Extrapolating understanding of food risk perceptions to emerging food safety cases

Abstract

Important determinants of risk perceptions associated with foods are the extent to which the potential hazards are perceived to have technological or naturally occurring origins, together with the acute vs. chronic dimension in which the potential hazard is presented (acute or chronic). This study presents a case study analysis based on an extensive literature review examining how these hazard characteristics affect people’s risk and benefit perceptions, and associated attitudes and behaviors. The cases include E. coli incidences (outbreaks linked to fresh spinach and fenugreek sprouts), contamination of fish by environmental pollutants, (organochlorine contaminants in farmed salmon), radioactive contamination of food following a nuclear accident (the Fukushima accident in Japan), and GM salmon destined for the human food chain. The analysis of the cases over the acute vs. chronic dimension suggests that longitudinal quantification of the relationship between risk perceptions and impacts is important for both acute and chronic food safety, but this has infrequently been applied to chronic hazards. Technologies applied to food production tend to potentially be associated with higher levels of risk perception, linked to perceptions that the risk is unnatural. However, for some risks (e.g. those involving biological irreversibility), moral or ethical concerns may be more important determinants of consumer responses than risk or benefit perceptions. (Lack of) trust has been highlighted in all of the cases suggesting transparent and honest risk–benefit communications following the occurrence of a food safety incident. Implications for optimizing associated risk communication strategies, additional research linking risk perception, and other quantitative measures, including comparisons in time and space, are suggested.

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Extrapolating understanding of food risk
perceptions to emerging food safety cases
Gülbanu Kaptan, Arnout R.H. Fischer & Lynn J. Frewer
To cite this article: Gülbanu Kaptan, Arnout R.H. Fischer & Lynn J. Frewer (2017): Extrapolating
understanding of food risk perceptions to emerging food safety cases, Journal of Risk
Research, DOI: 10.1080/13669877.2017.1281330
To link to this article: http://dx.doi.org/10.1080/13669877.2017.1281330
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Extrapolating understanding of food risk perceptions to emerging
food safety cases
Gülbanu Kaptan
a
*
1
, Arnout R.H. Fischer
b
and Lynn J. Frewer
a
a
Food and Society Group, School of Agriculture, Food and Rural Development, Newcastle
University, Newcastle upon Tyne, UK;
b
Marketing and Consumer Behaviour Group,
Wageningen University, Wageningen, Netherlands
(Received 2 May 2015; final version received 12 December 2016)
Important determinants of risk perceptions associated with foods are the extent to
which the potential hazards are perceived to have technological or naturally
occurring origins, together with the acute vs. chronic dimension in which the
potential hazard is presented (acute or chronic). This study presents a case study
analysis based on an extensive literature review examining how these hazard
characteristics affect people’s risk and benefit perceptions, and associated attitudes
and behaviors. The cases include E. coli incidences (outbreaks linked to fresh spi-
nach and fenugreek sprouts), contamination of fish by environmental pollutants,
(organochlorine contaminants in farmed salmon), radioactive contamination of
food following a nuclear accident (the Fukushima accident in Japan), and GM sal-
mon destined for the human food chain. The analysis of the cases over the acute
vs. chronic dimension suggests that longitudinal quantification of the relationship
between risk perceptions and impacts is important for both acute and chronic food
safety, but this has infrequently been applied to chronic hazards. Technologies
applied to food production tend to potentially be associated with higher levels of
risk perception, linked to perceptions that the risk is unnatural. However, for some
risks (e.g. those involving biological irreversibility), moral or ethical concerns
may be more important determinants of consumer responses than risk or benefit
perceptions. (Lack of) trust has been highlighted in all of the cases suggesting
transparent and honest risk–benefit communications following the occurrence of a
food safety incident. Implications for optimizing associated risk communication
strategies, additional research linking risk perception, and other quantitative mea-
sures, including comparisons in time and space, are suggested.
Keywords: Food risk; risk perception; benefit perception; risk communication,
food safety
1. Introduction
It has been established that people’s responses to different risks are affected by how
they perceive potential hazard characteristics. Furthermore people’s risk perceptions
do not always align with technical risk estimates provided by experts (Fischhoff
et al. 1978; Slovic 2000). People’s risk perceptions are often reasonable but can also
militate against adoption of self protective behaviors, implying that effective risk
communication may be required (Fischhoff and Kadvany 2011). In the context of
public health, effective risk communication aims to provide laypeople with the
*Corresponding author. Email: g.kaptan@leeds.ac.uk
© 2017 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives
License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduc-
tion in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.
Journal of Risk Research, 2017
http://dx.doi.org/10.1080/13669877.2017.1281330

