Mad Cows and Mother's Milk

See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/264120977 Mad Cows and Mother's Milk Book · January 2004 CITATIONS READS 16 21 1 author: William Leiss University of Ottawa 92 PUBLICATIONS 1,119 CITATIONS SEE PROFILE Some of the authors of this publication are also working on these related projects: Risk Communication - Between theories and practices for a scientifically sound strategy View project The Rule of President Trump View project All content following this page was uploaded by William Leiss on 02 September 2015. The user has requested enhancement of the downloaded file. Mad Cows and Mother’s Milk: The Perils of Poor Risk Communication (Second edition, November 2004) By William Leiss and Douglas Powell: http://www.mqup.ca/mad-cows-and-mother-s-milk--second-edition-products9780773528178.php?page_id=73& Available as an eBook, Paperback, and Cloth Overview: Communicating the nature and consequences of environmental and health risks is still one of the most problematic areas of public policy in Western democracies. "Mad Cows and Mother's Milk" outlines the crucial role of risk management in dealing with public controversies and analyses risk communication practice and malpractice to provide a set of lessons for risk managers and communicators. This second edition adds new case studies on mad cow disease in North America, climate change, and genetics technologies. The first of the new case studies brings the story of the Bovine Spongiform Encephalopathy (BSE) outbreak in the United Kingdom in the 1980s up-to-date. Mad cow disease is still being discovered in UK herds and cases of mad cow disease have been found in twenty countries across the European continent and as far away as Japan with devastating consequences for the food industry. BSE has now been discovered on the North American continent in two cows born in Canada. The original cause of these two new cases is almost certainly importation of infected cattle, cattle feed, or both from Britain. Canadian government regulators and those in the cattle industry have failed to correctly assess the risks of the disease in the Canadian herd, take the precautionary measures needed to prevent the spread of disease, and communicate risks and precautionary measures to the public. The second new study deals with global warming. Not only is every aspect of this risk debate both contentious and difficult for the public to understand but the potential consequences of the risks extend all the way to global catastrophe for human civilization. A new chapter outlines the many dimensions of risk debate in the context of the need for effective and sustained dialogue by an informed public. The last new case study provides an introduction to genomic science, which is placed in the context of both the health benefits expected from genetic manipulation and some of the risk factors associated with it. One example is gene therapy, which can be used to eliminate inherited genetic diseases (i.e. cystic fibrosis), enhance human traits (i.e. athletic performance), and perhaps double life-spans. Gene technologies are relevant to some of the most fundamental human values. This new chapter suggests that we must think about the range of new risks introduced by these technologies as well as the potential benefits - and that we should do this collective thinking soon, since, given the furious pace of genomics discoveries, the possibilities will be with us sooner than we imagine. 1 All of the case studies emphasize the need for effective communication about risks to allow effective dialogue by informed publics on health and environmental risks. Preface to the Second Edition (2004): Three brand-new, extensive case studies have been added for this edition – on BSE (mad-cow disease) in North America, climate change and the Kyoto Protocol, and genomics. The format for these new studies follows the one developed for the seven originally published in the first edition, which may be summarized as follows. Risk management issues which come to public attention are predominantly those which touch upon either human health concerns, or environmental concerns, or some combination of both. In this context, risk can be described as the chance that something bad or undesirable might happen, either to the population as a whole or to some specific individuals or groups. At the core of all such risk issues is a highly technical characterization of what the nature and scope of the risk is thought to be by specialists in the relevant fields, who may be physicists, biologists, chemists, engineers, climate modelers, or medical researchers. Then additional precision is provided by the work of statisticians, who will try to assign a more specific probability to the chance of occurrence: Are we talking about a one-in-a-hundred risk, or a one-in-a-million chance? They will also seek to determine what are the important u e tai ties that lie ehi d the appa e t p e isio of the isk u e . A di ediatel , f o the sta dpoi t of o di a itize s, ho o a out health isks ut are inexpert in the technical aspects of its description, this is where the trouble starts. The trouble arises first with science. There is a widespread belief that the findings reported in peer-reviewed and published scientific papers ha e a ki d of autho itati e status, as fa ts, hi h