The art of governing public policy pathologies

The art of governing public policy pathologies | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The art of governing public policy pathologies Antunes Eanes Muaquesse This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8253274/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract This article examines how a food additive associated with elevated cancer risks and persistent water pollution can be maintained at the heart of contemporary food systems. Drawing on a qualitative, comparative case study of Canada, the United States, and Europe, the analysis mobilizes legal and regulatory texts, agency opinions, litigation, NGO and industry positions, as well as the scientific literature on E251. The theoretical framework combines bounded rationality and incrementalism (Simon, 1959 ; Lindblom, 1984), path dependence and gradual change (Pierson, 2000 ; Mahoney & Thelen, 2010 ), blame avoidance and non-decision (Bachrach & Baratz, 1963 ; Weaver, 1986 ), regulatory capture and advocacy coalitions (Dal Bó, 2006 ; Sabatier & Jenkins-Smith, 1999 ), as well as policy instrumentation and the biopolitics of acceptable risk (Almas, 1999 ; Foucault, 1976 ; Lascoumes & Le Galès, 2004 ). Three main findings emerge: the accumulation of health and environmental evidence without substantial revision of the standards applicable to E251; the structuring role of pro-additive coalitions in stabilizing regulatory compromises that constrain the scope of reform; and the construction, through regulatory instruments, of a carcinogenic risk rendered politically manageable and socially differentiated. On this basis, the article advances the notions of tumor policies, toxic continuity, and delinquent oncology in public action to capture regulatory regimes that organize the chronic management of toxicity rather than its effective reduction. Sodium nitrate (E251) tumor policies risk regulation regulatory capture captured public policies I. Introduction Sodium nitrate (E251) is one of those discreet compounds that circulate through our plates, groundwater, and institutional reports without ever truly taking center stage in political debate. Classified among controversial additives, associated with probable carcinogenic risks and chronic water pollution, it nonetheless remains widely used in processed meat and ultra-processed food supply chains, under standards that organize its tolerance rather than its removal (Chazelas et al., 2022 ). This article therefore poses a twofold question: how can an additive linked to excess cancer risks and persistent water contamination continue to be normalized at the core of contemporary food systems? And what does the E251 case reveal about current pathologies of public action in the regulation of food and environmental risks in Canada, the United States, and Europe? On the public health side, cohort studies and meta-analyses (Essien et al., 2022 ; Mendy & Thorne, 2024 ; Ma et al., 2018 ) converge: added nitrites and nitrates (including E251 and E252) are associated with excess cancer risks (breast, prostate, colon, stomach), sometimes at exposure levels below current regulatory thresholds, whereas plant-based nitrates, integrated into diets rich in antioxidants, appear instead to be protective. Environmentally, research on the Nitrates Directive and groundwater quality (Goodchild, 1998 ; Musacchio et al., 2020 ; Wiering et al., 2023 ) highlights the persistence, and in some regions the worsening, of nitrate concentrations despite several decades of policies aimed at reducing agricultural inputs. Taken together, these two observations show that society functions as an open-air laboratory where certain groups (children, pregnant women, rural populations relying on groundwater, consumers locked into cheap food), are highly exposed and become non-consenting trial populations in a toxic public cuisine that remains legally authorized. We propose to interpret this situation not as a simple regulatory lag but as the symptom of a pathology in the governance of risk. The state is not ignorant; it behaves like a delinquent oncologist who, despite growing knowledge of the risks, organizes a toxicity deemed acceptable rather than confronting its structural causes. This pathology unfolds at the intersection of bounded rationality and routinized incrementalism that privilege marginal adjustments (Simon, 1959 ; Lindblom, 1979 ); path dependence and gradual institutional drift that make challenging existing compromises increasingly costly (Pierson, 2000 ; Mahoney & Thelen, 2010 ); mechanisms of non-decision and blame avoidance that keep the issue in a gray zone of partial revisions and repeated expert assessments without clear arbitration (Bachrach & Baratz, 1963 ; Weaver, 1986 ); phenomena of capture and pro-additive advocacy coalitions (Dal Bó, 2006 ; Sabatier & Jenkins-Smith, 1999 ; Lacy-Nichols & Williams, 2021 ); and a biopolitics of acceptable risk, in which regulatory instruments socially and territorially distribute carcinogenic exposures deemed manageable (Beck, 1994 ; Foucault, 1976 ; Lascoumes & Le Galès, 2004 ). Existing scholarship sheds light on each of these dimensions in turn: the toxicology and epidemiology of nitrates; analyses of the Nitrates Directive and water governance; work on the risk society; research on capture and industrial influence; and studies of policy instruments and processes (Kingdon, 1984 ; Howlett et al., 2020 ; Jann & Wegrich, 2007 ; Baumgartner et al., 2006 ). Few studies, however, follow a single regulatory object over time and across multiple politico-administrative levels to weave these strands together into an integrated diagnosis. In response to this gap, the article pursues a dual objective. Empirically, it uses sodium nitrate (E251) as a qualitative, comparative case study to reveal the logics of instrumentation, regulation, and delegation that structure nitrate risk governance in Canada, the United States, and Europe. Theoretically, it develops a diagnosis that articulates bounded rationality, path dependence, non-decision, capture, and the biopolitics of risk, reading E251 as an analyzer of a delinquent oncology of public action. The contribution is threefold: empirical, by offering a multi-level case study of a controversial additive; theoretical, by bringing together several traditions in public policy analysis; and conceptual, by advancing the notions of tumor policies, toxic continuity, and delinquent oncology to characterize regulatory regimes that organize the chronic management of toxicity rather than its effective reduction. The article is structured as follows: Section II sets out the theoretical framework, section III details the case-study methodology, section IV presents the empirical findings, and section V discusses the theoretical and normative implications before the conclusion. II. Theoretical framework The E251 case highlights structural problems in how public policies are conceived and implemented. Interpreting it as a tumor embedded in the body of food and environmental policy makes it possible to articulate several theoretical contributions in a common diagnosis: the issue is no longer a regulatory delay but the deliberate maintenance of a risky additive within a pathological configuration of public action. a) Bounded rationality as organized inaction and incrementalism Bounded rationality and incrementalism help explain how institutions stabilize organized inaction. Since Simon (1959), it is difficult to treat the failure to ban a carcinogenic additive as a simple error or information deficit. Bounded rationality suggests that E251’s management reflects institutionalized satisficing: authorities maintain the additive, adjust thresholds, refine testing protocols, yet leave supply chains intact. Inaction is no longer the absence of decision, but a routinized form of reasoning under conditions of uncertainty, information overload, and political and interest-based conflict. Lindblom’s (1979) incrementalism extends this diagnosis. E251’s trajectory resembles organized muddling through, composed of small adjustments rather than decisive breaks, because most of the issue is handled within routine subsystems, while only a handful of concerns reach the central agenda (Jones, 1999). Epidemiological signals, scientific alerts, and associative mobilizations accumulate without triggering the rupture that punctuated-equilibrium theory would lead one to expect (True et al., 2007): the additive remains confined to a technical administrative regime of regulation, marginal within visible public health priorities. The garbage can model captures this dynamic as the product of contingent encounters among problems, solutions, participants, and decision opportunities within an ambiguous process (Cohen et al., 1972). Rule revisions, updates of standards, or media scandals primarily open windows for marginal tweaks (threshold adjustments, additional labeling, revised methods), without allowing the option of eliminating the additive to gain durable traction. This immobilism is explained by path-dependent effects (Pierson, 2000) and gradual institutional change (Mahoney & Thelen, 2010): decades of permissive standards and aligned instruments have generated high transition costs. Any substantial revision would affect production chains, inspection techniques, and accountability arrangements. Continuous adjustments (occasional tightening of limits, extra labeling requirements, strengthened controls) amount to sedimentation or drift: they create an appearance of movement without altering the additive itself. Forester (1984) invites us to reread bounded rationality considering power asymmetries: in contexts marked by structural inequalities, incrementalism becomes a political instrument that delays or weakens decisions costly to dominant actors. Applied to E251, this means that technical adjustments are not neutral; they render an ongoing system of contamination more tolerable, thereby avoiding an open confrontation between public health imperatives and agro-industrial interests. Finally, following Eymeri-Douzans (2021), public decision-making appears less as the choice of a single decision-maker than as the outcome of a system of action composed of routines, forums for debate, and administrative compromises. The additive’s persistence is thus better understood as ordinary governmental rationality than as an individual failure. Empirically, this framework is mobilized in Section IV.a to analyze the sequences of evidence accumulation and the near stability of standards, which together sketch a largely ineffective policy cycle. b) Regulatory capture and metastasized coalitions A second theoretical pillar mobilizes the notions of regulatory capture and advocacy coalitions. Capture, in Dal Bó’s (2006) sense, refers to the processes through which regulated industries steer regulators’ choices, directly or indirectly, in their favor. Carpenter (2013) shows that capture operates less through overt pressure than through the gradual imprinting of regulatory agencies’ professional cultures, encouraging them to prioritize innovation, competitiveness, or managed risk over strong precautionary principles. In the food sector, major corporations readily present themselves as part of the solution: they promote self-regulation, participate in partnerships with health authorities, and deploy corporate social responsibility strategies. Lacy-Nichols and Williams (2021) interpret this posture as a form of soft capture, in which rules are co-produced with those they are supposed to constrain, while the public sphere polarizes between reasonable health actors and opponents dismissed as utopian. In nutrition policy, this often leads to declaratory arrangements where political will proves insufficient to overcome industrial resistance (Cullerton et al., 2016). The advocacy coalition framework (Sabatier & Jenkins-Smith, 1999) helps characterize these arrangements by emphasizing the stability of shared core beliefs across heterogeneous actors. In our case, one can reconstruct a pro-additive coalition bringing together meat processors, agricultural unions, some academics, authorities, and experts, organized around beliefs such as the centrality of competitiveness, technical confidence, and the normality of additives in agro-industrial modernity. By contrast, networks aligned with diversity or food justice are often confined to local or technical projects, with limited access to normative arenas (Clark, 2018). These coalitions intervene throughout the policy process: initial framing within restricted expert circles; circulation of issues in narrow decision arenas; implementation relying on corporate self-regulation; and evaluation reduced to formal compliance (Jann & Wegrich, 2007). These dynamics interact with constraints on political attention: government agendas are saturated, and additives are relegated behind issues deemed more pressing (climate, employment, health in a broad sense) (Baumgartner et al., 2006). Constructing public problems requires framing, dramatization, and generalization (Hilgartner & Bosk, 1988; Neveu, 1999; Cefaï & Terzi, 2020; Kingdon, 1984). As long as cancers are depicted in vague lifestyle terms rather than as consequences of specific chemical exposures, the responsibility of industry and authorities remains diffuse (Stone, 1989). Public responses then take the form of symbolic rearrangements (gradual dose reductions, awareness campaigns, labeling) that create the illusion of action without truly challenging the additive regime (Zittoun, 2013). Woll (2019) uses the notion of captured regulation to describe this