information they need to make informed, independent judgments (Morgan et al.
2002). Food safety is of particular interest in this context, as there is some evidence
suggesting that food risks are perceived differently from non-food risks (FAO/WHO,
forthcoming). This is because complete avoidance of food risks is not possible, and
because food has cultural, symbolic, familial, and religious connotations which must
be taken into account when developing risk messages (Frewer et al. 2015). In
addition, food may simultaneously be associated with risks, such as inclusion of
contaminants, and benefits, such as nutritional advantages (Cohen et al. 2005;
Hoekstra et al. 2013a,2013b; van der Voet, de Mul, and van Klaveren 2007)
suggesting that both risk and benefit perceptions associated with foods need to be
considered when developing risk communication strategies (van Dijk, Fischer, and
Frewer 2011; Hooper 2006; Saba and Messina 2003).
Some types of determinants of risk perceptions seem to be specifically impor-
tant in shaping people’s responses to food risks such as the extent to which the
potential hazards are perceived to have ‘technological’or ‘naturally occurring’
origins (Frewer et al. 2013b; Rozin et al. 2004; Siegrist 2008). The application of
technologies to food production may be perceived as hazardous. Failing to take
account of this negative starting point, and subsequent negligence of the needs
and priorities of consumers during the process of technology development and
implementation, has resulted in societal rejection of potentially useful emerging
food technologies such as genetically modified (GM) foods (Frewer et al. 2011;
Raley et al. 2016). In contrast, consumers’low levels of risk perceptions associ-
ated with naturally occurring food hazards has increased their tendency to adopt
potentially risk behaviors, for example in relation to food preparation practices
(Nauta et al. 2008).
Further complexity is provided by the acute vs. chronic context in which the
potential hazard is presented (Glik 2007). Presenting a naturally occurring risk in an
acute or ‘crisis’context may increase risk perceptions (Pidgeon, Kasperson, and
Slovic 2003). Examples include foodborne outbreaks that may be difficult to predict
in terms of which microbial hazard will occur when, and affect whom. In the case
of chronically occurring food hazards, (e.g. radioactive contamination of food), more
information regarding the potential for varied impacts across differentially vulnera-
ble populations may become available as a consequence of the ongoing risk assess-
ment process (WHO/FAO, forthcoming). The acute vs. chronic context of the hazard
may differentially influence people’s perceptions of risks, and hence their behaviors.
In order to understand the potential impacts of both acute and chronic food safety
incidents on both public health and economic functioning of the food chain, it is
important to quantify the relationships between food risk perceptions and impacts.
However, new metrics may be needed to assess this relationship (Dreyer et al.
2010), which can be formally included in the risk assessment phase of the risk anal-
ysis process.
This paper presents case study analyses based on an extensive literature review
examining how food hazard characteristics affect people’s risk and benefit
perceptions, and associated attitudes and behaviors. Two ‘axes’frame the analysis.
The first relates to the ‘risk origin’(technological or natural). The second relates to
the ‘acute vs. chronic dimension’of the food hazard. Therefore, the following
hypotheses will be tested through case study analysis:
2G. Kaptan et al.

H1: Consumers perceive the application of technologies to food production as
hazardous.
H2: Consumers’risk perceptions of naturally occurring food hazards may have
negative impacts regarding optimizing nutrition.
H3: Acute vs. chronic hazards differentially influence people’s risk perceptions and
behaviors due to the temporal context
2. Methodology
Use of case studies to understand a specific research question is a research strategy
that focuses on understanding the dynamics present within a single or multiple set-
tings (Eisenhardt 1989). In the comparative analysis of cases that follows, four food-
related cases were presented. In each case, it is arguable that there is potential for
risk perceptions associated with the food hazard to lead consumers to behave in a
way contrary to their own, and societal interests, where societal is understood to
refer to a ‘common good.’Thus, it should be possible to derive generic, as well as
situation specific, conclusions regarding risk perception and food choice. The cases
selected have been subject to considerable attention among different stakeholders
(e.g. the scientific community in general, regulatory agencies, media, and representa-
tives of civic society such as non-governmental organizations). The cases include
E. coli incidences, (outbreaks linked to fresh spinach and fenugreek sprouts), con-
tamination of fish by environmental pollutants, (organochlorine contaminants in
farmed salmon), radioactive contamination of food following a nuclear accident (the
accident at the Fukushima Dai-ichi nuclear power plant), and genetically modified
(GM) salmon destined for the human food chain.
Classification of the cases according to risk origin and acute vs. chronic
dimension is provided in Table 1.
Each case is described with a brief explanation about the risk issue, information
about the factors linked to increased consumer risk perceptions, the impact of the
incident, a chronological overview from consumers’perspective, and where feasible,
research reporting consumers’attitudes and behavior during and/or after the
incidents, and, if applicable, discussion of the additional metrics needed to quantify
the relationship between risk perceptions and impacts.
Table 1. Classification of the cases according to risk origin (technological vs. natural) and
acute vs. chronic dimension.
Case Technological
vs. natural Acute vs. chronic
•E. coli 0157:H7 outbreak linked to fresh spinach
(USA, September 2006)
•E.coli outbreak linked to fenugreek sprouts
(Germany, May-June 2011)
Natural Acute
•Organochlorine contaminants in farmed Atlantic
salmon (United Kingdom, January 2004) Technological Chronic
presented in a
crisis context
•The accident at the Fukushima Dai-ichi nuclear
power plant (Japan, March 2011) Technological Acute and
chronic
•GM salmon destined for the human food chain Technological Chronic
Journal of Risk Research 3

The number of English language media reports that were published about each
case are provided in Table 2. Although not having access to media reports in other
languages (e.g. German, Japanese) is a limitation to reflect the complete picture on
the information that those consumers received, Table 2may still be a good proxy
reflecting societal interests or social amplification of risk effect.
3. Case studies
3.1. E. coli incidences
Some strains of E. coli bacteria (e.g. Shiga Toxin producing E. coli (STEC) such as
E. coli 0157:H7, E. coli O104:H4) are pathogenic, resulting in diarrhea or serious
conditions (e.g. hemolytic uremic syndrome (HUS)) that can be fatal (UK Food
Standards Agency 2013). STEC are among the most reported and monitored food
Table 2. Overview of English language media reporting on the four cases in this paper.
Incident
Science reports
Organochloride
in Farmed
Salmon E. coli 0157:H7
in fresh Spinach Fukushima nuclear
power plant accident
E. coli 0104:
H4 in
fenugreek
sprouts
Timeline
\First report January 2004 September 2006 March 2011 May 2011
2004 3 reports
(January)
2005 1 report
(October)
2006 16 reports (8 in
September, 6 in
October, 1 in
November, 1 in
December)
2007 1 report (March)
2008 1 report
(January) 4 reports (March,
June, July,
September)
2009 1 report (June)
2010
2011 3 reports (April,
August, October) 5 reports
(June)
2012 1 report (October)
2013 1 report (May)
2014 3 reports (2 in May, 1
in August)
2015 13 reports (1 in
January, 9 in
February (associated
with Japan visit
prince William), 3 in
April)
Total 5 22 21 5
Search term Organochloride
Farmed Coli Spinach Fukushima Food Coli Sprouts
Note: All search conducted for reports following first incident in LexisNexis academic power search
using Major US and world news as sources on 17-June-2016.
4G. Kaptan et al.