sta d far above the careless ruminations found in the ordinary discourses of mortals, for example, in remarks by politicians. To be sure, there is a substantial basis for this popular belief, namely, the strong, shared commitment of scientists to a formal methodology for the conduct of research. Although there are periodic episodes where shoddy or even fraudulent work slips through the peer review process, these are rare events indeed. These events are not the source of the popular misunderstanding of science, however. Rather, it is to be found in the failure to understand that scientific results are, like every other product of the human imagination, an interpretation of so e od of e ide e, ot fa ts as su h; a d that all such interpretations are of necessity limited by the existing overall state of knowledge; and that nature is subtle and does not yield its secrets easily. Above all, the popular misunderstanding often overlooks the reality that science is cumulative, tentative, always incomplete, and never-ending. The best advice to be given to any concerned citizen who expresses alarm upon encountering in media reports the apparently frightening revelations of a new scientific study is: Wait for the next study before taking any action. This advice is doubly sound where risks are concerned. As mentioned, the purely scientific aspects of a risk characterization are themselves an interpretation of a certain limited body of evidence (for example, what happened to the rats when they were dosed with a certain chemical?). But when all of the other ele a t o side atio s a e added, i o de to figu e out hethe this stud ’s fi di gs a e so ethi g a o e should o a out If it happe ed to the ats, ill it do the sa e to hu a s? , the situation just gets messier and messier. The risk assessor ight sa : Well, ased o this stud , it’s possible that there might two additio al ases of a e i the populatio at si ila le els of e posu e. 2 At which point the issue is off and running. Rarely does the dialogue continue right on the spot, as it should – fo e a ple, ith the uestio , add essed to the isk assesso : Ho su e a e ou of that? Whi h ould eli it the follo i g epl : Of ou se, I assu e ou k o that e’ e talki g a out the 95% o fide e le el he e. A d the ejoi de : What does that ea ? A d the epl : Well, e’ e 95% certain that the e ould ’t e o e tha t o additio al ases, ut, as I’ su e ou ealize, it’s uite possible that there will be fewer tha t o additio al a e s, a d possi l o e at all. The discipline of risk communication arises with the realization that most of us, listening to such a dialogue, need a lot of help – and rarely get what we need. We need help in understanding what scientists are talking about, especially since their work appears to be advancing at a blistering pace, with something fresh and momentous coming out each week. We need a great deal of help in coming to terms with probabilities, which forms the esse tial la guage of isk: What do ou ea , the e’s a % probability this ight o u : Is it o is ’t it goi g to happe ? You tell e that % of the e posed population might get sick under these circumstances, but what I want to know is, will it happen to me or kids? A d e e ui e so e help i figu i g out just what bad outcomes can or can not be prevented or lessened, and how this can be done, by some combination of creative scientific research, sound risk assessments, enlightened government policy – and good (responsible) behaviour on the part of citizens. There are some reasons for optimism on this score, despite the prevailing view in some expert circles that the public is hopeless when it comes to risk. The technical language of risk is used more frequently in media reporting, as a way of framing the explanation of events, and over time this contributes to increased risk literacy among the public. Both the print and electronic media report regularly on new scientific studies of general interest, in part because leading journals, especially Science and Nature, take steps to provide journalists with news about forthcoming studies. For someone like me, who has been a lifelong, dedicated reader of daily newspapers, what has happened in the last decade is nothing short of astonishing: At least once or twice every week, there will be prominent (often front-page) coverage of a new scientific study, complete with an extensive summary, quotations from the study authors as well as from other scientists, and references to other relevant work. Many of these articles are about revisions to previously-reported interpretations, for example (quite recently), a re-analysis of data about the usefulness of mammography screening for breast cancer risk, in which the newest analysis strongly criticized the earlier work, which itself had received enormous media publicity at the time. At least for the declining segment of the population who still reads newspapers, the resources currently available for tracking scientific studies relevant to popular health concerns have never been better. Then there is the Internet. In well-connected countries like Canada surfing the world-wide web for information has become a daily routine. Self-directed investigations of health and environmental issues are conducted by many individuals. It is safe to say that no other previous resource, including public libraries, could have