type of configuration, in which government actors themselves, through their choice of instruments and forums, contribute to limiting their own capacity to impose genuinely binding standards. Empirically, this pillar structures the analysis of actor configurations, belief systems, and instruments in Section IV.b, dedicated to metastasized coalitions and the stabilization of a pro-additive status quo. c) The rational silence of invisible power A third theoretical strand brings together non-decision, blame avoidance, and a situated critique of rational choice theory. From a perspective inspired by Downs (1957) and Olson (1971), one would expect governments seeking to maximize support to arbitrate between electoral costs and health benefits, and diffuse groups (exposed consumers) to organize in defense of their interests. Yet the risks associated with E251 are diffuse, delayed, and socially unequal, making it difficult to build powerful coalitions, whereas the economic costs of a ban are concentrated and defended by well-organized actors. The notion of non-decision (Bachrach & Baratz, 1963) is illuminating here: power also lies in the ability to prevent certain issues from fully reaching the agenda or from being decisively settled. In the case of E251, one can speak of structured non-decision: the politico-administrative apparatus keeps the file in a gray zone by multiplying additional studies, consultations, expert assessments, and impact evaluations, without ever embracing an outright ban. Weaver (1986) shows that this strategy is rational from the standpoint of blame avoidance: voters’ negativity bias encourages officeholders to shun decisions that create identifiable losers. Banning E251 would entail visible costs for well-entrenched sectors and territories with strong mobilization capacities, while health gains would be probabilistic, diffuse, and hard to attribute to a specific measure, especially given how deeply blame-avoidance logics structure health and environmental policy (Caune, 2019). Authorities thus have an interest in sheltering behind expert procedures, independent agencies, and technoscientific reference frames that disperse responsibility, dilute accountability, and defer the moment of decision. Rational choice theory remains relevant for analyzing utilitarian strategies and certain dynamics of collective action (Downs, 1957; Olson, 1971), but the E251 case suggests reintegrating it within a broader conception of rationality attentive to the social construction of problems, power asymmetries, and path-dependent effects. In this light, the pathology of public action appears as the product of an institutional configuration that makes it politically, economically, and cognitively more costly to fully protect bodies than to tolerate a toxicity deemed manageable. E251 thus becomes an analyzer of governance through non-decision: recognizing, documenting, and administering risk without crossing the threshold of rupture. This third pillar underpins Section IV.a, and informs the cross-reading of Sections b and c, where the additive’s persistence is interpreted as the outcome of governing danger through postponement, dilution, and chronic management rather than robust prevention. III. Methodology This research takes sodium nitrate (E251) as an entry point to interrogate a broader problem of public action: the persistent gap between knowledge of health and environmental risks and the effectiveness of regulatory policies. It is situated within the tradition of qualitative case studies as developed by Yin (2014, 2018) and Gagnon (2010), which is particularly suited to analyzing a contemporary phenomenon in its context when the boundaries between the object and its environment are blurred and « how? » and « why? » questions dominate. a) Research design and comparative framework The article adopts a qualitative, comparative approach. The case concerns the governance of E251 and, more broadly, the regulation of this additive in food and environmental policy. It is treated as an instrumental case: the aim is to use it as an analyzer of logics of instrumentation, governance architectures, and implicit trade-offs in the distribution of exposures (Lascoumes & Le Galès, 2004; Lascoumes & Simard, 2011; Halpern et al., 2014). The perspective is explicitly comparative. The analysis juxtaposes three politico-institutional arenas, like Canada, the United States, and Europe, to identify both convergences (stable thresholds, weight of pro-additive coalitions, fragmented responsibilities) and divergences (regulatory styles, degree of judicialization, role of civil society, or uses of the precautionary principle). The study period runs from the early 1990s (adoption of the 91/676/EEC Nitrates Directive and consolidation of North American drinking water standards) to 2025, with particular emphasis on the last two decades, marked by intensifying controversies over nitrites and nitrates and major regulatory revisions. The purpose is not to produce a statistical generalization to all risk policies but an analytical generalization in Yin’s sense: to test, through E251, a set of mechanisms and theoretical propositions about risk governance that can be transposed to, and debated in, other configurations (glyphosate, endocrine disruptors, persistent pesticides). b) A multi-level documentary corpus The study relies on systematic documentary analysis in Bowen’s (2009) sense, treating documents as social facts that condense choices, compromises, and power relations. Material was collected between 2022 and 2025 from scientific databases (uOttawa Library, Policy Sciences, Politics and Policy), agency websites (Canada, United States, European Commission), government portals, and civil society organizations. We retained texts produced between 1990 and 2025 that met three criteria: explicit mention of nitrates, nitrites, and, or E251; recognized status in regulation or public debate (legal or regulatory text, agency opinion, official report, position paper from a non-governmental or professional organization, or scientific document); and substantive contribution to understanding risk definitions, the instruments used, or the allocation of responsibilities. Strictly media content (general press, op-eds without analytical dimension) and redundant documents that did not add information beyond already included texts were excluded. The documentary corpus is structured across several levels, beginning with legal and regulatory texts. For Canada: drinking water standards (Health Canada), additive regulations (Canadian Food Inspection Agency), guidelines, and expert opinions. For the United States: Environmental Protection Agency (EPA) drinking water standards and Food and Drug Administration (FDA) and United States Department of Agriculture (USDA) provisions regarding additives and meat products. For Europe: the General Food Law, the Nitrates Directive, regulations on additives (including E251), and opinions and guidance from the European Food Safety Authority (EFSA). The analysis also draws on risk-regulation agency reports and opinions, in particular the EFSA opinion coordinated by Mortensen et al. (2017) on nitrates and nitrites, and the review commissioned by the UK Food Standards Agency (Kaur et al., 2025), as well as national reports on the implementation of the Nitrates Directive and on drinking water quality in Canada, the United States, and EU member states. In addition, we examine documents such as NGO and food-justice advocacy reports and communiqués, professional organizations’ positions, agro-food industry statements, and contributions to public consultations. These materials help identify coalitions of interests, their risk framings, and their preferred instruments (Woll, 2019; Lacy-Nichols & Williams, 2021). The corpus further includes scientific work on nitrates, water governance, and epidemiological and toxicological risk (Chazelas et al., 2022; Essien et al., 2022; Mendy & Thorne, 2024; Preston-Martin et al., 2000; Erichsen et al., 2024); environmental policy and implementation of the Nitrates Directive (Goodchild, 1998; Musacchio et al., 2020; Wiering et al., 2023; Středová, 2024); and analyses of food risk governance and fragmented public action (Cheftel, 2011; El Gemayel, 2025; Mechanic, 1978). The balance is not perfectly symmetrical across the three regions. The European Union is slightly overrepresented due to the density of its regulatory and evaluative production, but each region has a substantial core of comparable texts (standards, opinions, reports, position papers) allowing for systematic comparison. c) Analytical strategy and coding procedure The analysis combines three complementary registers: content analysis, sequence reconstruction, and interpretation through instruments. c.a) - Content analysis Documents underwent thematic analysis using qualitative data analysis software. The coding scheme combines deductive categories derived from the theoretical framework (bounded rationality, path dependence, capture, coalitions, non-decision, biopolitics of acceptable risk, types of instruments) and inductive categories developed during reading (formulations of uncertainty, justificatory registers, delegation and self-regulation devices). The unit of coding is the paragraph or section, to capture argumentative sequences rather than simple lexical occurrences. Approximately 15% of texts, distributed across the three regions, were double coded a few weeks apart to check intra-coder reliability and refine category definitions. The work is organized around structuring questions inspired by Bowen (2009): how is the risk associated with E251 defined (so-called acceptable thresholds, safety margins, uncertainty registers)? Which policy instruments are used (regulation, self-monitoring, labeling, economic incentives, informational devices)? How are responsibilities distributed among states, agencies, industry, farmers, local authorities, and consumers? For the comparative dimension, a common grid was built from Hood’s (1983) NATO typology (nodality, authority, treasure, organization) and Vedung’s (1998) « sticks, carrots, and sermons » classification. Each Canadian, American, or European text is thus read through the same dimensions, which makes it possible to compare the toolboxes deployed to regulate E251 and nitrates. c.b) - Reconstruction of critical sequences Some episodes were then analyzed using process tracing: adoption or revision of standards, agency opinions, scandals or litigation, and threshold adjustments. The aim is to reconstruct, for a few emblematic sequences, the chain of events: what triggers a revision or agenda-setting? Which actors intervene at each stage (agencies, ministries, industry, NGOs, courts)? Which compromises are stabilized and which options are ruled out? The work of Musacchio et al. (2020), Wiering et al. (2023), and Středová (2024) offers useful points of comparison for interpreting gaps between stated ambitions and the near stability of pollution levels, while the analyses of Mechanic (1978) on fragmentation and implementation games provide additional interpretive leverage. c.c) Interpretation through instruments and regulatory regimes Finally, the corpus is interpreted in light of work on policy instrumentation (Lascoumes & Le Galès, 2004; Lascoumes & Simard, 2011; Eliadis et al., 2005; Halpern et al., 2014), third-party government (Salamon, 2002), regulatory styles (Woll, 2019; Varone, 2000; Howlett, 2000; Vedung, 1998), and risk regimes (Beck, 1994; Chatalova et al., 2016). The aim is to show that instrument choice (numerical standards, HACCP schemes, labels, certifications, voluntary commitments, participatory forums) encodes political compromises and implicit hierarchies between health protection, economic competitiveness, and institutional stability, thereby preparing the empirical analysis of “tumor policies” in Section IV. d) Limits and scope of analytical generalization This approach has several limitations: dependence on document availability (and thus on countries with more extensive public data), absence of interviews with decision-making actors, and a focus on North American and European contexts. The material is neither exhaustive nor perfectly balanced, but it is sufficiently diverse to reveal regularities in risk definitions, favored instruments, and stabilized compromises. Within an analytical generalization framework, E251 is treated as a sentinel of a broader pathology of public action: chronic management of toxicity rather than its reduction. The results are not claimed to apply to all substances or all contexts but instead offer a bundle of theoretical mechanisms that can be tested, refined, or contested using other empirical cases. IV. Results This section presents the main insights from the comparative analysis of sodium nitrate (E251) regulation and, more broadly, of nitrate/nitrite governance in food and environmental policy. As the analysis unfolds, E251 ceases to appear as a mere technical additive and becomes an analyzer of failures in risk governance: it reveals tumor policies, understood as dense normative configurations (laws, labels, agencies, audits, consultations) that nonetheless leave largely intact the problem they purport to regulate. Three findings structure this section: the accumulation of evidence without substantial revision of standards, the decisive role of pro-additive coalitions in locking in the status quo, and the production, through regulatory instruments, of a carcinogenic risk rendered politically governable and socially differentiated. a) Accumulation of evidence, stable standards: a largely ineffective policy cycle If one