Bill Marler, a lawyer specialising in food-borne illness, has been involved in many high profile outbreaks over the past 30 years, including the 1993 E. coli outbreak at American chain Jack in the Box, which killed several children and forced the US government to administer a zero tolerance for the presence of the pathogen in food.
Food recalls, of which there are many, frequently fly under the radar. In 2014, the most recent year for which data is available, more than 8000 food products were recalled by the Food and Drug Administration and nearly 100 were recalled by the US Department of Agriculture (the figure in Australia is much lower, with FSANZ reporting 586 food items recalled in 10 years). The problem touches organic foods, too.
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Truth about food poisoning
Learn more about the causes and symptoms of food poisoning, how to avoid it and the truth behind carrots. Vision: NSW Food Authority.
The industry, Marler says, does a good job of nudging people to forget about recalls, and we all do a good job of obliging, because food safety isn't the sort of thing anyone likes to think about.
In a recent piece, published in Bottom Line Health, he lists six foods he no longer eats, because he believes the risk of eating them is simply too large. The list includes raw oysters and other raw shellfish, raw or under-cooked eggs, meat that isn't well-done, unpasteurised milk and juice, and raw sprouts.
"You wouldn't believe some of the things I have learnt over the years," he said. "I have some crazy stories."
I spoke to Marler to hear some of these stories, learn about the things we might want to think twice about eating, and better understand what exactly it is that people don't understand about food safety. The interview has been edited for length and clarity.
Would the average person be horrified if they knew what you know about the food system?
I think there are a lot of things about the food system that the general public would find completely nonsensical - not necessarily frightening, but definitely nonsensical. Like how E. coli is considered an adulterant in hamburgers, but salmonella and many other pathogens are not. How salmonella is allowed on chickens, which the USDA oversees, but salmonella is not allowed in any product that the FDA oversees.
In Australia, there is a national E. coli and Salmonella Monitoring program for the microbiological monitoring of carcass surfaces. As the recent salmonella outbreak in Sydney from chicken rolls and the 2014 outbreak in Melbourne from eggs show, the program is not flawless.
Why is it that the US government has acted on E. coli, but not on other pathogens, namely salmonella?
Where we are now is kind of where we are with vaccine and people, where you have some people questioning the necessity of a system that works, without question. You know, when was the last time you saw someone with polio? But you hear people in certain parts who take that reality and then wonder whether they need to vaccine their children since polio hasn't really been around. We see places advertising that they're undercooking hamburgers, because it tastes better. I find that worrisome. Even though we've pushed a lot of E. coli out of hamburgers, they're playing with fire by not cooking their hamburgers thoroughly.
Is the presence of salmonella any less dangerous?
No. In my view, what the US government did in 1994 with E. coli, was they knew what they wanted to do, which was to get it out of hamburger meat. They justified it by saying that the infectious dose was low, that people don't necessarily cook hamburgers the way they should - it's difficult to cook them thoroughly, and there's a high risk of cross contamination. They had a long list of arguments as to why they needed to take that action.
But frankly all of that applies to salmonella. The infectious dose for salmonella is higher, but we're talking about infinitesimal, invisible quantities of bacteria. 100,000 bacterium of salmonella would fit on the head of a pin. So you're not really looking at a product that is grossly contaminated; you're looking at a product that is a little contaminated, and that little bit of contamination is enough to get people really sick. Salmonella kills more Americans every year than E. coli does, and can cause severe long-term complications.
About 5.4 million Australians suffer from food poisoning each year resulting in an average of 120 deaths.
You were trending on Facebook recently, because you listed a handful of things that people love to eat but you refuse to eat for safety reasons.
It depends on how you look at it. I mean, if I went back and looked at all the foods I have been involved in that have poisoned people, you could make a very long list - the things you would be left with would be very short. When I made that list, I stuck a couple things together, like unpasteurised milk and juice. It's based on more than 20 years of experience, that has taught me that these are the food items that are, from my perspective, the ones that have caused more issues, and, especially in a restaurant setting, where you're not controlling the handling of your food, are best left alone. This doesn't mean that other things, like rockmelon couldn't find their way onto the list. But these are the ones that I have had to deal with the most often over the years.
You keep telling me that you have all these crazy stories - all these things I wouldn't believe. Can you share one of them?
I actually have the perfect one, which I told at a recent conference, and really floored people.
Do you know the juice Odwalla? Well, the juice is made by a company in California, which has made all sorts of other juices, many of which have been unpasteurised, because it's more natural. Anyway, they were kind of like Chipotle, in the sense that they had this aura of good and earthy and healthful. And they were growing very quickly. And they had an outbreak. It killed a kid in Colorado, and sickened dozens of others very seriously, and the company was very nearly brought to its knees. [The outbreak, which was linked to apple juice produced by Odwalla, happened 20 years ago].
If you look at how they handled the PR stuff, most PR people would say well, they handled it great. They took responsibility, they were upfront and honest about it, etc etc. What's interesting though is that behind the scenes, on the legal side of the equation, I had gotten a phone call, which by itself isn't uncommon. In these high profile cases, people tend to call me - former employees, former government officials, family members of people who have fallen ill, or unknown people giving me tips. But this one was different. It was a Saturday - I remember it well - and someone left me a voicemail telling me to make sure I get the US Army documents regarding Odwalla. I was like 'what the heck, what the heck are they talking about?' So I decided to follow up on it, and reached out to the Army and got something like 100 pages of documents. Well, it turned out that the Army had been solicited to put Army juice on Army PX's, which sell goods, and, because of that, the Army had gone to do an inspection of a plant, looked around and wrote out a report. And here's what's nuts: it had concluded that Odwalla's juice was not fit for human consumption.
It's crazy, right? The Army had decided that Odwalla's juice wasn't fit for human consumption, and Odwalla knew this, and yet kept selling it anyway. When I got that document, it was pretty incredible. But then after the outbreak, we got to look at Odwalla's documents, which included emails, and there were discussions amongst people at the company, months before the outbreak, about whether they should do end product testing - which is finished product testing - to see whether they had pathogens in their product, and the decision was made to not test, because if they tested there would be a body of data. One of my favourite emails said something like "once you create a body of data, it's subpoenable".
So, basically, they decided to protect themselves instead of their consumers?
Yes, essentially. Look, there are a lot of sad stories in my line of work. I've been in ICUs, where parents have had to pull the plug on their child. Someone commented on my article about the six things I don't eat, saying that I must be some kind of freak, but when you see a child die from eating an undercooked hamburger, it does change your view of hamburgers. It just does. I am a lawyer, but I'm also a human.
That Odwalla story is one of the crazier stories I can think of, but there are many others, and there would be many fewer if the way we handled food safety here made more sense.
The Washington Post with Fairfax Media