ever dreamed about putting an equivalent amount of information at the finger-tips of the ordinary citizen. This previously-undreamed-of opportunity is simultaneously a cautionary tale. There is no peer-review on the Internet itself, and advocacy is everywhere, as one should expect. Risk issues do not lose any of their complexity just because a lot of technical information is sudde l a essi le i o e’s ho e stud . To take only one example, some public health officials are quite concerned about the Internet-based campaigns, launched by individuals and groups, advising parents to avoid having their children vaccinated for common infectious diseases, due to alleged collateral risks such as autism. As we know from the world of advertising, arguments can be persuasive without necessarily being informative or balanced. Parents can make serious mistakes with their 3 hild e ’s health de idi g to t ust so e sou es o e others. More generally, the proliferation of spa e-mails offering alternative sources for health remedies offers a clue to the level of interest among the public in playing around with self-diagnosis and self-medication. This new context for health risk communication has inspired me and a group of like-minded colleagues to launch an experimental, web-based public information resource, using a single risk issue as a test case (http://www.emcom.ca). E o is a a o fo e do i e odulato o u i atio , although the issue is ette -k o u de the headi g, e do i e dis upto s. The risk refers to the possibility that very small concentrations of certain chemicals, industrially-produced in some cases and naturally-occurring in others, could cause a wide range of serious, adverse health impacts, for both children (developmental effects) and adults. Some of the risk factors are welldescribed for other animals – the endocrine system is common in all mammals – and can appear to be quite frightening to people. The problem is, no one yet knows whether most people should worry very much about these particular risks. At the same time, enough news is circulating about them to create a need for reliable and understandable expositions of the relevant scientific research. This is what the e o e site seeks to p o ide. The site is a aged a g oup of u i e sit -based researchers who ha e staked thei p ofessio al eputatio s o the lai that the site’s o te ts will be found to be accurate, complete, up-to-date, readily understandable by a non-expert member of the public, and interactive. It is also free of any advocacy for or against a course of action with respect to the issues, and it includes a number of innovations in information presentation, including animated graphics and la e ed do u e tatio e sho t pape s supple e ted lo ge a d o e te h i al e positio s . The e o site desig a d st ateg as o ei ed as a te plate hi h ould add ess any health or environmental issue set of significant public interest. The web-based strategy has tremendous advantages over conventional print publication, including ease of updating and revision, interactive responsiveness, ready addition of new sources and references, linkages with complementary sites, and the ability to use color graphics to aid comprehension of technical data. (All of which presuppose the availability of high-speed I te et o e tio , of ou se. I a a , the , the e o e site represents a fourth current case study, in addition to the three reported in this new edition. To be sure, the pu li ’s g asp of the isk issues e ie ed i those th ee hapte s – BSE in North America, climate change, genomics – could benefit enormously from the availability of similarly targeted web-based resources, which do not now exist, although the interested reader can find a good deal of supplementary insight by following the many web-links contained in the endnotes to each chapter. (For one of the studies, that on climate change and the Kyoto Protocol, a number of helpful graphics will be found among the PowerPoint presentations on my website: http://www.leiss.ca/presentations/.) Chapter 1 (BSE) is a solo effort. The senior author for chapter 2 (climate change) is Stephen Hill, Assistant Professor, Environmental & Resource Studies, Trent University, who holds a B.Sc. in Chemical E gi ee i g f o Quee ’s a d a Ph.D. in Environmental Science from the Faculty of Environmental Design, University of Calgary. For chapter 3 (genomics) the senior author is Michael Tyshenko, who has oth a do to ate i ole ula iolog a d a aste ’s i pu li ad i ist atio f o Quee ’s U i e sit , and is currently a Postdoctoral Fellow at the McLaughlin Centre for Population Health Risk Assessment, University of Ottawa. 4 Table of Contents: Preface to the First Edition ix Preface to the Second Edition xii PART ONE WAITING FOR THE SCIENCE 1 Mad Cows or Crazy Communications? 3 2 A Diagnostic for Risk Communication Failures 26 3 Dioxins, or Chemical Stigmata 41 4 Hamburger Hell 77 5 Silicone Breasts 99 PART TWO WAITING FOR THE REGULATORS 6 Lost in Regulatory Space: rBST 123 7 Gene Escape 153 8 Mother's Milk 182 9 Ten Lessons 210 PART THREE NEW PERILS FOR RISK MANAGERS 10 Two Stinking Cows: The Mismanagement of BSE Risk in North America 229 11 A Night at the Climate Casino: Canada and the Kyoto Quagmire 262 12 Life in the Fast Lane: An Introduction to Genomics Risks 296 Appendix 341 Notes 351 Bibliography 413 Index 443 5