The relationship between lay and technical views of Escherichia coli O157 risk.

Here, we bring together and contrast lay (accessible primarily through social science methodologies) and technical (via risk assessment and epidemiological techniques) views of the risk associated with the Escherichia coli O157 pathogen using two case study areas in the Grampian region of Scotland, and North Wales. Epidemiological risk factors of contact with farm animals, visiting farms or farm fields and having a private water supply were associated with postcode districts of higher than average disease incidence in the human population. However, this was not the case for the epidemiological risk factor of consumption of beef burgers, which was independent of disease incidence in the postcode district of residence. The proportion of the population expressing a high knowledge of E. coli O157 was greatest in high-incidence disease districts compared with low-incidence areas (17% cf. 7%). This supports the hypothesis that in high-disease-incidence areas, residents are regularly exposed to information about the disease through local cases, the media, local social networks, etc. or perhaps that individuals are more likely to be motivated to find out about it. However, no statistically significant difference was found between high- and low-incidence postcode districts in terms of the proportion of the population expressing a high likelihood of personal risk of infection (10% cf. 14%), giving a counterintuitive difference between the technical (epidemiological and quantitative microbiological risk assessment (QMRA)) and the lay assessment of E. coli O157 risk. This suggests that lay evaluations of E. coli O157 risk reflect intuitive and experience-based estimates of the risk rather than probabilistic estimates. A generally strong correspondence was found in terms of the rank order given to potential infection pathways, with environment and foodborne infection routes dominating when comparing public understanding with technical modelling results. Two general conclusions follow from the work. First, that integrative research incorporating both lay and technical views of risk is required in order that informed decisions can be made to handle or treat the risk by the groups concerned (e.g. the public, policy makers/risk managers, etc.). Second, when communicating risk, for example, through education programmes, it is important that this process is two-way with risk managers (e.g. including Food Standards Agency officials and communications team, public health infection control and environmental health officers) both sharing information with the public and stakeholder groups, as well as incorporating public knowledge, values and context (e.g. geographical location) into risk-management decisions.

Escherichia coli O157: comparing awareness of rural residents and visitors in livestock farming areas.

This research compared public opinions about Escherichia coli O157 (an increasing environmental hazard associated with livestock) in two farming areas with contrasting incidence of E. coli O157 disease. A questionnaire was administered in rural Grampian (10·8 cases/100,000 population per year) and North Wales (2·5 cases/100,000 population per year). Awareness was highest among farmers in Grampian (91%) and lowest among visitors to both areas (28%). Respondents were more likely to indicate vomiting (76%) than bloody diarrhoea (48%) as a common symptom. Undercooked meat and contact with farm animal faeces were identified by 60% of all respondents as risk factors who described 'basic hygiene' for risk reduction indoors. Visitors view E. coli O157 as a food hazard, not an environmental hazard that produces vomiting not dysentery. Efforts to reduce human infections in livestock farming areas could be improved with proximate reminders for visitors of the environmental pathway of E. coli O157 infection.