took the idealized policy cycle as a decision-making model, E251’s trajectory ought to be linear: evidence accumulation, threshold revision, and substitution or prohibition of the additive. The empirical material leads to the opposite conclusion: health and environmental knowledge advances while the normative architecture remains largely unchanged. a.a) Europe In Europe, cohort studies, particularly NutriNet-Santé (Chazelas et al., 2022; Essien et al., 2022), establish robust links between added nitrites and nitrates (E250, E251, E252) and excess cancer risks (breast, prostate, colon, stomach), while plant-based nitrates within antioxidant-rich diets appear protective. Regular consumers of nitrate/nitrite-rich additives emerge as the most exposed, shifting the focus back to industrial uses in ultra-processed products. Environmentally, work on the Nitrates Directive (Goodchild, 1998; Musacchio et al., 2020; Wiering et al., 2023) highlights persistent, and sometimes worsening, groundwater contamination despite three decades of vulnerable zones and action programs. Středová (2024), for example, shows how spreading calendars based on outdated climatic references authorize nitrogen applications at times when crops can no longer absorb it, maximizing leaching toward aquifers. Yet the main normative benchmarks evolve only at the margins. The EFSA opinion coordinated by Mortensen et al. (2017) maintains the acceptable daily intake (ADI) for nitrites at 0.07 mg/kg/day while acknowledging that infants and children may exceed this value when cumulative exposures are considered and emphasizing the issue of carcinogenic nitrosamines. The underlying structure of thresholds and evaluation methods is confirmed, accompanied by recommendations and calls for further research rather than a fundamental redefinition of basic parameters. a.b) Canada In Canada, analyses compiled by the Council of Canadian Academies (2013) document high nitrate concentrations in certain rural and agricultural areas, particularly in communities reliant on private wells. The risks are explicitly discussed, but public responses primarily take the form of responsibility shifts onto households, municipalities, or farmers: household treatment technologies, local programs, limited practice adjustments. Federal and provincial drinking water standards, initially designed to prevent methemoglobinemia, are only marginally reconsidered considering long-term cancer risks. In the food sector, the regulatory framework remains aligned with thresholds like those in the United States and Europe. The use of E251 and E252 remains authorized in certain meat-processing chains, subject to labeling requirements and controls embedded in HACCP systems. The texts examined show the predominance of arguments based on microbiological safety and supply-chain stability, while the issue of chronic exposure is relegated to the background. a.c) United States In the United States, the meta-analysis by Essien et al. (2022) and the work of Mendy and Thorne (2024) using NHANES data indicate that increases in drinking-water nitrates are associated with excess cancer mortality, sometimes at levels below the regulatory limit of 10 mg/L NO₃-N. Here again, drinking water standards, initially set to prevent infant methemoglobinemia, are rarely revisited despite the shift in concern toward cumulative carcinogenic exposures. On the food side, FDA and USDA provisions govern the use of nitrites and nitrates in meat products, but examination of opinions and industry guidance reveals logics like those observed in the two other regions: emphasis on preservation and botulism prevention, highlighted uncertainties, and calls for moderate use, without challenging routine practices. Major North American cohorts (National Institutes of Health and American Association of Retired Persons-NIH-AARP Diet and Health Study, Iowa Women’s Health Study), as synthesized in available reviews, have connected processed-food nitrites to cancers of the prostate, kidney, or bladder since the late 2000s. a.d) A slowed decision cycle Taken together, these elements trace a common pattern: health and environmental warning signals multiply, regulatory thresholds and evaluative frameworks remain largely stable, and adjustments are mainly marginal (recommendations, labels, minor ADI changes). They do not culminate in either an E251 ban or an ambitious overhaul of nitrate regimes in water. Procedural policy-cycle models thus appear more as normative references than accurate descriptions of actual dynamics: agenda-setting remains partial, formulation is confined to technocratic arenas, decision-making ratifies limited compromises, and implementation and evaluation rarely lead to major revisions. Agenda-setting theories (Kingdon, 1984; True et al., 2007) help illuminate this paradox in the background, but the core finding is empirical: in all three regions, central protective instruments evolve far more slowly than risk knowledge. Finally, participatory mechanisms, like public consultations on water quality, watershed committees, participatory devices in environmental action plans, appear only at the periphery of decisions concerning E251 and nitrates. When they do exist, they seem to have limited weight in altering already stabilized technical and economic compromises (DeLeon, 2006; Kathryn & Bryson, 2022). b) Transnational lock-in of the status quo The second finding shows how pro-additive coalitions, in all three contexts, contribute to locking in E251’s trajectory. These configurations do not merely defend a single additive; they constantly reconfigure instruments, narratives, and decision arenas in ways that make any challenge to the status quo politically costly. In Canada, documents from agro-industrial sectors and agricultural organizations echo European findings. Representatives of processed meat and beef sectors mobilize a repertoire combining rural employment protection, economic viability, and immediate sanitary safety. By contrast, positions taken by NGOs and health associations appear more dispersed and less institutionalized than in the European Union. Debates on rural drinking water quality highlighted by the Council of Canadian Academies (2013) illustrate this gap: nitrate concerns translate more into support for local infrastructure or household-level measures than into direct confrontation with professional organizations or agrifood value chains. The pro-additive coalition is less discursively structured but exerts substantial influence through its economic and political embeddedness. In the United States, strategies described in the literature on unhealthy commodities (Moodie et al., 2013) and on food industry influence (Nestle, 2016) are clearly visible in the material analyzed. Professional associations, industry-linked think tanks, and research centers funded by private capital produce reports and comments that downplay nitrite/nitrate risks or stress the uncertainty of available data. The “ part of the solution ” strategy described by Lacy-Nichols and Williams (2021) is reflected in the self-commitments of some large firms: marketing of “no added nitrites” meats (relying on nitrate-rich plant extracts), proliferation of reassuring labels, and partnerships with agencies on nutrition or physical activity. Parker et al. (2021) show how such labeling reforms privatize regulation: the burden of choice is shifted to consumers, while fundamental parameters governing additive use remain mostly unchanged. In Europe, Sievert et al. (2021) highlight obstacles to reducing red and processed meat consumption, showing how the meat industry combines economic power, cultural legitimacy (the centrality of meat and charcuterie in diets), and institutional anchoring (subsidies, tax regimes, trade agreements). Professional organizations’ positions and contributions to consultations on additives stress the need to preserve microbiological safety and sectoral competitiveness, framing E251 as an indispensable technical tool. At the same time, health-environment NGOs active in Commission or member-state consultations sometimes gain partial advances (lowering certain thresholds, strengthening labeling) without securing a political priority for banning E251. Analysis of contributions shows that standards are largely co-authored with industry, which proposes formulations, timelines, and exemptions in a spirit akin to voluntary commitments (Lacy-Nichols & Williams, 2021). Across all three configurations, the analysis reveals pro-additive coalitions endowed with significant resources (funded expertise, privileged access to decision-makers, media reach, economic weight), health-environment coalitions that are more fragmented, less resourced, and often confined to local or sectoral initiatives, and a tendency to shift the issue into technical forums (expert committees, working groups, consultations) rather than politicized arenas (parliaments, major media). This imbalance keeps E251 in a zone of low political visibility where negotiated adjustments with dominant actors appear as the only realistic options. It is this proliferating and adaptive character of coalitions, colonizing instruments (labels, voluntary commitments), knowledge (funded research), and arenas (public–private partnerships), that underpins the metaphor of metastasized coalitions. c) The making of societally risky public policies The third finding highlights a configuration in which, across the three arenas studied, E251 regulation contributes to the production of societally risky public policies. In Europe, EFSA opinions (Mortensen et al., 2017), the UK FSA review (Kaur et al., 2025), and epidemiological research (Erichsen et al., 2024; Essien et al., 2022; Preston-Martin et al., 2000) converge on particularly exposed groups: children, infants, residents of areas with high nitrate concentrations, and regular consumers of processed meats. Plausible links with various cancers and chronic conditions are acknowledged, but regulatory responses remain directed toward management rather than elimination of danger: ad hoc ADI adjustments, moderation recommendations, and promotion of organic alternatives. Quantified standards (ADIs, the 50 mg/L threshold for nitrates in water), additive-positive lists, HACCP devices, and labels function as technologies of government: they organize the distribution of exposures across the population and implicitly set a level of morbidity considered tolerable. The biopolitical dimension discussed in the theoretical framework finds concrete expression in how texts delineate risks and define target publics. In Canada, official and scientific documentation emphasizes exposure inequalities linked to rural and agricultural contexts. Drinking water norms and national guidelines acknowledge these vulnerabilities, but the instruments chosen (targeted aid programs, local technical interventions, usage recommendations) have the effect of territorializing risk management rather than questioning nitrogen-input regimes or threshold relevance. In the food arena, the combination of federal rules and voluntary industry initiatives produces an assemblage in which nitrate/nitrite-rich products coexist with natural or no added nitrites lines. Risk partly becomes a function of choice capacity and purchasing power, with certain consumer groups confined to more exposed, low-cost product ranges. In the United States, data on nitrates in water (Essien et al., 2022; Mendy & Thorne, 2024) show that high exposures particularly affect rural communities and low-income populations. The dominant instruments (unchanged federal standards, local responsibility for compliance, informational devices) shape a landscape in which health vulnerability closely tracks socio-territorial position. In food systems, the coexistence of ultra-processed products containing nitrites and good label lines aimed at higher-income market segments accentuates this differentiation. Existing policies treat E251 as a technically manageable risk rather than as a matter of health justice. Taken together, these elements suggest that the pathology of public action does not rest solely on vertical capture by industrial interests. It is rooted in a mode of government that, through its instruments, standards, and routines, produces a harmful normality: exposures are identified, monitored, and modeled, but the question of their social, territorial, and intergenerational acceptability is rarely posed directly. In this context, sodium nitrate (E251) can be read as an administrative tumor: a problematic element that authorities seek to manage and compartmentalize rather than remove. Comparing Europe, Canada, and the United States reveals distinct regulatory styles but a shared underlying logic: recognizing, constraining, and distributing risk without pursuing structural detoxification of agricultural and food systems. These results set the stage for the discussion, which draws out their theoretical implications. V. Discussion The E251 case brings us back to the two questions that structure the analysis: how can a product associated with elevated cancer risks be maintained, monitored, yet normalized at the heart of large-scale agrifood chains? And what does this paradox reveal about societal risk, the government of bodies, and institutional capacity to confront dangers they themselves help to organize? The hypothesis of a delinquent oncology of public action refers to a politico-institutional order that learns less to reduce toxicity than to administer, distribute, and legitimize it, rendering it socially presentable. In Beck’s (1994) risk-society perspective, sodium nitrate confirms the shift toward