where 165 people died in 1988). Ultimately, When Food Kills: BSE, E. coli, and Disaster Science does not live up to the promise of its title.
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