A test of Rasmussen's risk management framework in the food safety domain: BSE in the UK

In 1986, bovine spongiform encephalopathy (BSE) was identified in the UK. Millions of BSE-infected cows were slaughtered and over 150 people contracted variant Creutzfeldt-Jakob disease, an inevitably fatal human form of BSE. Tragic incidents such as this provide valuable opportunities to understand and improve the safety of complex socio-technical systems. By studying accidents, knowledge can be gained that can improve system safety. The purpose of this article is to test the usefulness of Rasmussen's risk management framework for explaining how and why accidents occur in the food production domain. This was accomplished by using the framework to retrospectively investigate how and why BSE was transmitted through the human and animal food supply in the UK from 1986 to 1996. More specifically, an AcciMap and Conflict Map were constructed to represent contributing factors of the epidemic according to the structure of Rasmussen's framework. These factors were used to test the seven predictions made by the framework. All seven predictions were supported by the evidence, indicating that Rasmussen's risk management framework shows promise as a theoretically driven explanation of how and why accidents happen in complex socio-technical systems, particularly in the food production domain.