pathogens in the EU and US because they frequently cause sporadic cases of
illnesses and large foodborne outbreaks in these countries (Centers for Disease
Control and Prevention 2013; European Food Safety Authority 2013). When com-
municated in a ‘crisis’context, E. coli outbreaks have the potential to generate high
level of public concern (UK Food Standards Agency 2013).
Consumption of foods and food categories associated with the outbreak tends to
decline during the course of the outbreak (Mazzocchi 2006; McCullough, Marsh,
and Huffaker 2013; Oniki 2006). These effects are large enough to quantify the
‘acute’impacts of a food safety incident by examination of product-specific sales
data (Hooper 2006; Saba and Messina 2003). However, risk perceptions may have
negative unintended consequences, such as not consuming the product or substitutes
for a prolonged period after the crisis ends, in spite of their health benefits (Cuite
et al., forthcoming). Such ‘stigmatization’of foods may therefore have negative
long-term health effects (Gregory, Slovic, and Flynn 1996). Against this, failure to
communicate risks effectively may have negative consequences for health if people
fail to adopt self-protective behaviors. For example, (SteelFisher et al. 2013) asked
participants from different age groups about their self-protective behaviors with
regard to a hypothetical foodborne outbreak and found that they were very likely to
adopt a range of recommended protective behaviors (although this is less common
among older than younger participants). However, consumer surveys that were
conducted during/following actual outbreaks in the US have shown that 41% of con-
sumers, who were aware of the recall, did not look for the recalled food in their
homes (Hallman, Cuite, and Hooker 2009), and that only 35% stopped eating that
food (Blendon et al. 2010)
E. coli incidences may also occur sporadically where the risk is more likely to
be presented in a ‘chronic’context, and in these cases risks may be perceived as rel-
atively ‘lower.’In these cases, people are much less motivated to change behaviors,
including self-protective ones (Fischer, Frewer, and Nauta 2006). Underreporting of
the illness has been reported as a significant problem (Kaptan and Fischhoff 2011)
due to being unsure of the cause, not knowing who to contact, believing reporting
would not be helpful, and being too ill (Arendt et al. 2013). It is therefore relevant
to compare perceptions of E. coli incidences across ‘acute’and ‘chronic’contexts.
Acute E. coli 0157:H7 outbreak linked to fresh spinach. In September 2006,
E. coli 0157:H7 infections associated with fresh spinach affected over 200 people in
26 North American states. More than 100 of these cases were hospitalized, and 31
developed a form of kidney failure (HUS) that resulted in three deaths (Centers for
Disease Control and Prevention 2006; Gelting et al. 2011). The source of the out-
break was identified as the processing and packaging plant of Natural Selection
Foods, LLC in San Juan Bautista, CA. The precise means by which the bacteria
spread to the spinach remained unknown, but US public health agencies were able
to make predictions based on field work (US Food and Drug Administration 2007).
Following the outbreak, the lettuce safety initiative that had been launched in
2006 was expanded to include spinach (US Food and Drug Administration 2013b).
This initiative aimed to reduce public health risks by focusing on the product, agents
and areas of greatest concern and to alert consumers early and respond rapidly in
the event of an outbreak.
During the outbreak, US Food and Drug Administration’s (FDA) first advice to
consumers was not to eat bagged fresh spinach (US Food and Drug Administration
2006c). This was updated the next day to not to eat fresh spinach and fresh spinach
Journal of Risk Research 5