risks produced by industrial modernity itself. Almås (1999) shows how proliferating food scandals and competing expertise’s transform food safety into a matter of trust and governance. E251 becomes paradigmatic for this reflexive modernity: individual disease probabilities remain statistically moderate, yet uncertainties about long-term effects, combined with other substance, overlay the complexity of production chains. In this context, labeling offers largely illusory protection. As with genetically modified organisms (GMOs) or herbicide-resistant weeds discussed by Almås, responsibility is transferred to consumers, who are expected to keep their own danger ledger based on technical, fragmented, and hard-to-interpret information. Chatalova et al. (2016) extend this diagnosis by linking Beck to the technological treadmill: agricultural intensification and industrial food processing generate productivity gains at the price of a risk treadmill in which economic benefits concentrate upstream while health and ecological costs are shifted onto consumers and health systems. Embedded in standardized meat-processing and transformation processes, E251 helps ensure microbiological safety in long, globalized supply chains while contributing to a diffuse carcinogenic danger, poorly attributable at the individual level but cumulative at population scale. The presence of sodium nitrate in ultra-processed foods dominated by agro-industrial oligopolies reflects a globalized food regime that prioritizes profit over public health (Stuckler & Nestle, 2012; Millstone & Lang, 2003). Mapping the concentration of firms and the spread of fast-food chains illustrates how certain product combinations (processed meats, additives, sugary beverages) diffuse first in North America, then in Europe and emerging economies. E251 regulation is largely designed not to disrupt these transnational value chains. A Foucauldian lens further sharpens this diagnosis. Fraser et al. (2019), in their work on the reconfiguration of stroke care in London, show how authorities construct a case, quantify risk, identify a hazard (inequalities in access to specialized care), and organize a spatialized response. Transposed to food systems, this case, risk, crisis schema, illuminates E251’s management by contrast: health authorities appear to have a clearly documented case without ever treating it as a genuine public crisis. The additive is recognized as problematic, thresholds are adjusted at the margins, but the production infrastructures that make it functional remain unchanged. Where stroke has prompted a biopolitics of visible risk reduction, sodium nitrate instead falls under a biopolitics of stabilization: toxicity is administered, an admissible dose is calculated, but the legitimacy of exposure itself is left largely unexamined. Debates on disability surveillance show that monitoring devices oscillate between exclusionary and affirmative biopolitics, depending on whether data collection serves to control populations or to document barriers and strengthen rights (Saltes, 2013). In the food domain, a similar tension characterizes residue and contaminant monitoring: depending on design, such instruments can entrench the status quo or render certain exposures politically intolerable. Delinquent oncology, as it emerges here, emphasizes public action’s capacity to co-produce oncogenic exposures while shifting social costs elsewhere. Han’s (2022) analysis of China shows how artificial food risks are unevenly distributed: advantaged groups turn to supposedly safer circuits, whereas poorer populations, with fewer economic and informational resources, remain trapped in cheaper, more hazardous products. There is little evidence that North American or European trajectories escape this logic: consumption of nitrate-rich processed foods is often concentrated among working-class groups, caught in a double bind, participating in the food market without the capital needed to shield themselves from its risks. This dimension raises questions about a weakened moral foundation of public action that implicitly rests on a hierarchy of lives and diseases considered acceptable. Cancers induced or aggravated by legally regulated exposures are diluted in chronic disease statistics, without spectacular images or salient political events, and are ill-suited to crisis staging (Fraser et al., 2019). The E251 case confirms, while reframing, Beck’s (1994) critique of organized irresponsibility. From the standpoint of public action theories, sodium nitrate also exposes the limits of conceptions overly centered on decision as the nodal moment. Commaille (2019) reminds us that the sociology of public action invites attention to multiple, multi-level, heterogeneous actor configurations. Public policy must be analyzed as a system of action in which actions and non-actions, substantive content and instruments, administrative outputs and social effects are intertwined (Mény & Thoenig, 1989). Within this perspective, the fixation of thresholds and the authorization or prohibition of an additive, often framed as the decent decision, run the risk of obscuring downstream risk normalization: standardized industrial processes, control routines, and labeling schemes. E251 thus leads us to revisit DeLeon’s (2006) critique of technocratic political science: promises of rational control collide with action regimes marked by legitimacy crises, sporadic scandals, and institutional compromises. The policy-process frameworks (Weible & Sabatier, 2017) remain heuristic tools for deciphering this case. The coalition approach reveals, around sodium nitrate, a pro-productivist coalition (agro-industry, economic ministries, experts focused on microbiological safety), and a more diffuse coalition centered on health and the environment. The structural weakness of the latter, faced with a technically complex and low-visibility issue, contributes to the stability of the path followed. Punctuated-equilibrium theory (True et al., 2007) suggests that only highly mediatized crises (drinking-water scandals, revelations of massive contamination) open windows for punctual policy corrections. In their absence, equilibrium takes the form of a succession of marginal adjustments. The notion of regulatory capture must, however, be nuanced considering Carpenter (2013). His reconstruction of FDA history shows that Stiglerian capture through entry barriers poorly describes early phases of pharmaceutical regulation. More recently, by contrast, budgetary vulnerability, fee dependence, and cultural capture of evaluative categories have become central. By analogy, E251 regulation is less a matter of frontal capture, where industry directly imposes its norms, than of progressive stabilization, in which agencies internalize an implicit compromise: better to accept a supposedly controlled carcinogen than risk botulism scares or destabilize export-oriented sectors. Palier and Surel’s (2005) « three I’s » framework helps restate this finding. Institutions (EU directives, standards, health agencies), interests (agro-industry, exports, jobs), and ideas (food modernity, microbiological safety) interlock to stabilize a regime in which a potentially carcinogenic additive paradoxically becomes a safety instrument. This stabilization unfolds within a path-dependent dynamic (Pierson, 2000): once industrial infrastructures, operational protocols, and dietary habits have been organized around the additive, technological, economic, and political switching costs become very high. Cold-chain logistics, manufacturing methods, consumption practices, and administrative routines thus generate increasing returns that make abandoning E251 difficult even where alternatives exist. Public action finds itself in a paradoxical situation: the system can identify risks yet remains trapped on a path where the radical option (a ban) appears too costly or uncertain. Mahoney and Thelen (2010) and Muller (2005) nonetheless warn against inferring absolute irreversibility: transformations can emerge through progressive revision of rules and referentials. Cognitively, sodium nitrate is underpinned by a sectoral referential focused on microbiological risk prevention, itself articulated with a more general referential of productivity and market efficiency. As long as this pairing remains hegemonic, long-term carcinogenicity is reclassified as an acceptable risk. Actors such as epidemiologists, NGOs, and some international organizations seek to introduce alternative frames (dietary sobriety, primacy of environmental health, strengthened precautionary principle). These competing referential remain minority positions, but the removal of nitrites by some retailers, local experiments with bans in school cafeterias, and stricter labeling requirements signal early stages of institutional redesign: recomposed alliances, challenges to the dominant referential, and rising political costs associated with maintaining the status quo. This case brings to light certain blind spots in political science, already noted by DeLeon (2006). Emerging in part from a desire to respond to legitimacy crises (Vietnam, Watergate, energy crises) (pp. 44–50), the field still struggles to apprehend extended forms of violence and diffuse blind policies that shape issues such as food toxicity. By focusing on decision quality, policy coherence, or instrument effectiveness, one risks sidelining the moral question: how many cancers induced by legally regulated exposures does a society deem acceptable, and for which groups? Delinquent oncology designates precisely this blind zone where instrumental rationality encounters its own ethical limits. The analysis centers on a specific additive, in predominantly North American (Canada, United States) and European contexts, and relies mainly on documentary materials rather than on direct investigation of decision-making arenas or industrial sectors. Other substances (glyphosate, endocrine disruptors, persistent pesticides) and other configurations (the Global South, peasant agricultures, Indigenous food systems) could corroborate, nuance, or challenge this diagnosis. In Canada, for example, in northern British Columbia, the Lheidli T’enneh First Nation announced in November 2025 a ban, albeit largely symbolic, on herbicide use, particularly glyphosate, over a territory that includes the city of Prince George and the Robson Valley. Such initiatives hint at alternative configurations of power and normativity around toxic risks. The emphasis on institutions and risk regimes here also partly sidelines consumers’ everyday practices, existing forms of resistance, and possible transformations of food systems. Nonetheless, sodium nitrate plays a revealing role: it exposes tensions between the risk society, the government of bodies, and path dependence, showing how complex public action can simultaneously protect, expose, treat, and allow the proliferation of cancers deemed acceptable. It is from this diagnosis, and its blind spots, that one can begin to sketch, in other contexts, the conditions for a less delinquent public response to the health crisis it currently helps to produce. VI. Conclusion This article examined how an additive now associated with heightened cancer risks and chronic water pollution can remain widely used and regulated at the core of contemporary food systems, and what the sodium nitrate (E251) case reveals about the fragilities of food and environmental risk-management policies in Canada, the United States, and Europe. Three main conclusions emerge. First, health and environmental evidence can no longer be treated as peripheral signals: large cohort studies and meta-analyses (Chazelas et al., 2022; Essien et al., 2022; Mendy & Thorne, 2024; Bouvard et al., 2015; Ma et al., 2018) establish robust links between additive nitrates and nitrites, waterborne nitrates, and excess cancer risks, while research on the Nitrates Directive and groundwater (Goodchild, 1998; Musacchio et al., 2020; Wiering et al., 2023) demonstrates the persistence, and sometimes aggravation, of contamination levels. Second, this body of evidence coexists with marked normative inertia: agency opinions (Mortensen et al., 2017; Kaur et al., 2025) exemplify a kind of inverted precautionary principle, in which gradual adjustments to ADIs and additive lists effectively reconfirm an architecture based on the routine use of nitrate preservatives, within a policy cycle that remains durably jammed (Howlett et al., 2020; Mény & Thoenig, 1989; Jann & Wegrich, 2007). Third, the hypothesis of metastasized coalitions is supported: the advocacy coalition framework (Sabatier & Jenkins-Smith, 1999; Weible et al., 2017, 2025) reveals a dominant pro-additive coalition (agro-industry, economic administrations, microbiological-safety experts) facing more diffuse and under-resourced health–environment coalitions (Clark, 2018; Moodie et al., 2013; Nestle, 2016; Lacy-Nichols & Williams, 2021), such that E251 appears less as an oversight than as the ordinary product of a continuous political process. Theoretically, the sodium nitrate case is proposed as an analyzer of a delinquent oncology of public action. By combining bounded rationality and incrementalism (Simon, 1959; Lindblom, 1979; Jones, 1999), path dependence and gradual change (Pierson, 2000; Mahoney & Thelen, 2010), non-decision and blame avoidance (Bachrach & Baratz, 1963; Weaver, 1986), capture and coalitions (Dal Bó, 2006; Carpenter, 2013; Sabatier & Jenkins-Smith, 1999; Weible et al., 2017, 2025), the risk society (Beck, 1994; Chatalova et al., 2016), and the biopolitics of regulation (Foucault, 1976; Lascoumes & Le Galès, 2004), the article advances the idea of an enlarged rationality of public decision-making. The goal is no longer simply to explain trade-offs through utility calculations, but to grasp regimes of disease normalization and socially unequal exposure. The notions of tumor policies, metastasized coalitions, and toxic continuity aim to capture configurations in which technical sophistication, the multiplication of actors, and normative density coexist with a persistent inability to reduce risk in practice: instrumentation becomes pathological, organizing a biopolitical management of an acceptable cancer rather than a collective detoxification effort. This diagnosis calls for a shift in criteria for evaluating public policies. Beyond internal coherence or cost-benefit balance, it is necessary to interrogate implicit choices about which lives and diseases are considered bearable, which groups are more exposed (working-class populations, consumers dependent on cheap food, rural and Indigenous communities), and how responsibility is shifted to individuals via labeling and better choice rhetoric. Normatively, this points toward a strengthened precautionary principle (reversing the burden of proof on additives and cumulative exposures, empowering more independent and better-resourced agencies, opening threshold revisions to public deliberation), integrated nitrogen cycle management (from soil to plate) that links agricultural, environmental, and health policies, and more substantial support for health-environment coalitions. For research, several extensions emerge: expanding the analysis to other sentinel substances (endocrine disruptors, persistent pesticides) and other geopolitical configurations, and documenting through fieldwork the mechanisms of diffuse capture and non-decision, as well as ordinary practices of consumption and resistance (community kitchens, short food chains, public canteens). 