Life is inherently full of activities that may affect our health or well being. We face risks every day whether it's by crossing the street, eating food or driving a car. Yet this shouldn't interfere with everyday activities. Although some of us are voluntarily accepting risks related with taking part in high-risk sports, for many of us it can be difficult to decide which less well-known risks to worry about or avoid and which ones to accept.

One key challenge is obtaining good, science-based information about the relative risks of different activities, especially when it comes to a very personal and pleasurable activity --eating and drinking. Research in both Europe and the United States (1) shows that the public tends to misjudge the relative risks from food safety issues, ranking pesticide residues as posing a much greater threat to human health than harmful micro-organisms or not achieving a healthful diet. Yet nutritionists and public health experts agree that the biggest health risks facing most people is a lack of exercise coupled with a poor diet.

What are the probabilities of certain risks?

Precise estimates of all food-related risks are not yet available, however we can think rationally about food safety and appropriate health-promoting (or risk-reducing) behaviors by examining food safety risks in the context of other health and safety hazards. This helps provide a framework for putting food safety risks in perspective with other health risks.

Understanding risk as a probability concept

Most of us have little experience in thinking about the size or magnitude of different risks. Although we have an intuitive sense that some risks are smaller or larger than others are, research shows that people tend to underestimate relatively large risks, such as heart disease and heart attacks, and overestimate relatively small risks such as botulism, a foodborne illness caused by bacteria. Public misperceptions may be driven in part by what we hear and read but a lack of understanding about risk magnitudes and how to interpret risk information also influences them.

Judging the probability of a risk related to a certain activity such as eating can be more relevant if the risk is compared to other, more familiar ones. For example, consider the fact that the annual risk of dying in France from motor vehicle accidents in 1996 was about 19.4 in 100,000. This means that in every group of 100,000 people, 19 died from a traffic accident in that year.

Is this a big risk? Table 2 shows that each year, the average probability of dying from motor vehicle accidents in France was more than 12 times higher than the risk of drowning. In contrast, this probability was 14 times lower than the annual risk of dying from heart disease and nearly 16 times lower than the risk of dying from cancer. Thus, driving a car posed a significant risk when compared to other public health hazards yet it still trailed behind several leading causes of death.

Putting risk into perspective

While data on foodborne risks are limited, it is estimated that most food-related disease results from harmful bacteria such as Campylobacter and Salmonella - and most foodborne illnesses result from inappropriate food handling at home.

Data from the United States shows that there is an approximate annual probability of dying from foodborne illness of 3.6 in 100,000. This is 7 times greater than the risk of dying from tuberculosis in the US each year and 100 times greater than the risk of dying from floods. On the other hand, this risk is 78 times lower than the probability of dying from heart disease, 57 times lower than dying from cancer and 4 times lower than dying from motor vehicle accidents. Even the mere act of eating food poses an annual risk of dying from choking of 5 in one million. Of course, the risk of not eating means 100% probability of dying!

Look at the outcome

Besides thinking about risk in a broader context, it is important to be aware of the risks we are talking about. Risks can refer to a variety of health outcomes such as death, cancer and non-fatal injuries or minor illness, and risk rankings differ depending on which outcome is used. For example, the risk of dying from foodborne disease ranks relatively low but 20-50 people per 100,000 may get diarrhea as an outcome.

Food for thought

Everything we do in life poses some degree of risk. Attitudes to foodborne and other risks should be based on well-informed decision-making and science rather than allowing sensationalised media stories to lead us to believe that the risk is greater than it actually is.

RISK COMPARISONS

Annual risk of males dying in France, Italy and the United Kingdom per hundred thousand persons

	MALES ONLY, ALL AGES
	France 1996	Italy 1996	UK 1997
Total deaths (000)	28,423	27,804	28,990
	Death per 100,000 per year
Cardiovascular disease	280.2	401.2	430.0
Cancer	306.8	311.0	275.0
Cerebrovascular disease	63.5	102.7	85.9
Pneumonia	27.9	12.2	84.0
Diabetes	10.1	24.0	10.5
Nutritional deficiency	2.6	0.1	0.1
Accidents (all)	57.2	45.6	24.8
Road Traffic Accident	19.4	21.9	9.1
Drowning	1.6	1.3	0.7
Fire	1.1	0.7	1.1

(Based on mortality data in 'World Health Statistics, 1997-1999 edition. World Health Organization. http://www.who.int/)

WHAT DO WE FEAR?

Research on how people interpret risk has reported some interesting findings.
For example, it has been found that:

• People tend to overestimate the danger of rare events yet underestimate dangers of more common events like driving a car.
• People tend to assume that if they can control a situation they are safer. The high number of traffic accident fatalities shows this is an erroneous assumption.
• People are less likely to fear the risk of an unhealthy lifestyle than levels of pesticides in foods. Yet the statistics show that people are far more likely to die from lifestyle-related diseases such as coronary heart disease and cancers.
• People tend to be less likely to fear natural disasters - typhoons, earthquakes, floods - than man-made disasters.
• People are more worried by dramatic but infrequent events than by "boring" risks like slipping on a wet floor.

H.A Cohl, "Are We Scaring Ourselves to Death?" St Martins Griffin, 1997

References

• Supermarket Research Institute market research, 1997
• World Health Statistics, 1997-1999 edition. World Health Organization. http://www.who.int/)
• H.A Cohl, "Are We Scaring Ourselves to Death?" St Martins Griffin, 1997

FOOD TODAY 03/2002