"Will that kill my kid?" Unwashed Apple Edition

Yeah, most of the country is in a heat wave, but the PSL is back, which means instagram will soon be one giant gallery of apple orchards. 

 #fall #nature #outdoors #back2nature #momlife #blessed #smug #ugh

#fall #nature #outdoors #back2nature #momlife #blessed #smug #ugh

With all of those photos comes an uptick in searches about orchard fare. Is it safe to eat the apples?

In a 2017 article published in Forensic Science, Medicine, and Pathology, forensic pathologist and editor-in-chief Roger Byard outlines the six ways that food can kill you: infection, natural toxins, anaphylaxis, poisoning, mechanical issues, and the catch-all, miscellaneous causes. If you're a fiction writer looking for a creative way to kill of a character, Byard offers many great choices, including Boerhaave syndrome, the "spontaneous rupture of the esophagus from vomiting" that can result from overeating. 

Eating apples is (probably) not going to turn you into Mr. Creosote, so you don't have to worry about most of Byard's miscellaneous causes. But what about the other five? I've described your risk below. 

Anaphylaxis

You probably already know if your child is allergic to apples, given that it's one of most preschooler's ten acceptable foodstuffs. Apple-dependent exercise-induced anaphylaxis (meaning an allergic reaction that occurs with rigorous exercise) is probably also not a factor 1) because it's so exceedingly rare and 2) because children are not known for sitting quietly. 

Poisoning

If birds and cuddly forest creatures follow your child through the orchard, you may have to worry about poisoning. Aside from Snow White, there aren't many famous cases of apple tampering. Scary Halloween stories may make us think that apple poisoning is out there, but stories of poison and razor blades have been well-debunked

What about pesticides? Apples landed the dubious honor of #4 on the Environmental Working Group's 2018 Dirty Dozen list, because 90% of conventionally-grown apples tested by the EWG had pesticide residue, and 80% contained a specific pesticide--diphenylamine--which is banned in Europe. 

The EWG's gorgeous web design and simple declarative statements make it seem obvious to skip the family orchard trip this year--or to at least favor your local organic farmer. But...

In an interview for NPR, Joseph Schwarcz, who directs McGill University's Office for Science and Society, advises consumers not to panic about reports of pesticides in produce, singling out apples. "Apples contain pesticides" does not mean "eating apples poses risk," just as "this pesticide is banned in Europe" does not mean "this pesticide is dangerous to human health." 

Natural toxins

So you don't need to worry too much about poisoning from apples, at least from outside sources. But what about the toxins inside the apple?

Just traveling to the apple orchard means you're already okay with a little cyanide.

Apples contain amygdalin, which is a cyanide-sugar compound that, when ingested, metabolizes into cyanide. But you'd have to chew and swallow the seeds--and a lot of them--to die of apple pip poisoning. 

Mechanical issues

Whatever's on or in the apples probably won't kill you. But what about the apples themselves? Choking, which is one of the main mechanical issues covered in Byard's article, seems like a reasonable enough concern for orchard-goers because choking headlines make food sound terrifying. Choking is a leading cause of death among children ages 1-14. Choking sends 34 kids a day to the ER. One children dies from choking every five days. 

Looked at differently, though, choking can be made to look much less scary. The CDC's Leading Causes of Death by Age Group chart broadly categorizes the the top ten causes of death for each group. For the first six age groups in the chart (1-4, 5-9, 10-14, 15-24, 25-34, and 35-44), the top causes of death is "unintentional injury." In other words, the leading cause of death for children and younger adults is accidents. Other causes, like heart disease, or the flu, or sepsis, are lower on the list because the younger population is generally healthy to begin with. It's not surprising, then, that accidents make up a higher proportion of deaths. 

For children ages 1-14, suffocation was the fifth highest cause of unintentional injury death, which makes it seem as though choking represents a huge number of deaths. Another way to read this is that choking deaths make up one part of one category (suffocation), which makes up one part of another category (unintentional injury deaths), which makes up part of the full set (childhood deaths). 

Choking is a legitimate concern, of course, but it should be a little less concerning given how rare choking is compared to how many people eat. 

Infections

Sure, you're willing to tolerate the small risks of naturally-occurring poison, pesticides, and choking. But what about E.coli? 

The CDC maintains a database of all multistate food outbreaks since 2006. You're probably familiar with many of those outbreaks, like raw flour in 2016 or romaine lettuce earlier this year. 

If you look at all of the foods on that list, you'll start to see patterns. There are meats like chicken, beef, and pork, as well as many animal products, like milk, cheese, eggs, and ice cream. There are a lot of plants that grow close to the ground, including alfalfa sprouts, scallions, nuts, strawberries, cucumbers, and cantaloupes. There are also minimally-processed foods, including cut or dried fruit. 

What all of these foods have in common is proximity to animal waste. Foods that come into contact with feces, be they animals (whose intestines sometimes rupture during processing) or their eggs (that can carry illness even after washing), or things those animals poop on (plants that grow close to the ground), have a higher risk for diseases that thrive in animal intestines. 

Most fresh tree fruits seem to avoid fecal contamination, which makes them relatively safe from fecal-transmitted infections like E.coli or salmonella. 

The one animal you should be worried about is humans, specifically, the tiny ones loading apples into your reusable grocery bags between coughs and nose wipes. Eating the unwashed apples handled by your kids? You might as well be bobbing for apples or licking a preschool table. But how can you not take a bite of an apple presented to you by a proud four-year old? Some things are worth the risk.