containing products (US Food and Drug Administration 2006b). The advice was
updated again to confirm that spinach grown in non-implicated areas was safe to
consume (US Food and Drug Administration 2006a). One consequence of FDA’s
communication was that around 18% of American consumers surveyed reported that
they had stopped buying other bagged vegetables (Cuite et al., forthcoming).
Bagged spinach expenditures were still 10% down at the end of 2007. In addition,
over a period of 68 weeks, retail expenditures decreased 20% for bagged spinach,
1% for unbagged spinach, and 1% for all leafy greens (Arnade, Calvin, and Kuchler
2009).
Acute E. coli O104:H4 outbreak linked to fenugreek sprouts. Over 3800 cases of
E. coli O104:H4 infections were reported in Germany between May and June 2011.
More than 800 of those developed HUS that resulted in 54 deaths (Frank et al.
2011; Werber et al. 2012). In addition, several cases were reported in 12 other
European countries, as well as the US and Canada (Bloch, Felczykowska, and
Nejman-Faleńczyk 2012). Fenugreek seeds imported from Egypt were the most
likely common link between the outbreak in Germany and a related outbreak in
France (European Food Safety Authority 2011). As a result, the European Commis-
sion temporarily banned the import of fenugreek and certain seeds from Egypt to
the European Market on July 6 (European Commission 2011). The relative rarity of
the bacterial strain, the associated serious health consequences, difficulties in tracing
the bacteria back to the food source, and communication failures on the part of
authorities resulted in global media attention.
The German public health authorities provided information about the outbreak
initially on 24 May 2011, without a reference to the affected crop. Consumers were
advised the next day to be careful when eating raw tomatoes, lettuce, and cucum-
bers, in particular in Northern Germany, as these vegetables were believed to be the
potential causes of the outbreak. On 26 May, the German authorities announced that
three cucumbers from Spain were identified as the potential cause of the outbreak.
On 1 June, however, the Spanish cucumbers were cleared. Finally, on 10 June,
consumers were advised not to eat raw sprouts as contaminated sprouts of a Lower
Saxony producer were identified as the source of the outbreak. On 23 June, an inter-
national investigation concluded that fenugreek sprouts were the common link
between the German outbreak and a related outbreak in France (Werber et al. 2012).
On 5 July, consumers were informed that the outbreak had ended but were still
advised not to eat raw sprouts.
Consumer advisories during the outbreak have been criticized in terms of
implicating a broad scope of unaffected produce as potential sources (cucumbers,
tomatoes, and lettuce while the actual source was fenugreek sprouts). Furthermore,
foreign production (Spain) was implicated in the outbreak, whereas in reality the
problem had domestic origins, thus misleading consumers (Poudelet 2012; WHO
2011). As a consequence, consumer demand for a range of fresh produce, in
particular, produce grown locally and imported from Spain declined considerably
(Anderson 2011; Exner 2011). For example, German institutional kitchens (e.g.
Stuttgart’s youth hostels) stopped serving fresh salad. As well as having potentially
negative impacts on the nutritional quality of diets, the negative economic impacts
on Spanish producers were severe, with concomitant impacts on the broader local
communities (Anderson 2011).
In contrast to acute outbreaks, chronic E. coli incidents affecting only one or
very few people occur relatively frequently (Tariq, Haagsma, and Havelaar 2011).
6G. Kaptan et al.

These incidents tend not to receive much media attention and are not the focus of
acute risk communication, although the consequences for affected individuals can be
as severe as those who were infected during an outbreak. Optimistic bias (where
people do not perceive they are personally vulnerable to a specific food risk)
appears to militate against the adoption of safe domestic food hygiene practices
associated with the prevention of foodborne illness (Miles and Scaife 2003;
Redmond and Griffith 2004; Verbeke et al. 2007). In addition, engaging in safe food
preparation practices may be considered as too difficult or otherwise costly or incon-
venient as the risks of public health problems linked to microbial contamination of
food are perceived to be low (Fischer, Frewer, and Nauta 2006).
3.2. Contamination of fish by environmental pollutants
Seafood, in particular fish, is an important supplier of omega-3 fatty acids, and a sig-
nificant source of protein, vitamins, and minerals that are essential to maintain good
health. Research has suggested that fish consumption may contribute to prevention
of certain illnesses such as cardiovascular disease (Kris-Etherton, Harris, and Appel
2003), and cancer (Norat et al. 2005), and is beneficial to fetal neurodevelopment
(Nesheim and Yaktine 2007). Increased fish consumption is frequently targeted as a
public health nutrition goal (Ruxton et al. 2004). However, fish is also associated
with environmental contaminants such as methylmercury and organochlorine
compounds (e.g. PCB). Methylmercury might have adverse effects on developing
fetuses (Nesheim and Yaktine 2007), while PCB’s might adversely affect liver,
kidney, and central nervous system (Sirot, Leblanc, and Margaritis 2012). Vulnera-
bilities to risk also vary across the population (for example, pregnant women and
immuno-compromised individuals are more at risk from negative effects), and it is
important to examine risk–benefit perceptions across different population groups
(van Dijk et al. 2012).
The source of contamination with methylmercury or organochloride in fish may
be perceived as technological or at least unnatural in origin. Both negative and posi-
tive consequences of changes in fish consumption may be perceived to be delayed,
as health impacts (both toxicity effects and positive effects of omega-3 consump-
tion) are long term. Communicating risks and benefits of fish consumption presents
a challenge for experts to target the information to the appropriate audience and to
help differentially vulnerable consumers make informed decisions to optimize their
own health protection (Engelberth et al. 2013; Verbeke et al. 2008).
There is some evidence to suggest that risk communication in this regard is
successful. Studies assessing the effect of risk communication messages (e.g. FDA
mercury advisories) on awareness and behavior of vulnerable consumer groups
demonstrate that they are generally aware of the risks, and follow the recommenda-
tions related to amount and what type of fish to consume, however, particular
attention is needed for less educated, less knowledgeable, and low-income groups
(e.g. Driscoll, Sorensen, and Deerhake 2012; Lando, Fein, and Choinière 2012;
Shimshack, Ward, and Beatty 2007; Teisl et al. 2011).
Organochlorine contaminants in farmed Atlantic salmon. An article published in
the 9 January 2004, issue of Science reported that farmed Atlantic salmon (particu-
larly from Scotland and the Faroe Islands) contained higher levels of organochlorine
contaminants than wild Pacific salmon. The authors suggested that consumption of
this particular fish should be limited to less than one and a half portions per month
Journal of Risk Research 7