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Increasing Returns, Path Dependence, and the Study of Politics. The American Political Science Review, 94(2), 251-267. https://doi.org/10.2307/2586011 Pressman, J. L., and Wildavsky, A.B. (1984). Preface to the third edition, Preface & Appearances, in Implementation: How Great Expectations in Washington Are Dashed in Oakland. 3rd ed. (1973). Berkeley: University of California, pp. xv-xxvi, 1-6. Preston-Martin, S., Pogoda, J. M., Mueller, B. A., Lubin, F., Modan, B., Holly, E. A., Filippini, G., Cordier, S., Peris-Bonet, R., Choi, W., Little, J., & Arslan, A. (1998). Results from an International Case-Control Study of Childhood Brain Tumors: The Role of Prenatal Vitamin Supplementation. Environmental Health Perspectives, 106, 887-892. https://doi.org/10.2307/3434206 Roberts, H. (1993). [Rev. of Risk Society: Towards a New Modernity]. Sociology (Oxford), 27(4), 708-709. Sabatier, P. & Jenkins-Smith, H. (1999). The Advocacy Coalition Framework : An Assessment, in Sabatier, P. (ed.), Theories of the Policy Process, Boulder (Colo.), Westview Press, p. 117-166. http://faculty.cbpp.uaa.alaska.edu/afgjp/PADM606/The%20Advocacy%20Coalition%20Framework.pdf Salamon, L. M. (Eds.). (2002). The Tools of Government: A Guide to the New Governance. Oxford University Press. Saltes, N. (2013). ‘Abnormal’ Bodies on the Borders of Inclusion: Biopolitics and the Paradox of Disability Surveillance. Surveillance & Society , 11 (1/2), 55-73. https://doi.org/10.24908/ss.v11i1/2.4460 Sievert, K., Lawrence, M., Parker, C., & Baker, P. (2021). Understanding the Political Challenge of Red and Processed Meat Reduction for Healthy and Sustainable Food Systems: A Narrative Review of the Literature. International Journal of Health Policy and Management , 10 (12), 793-808. https://doi.org/10.34172/ijhpm.2020.238 Simon, H. A. (1959). Theories of Decision-Making in Economics and Behavioral Science. The American Economic Review, 49(3), 253-283. Stone, D. A. (1989). Causal Stories and the Formation of Policy Agendas. Political Science Quarterly , 104 (2), 281-300. https://doi.org/10.2307/2151585 Středová, H., Fukalová, P., Chuchma, F., Haberle, J., & Středa, T. (2024). Nitrates directive restriction: To change or not to change in terms of climate change, that is the question. The Science of the Total Environment , 917 , Article 170381. https://doi.org/10.1016/j.scitotenv.2024.170381 Stuckler, D., & Nestle, M. (2012). Big Food, Food Systems, and Global Health. PLoS Medicine , 9 (6), e1001242. https://doi.org/10.1371/journal.pmed.1001242 True, J., Jones, B., Baumgartner, F. (2007), « Punctuated Equilibrium Theory. Explaining Stability and Change in Policy Making », in Sabatier, P. (dir.), Theories of the Policy Process, Boudler (Colo.), Westview Press, p. 155-187. https://ruby.fgcu.edu/courses/twimberley/EVR2861/theorypolprocess.pdf Varone, Frédéric. (2000). « Le choix des instruments de l'action publique : analyse comparée des politiques énergétiques en Europe et Amérique du nord », Revue internationale de politique comparée , 7 (1), p. 167-201 ou 2001. « Les instruments de la politique énergétique : analyse comparée du Canada et des États-Unis », Revue canadienne de science politique , 34 (1), p. 3-28. Vedung, E. (1998). Policy Instruments: Typologies and Theories. In E. Vedung, R. C. Rist, & M.-L. Bemelmans-Videc (Eds.), Carrots, Sticks & Sermons (1st ed., pp. 21-58). Routledge. https://doi.org/10.4324/9781315081748-2 Vogel, E. M., Burt, S. D., & Church, J. (2010). Case Study on Nutrition Labelling Policy-making in Canada. Canadian Journal of Dietetic Practice and Research , 71 (2), 85-92. https://doi.org/10.3148/71.2.2010.85 Weaver, R. K. (1986). The Politics of Blame Avoidance. Journal of Public Policy , 6 (4), 371-398. https://doi.org/10.1017/S0143814X00004219 Weible, C. M., & Sabatier, P. A. (2017). Weible, Christopher M., and Paul A. Sabatier. 2017. Theories of the Policy Process. Boulder, CO: Westview Press. European Policy Analysis , 3 (2), 397-397. https://doi.org/10.1002/epa2.1023 Weible, C. M., Crawford, A. M., Fullerton, A. H., Gabehart, K. M., Imhoff, K. E., & Mariani, G. (2025). Deep core advocacy coalitions. Policy & Society, 44(2), 184-199. https://doi.org/10.1093/polsoc/puaf003 Weible, C. M., Crawford, A. M., Fullerton, A. H., Gabehart, K. M., Imhoff, K. E., & Mariani, G. (2025). Deep core advocacy coalitions. Policy & Society, 44(2), 184-199. https://doi.org/10.1093/polsoc/puaf003 Wiering, M., Kirschke, S., & Akif, N. U. (2023). Addressing diffuse water pollution from agriculture: Do governance structures matter for the nature of measures taken? Journal of Environmental Management , 332 , Article 117329. https://doi.org/10.1016/j.jenvman.2023.117329 Woll, C. (2019). Régulation. Dans L. Boussaguet, S. Jacquot et P. Ravinet Dictionnaire des politiques publiques : 5e édition entièrement revue et corrigée (5e éd., p. 540-546). Presses de Sciences Po. https://doi-org.proxy.bib.uottawa.ca/10.3917/scpo.bouss.2019.01.0540. Yin, R. K. (2014). Case Study Research Design and Methods (5th ed.). Thousand Oaks, CA: Sage. 282 pages. Yin, R. K. (2018). Case study research and applications. Design and methods (6 ed.) . SAGE . Zittoun, P. (2013). Entre définition et propagation des énoncés de solution: l’influence du discours en « action » dans le changement d’une politique publique. Revue française de science politique, 63(3‑4) Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Introduction","content":"\u003cp\u003eSodium nitrate (E251) is one of those discreet compounds that circulate through our plates, groundwater, and institutional reports without ever truly taking center stage in political debate. Classified among controversial additives, associated with probable carcinogenic risks and chronic water pollution, it nonetheless remains widely used in processed meat and ultra-processed food supply chains, under standards that organize its tolerance rather than its removal (Chazelas et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). This article therefore poses a twofold question: how can an additive linked to excess cancer risks and persistent water contamination continue to be normalized at the core of contemporary food systems? And what does the E251 case reveal about current pathologies of public action in the regulation of food and environmental risks in Canada, the United States, and Europe?\u003c/p\u003e\u003cp\u003eOn the public health side, cohort studies and meta-analyses (Essien et al., \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Mendy \u0026amp; Thorne, \u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Ma et al., \u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) converge: added nitrites and nitrates (including E251 and E252) are associated with excess cancer risks (breast, prostate, colon, stomach), sometimes at exposure levels below current regulatory thresholds, whereas plant-based nitrates, integrated into diets rich in antioxidants, appear instead to be protective. Environmentally, research on the Nitrates Directive and groundwater quality (Goodchild, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e1998\u003c/span\u003e; Musacchio et al., \u003cspan citationid=\"CR67\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Wiering et al., \u003cspan citationid=\"CR95\" class=\"CitationRef\"\u003e2023\u003c/span\u003e) highlights the persistence, and in some regions the worsening, of nitrate concentrations despite several decades of policies aimed at reducing agricultural inputs. Taken together, these two observations show that society functions as an open-air laboratory where certain groups (children, pregnant women, rural populations relying on groundwater, consumers locked into cheap food), are highly exposed and become non-consenting trial populations in a toxic public cuisine that remains legally authorized.\u003c/p\u003e\u003cp\u003eWe propose to interpret this situation not as a simple regulatory lag but as the symptom of a pathology in the governance of risk. The state is not ignorant; it behaves like a delinquent oncologist who, despite growing knowledge of the risks, organizes a toxicity deemed acceptable rather than confronting its structural causes. This pathology unfolds at the intersection of bounded rationality and routinized incrementalism that privilege marginal adjustments (Simon, \u003cspan citationid=\"CR83\" class=\"CitationRef\"\u003e1959\u003c/span\u003e; Lindblom, \u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e1979\u003c/span\u003e); path dependence and gradual institutional drift that make challenging existing compromises increasingly costly (Pierson, \u003cspan citationid=\"CR74\" class=\"CitationRef\"\u003e2000\u003c/span\u003e; Mahoney \u0026amp; Thelen, \u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e2010\u003c/span\u003e); mechanisms of non-decision and blame avoidance that keep the issue in a gray zone of partial revisions and repeated expert assessments without clear arbitration (Bachrach \u0026amp; Baratz, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e1963\u003c/span\u003e; Weaver, \u003cspan citationid=\"CR91\" class=\"CitationRef\"\u003e1986\u003c/span\u003e); phenomena of capture and pro-additive advocacy coalitions (Dal B\u0026oacute;, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2006\u003c/span\u003e; Sabatier \u0026amp; Jenkins-Smith, \u003cspan citationid=\"CR79\" class=\"CitationRef\"\u003e1999\u003c/span\u003e; Lacy-Nichols \u0026amp; Williams, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e2021\u003c/span\u003e); and a biopolitics of acceptable risk, in which regulatory instruments socially and territorially distribute carcinogenic exposures deemed manageable (Beck, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e1994\u003c/span\u003e; Foucault, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e1976\u003c/span\u003e; Lascoumes \u0026amp; Le Gal\u0026egrave;s, \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e2004\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eExisting scholarship sheds light on each of these dimensions in turn: the toxicology and epidemiology of nitrates; analyses of the Nitrates Directive and water governance; work on the risk society; research on capture and industrial influence; and studies of policy instruments and processes (Kingdon, \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e1984\u003c/span\u003e; Howlett et al., \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Jann \u0026amp; Wegrich, \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e2007\u003c/span\u003e; Baumgartner et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2006\u003c/span\u003e). Few studies, however, follow a single regulatory object over time and across multiple politico-administrative levels to weave these strands together into an integrated diagnosis. In response to this gap, the article pursues a dual objective. Empirically, it uses sodium nitrate (E251) as a qualitative, comparative case study to reveal the logics of instrumentation, regulation, and delegation that structure nitrate risk governance in Canada, the United States, and Europe. Theoretically, it develops a diagnosis that articulates bounded rationality, path dependence, non-decision, capture, and the biopolitics of risk, reading E251 as an analyzer of a delinquent oncology of public action.\u003c/p\u003e\u003cp\u003eThe contribution is threefold: empirical, by offering a multi-level case study of a controversial additive; theoretical, by bringing together several traditions in public policy analysis; and conceptual, by advancing the notions of tumor policies, toxic continuity, and delinquent oncology to characterize regulatory regimes that organize the chronic management of toxicity rather than its effective reduction. The article is structured as follows: Section II sets out the theoretical framework, section III details the case-study methodology, section IV presents the empirical findings, and section V discusses the theoretical and normative implications before the conclusion.