FOOD IRRADIATION

848 FOOD IRRADIATION

SIR,-Mr Webb and Mr Lang (March 4, p 498) failed not only to the issues raised by the FAO/IAEA/WHO/ITC Geneva Conference on food irradiation but also to provide a true perspective on the operation of this important intergovernmental meeting. The International Organisation of Consumer Unions (IOCU) represents groups whose members are active in consumer issues. This does not mean that consumers, the vast majority, who are not members of these groups are unrepresented at intergovernmental meetings. They are represented by their governments, and many government delegations to Geneva included consumer representatives. The Secretariat (FAO/IAEA/WHO/ITC) serves its member nations, just as governments serve their citizens, all of whom are consumers. Advocacy groups are invited to such meetings as observers and are often asked to give their options. But the input of official government delegations can never be subjugated to the opinions of any one advocacy group. Eleven non-governmental organisations, representing a very broad spectrum of opinion on food irradiation attended the conference. In Geneva IOCU was not only given more floor time than any other observer but also, because of the very vocal and controversial nature of their intervention, the conference made an extraordinary effort to accommodate IOCU’s request for a special session devoted to "their" issues. No other observer group was afforded such attention. The IOCU paper on Outstanding Questions on the Safety of Irradiating Food was answered by four world experts. Although the

clarify

comprehensive and well-documented answers were appreciated by observers and delegates they did not seem to satisfy IOCU. Indeed, a draft press release referring to the special sessions so outraged delegates by its one-sided representation that IOCU publicly indicated that it would not be published officially. Webb and Lang state that 97% of those responding to a poll thought that the UK irradiation ban should not be lifted until detection methods were available. They further state that IOCU, representing 170 consumer bodies, had called for a moratorium on irradiation. These are impressive numbers. What Webb and Lang do not say was that the president of the Chinese Academy of Preventive Medicine, who had been elected vice-president of the conference, had eloquently argued the tremendous value of food irradiation in preventing food-borne disease and reducing food losses. She went on to say that she represented 1000 million consumer "bodies". The "private individual representing no consumer body", referred to by Webb and Lang, was Queensland’s commissioner for consumer affairs; and what they describe as "dangerous contempt for the concerns of the consumer movement" was her profound respect for the consumer movement and her concern that it does not become a political tool serving needs other most

than those of the consumer. The controversy over salmonellosis highlights the fact that hundreds of thousands of consumers every year have food-borne diseases that to a certain extent are preventable through food irradiation. The president of the Chinese Academy of Preventive Medicine, when asked by a journalist how irradiated food should be labelled, suggested the simple statement "This Food is Good for You". Food and Agricultural Industries Service, Agriculture Services Division, UN Food and Agriculture Organisation, 00100 Rome, Italy

MORTON SATIN

CIGUATERA AND MILITARY ACTIVITY

SIR,-Dr Ruff (Jan 28,

p

201) suggests

a

correlation between

ciguatera and nuclear explosions. We have lived in Micronesia and treated patients with ciguatara poisoning. Some of the data presented could suggest a correlation with the number of licensed taxi cabs on the affected islands or, more probably, longitude (the farther east, the more ciguatera). The relation with military activity and nuclear explosions is tenuous, and there is no evidence of cause and effect. Military activity is not defmed, but we do note an association with gonorrhoea.

The only inhabited atoll in the Marshall Islands where there were nuclear expolsions is Enewetak. There have been no ciguatera cases there. Many of the Micronesian islands without ciguatera are closer to Enewetak than Majuro. Majuro has no military activity. Most of the cases of ciguatera are in Jaluit, which is even further from the nuclear sites. To suggest that all fish poisoning is ciguatoxin related is inappropriate, and to suggest that it is the likely cause of gastroenteritis in Micronesia is even less appropriate. One should also consider whether pelagic or reef fish are eaten locally; fish poisoning is more likely to be due to scombroid poisoning if the local diet tends more towards pelagic fish. The local economy is also important; the more heavily populated areas may be more dependent on canned and frozen food. Drinking water in Micronesia is often contaminated, and it is unlikely that much gastrointestinal illness was due to ciguatera, especially in population centres with inadequate water supplies. The data may suggest that increased population density, road and causeway building, and the use of explosives for fishing on the reefs are factors in the incidence of ciguatera poisoning. Recent military activity is not necessarily related to the use of explosives for fishing since some of the explosives being used were left over from the war in the Pacific in the 1940s. Large Clinic, Pnnce Rupert, British Columbia

GRAHAM W. CONWAY

Simcoe County District Health Unit, County Administration Centre, Midhurst, Ontario, Canada L0L 1X0

J. WALTER EWING

CHILDREN IN DETENTION IN SOUTH AFRICA

SiR,—At the recent annual general meeting of the South African Paediatric Association the following motion was unanimously adopted: "This Association re-affirms its implacable opposition to the imprisonment of children without trial and to the torture and abuse of children." The word "re-affirms" was used because this principle was clearly stated in clauses 4.3.3 and 4.3.2.2 of the Association’s document Children in Detention: a Code for their

77aM/!.’ O. J. RANSOME, Chairman South African Paediatric Association, PO Box 1006, 2109 Melville,

Johannesburg, South Africa

HERNA ROODE D. W. BEATTY M. D. BOWIE P. J. FARRANT K. C. HOUSEHAM S. P. E. NAUDE P. L. VAN DER MERWE D. F. WITTENBERG H. L. UTIAN

OJ. Children in detention. a code for their handling. S Afr Med J 1987; 71 (suppl, June 20).

1. Ransome

COMPLAINTS AND LITIGATION

SIR,-As a victim of the present system of litigation on medical negligence’ I write to applaud the proposals for reform put forward by Sir Cecil Clothier (March 18, p 603). Any move that reduces the number of complaints that end up in the courts is to be welcomed. The adversarial system does not lead to justice when extreme positions are adopted in defence of colleagues accused of having caused injury unnecessarily. Nobody is infallible but the present system leaves little room for the admission of error, the offer of a sincere apology (which would often disarm the complainant), and a reassurance that more care will be taken in the future. There is no reason to suppose that doctors would be any more willing to admit to error under a no-fault compensation scheme than they are at present. This is just one of the reasons why the British Medical Association’s proposals put forward at a joint meeting with the Royal Society of Medicine in January were not greeted with anything like enthusiasm by organisations representing those who suffer medical mishap. A clinical judgment review board, as suggested by Sir Cecil, would appear to put accountability before financial considerations-an order of priorities that could lead to improvements in the standard of medical practice. A no-fault system without due inquiry into causation would not have this desirable