and concluded that consumption of farmed Atlantic salmon may pose risks that limit
the beneficial effects of fish consumption. In response to this article, the UK Food
Standards Agency immediately issued a press release, pointing out that the levels of
dioxins and PCB’s found in this study were in line with those previously found by
the UK Food Standards Agency (FSA), and are within safety levels set by the World
Health Organization (UK Food Standards Agency 2004a). On 9 January, the FSA
issued a more detailed response highlighting that there is no reason to avoid eating
Scottish farmed salmon or any other salmon (UK Food Standards Agency 2004b).
Later, in 2004, an inter-committee subgroup consisting of experts from the British
Scientific Advisory Committee on Nutrition and Committee on Toxicity issued a
report suggesting that the UK population should be encouraged to increase its oily
fish consumption to one portion a week to confer significant public health benefits
without appreciable risk from the contaminants in fish (Scientific Advisory Commit-
tee on Nutrition 2004). The Science article and subsequent responses from the
Scottish Salmon Industry, and FSA received substantial media attention in the UK
(BBC News 2004; Highfield 2004).
In a cross-national European study conducted with 206 participants from
Germany, Greece, Norway, and UK (van Kleef et al. 2009), participants were inter-
viewed about recent food safety incidents in their home countries. Fifty-two partici-
pants from the UK were interviewed about their opinions regarding contaminated
farmed Atlantic salmon incident. The results suggest that UK participants were gen-
erally confused about the conflicting information provided by the media reporting
the Science article and FSA’s response. They required more information about how
guidelines on contaminants are developed and reviewed and wanted to be updated
about follow-up activities such as investigations. They also reported that they do not
trust the salmon industry because in their view the industry is more concerned about
economic motivations than the safety of fish. Lack of trust in the farmed salmon
industry was also found in more recent studies (Schlag and Ystgaard 2013), but was
reported as not predicting consumption choices for salmon (Hall and Amberg 2013).
In studies on other food safety incidents (e.g. BSE), consumption behaviors have
been found to be affected by lack of trust (Pieniak et al. 2008; Rosati and Saba
2004).
Chronic contamination of salmon resulted in reduced levels of trust in food
industry (van Kleef et al. 2009; Schlag and Ystgaard 2013). However, in order to
quantify the effects of this increased risk perception and reduced trust on fish con-
sumption, additional research is needed on people’s attitude toward nuclear power.
As part of this, it is important to segregate risk perceptions associated with farmed
salmon from those associated with fish in general, in order to establish the extent to
which risk perceptions have generalized to other fish or seafood species. Thus, with-
out further analysis, the long-term public health impacts of this chronic food safety
incident are unknown.
3.3. Radioactive contamination of food following a nuclear accident
Nuclear power has long been perceived as unacceptably risky by some members of
the public. Incidents such as the Chernobyl accident have highlighted the potentially
negative effects of a nuclear accident to human and environmental health in general
(Drottz-Sjöberg and Sjoberg 1990; Renn 1990), and the human food chain in partic-
ular (BBC News 2011; Beach 1990). In the early 2000’s, nuclear power has been
8G. Kaptan et al.

repositioned as a solution to mitigate climate change because it has the potential to
contribute to the growing demand for energy without emitting carbon dioxide to the
atmosphere (International Atomic Energy Agency 2013; Sailor et al. 2000;US
Department of Energy 2005; Whitfield et al. 2009), although its adoption in this
regard is controversial (Sovacool and Cooper 2008). Accordingly, research has sug-
gested people’s attitude toward nuclear power is becoming less negative (Brook
2012; Goodfellow, Williams, and Azapagic 2011). However, the catastrophic
Fukushima nuclear accident that occurred, following a tsunami, in Japan in March
2011 may have had a negative impact upon this trend toward more positive attitudes
(Kanda, Tsuji, and Yonehara 2012; Poortinga, Aoyagi, and Pidgeon 2013).
Although not strictly a ‘technological food production’related hazard, this case
represents the occurrence of an acute food hazard with technological origins, where
perceptions (based on those learned from previous examples of similar incidents)
are formed rapidly under conditions of uncertainty, and are linked to unintended and
uncontrollable effects of technology. In addition, perceptions are shaped by uncer-
tainties associated with the geographic and temporal ‘spread’of impacts, in particu-
lar immediately after the crisis has occurred (Hamada and Ogino 2012).
Research shows that most consumers (both in the country of the incident and
neighboring countries) avoid purchasing products from affected areas in the after-
math of the incident and this avoidance behavior still continues in the following
years although at a lower extent (e.g. Belyakov 2015; Hee et al. 2014; Sawada,
Aizaki, and Sato 2014; Turcanu et al. 2007). However, avoidance from the food
grown in contaminated areas also depends on food availability. For example, in the
aftermath of the Chernobyl accident, many people continued consuming contami-
nated food due to poverty and lack of alternative food supply (Belyakov 2015). The
accident at the Fukushima Dai-ichi nuclear power plant (NPP). On 11 March 2011,
an earthquake of 9.0 magnitude created a powerful tsunami that flooded the Fukush-
ima Dai-ichi NPP in Japan. As the flooding cut off power for cooling and created
malfunction of all backup systems, reactors overheated, and a marked amount of
radiation was released to the environment, including the Pacific Ocean.
The Japanese authorities evacuated citizens living within 20 km radius and sug-
gested that people living in the radius of 20–30 km of the plant remain indoors. On
17 March , provisional standards for radioactivity in foods were established as
radioactive contamination of food was observed in areas far from the NPP. These
standards were subsequently revised and lowered in April 2011 (Baba 2013).
There were no initial deaths or serious exposures to radiation at the NPP. How-
ever, the evacuation resulted in 60 immediate deaths of patients or elderly people in
nursing homes and health care facilities due to deterioration of serious medical condi-
tions (González et al. 2013). On 16 December , more than 9 months after the accident,
the Japanese authorities declared the plant to be stable, although acknowledging that
it would take decades to decontaminate the surrounding areas (Buerk 2011).
The Japanese Government announced a comprehensive review of its energy pol-
icy to emphasize renewable sources. In addition, all NPP’s in Japan have either been
closed or had their operations suspended for safety inspections and maintenance.
The accident has also affected other countries’future energy plans. In response to
German citizens’rising concerns about nuclear energy as a result of the Fukushima
accident, Germany announced plans to shut down all its nuclear reactors by 2022.
Similarly, Switzerland agreed to phase out its five aging power reactors, and Italy
decided to exclude nuclear energy from its future energy mix.
Journal of Risk Research 9