\u003c/p\u003e"},{"header":"II. Theoretical framework","content":"\u003cp\u003eThe E251 case highlights structural problems in how public policies are conceived and implemented. Interpreting it as a tumor embedded in the body of food and environmental policy makes it possible to articulate several theoretical contributions in a common diagnosis: the issue is no longer a regulatory delay but the deliberate maintenance of a risky additive within a pathological configuration of public action.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ea) Bounded rationality as organized inaction and incrementalism\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBounded rationality and incrementalism help explain how institutions stabilize organized inaction. Since Simon (1959), it is difficult to treat the failure to ban a carcinogenic additive as a simple error or information deficit. Bounded rationality suggests that E251\u0026rsquo;s management reflects institutionalized satisficing: authorities maintain the additive, adjust thresholds, refine testing protocols, yet leave supply chains intact. Inaction is no longer the absence of decision, but a routinized form of reasoning under conditions of uncertainty, information overload, and political and interest-based conflict. Lindblom\u0026rsquo;s (1979) incrementalism extends this diagnosis. E251\u0026rsquo;s trajectory resembles organized muddling through, composed of small adjustments rather than decisive breaks, because most of the issue is handled within routine subsystems, while only a handful of concerns reach the central agenda (Jones, 1999). Epidemiological signals, scientific alerts, and associative mobilizations accumulate without triggering the rupture that punctuated-equilibrium theory would lead one to expect (True et al., 2007): the additive remains confined to a technical administrative regime of regulation, marginal within visible public health priorities.\u003c/p\u003e\n\u003cp\u003eThe garbage can model captures this dynamic as the product of contingent encounters among problems, solutions, participants, and decision opportunities within an ambiguous process (Cohen et al., 1972). Rule revisions, updates of standards, or media scandals primarily open windows for marginal tweaks (threshold adjustments, additional labeling, revised methods), without allowing the option of eliminating the additive to gain durable traction. This immobilism is explained by path-dependent effects (Pierson, 2000) and gradual institutional change (Mahoney \u0026amp; Thelen, 2010): decades of permissive standards and aligned instruments have generated high transition costs. Any substantial revision would affect production chains, inspection techniques, and accountability arrangements. Continuous adjustments (occasional tightening of limits, extra labeling requirements, strengthened controls) amount to sedimentation or drift: they create an appearance of movement without altering the additive itself.\u003c/p\u003e\n\u003cp\u003eForester (1984) invites us to reread bounded rationality considering power asymmetries: in contexts marked by structural inequalities, incrementalism becomes a political instrument that delays or weakens decisions costly to dominant actors. Applied to E251, this means that technical adjustments are not neutral; they render an ongoing system of contamination more tolerable, thereby avoiding an open confrontation between public health imperatives and agro-industrial interests. Finally, following Eymeri-Douzans (2021), public decision-making appears less as the choice of a single decision-maker than as the outcome of a system of action composed of routines, forums for debate, and administrative compromises. The additive\u0026rsquo;s persistence is thus better understood as ordinary governmental rationality than as an individual failure. Empirically, this framework is mobilized in Section IV.a to analyze the sequences of evidence accumulation and the near stability of standards, which together sketch a largely ineffective policy cycle.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eb) Regulatory capture and metastasized coalitions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA second theoretical pillar mobilizes the notions of regulatory capture and advocacy coalitions. Capture, in Dal B\u0026oacute;\u0026rsquo;s (2006) sense, refers to the processes through which regulated industries steer regulators\u0026rsquo; choices, directly or indirectly, in their favor. Carpenter (2013) shows that capture operates less through overt pressure than through the gradual imprinting of regulatory agencies\u0026rsquo; professional cultures, encouraging them to prioritize innovation, competitiveness, or managed risk over strong precautionary principles.\u003c/p\u003e\n\u003cp\u003eIn the food sector, major corporations readily present themselves as part of the solution: they promote self-regulation, participate in partnerships with health authorities, and deploy corporate social responsibility strategies. Lacy-Nichols and Williams (2021) interpret this posture as a form of soft capture, in which rules are co-produced with those they are supposed to constrain, while the public sphere polarizes between reasonable health actors and opponents dismissed as utopian. In nutrition policy, this often leads to declaratory arrangements where political will proves insufficient to overcome industrial resistance (Cullerton et al., 2016).\u003c/p\u003e\n\u003cp\u003eThe advocacy coalition framework (Sabatier \u0026amp; Jenkins-Smith, 1999) helps characterize these arrangements by emphasizing the stability of shared core beliefs across heterogeneous actors. In our case, one can reconstruct a pro-additive coalition bringing together meat processors, agricultural unions, some academics, authorities, and experts, organized around beliefs such as the centrality of competitiveness, technical confidence, and the normality of additives in agro-industrial modernity. By contrast, networks aligned with diversity or food justice are often confined to local or technical projects, with limited access to normative arenas (Clark, 2018).\u003c/p\u003e\n\u003cp\u003eThese coalitions intervene throughout the policy process: initial framing within restricted expert circles; circulation of issues in narrow decision arenas; implementation relying on corporate self-regulation; and evaluation reduced to formal compliance (Jann \u0026amp; Wegrich, 2007). These dynamics interact with constraints on political attention: government agendas are saturated, and additives are relegated behind issues deemed more pressing (climate, employment, health in a broad sense) (Baumgartner et al., 2006). Constructing public problems requires framing, dramatization, and generalization (Hilgartner \u0026amp; Bosk, 1988; Neveu, 1999; Cefa\u0026iuml; \u0026amp; Terzi, 2020; Kingdon, 1984). As long as cancers are depicted in vague lifestyle terms rather than as consequences of specific chemical exposures, the responsibility of industry and authorities remains diffuse (Stone, 1989).\u003c/p\u003e\n\u003cp\u003ePublic responses then take the form of symbolic rearrangements (gradual dose reductions, awareness campaigns, labeling) that create the illusion of action without truly challenging the additive regime (Zittoun, 2013). Woll (2019) uses the notion of captured regulation to describe this type of configuration, in which government actors themselves, through their choice of instruments and forums, contribute to limiting their own capacity to impose genuinely binding standards. Empirically, this pillar structures the analysis of actor configurations, belief systems, and instruments in Section IV.b, dedicated to metastasized coalitions and the stabilization of a pro-additive status quo.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ec) The rational silence of invisible power\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA third theoretical strand brings together non-decision, blame avoidance, and a situated critique of rational choice theory. From a perspective inspired by Downs (1957) and Olson (1971), one would expect governments seeking to maximize support to arbitrate between electoral costs and health benefits, and diffuse groups (exposed consumers) to organize in defense of their interests. Yet the risks associated with E251 are diffuse, delayed, and socially unequal, making it difficult to build powerful coalitions, whereas the economic costs of a ban are concentrated and defended by well-organized actors. The notion of non-decision (Bachrach \u0026amp; Baratz, 1963) is illuminating here: power also lies in the ability to prevent certain issues from fully reaching the agenda or from being decisively settled. In the case of E251, one can speak of structured non-decision: the politico-administrative apparatus keeps the file in a gray zone by multiplying additional studies, consultations, expert assessments, and impact evaluations, without ever embracing an outright ban.\u003c/p\u003e\n\u003cp\u003eWeaver (1986) shows that this strategy is rational from the standpoint of blame avoidance: voters\u0026rsquo; negativity bias encourages officeholders to shun decisions that create identifiable losers. Banning E251 would entail visible costs for well-entrenched sectors and territories with strong mobilization capacities, while health gains would be probabilistic, diffuse, and hard to attribute to a specific measure, especially given how deeply blame-avoidance logics structure health and environmental policy (Caune, 2019).\u003c/p\u003e\n\u003cp\u003eAuthorities thus have an interest in sheltering behind expert procedures, independent agencies, and technoscientific reference frames that disperse responsibility, dilute accountability, and defer the moment of decision. Rational choice theory remains relevant for analyzing utilitarian strategies and certain dynamics of collective action (Downs, 1957; Olson, 1971), but the E251 case suggests reintegrating it within a broader conception of rationality attentive to the social construction of problems, power asymmetries, and path-dependent effects.\u003c/p\u003e\n\u003cp\u003eIn this light, the pathology of public action appears as the product of an institutional configuration that makes it politically, economically, and cognitively more costly to fully protect bodies than to tolerate a toxicity deemed manageable. E251 thus becomes an analyzer of governance through non-decision: recognizing, documenting, and administering risk without crossing the threshold of rupture. This third pillar underpins Section IV.a, and informs the cross-reading of Sections b and c, where the additive\u0026rsquo;s persistence is interpreted as the outcome of governing danger through postponement, dilution, and chronic management rather than robust prevention.\u003c/p\u003e"},{"header":"III. Methodology","content":"\u003cp\u003eThis research takes sodium nitrate (E251) as an entry point to interrogate a broader problem of public action: the persistent gap between knowledge of health and environmental risks and the effectiveness of regulatory policies. It is situated within the tradition of qualitative case studies as developed by Yin (2014, 2018) and Gagnon (2010), which is particularly suited to analyzing a contemporary phenomenon in its context when the boundaries between the object and its environment are blurred and \u0026laquo; how? \u0026raquo; and \u0026laquo; why? \u0026raquo; questions dominate.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ea) Research design and comparative framework\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe article adopts a qualitative, comparative approach. The case concerns the governance of E251 and, more broadly, the regulation of this additive in food and environmental policy. It is treated as an instrumental case: the aim is to use it as an analyzer of logics of instrumentation, governance architectures, and implicit trade-offs in the distribution of exposures (Lascoumes \u0026amp; Le Gal\u0026egrave;s, 2004; Lascoumes \u0026amp; Simard, 2011; Halpern et al., 2014).\u003c/p\u003e\n\u003cp\u003eThe perspective is explicitly comparative. The analysis juxtaposes three politico-institutional arenas, like Canada, the United States, and Europe, to identify both convergences (stable thresholds, weight of pro-additive coalitions, fragmented responsibilities) and divergences (regulatory styles, degree of judicialization, role of civil society, or uses of the precautionary principle). The study period runs from the early 1990s (adoption of the 91/676/EEC Nitrates Directive and consolidation of North American drinking water standards) to 2025, with particular emphasis on the last two decades, marked by intensifying controversies over nitrites and nitrates and major regulatory revisions.\u003c/p\u003e\n\u003cp\u003eThe purpose is not to produce a statistical generalization to all risk policies but an analytical generalization in Yin\u0026rsquo;s sense: to test, through E251, a set of mechanisms and theoretical propositions about risk governance that can be transposed to, and debated in, other configurations (glyphosate, endocrine disruptors, persistent pesticides).