Why are health messages usually given from a negative or risk perspective? No sooner does the sun shine on the first hot day of the year than health experts are warning us about the dangers of skin cancer. Alcohol is sold with advice about health problems if we don’t drink in moderation.
Apart from cookery shows, food and health is nearly always discussed in the media from an obesity or diabetes perspective. The latest fun things to come under scrutiny by health experts are festivals and mass gatherings. The March 2013 issue of
Eurosurveillance
reports on disease outbreaks associated with large open air festivals, including music festivals. The findings are particularly relevant to Ireland because of all the gatherings planned for this year.
Top 20 outbreaks
The report lists the top 20 international music festivals in 2012 by estimated attendance per day, ranging from Glastonbury UK, with 180,000 people, Big Day Out in Australia attended by 56,000, and Hyde Park, London with over 18,000 attendees. Infectious disease outbreaks occurring during large scale festivals are grouped into three main categories: faecal-oral transmission and gastrointestinal diseases; respiratory transmissions and respiratory infections; and blood-borne and sexually transmitted infections. On average, 1,700 in every 100,000 attendees at any festival seek medical care during these events and others contact their doctor a few days later depending on the disease and incubation period.
In the US, 3,000 people contracted gastroenteritis during the Michigan Women’s Music Festival. An investigation by public health officials found that the outbreak was caused by Shigella bacteria in contaminated tofu salad. The problem was compounded by limited access to soap and water for hand washing and large numbers of untrained food handlers. Cream and pastry containing Salmonella bacteria led to nearly 1,500 cases of gastroenteritis, with 117 hospitalisations, at a music festival in Spain.
More than 300 children attending a festival in Wales contracted Norovirus because vomit was not cleaned up properly. Unpasteurised milk caused 72 cases of gastroenteritis at Glastonbury music festival. The only mention of an Irish festival in the Eurosurveillance report was Oxegen 2004 when 1.7 per cent of attendees sought medical attention from the first aid facilities at the concert venue.
Gastroenteritis was not a big problem and stomach complaints were mainly due to alcohol abuse.
The Irish record
Does this mean that Irish festivals are particularly safe from a gastrointestinal disease point of view? Well yes, it seems they are. Notwithstanding the horse meat problem, eating out is pretty safe everywhere in Ireland because of the food safety regulations and inspection system. Food served at festivals is controlled by the Food Safety Authority of Ireland's Guidance Note No. 16 Food Stalls (Revision 1). This regulates the source/supply of food; preparation (and cooking) off-site, transportation of food to the festival, preparation (including cooking and reheating) of food at the festival, and serving food. Mobile food vans must comply with the regulations for stalls.
The regulations cover all types of food from fresh fruit, meat, fish and eggs, to food in packets, cans and bottles. Selling bread and bakery products, not requiring temperature controls, such as plain scones, is regarded as low-risk. Medium-risk activities include selling sandwiches, cream cakes, salads and cheese. Selling meat and meat products such as chicken curry, meat pies and lasagne are high-risk activities. Stall requirements vary depending on the category of risk. The standards of food safety and hygiene that apply to restaurants also apply to food stalls, mobile food vans, and food handlers. Environmental Health Officers (EHOs) from the HSE carry out regular inspections. In 2011, 27,055 establishments were inspected of which 4,437 committed infringements. Nearly 2,000 food complaints and 500 cases of foodborne illness were investigated as well as 122 outbreaks affecting 1,123 people. The FSAI closed 91 food businesses in 2012 as a result of these investigations.
While people need to know the health risks associated with human leisure activities, it is worth stressing the positive aspects of attending festivals and gatherings. They are good for social, psychological, and physical health and the risk of contracting nasty illnesses is very slim. Where there is profit to be made there will be food businesses that will breach food safety regulations. Complain to either the FSAI or the HSE if the food you buy at festivals is not up to scratch. Do not think that lower standards apply at these events than we expect from good restaurants and cafés. Enjoy the Year of the Gathering.
Dr Jacky Jones is a former HSE regional manager of health promotion
jjones@irishtimes.com