Communication efforts by the Japanese authorities to the public during and
aftermath of the disaster have been widely criticized due to lack of transparency,
downplaying the extent of the disaster, and failure to warn about likely events as
raising concerns, as well as shedding doubt on credibility of the government
(Figueroa 2013; Funabashi and Kitazawa 2012; González et al. 2013; Ng and Lean
2012; Poortinga, Aoyagi, and Pidgeon 2013). There is evidence from within Japan
that public support for nuclear power, which was not high before the incident, has
been further reduced (Figueroa 2013; Kato et al. 2013; Poortinga, Aoyagi, and
Pidgeon 2013).
People’s risk perceptions associated with nuclear contamination are extremely
high, both in terms of general environmental contamination (Slovic 2012), and in
relation to the food supply (Burger 2012). Thus, even a low level of radioactive con-
tamination of foods may result in consumer rejection, even if the level of contamina-
tion is similar in magnitude to naturally occurring background levels of radiation.
As a consequence, in the short term, foods which are technically safe to consume
may be rejected by consumers (International Atomic Energy Agency 2013). This is
particular concern in a crisis situation, for example, following a nuclear accident,
where it may be difficult to provide adequate food supplies to the effected popula-
tion as other crisis management activities (e.g. evacuation, provision of medical aid)
may have higher priorities in terms of resource allocation. Given that contamination
is likely to be perceived as ubiquitous within the region, short-term problems associ-
ated with under nutrition may occur (Spirichev et al. 2006). Thus, risk perceptions
may result in acute nutritional deficiencies in a population which is dealing with
multiple potential health, injury, and infrastructure concerns associated with the
aftermath of an earthquake. In the long term, there is the potential for all foods pro-
duced or stored within the vicinity of the nuclear accident to be ‘stigmatized’or
rejected. Thus, consumer rejection of food produced in the affected region may have
negative impacts on the local economy. This may extend beyond local consumers
and affect export markets. National food production, unaffected by the nuclear inci-
dent itself, may be stigmatized, which will further impact on the national or even
regional economy. In summary, such incidents may cause consumers to act rapidly
to protect themselves from harm, but in the long term, their risk perceptions may
‘stigmatize’foods produced within local production systems, with concomitant neg-
ative socioeconomic impacts. In a crisis, when food availability is potentially an
issue, health problems associated with malnutrition may result from the perception
that all local food supplies have been contaminated by radiation (WHO 2013). In
order to quantify these relationships, it is important to measure risk perceptions and
dietary choices immediately after the incident has occurred, as economic measures
are unlikely to be reliable owing to multiple perturbances. Longitudinal analysis
might usefully correlate economic data associated with local food production (both
in terms of price and volume) with risk perceptions of local consumers, and
consumers in export markets for local and national products.
3.4. GM animals applied to food production
GM technology has been applied to various crops, including those intended for food
and animal feed, and to production animals (Cowan, forthcoming; Frewer et al.
2013a). However, food products derived from GM animals have not yet entered the
US and European market, although regulatory approval appears imminent for
10 G. Kaptan et al.

some applications (Maxmen 2012; US Food and Drug Administration 2015a;
Vàzquez-Salat et al. 2012). Medical applications based on pharmaceuticals derived
from GM animals are more widespread internationally (Houdebine 2009,2011), in
particular in relation to disease models (Laible 2009; Prather, Shen, and Dai 2008).
The use of GM animals in food production systems potentially confers benefits in
terms of food safety, enhanced nutrition, and improved food security (Niemann and
Kues 2007). Consumer perceptions of risk are higher for GM animal-related food
applications than plant-related applications, and may militate against their use in
food production. Other areas of application such as medical applications appear
more acceptable to the public, primarily because the benefits are perceived to out-
weigh the risks (Frewer et al. 2014; Frewer et al. 2013b). Particular concerns are
associated with animal welfare issues, and perceptions that negative environmental
impacts may be associated with intended or unintended environmental releases of
GM animals (Einsiedel 2005). What distinguishes the case of GM animals applied
to agriculture to the other cases presented here is that it is associated not only with
high levels of risk perception, but also high levels of moral or ethical concerns on
the part of the public, particularly in the US and Asia (Frewer et al. 2013b).
GM salmon destined for the human food chain. At the time of writing, a GM
salmon destined for human consumption has been approved for sale by Health
Canada (Health Canada AquAdvantage Salmon 2016), and also approved as safe
and nutritious to eat by the FDA (US Food and Drug Administration 2015b). The
genetic modification increases growth rate (Aerni 2004), anticipating increased
demand for fish and fish products over the coming decade (OECD and Food and
Agriculture Organization of the United Nations, forthcoming). Accordingly, GM fish
has been considered as a sustainable solution in terms of food security. Atlantic
salmon is one of the food species that has been subjected to GM (Menozzi, Mora,
and Merigo 2012). It has been argued that GM salmon offers nutritional advantages,
including resistance to environmental stressors and pathogens, and increased avail-
ability of omega three fatty acids (US Food and Drug Administration 2013a). Disad-
vantages may be associated with the need to ensure allergens are not introduced into
the human food chain (Nakamura et al. 2009), and less than 100% sterility resulting
in potential cross-breeding with wild varieties of salmon (Le Curieux-Belfond et al.
2009). The advantage for consumers may be economic (retail price reduction), or
nutritional (increased availability of foods rich in heath promoting components)
(Mora et al. 2012). Against this, the issue of environmental impact (for example,
unintended release of animals into the environment and animal welfare concerns)
remains a potential source of controversy (Frewer et al. 2014). One recent study
(Mather, Vikan, and Knight 2016) that measured Norwagian consumers’willingness
to purchase GM-labeled salmon found aversion to GM animal concept and high-
lighted the necessity of communicating consumer benefits for GM salmon to be
accepted in markets where GM labeling is required. Therefore, the primary drivers
of risk perceptions, at least in Europe, appear to be perceptions that the application
of GM technologies to animals is risky. Consumers in North America and South-
East Asia tend to be more concerned about moral and ethical issues (Frewer et al.
2013b). The lack of equity of distribution of benefits across different countries and
across populations is regarded as another potential issue militating against the devel-
opment of such production animals. Perceptions leading to consumer rejection are
not linked to the use of GM animals per se, but rather focused on their use in the
food supply chain.
Journal of Risk Research 11