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eb) A multi-level documentary corpus\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study relies on systematic documentary analysis in Bowen\u0026rsquo;s (2009) sense, treating documents as social facts that condense choices, compromises, and power relations. Material was collected between 2022 and 2025 from scientific databases (uOttawa Library, Policy Sciences, Politics and Policy), agency websites (Canada, United States, European Commission), government portals, and civil society organizations. We retained texts produced between 1990 and 2025 that met three criteria: explicit mention of nitrates, nitrites, and, or E251; recognized status in regulation or public debate (legal or regulatory text, agency opinion, official report, position paper from a non-governmental or professional organization, or scientific document); and substantive contribution to understanding risk definitions, the instruments used, or the allocation of responsibilities. Strictly media content (general press, op-eds without analytical dimension) and redundant documents that did not add information beyond already included texts were excluded.\u003c/p\u003e\n\u003cp\u003eThe documentary corpus is structured across several levels, beginning with legal and regulatory texts. For Canada: drinking water standards (Health Canada), additive regulations (Canadian Food Inspection Agency), guidelines, and expert opinions. For the United States: Environmental Protection Agency (EPA) drinking water standards and Food and Drug Administration (FDA) and United States Department of Agriculture (USDA) provisions regarding additives and meat products. For Europe: the General Food Law, the Nitrates Directive, regulations on additives (including E251), and opinions and guidance from the European Food Safety Authority (EFSA).\u003c/p\u003e\n\u003cp\u003eThe analysis also draws on risk-regulation agency reports and opinions, in particular the EFSA opinion coordinated by Mortensen et al. (2017) on nitrates and nitrites, and the review commissioned by the UK Food Standards Agency (Kaur et al., 2025), as well as national reports on the implementation of the Nitrates Directive and on drinking water quality in Canada, the United States, and EU member states. In addition, we examine documents such as NGO and food-justice advocacy reports and communiqu\u0026eacute;s, professional organizations\u0026rsquo; positions, agro-food industry statements, and contributions to public consultations. These materials help identify coalitions of interests, their risk framings, and their preferred instruments (Woll, 2019; Lacy-Nichols \u0026amp; Williams, 2021).\u003c/p\u003e\n\u003cp\u003eThe corpus further includes scientific work on nitrates, water governance, and epidemiological and toxicological risk (Chazelas et al., 2022; Essien et al., 2022; Mendy \u0026amp; Thorne, 2024; Preston-Martin et al., 2000; Erichsen et al., 2024); environmental policy and implementation of the Nitrates Directive (Goodchild, 1998; Musacchio et al., 2020; Wiering et al., 2023; Středov\u0026aacute;, 2024); and analyses of food risk governance and fragmented public action (Cheftel, 2011; El Gemayel, 2025; Mechanic, 1978).\u003c/p\u003e\n\u003cp\u003eThe balance is not perfectly symmetrical across the three regions. The European Union is slightly overrepresented due to the density of its regulatory and evaluative production, but each region has a substantial core of comparable texts (standards, opinions, reports, position papers) allowing for systematic comparison.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ec) Analytical strategy and coding procedure\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe analysis combines three complementary registers: content analysis, sequence reconstruction, and interpretation through instruments.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ec.a) - Content analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDocuments underwent thematic analysis using qualitative data analysis software. The coding scheme combines deductive categories derived from the theoretical framework (bounded rationality, path dependence, capture, coalitions, non-decision, biopolitics of acceptable risk, types of instruments) and inductive categories developed during reading (formulations of uncertainty, justificatory registers, delegation and self-regulation devices). The unit of coding is the paragraph or section, to capture argumentative sequences rather than simple lexical occurrences. Approximately 15% of texts, distributed across the three regions, were double coded a few weeks apart to check intra-coder reliability and refine category definitions.\u003c/p\u003e\n\u003cp\u003eThe work is organized around structuring questions inspired by Bowen (2009): how is the risk associated with E251 defined (so-called acceptable thresholds, safety margins, uncertainty registers)? Which policy instruments are used (regulation, self-monitoring, labeling, economic incentives, informational devices)? How are responsibilities distributed among states, agencies, industry, farmers, local authorities, and consumers? For the comparative dimension, a common grid was built from Hood\u0026rsquo;s (1983) NATO typology (nodality, authority, treasure, organization) and Vedung\u0026rsquo;s (1998) \u0026laquo; sticks, carrots, and sermons \u0026raquo; classification. Each Canadian, American, or European text is thus read through the same dimensions, which makes it possible to compare the toolboxes deployed to regulate E251 and nitrates.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ec.b) - Reconstruction of critical sequences\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSome episodes were then analyzed using process tracing: adoption or revision of standards, agency opinions, scandals or litigation, and threshold adjustments. The aim is to reconstruct, for a few emblematic sequences, the chain of events: what triggers a revision or agenda-setting? Which actors intervene at each stage (agencies, ministries, industry, NGOs, courts)? Which compromises are stabilized and which options are ruled out? The work of Musacchio et al. (2020), Wiering et al. (2023), and Středov\u0026aacute; (2024) offers useful points of comparison for interpreting gaps between stated ambitions and the near stability of pollution levels, while the analyses of Mechanic (1978) on fragmentation and implementation games provide additional interpretive leverage.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ec.c) Interpretation through instruments and regulatory regimes\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFinally, the corpus is interpreted in light of work on policy instrumentation (Lascoumes \u0026amp; Le Gal\u0026egrave;s, 2004; Lascoumes \u0026amp; Simard, 2011; Eliadis et al., 2005; Halpern et al., 2014), third-party government (Salamon, 2002), regulatory styles (Woll, 2019; Varone, 2000; Howlett, 2000; Vedung, 1998), and risk regimes (Beck, 1994; Chatalova et al., 2016). The aim is to show that instrument choice (numerical standards, HACCP schemes, labels, certifications, voluntary commitments, participatory forums) encodes political compromises and implicit hierarchies between health protection, economic competitiveness, and institutional stability, thereby preparing the empirical analysis of \u0026ldquo;tumor policies\u0026rdquo; in Section IV.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ed) Limits and scope of analytical generalization\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis approach has several limitations: dependence on document availability (and thus on countries with more extensive public data), absence of interviews with decision-making actors, and a focus on North American and European contexts. The material is neither exhaustive nor perfectly balanced, but it is sufficiently diverse to reveal regularities in risk definitions, favored instruments, and stabilized compromises.\u003c/p\u003e\n\u003cp\u003eWithin an analytical generalization framework, E251 is treated as a sentinel of a broader pathology of public action: chronic management of toxicity rather than its reduction. The results are not claimed to apply to all substances or all contexts but instead offer a bundle of theoretical mechanisms that can be tested, refined, or contested using other empirical cases.\u003c/p\u003e"},{"header":"IV. Results","content":"\u003cp\u003eThis section presents the main insights from the comparative analysis of sodium nitrate (E251) regulation and, more broadly, of nitrate/nitrite governance in food and environmental policy. As the analysis unfolds, E251 ceases to appear as a mere technical additive and becomes an analyzer of failures in risk governance: it reveals tumor policies, understood as dense normative configurations (laws, labels, agencies, audits, consultations) that nonetheless leave largely intact the problem they purport to regulate. Three findings structure this section: the accumulation of evidence without substantial revision of standards, the decisive role of pro-additive coalitions in locking in the status quo, and the production, through regulatory instruments, of a carcinogenic risk rendered politically governable and socially differentiated.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ea) Accumulation of evidence, stable standards: a largely ineffective policy cycle\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIf one took the idealized policy cycle as a decision-making model, E251\u0026rsquo;s trajectory ought to be linear: evidence accumulation, threshold revision, and substitution or prohibition of the additive. The empirical material leads to the opposite conclusion: health and environmental knowledge advances while the normative architecture remains largely unchanged.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ea.a) Europe\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn Europe, cohort studies, particularly NutriNet-Sant\u0026eacute; (Chazelas et al., 2022; Essien et al., 2022), establish robust links between added nitrites and nitrates (E250, E251, E252) and excess cancer risks (breast, prostate, colon, stomach), while plant-based nitrates within antioxidant-rich diets appear protective. Regular consumers of nitrate/nitrite-rich additives emerge as the most exposed, shifting the focus back to industrial uses in ultra-processed products. Environmentally, work on the Nitrates Directive (Goodchild, 1998; Musacchio et al., 2020; Wiering et al., 2023) highlights persistent, and sometimes worsening, groundwater contamination despite three decades of vulnerable zones and action programs. Středov\u0026aacute; (2024), for example, shows how spreading calendars based on outdated climatic references authorize nitrogen applications at times when crops can no longer absorb it, maximizing leaching toward aquifers.\u003c/p\u003e\n\u003cp\u003eYet the main normative benchmarks evolve only at the margins. The EFSA opinion coordinated by Mortensen et al. (2017) maintains the acceptable daily intake (ADI) for nitrites at 0.07 mg/kg/day while acknowledging that infants and children may exceed this value when cumulative exposures are considered and emphasizing the issue of carcinogenic nitrosamines. The underlying structure of thresholds and evaluation methods is confirmed, accompanied by recommendations and calls for further research rather than a fundamental redefinition of basic parameters.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ea.b) Canada\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn Canada, analyses compiled by the Council of Canadian Academies (2013) document high nitrate concentrations in certain rural and agricultural areas, particularly in communities reliant on private wells. The risks are explicitly discussed, but public responses primarily take the form of responsibility shifts onto households, municipalities, or farmers: household treatment technologies, local programs, limited practice adjustments. Federal and provincial drinking water standards, initially designed to prevent methemoglobinemia, are only marginally reconsidered considering long-term cancer risks.\u003c/p\u003e\n\u003cp\u003eIn the food sector, the regulatory framework remains aligned with thresholds like those in the United States and Europe. The use of E251 and E252 remains authorized in certain meat-processing chains, subject to labeling requirements and controls embedded in HACCP systems. The texts examined show the predominance of arguments based on microbiological safety and supply-chain stability, while the issue of chronic exposure is relegated to the background.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ea.c) United States\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn the United States, the meta-analysis by Essien et al. (2022) and the work of Mendy and Thorne (2024) using NHANES data indicate that increases in drinking-water nitrates are associated with excess cancer mortality, sometimes at levels below the regulatory limit of 10 mg/L NO₃-N. Here again, drinking water standards, initially set to prevent infant methemoglobinemia, are rarely revisited despite the shift in concern toward cumulative carcinogenic exposures. On the food side, FDA and USDA provisions govern the use of nitrites and nitrates in meat products, but examination of opinions and industry guidance reveals logics like those observed in the two other regions: emphasis on preservation and botulism prevention, highlighted uncertainties, and calls for moderate use, without challenging routine practices. Major North American cohorts (National Institutes of Health and American Association of Retired Persons-NIH-AARP Diet and Health Study, Iowa Women\u0026rsquo;s Health Study), as synthesized in available reviews, have connected processed-food nitrites to cancers of the prostate, kidney, or bladder since the late 2000s.