NR AKXB
AU Simpson,C.; Dealler,S.F.; Patterson,W.
TI Bovine spongiform encephalopathy. Study shows need for better communication between government and doctors.
QU British Medical Journal 1996 Nov 2; 313(7065): 1146-7
IA http://bmj.bmjjournals.com/cgi/content/full/313/7065/1146/a
PT letter
VT
In contrast to the heated scientific debate on bovine spongiform encephalopathy and the public health, which has raged for many years in other European countries, in Britain advice on possible health risks and the safety of beef and beef products has come largely from central government. This has prompted organisations such as the Consumers' Association to complain that the issuing of selected information on bovine spongiform encephalopathy, aimed at reassuring the public, prohibits informed decision taking and debate on food safety. For example, the brains of cattle potentially infected with bovine spongiform encephalopathy continued to enter the human food chain until November 1989. During this time the Department of Health and other government departments advised that all beef produce was safe to eat. Other health professionals were more cautious in their interpretation of the science,(1) (2) but their concerns were not reflected in official communications.
In March 1996 a new variant of Creutzeldt-Jakob disease was reported in younger people in Britain; it was possibly associated with exposure to the agent causing bovine spongiform encephalopathy.(3) Before this our concern that medical professionals had inadequate knowledge and understanding of bovine spongiform encephalopathy prompted us to survey all 1038 doctors in North Yorkshire. Our aims were to determine their knowledge of spongiform encephalopathies, the proportion who had reduced their consumption of beef products, and the proportion who had been consulted on this issue by patients.
The response rate to the survey in September 1995 was 86% (644 men, 244 women). Test-retest reliability was 92% (1404 questions in a 35 test-retest sample). Although just over a quarter of doctors had been consulted by patients for advice about bovine spongiform encephalopathy, most (55%) thought that their knowledge of the subject was inadequate for them to give such advice. More than a third of doctors had decreased their consumption of beef products or had stopped eating them altogether, specifically because of unresolved fears about bovine spongiform encephalopathy. Less than a fifth of doctors were satisfied that control procedures were adequate to protect health.
Table 1 - Medical practitioners' knowledge of bovine spongiform encephalopathy (BSE), experience of consultations about BSE, and change in consumption of beef products
Yes No Unsure Total
Do you have anxieties about
safety of beef? 390 369 129 888
Are control measures
concerning BSE adequate? 163 193 528 884
Is your knowledge of BSE
adequate to advise patients 174 480 226 880
on possible health risks?
Often Occasionally No
Have patients asked you about
BSE and safety of beef? 8 225 651 884
Yes No
Have you reduced your
consumption of, or stopped
eating, beef products because 283 528 811
of BSE?
This study shows the need for better communication between central government and medical practitioners on important public health issues such as food safety. It also shows the need for vibrant public health leadership and debate (4) which are necessary if consumers are to have confidence in official communiques. When these are absent the media will gladly fill the vacuum.
References
1 Holt T A, Phillips J. Bovine spongiform encephalopathy. BMJ 1988;296:1581-2.
2 BSE and scrapie agents for change. Lancet 1988;ii:607-8.
3 Will R G, Ironside J W; Zeidler M, Cousens N, Estibeiro K, Alperovitch A, et al. A new variant of Creutzefeldt-Jacob disease in the UK. Lancet 1996;347:921-5.
4 Gore S. Bovine Creutzfeldt-Jakob disease? BMJ 1996 312:791-2. (30 March.)
AD CHRISTOPHER SIMPSON Consultant psychiatrist, Friarage Hospital, Northallerton DL6 1JG, STEPHEN DEALLER Consultant microbiologist, Burnley General Hospital, Burnley BB10 2PQ, WILL PATTERSON Consultant in communicable disease control, North Yorkshire Health Authority, York Y03 4XF
MH Animal; Cattle; Communication; Creutzfeldt-Jakob Syndrome/*transmission; Encephalopathy, Bovine Spongiform; Government; Human; Interprofessional Relations; Physicians
SP englisch
PO England