In the case of GM animals used in food production, it is difficult to argue that
consumers’risk perceptions militate against their own interests. It could be argued
that lower prices for animal proteins high in beneficial nutrients represents a consid-
erable consumer benefit which will deliver advantages to public health, although this
may not be such an important benefit given that early innovations are destined for
more affluent countries (Menozzi, Mora, and Merigo 2012). Of potentially greater
importance regarding consumer adoption is the issue of how moral and ethical con-
cerns contribute to rejection of GM animals in food (Kaiser et al. 2007). It is sug-
gested that the principle of informed choice, through adoption and implementation
of an effective traceability and labeling policy, will prove beneficial if and when
products are released into the market. Even if consumers perceive that adequate risk
assessment procedures are introduced, that animal welfare standards are met, and
that governance structures are adequate, perceived benefits may not outweigh moral
and ethical concerns. However, providing further information about risk and benefit
assessments is unlikely to alleviative these, and this is what distinguishes the GM
case for the others presented in this paper. In this case, measuring moral concerns,
and how these change (for example, after the initial commercialization of products
developed using GM animals) may be a useful tool for developing policies further.
4. Discussion
Four food safety cases where risk perceptions associated with the food hazards have
been presented. In three of these (E.coli outbreaks, linked to fresh spinach and
fenugreek sprouts, organochlorine contaminants in farmed salmon, and radioactive
contamination following the Fukushima accident), it was concluded that risk percep-
tions may lead consumers to behave in a way contrary to their own, and societal
interests. In the fourth (GM salmon destined for the human food chain), moral con-
cerns may influence consumer behavior to a greater extent than risk perceptions. In
relation to these cases, how technological vs. natural and acute vs. chronic nature of
food hazards affected people’s risk and benefit perceptions, and associated attitudes
and behaviors, has been examined.
An initial starting point to examine the acute vs. chronic dimension is that in risk
assessment more is known about the acute effects of a food safety incident com-
pared to long-term impacts, in particular when examining (changes in) risk percep-
tions and subsequent consumption behaviors. In the case of the E. coli outbreaks,
and the reporting of contamination of Atlantic salmon, short-term impacts can be
‘metricized’through analysis of changes in risk perceptions and consumption and
sales patterns. The long-term impacts on dietary choices have not, to our knowledge,
been analyzed, and it is not clear how risk and benefit perceptions affect dietary
choices in the long term. These chronic effects are particularly complex because vul-
nerabilities to the risk change through the lifecycle of consumers (for example, with
respect to age and immune status) (Ma and Fang 2013; Wada et al. 2013), and also
vary between different demographic groups (for example, with respect to gender)
(McCombe, Greer, and Mackay 2009; Yan et al. 2010). In addition, improved scien-
tific knowledge, for example about toxicology may result in food choice dilemmas
in the future. A recent example is that of inorganic arsenic in the food supply
(Llorente-Mirandes et al. 2014), where reports of relatively high levels of arsenic in
vegetables may fuel consumer risk perceptions, with the consequence of reduced
vegetable consumption. This reduction may lead to net negative impact on long-term
12 G. Kaptan et al.

public health. Longitudinal assessment of the relationship between risk perceptions
and consumer choices is required. Linking these data with economic assessment
would be useful in order to determine the socio-economic impacts (for example, to
local producers in the case of Fukushima). In the case of GM Salmon, such analysis
would need to be projected at present, as approval is pending. If approval is given
to commercialize GM salmon in the human food chain, there may be ample opportu-
nity to assess the relative influence of consumer risk perceptions and moral and ethi-
cal concerns, on purchasing and consumption. Analysis of external changes (for
example, societal debate about synthetic biology applications in food production)
might further crystallize public opinion regarding the biological sciences in general
(Torgersen 2009; Torgersen and Schmidt 2013).
The analysis of the cases over the risk origin (technological vs. natural)
presented support for the contention that technologies applied to food production are
associated with higher levels of risk perception, potentially because they are
perceived to be unnatural. However, the available evidence suggests that intrinsic
(or intuitive) consumer concerns about ethical or moral issues are closely associated
with the introduction of GM animals applied to food production, more than ‘objec-
tive’hazards like health risks. The issue of whether alternative, less controversial,
technological approaches may be available to deliver the same benefits may also
need to be considered, as this is an issue influencing consumer acceptance (Gupta,
Fischer, and Frewer 2012). In contrast, while it is possible to construct extrinsic
ethical arguments regarding the risks of nuclear power (for example, the potential
for environmental harm), this would relate to risks of a nuclear accident, rather
than a concern located in the development and application of the (enabling)
technology itself.
The importance of developing trust has been highlighted in all of the cases,
although this may have greatest impact in terms of long-term consumer responses to
risk–benefit communications (Berg 2004; Frewer et al. 2015). Communicating risk
uncertainty to the public has emerged as an important issue. Therefore, communicat-
ing transparent and honest information, in particular telling the consumers what the
authorities know and do not know, with clear recommendations for actionable
behavior changes if relevant, may increase trust in information following the occur-
rence of a food safety incident (Frewer et al. 2015; Kaptan and Fischhoff 2010).
Communication of uncertainties associated with the scientific assessment of risks
and benefits may also be relevant where these exist, and need to be communicated
to consumers in terms of consumer protection or the generation of consumer confi-
dence in information (Beck and Kropp 2011; Thompson 2002). In the case of both
acute and chronic risks, it is noticeable that transparency about new scientific infor-
mation, novel technologies, and internal decision-making processes of regulatory
agencies rises as an important determinant affecting risk perceptions.
The Fukushima accident case exemplifies the importance of prior attitudes and
value orientations toward nuclear power in risk information, suggesting that there is
no single public with regard to energy preferences and corresponding risk beliefs
but rather there are multiple populations with different viewpoints (Greenberg and
Truelove 2011; Whitfield et al. 2009). This result seems to some extent similar to
those of experimental studies involving prior attitudes toward food (Fischer and
Frewer 2009; Van Dijk et al. 2012).
In all the cases presented here, consumers needed to make informed decisions by
understanding and balancing their decisions regarding both risks and benefits
Journal of Risk Research 13

