affordable nutrition, but given the task of the workshop, discussion focused on adverse health effects. Working group participants discussed a wide range of potential adverse health impacts from food production, processing, marketing, and consumption. Among these were

  • acute and chronic illness from foodborne pathogens and parasites (e.g., enterohemorrhagic E. coli in beef, Salmonella in poultry or produce, and parasites like Toxoplasma gondii);
  • the effects of exposure to chemicals (i.e., drug residues, hormones, and environmental toxins);
  • diet-related chronic disease (e.g., diabetes, cardiovascular disease, cancer);
  • occupational injuries and disease associated with agricultural production and food processing;
  • adverse health effects associated with transportation (e.g., motor vehicle crashes, effects of air pollution);
  • effects of exposure to air and water pollution from production practices (e.g., pesticide drift, manure-related ammonia emissions, and polluted surface water);
  • mental health impacts (e.g., mental stress associated with living or working near concentrated animal feeding operations [CAFOs] or with living and working conditions among migrant laborers); and
  • social impacts (e.g., effects of CAFOs on independence of rural communities, rural development, ability to conduct social or leisure activities) (see also Donham et al., 2007).

There was discussion about how much evidence of causality, as opposed to association, is necessary to identify an effect. The working group participants viewed their task for this exercise as discussing the scope of possible adverse health effects. Many participants recognized the importance of further work that would help to establish causality and to quantify the extent of the impacts. As one participant said, “This is just hypothesis generation at this point.”

Measurement/Limitations

Working group participants discussed the availability and usefulness of different data sources that could be used to quantify these impacts. In general, there are limits to the usefulness of disease surveillance data in providing a comprehensive picture of health patterns associated with food production and consumption. Chemical exposures in agricultural production can result in acute illness. Those poisoned may seek care and cases may be reported to public health authorities. But there can be long latency



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