Thursday, 9 November 2023

Battle for safe milk

Buying milk used to be a life-or-death gamble, especially for the poor. But laws ensuring public safety were resisted for more than a century. In an age of novel pathogens and growing scientific obscurantism, it’s a warning.

How safe is the milk you buy from local shop? We’re talking about cow’s milk here – not the kind made from oats, peas or soy beans. Pretty safe, right? If you aren’t allergic to it, you can be almost 100% certain that legally-compliant milk consumed before its expiration date isn’t going to make you ill.

Having said that, recent exchanges between environmental health professionals on RHE's 'Communities' platform indicate that milk being sold via vending machines, now popping-up in a myriad of locations across the UK, may present significant risks to the health of the public, unless careful and diligent management is exercised by those owning and operating them.

The sale of unpasteurized or ‘raw’ cows’ milk is prohibited in England except from farm premises, where microbial controls can be more confidently guaranteed, thanks to visits from EHOs. Legislation and effective food safety enforcement normally protect us.

But that wasn't always the case. Bovine TB was identified as health risk to humans who drank milk from infected animals in the 1890s. Yet milk pasteurisation did not become compulsory in England, Wales and Northern Ireland until 1985. It is estimated is that a million deaths were caused in Great Britain by bovine TB contracted from infected milk from 1850 to 1950.

As we saw with BSE and, more recently, Covid-19, new zoonotic pathogens can emerge at any time. Political delay while science is uncertain is understandable – even advisable. But, in the case of milk, proven aetiologies between animal and human disease went unheeded by policy makers for a century. It’s a shocking example from history and a warning – especially as the links between science and policy are now loosening, in era when social media channels amplify ignorance.

The first laws allowing EHOs to crack down on filthy dairies and cowsheds, that were known incubators for animal and human disease were passed in 1879. Buying milk was a life-or-death gamble, especially for the poor, who needed it most for its fat, carbohydrates, vitamins and minerals.

Milk could be watered down and adulterated with chalk, flour or arrowroot. It could also be contaminated with bacteria causing typhoid, enteritis, diphtheria, scarlet fever and TB. In 1907, a Royal Commission stated definitively, following a debate that had raged since the 1880s, that bovine TB could transfer, in a lethal form, to humans.

Despite this significant announcement, legislation protecting the public was successfully resisted by vested interests for decades. In rural districts, adoptive laws imposing hygienic standards on dairy farmers were rarely and unevenly enforced. 

Milk was poisoning the poor

That was less the case in large cities. But their medical officers of health knew that, each day, trainloads of TB-infected milk were arriving from the countryside to serve fast-growing populations. It was an issue of grave concern – a public health scandal – especially for infants who relied on milk, ‘nature’s perfect food’, to avoid rickets and malnutrition.

From the 1890s, the Liverpool and Manchester Corporations and the London Council used private acts of Parliament to assume powers allowing them to prevent the sale of milk from tubercular cows. Uniform national legislation was urgently needed to tackle what was now a well-known and preventable threat to public health, but the implementation of Herbert Samuel's 1914 Milk and Dairies Bill of 1914, designed for that purpose, was postponed by the onset of the First World War and it took many more years for uniform protection of the public from infected milk to be assured.

Clean milk’s most persuasive champion of the new century appears in The Sanitary Journal in February 1916, in which a talk he gave to EHOs is recorded. Wilfred Buckley was born in Birmingham in 1873 and amassed a fortune from his family's exporting business. Returning from the US in 1906, he purchased a 1,000-acre estate in Moundsmere, Hampshire, and set himself up as a sheep, poultry and dairy farmer.

Buckley had a personal interest in hygienic dairy farming. His daughter contracted bovine TB in 1902. With a fellow dairy farmer, the wealthy newspaper proprietor, Waldorf Astor MP, owner of the Cliveden Estate and vice president of the Pure Food and Health Society of Great Britain, he had set up the National Clean Milk Society (NCMS) in 1915.

The society advocated the mandatory refrigerated transportation of 'certified' milk of guaranteed cleanliness and hygiene score cards for dairy farmers. These had been successfully adopted in the US but not in Britain, whose farming practices remained firmly rooted in the nineteenth century. 

Buckley was a persuasive campaigner. He used multimedia techniques – pamphlets, posters, articles, films and lectures illustrated with magic lantern slides – to put across his shocking and compelling message – an average sample of milk contained the same number of bacteria per cubic centimetre as a municipal sewage farm.

As a result, he was gaining powerful allies, including the king's surgeon, Sir Frederick Treves. A 'milk drought' was also impelling government intervention in the milk supply, as had taken place in munitions and housing. In October 1916, milk reached the shocking price of 6d a quart in some London districts, resulting in a demonstration by mothers and infants in Hyde Park.

Wars tighten standards

In December 1916, a Ministry of Food Control was created. Its second minister, Lord Rhondda, adopted unprecedented national powers. In October, Buckley was appointed director of milk supplies, a position in which he was able to exert considerable influence on Lord Astor's official inquiry into milk production.

Milk prices were now fixed and the Local Government Board was given powers to regulate distribution and sale, including reduced prices for mothers and children. Most significantly, from Buckley's point of view, milk grading was initiated, on a small scale.

From September 1918, dairies with high hygiene scores could be licensed to produce grade A milk, which was awarded a 3d a pint premium. Grade B milk was slightly less clean, but still of a high standard. The scheme was inherited from the Local Government Board in 1919 by the new Ministry of Health but, to the frustration of the UK's first health minister, Liberal MP, Christopher Addison, it was not mandatory and was patchily adopted.

After the war, Buckley continued to give lectures for the NCMS and helped to set up the National Milk Publicity Council. He died aged 60, in 1933, un-knighted despite his years of valiant campaigning.

Through the 1920s and 1930s, the opposition of the farming lobby to dairy reform prevailed. It would take another war and further technological developments for effective mandatory national standards to be introduced. The Milk (Special Designations) Bill of l949 ushered in certified TB-free herds and the widespread use of pasteurisation, the efficacy of which had been known in the nineteenth century. One of the strongest advocates of the bill had been the Labour MP, Edith Summerskill, who was Parliamentary secretary to the food ministry and a campaigner for women's rights. As a doctor she had seen, seen first-hand, the effects of poor nutrition on mothers and young children in the 1930s.

Will Hatchett has been a journalist since 1986 He was editor of Environmental Health News from 1998 until 2018. The views expressed here are purely his own.