associated with associated food choice behaviors. If relevant risk–benefit information
is not available, people may rely on judgmental heuristics, or rules of thumb such as
availability heuristic (Gilovich, Griffin, and Kahneman 2003; Kahneman, Slovic,
and Tversky 1982). The availability heuristic may explain why foods are rejected
when only risk information is provided. As a consequence, the associated risk atti-
tude will be the most available and most influential attitudinal influence on con-
sumers’decisions. Other inferences are derived from people’s existing mental
models allowing them a framework to interpret issues in the news media, participate
in discussions, feel competent to make decisions, and generate options (Fischhoff
2009). Mental models can provide essential structure in understanding risk
communication, but also produce incorrect conclusions if they contain incorrect
beliefs and/or misconceptions. Therefore communications need to be tested before
(and evaluated after) they are utilized because mental models of risk communicators
and the target audience may be different, thus leading to unexpected impacts of the
communication.
It should be possible to extrapolate the results of the case studies presented here
to emerging food risks, where there is little existing data regarding risk perceptions.
Emerging food risk issues include synthetic biology (both in general and as applied
to food production) (Pauwels 2013), increased mycotoxin levels in the global food
supply (Wu 2006), and inorganic arsenic in food and water (Moreno-Jimenez,
Esteban, and Penalosa 2012; Smith and Steinmaus 2009). The case studies highlight
an important research need in the context of examining the relationship between risk
perceptions and impacts (whether on health or socioeconomic functioning of
affected societies). While there is some evidence to assess the short-term impacts of
food risk events (for example, in relation to sales volumes of foods and food com-
modities associated with a food risk incident), the long-term impacts are not under-
stood, as other external factors also influence consumer demand. Developing metrics
to assess this would not only enable greater understanding of the relationship
between risk perceptions and consumer behaviors, but also allow mapping of the
‘stigmatization’following a risk incident of foods in potentially affected food chains
or regions. The analysis of big data, in particular internet searches and social media
activity such as Twitter may serve to link perceptions and concerns to food safety
incidents (Wilson and Brownstein 2009). While such analyses may be limited in
terms of pinpointing local incidents, in particular in developing countries (Carneiro
and Mylonakis 2009), consumer concern following an announcement of such inci-
dents can be monitored, and risk communication adjusted accordingly. In addition,
methods to simultaneously quantify risk perceptions, psychological impacts, and
impacts on local and regional economies are needed, which have to be utilized in
conjunction with assessments of public health and environmental impacts, possibly
utilized the same models. Methodologies which can harmonize natural and social
science data sets are needed to generate predictive power in this respect.
5. Conclusions
In this study, two axes, risk origin (natural vs. technological) and acute vs. chronic
dimension have framed the analysis of four different food safety incidents. In the
case of the ‘naturally’occurring incidents, it was concluded that there is potential
for risk perceptions to override consumer best interests from the perspective of
optimal nutrition (in particular relative to under consumption of health promoting
14 G. Kaptan et al.

nutrients). In the case of technological potential hazards (e.g. a food safety incident
linked to a nuclear accident), consumers own interests may also be harmed in the
short term, and therefore developing a comprehensive understanding of consumer
perceptions as well as technical risk estimates is needed to develop effective com-
munication. In the case of GM animals applied to food production, other concerns,
which are potentially moral or ethical in nature, may be more relevant to consumer
acceptance than their risk perceptions. In this case, it is difficult to argue that con-
sumer risk perceptions are operating contrary to their own interests. The principle of
consumer choice (implemented through effective traceability and labeling policies
for GM animal food products) may allow consumers to make judgments according
to their own ethical priorities, although this will not be helpful for those individuals
for whom a moratorium on, or discontinuation of, research is required. In the case
of acute and chronic food safety incidents, long-term analysis linking perceptions to
robust measures of impact is important but infrequent. Future research should aim to
quantify the links between risk perceptions, behaviors economic effects, and public
health and environmental risk indicators.
Disclosure statement
No potential conflict of interest was reported by the authors.
Funding
This work was supported by a travel grant from the Harvard Center for Risk Analysis to pre-
sent at the Risk, Perception, and Response Conference that was held at the Harvard School
of Public Health on 20–21 March 2014.
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