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ea.d) A slowed decision cycle\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTaken together, these elements trace a common pattern: health and environmental warning signals multiply, regulatory thresholds and evaluative frameworks remain largely stable, and adjustments are mainly marginal (recommendations, labels, minor ADI changes). They do not culminate in either an E251 ban or an ambitious overhaul of nitrate regimes in water. Procedural policy-cycle models thus appear more as normative references than accurate descriptions of actual dynamics: agenda-setting remains partial, formulation is confined to technocratic arenas, decision-making ratifies limited compromises, and implementation and evaluation rarely lead to major revisions.\u003c/p\u003e\n\u003cp\u003eAgenda-setting theories (Kingdon, 1984; True et al., 2007) help illuminate this paradox in the background, but the core finding is empirical: in all three regions, central protective instruments evolve far more slowly than risk knowledge. Finally, participatory mechanisms, like public consultations on water quality, watershed committees, participatory devices in environmental action plans, appear only at the periphery of decisions concerning E251 and nitrates. When they do exist, they seem to have limited weight in altering already stabilized technical and economic compromises (DeLeon, 2006; Kathryn \u0026amp; Bryson, 2022).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eb) Transnational lock-in of the status quo\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe second finding shows how pro-additive coalitions, in all three contexts, contribute to locking in E251\u0026rsquo;s trajectory. These configurations do not merely defend a single additive; they constantly reconfigure instruments, narratives, and decision arenas in ways that make any challenge to the status quo politically costly. In Canada, documents from agro-industrial sectors and agricultural organizations echo European findings. Representatives of processed meat and beef sectors mobilize a repertoire combining rural employment protection, economic viability, and immediate sanitary safety. By contrast, positions taken by NGOs and health associations appear more dispersed and less institutionalized than in the European Union. Debates on rural drinking water quality highlighted by the Council of Canadian Academies (2013) illustrate this gap: nitrate concerns translate more into support for local infrastructure or household-level measures than into direct confrontation with professional organizations or agrifood value chains. The pro-additive coalition is less discursively structured but exerts substantial influence through its economic and political embeddedness.\u003c/p\u003e\n\u003cp\u003eIn the United States, strategies described in the literature on unhealthy commodities (Moodie et al., 2013) and on food industry influence (Nestle, 2016) are clearly visible in the material analyzed. Professional associations, industry-linked think tanks, and research centers funded by private capital produce reports and comments that downplay nitrite/nitrate risks or stress the uncertainty of available data. The \u0026ldquo;\u003cem\u003epart of the solution\u003c/em\u003e\u0026rdquo; strategy described by Lacy-Nichols and Williams (2021) is reflected in the self-commitments of some large firms: marketing of \u0026ldquo;no added nitrites\u0026rdquo; meats (relying on nitrate-rich plant extracts), proliferation of reassuring labels, and partnerships with agencies on nutrition or physical activity. Parker et al. (2021) show how such labeling reforms privatize regulation: the burden of choice is shifted to consumers, while fundamental parameters governing additive use remain mostly unchanged.\u003c/p\u003e\n\u003cp\u003eIn Europe, Sievert et al. (2021) highlight obstacles to reducing red and processed meat consumption, showing how the meat industry combines economic power, cultural legitimacy (the centrality of meat and charcuterie in diets), and institutional anchoring (subsidies, tax regimes, trade agreements). Professional organizations\u0026rsquo; positions and contributions to consultations on additives stress the need to preserve microbiological safety and sectoral competitiveness, framing E251 as an indispensable technical tool. At the same time, health-environment NGOs active in Commission or member-state consultations sometimes gain partial advances (lowering certain thresholds, strengthening labeling) without securing a political priority for banning E251. Analysis of contributions shows that standards are largely co-authored with industry, which proposes formulations, timelines, and exemptions in a spirit akin to voluntary commitments (Lacy-Nichols \u0026amp; Williams, 2021).\u003c/p\u003e\n\u003cp\u003eAcross all three configurations, the analysis reveals pro-additive coalitions endowed with significant resources (funded expertise, privileged access to decision-makers, media reach, economic weight), health-environment coalitions that are more fragmented, less resourced, and often confined to local or sectoral initiatives, and a tendency to shift the issue into technical forums (expert committees, working groups, consultations) rather than politicized arenas (parliaments, major media). This imbalance keeps E251 in a zone of low political visibility where negotiated adjustments with dominant actors appear as the only realistic options. It is this proliferating and adaptive character of coalitions, colonizing instruments (labels, voluntary commitments), knowledge (funded research), and arenas (public\u0026ndash;private partnerships), that underpins the metaphor of metastasized coalitions.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ec) The making of societally risky public policies\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe third finding highlights a configuration in which, across the three arenas studied, E251 regulation contributes to the production of societally risky public policies. In Europe, EFSA opinions (Mortensen et al., 2017), the UK FSA review (Kaur et al., 2025), and epidemiological research (Erichsen et al., 2024; Essien et al., 2022; Preston-Martin et al., 2000) converge on particularly exposed groups: children, infants, residents of areas with high nitrate concentrations, and regular consumers of processed meats. Plausible links with various cancers and chronic conditions are acknowledged, but regulatory responses remain directed toward management rather than elimination of danger: ad hoc ADI adjustments, moderation recommendations, and promotion of organic alternatives.\u003c/p\u003e\n\u003cp\u003eQuantified standards (ADIs, the 50 mg/L threshold for nitrates in water), additive-positive lists, HACCP devices, and labels function as technologies of government: they organize the distribution of exposures across the population and implicitly set a level of morbidity considered tolerable. The biopolitical dimension discussed in the theoretical framework finds concrete expression in how texts delineate risks and define target publics.\u003c/p\u003e\n\u003cp\u003eIn Canada, official and scientific documentation emphasizes exposure inequalities linked to rural and agricultural contexts. Drinking water norms and national guidelines acknowledge these vulnerabilities, but the instruments chosen (targeted aid programs, local technical interventions, usage recommendations) have the effect of territorializing risk management rather than questioning nitrogen-input regimes or threshold relevance. In the food arena, the combination of federal rules and voluntary industry initiatives produces an assemblage in which nitrate/nitrite-rich products coexist with natural or no added nitrites lines. Risk partly becomes a function of choice capacity and purchasing power, with certain consumer groups confined to more exposed, low-cost product ranges.\u003c/p\u003e\n\u003cp\u003eIn the United States, data on nitrates in water (Essien et al., 2022; Mendy \u0026amp; Thorne, 2024) show that high exposures particularly affect rural communities and low-income populations. The dominant instruments (unchanged federal standards, local responsibility for compliance, informational devices) shape a landscape in which health vulnerability closely tracks socio-territorial position. In food systems, the coexistence of ultra-processed products containing nitrites and good label lines aimed at higher-income market segments accentuates this differentiation. Existing policies treat E251 as a technically manageable risk rather than as a matter of health justice.\u003c/p\u003e\n\u003cp\u003eTaken together, these elements suggest that the pathology of public action does not rest solely on vertical capture by industrial interests. It is rooted in a mode of government that, through its instruments, standards, and routines, produces a harmful normality: exposures are identified, monitored, and modeled, but the question of their social, territorial, and intergenerational acceptability is rarely posed directly. In this context, sodium nitrate (E251) can be read as an administrative tumor: a problematic element that authorities seek to manage and compartmentalize rather than remove. Comparing Europe, Canada, and the United States reveals distinct regulatory styles but a shared underlying logic: recognizing, constraining, and distributing risk without pursuing structural detoxification of agricultural and food systems. These results set the stage for the discussion, which draws out their theoretical implications.\u003c/p\u003e"},{"header":"V. Discussion","content":"\u003cp\u003eThe E251 case brings us back to the two questions that structure the analysis: how can a product associated with elevated cancer risks be maintained, monitored, yet normalized at the heart of large-scale agrifood chains? And what does this paradox reveal about societal risk, the government of bodies, and institutional capacity to confront dangers they themselves help to organize? The hypothesis of a delinquent oncology of public action refers to a politico-institutional order that learns less to reduce toxicity than to administer, distribute, and legitimize it, rendering it socially presentable. In Beck\u0026rsquo;s (1994) risk-society perspective, sodium nitrate confirms the shift toward risks produced by industrial modernity itself.\u003c/p\u003e\n\u003cp\u003eAlm\u0026aring;s (1999) shows how proliferating food scandals and competing expertise\u0026rsquo;s transform food safety into a matter of trust and governance. E251 becomes paradigmatic for this reflexive modernity: individual disease probabilities remain statistically moderate, yet uncertainties about long-term effects, combined with other substance, overlay the complexity of production chains. In this context, labeling offers largely illusory protection. As with genetically modified organisms (GMOs) or herbicide-resistant weeds discussed by Alm\u0026aring;s, responsibility is transferred to consumers, who are expected to keep their own danger ledger based on technical, fragmented, and hard-to-interpret information.\u003c/p\u003e\n\u003cp\u003eChatalova et al. (2016) extend this diagnosis by linking Beck to the technological treadmill: agricultural intensification and industrial food processing generate productivity gains at the price of a risk treadmill in which economic benefits concentrate upstream while health and ecological costs are shifted onto consumers and health systems. Embedded in standardized meat-processing and transformation processes, E251 helps ensure microbiological safety in long, globalized supply chains while contributing to a diffuse carcinogenic danger, poorly attributable at the individual level but cumulative at population scale.\u003c/p\u003e\n\u003cp\u003eThe presence of sodium nitrate in ultra-processed foods dominated by agro-industrial oligopolies reflects a globalized food regime that prioritizes profit over public health (Stuckler \u0026amp; Nestle, 2012; Millstone \u0026amp; Lang, 2003). Mapping the concentration of firms and the spread of fast-food chains illustrates how certain product combinations (processed meats, additives, sugary beverages) diffuse first in North America, then in Europe and emerging economies. E251 regulation is largely designed not to disrupt these transnational value chains.\u003c/p\u003e\n\u003cp\u003eA Foucauldian lens further sharpens this diagnosis. Fraser et al. (2019), in their work on the reconfiguration of stroke care in London, show how authorities construct a case, quantify risk, identify a hazard (inequalities in access to specialized care), and organize a spatialized response. Transposed to food systems, this case, risk, crisis schema, illuminates E251\u0026rsquo;s management by contrast: health authorities appear to have a clearly documented case without ever treating it as a genuine public crisis. The additive is recognized as problematic, thresholds are adjusted at the margins, but the production infrastructures that make it functional remain unchanged. Where stroke has prompted a biopolitics of visible risk reduction, sodium nitrate instead falls under a biopolitics of stabilization: toxicity is administered, an admissible dose is calculated, but the legitimacy of exposure itself is left largely unexamined.\u003c/p\u003e\n\u003cp\u003eDebates on disability surveillance show that monitoring devices oscillate between exclusionary and affirmative biopolitics, depending on whether data collection serves to control populations or to document barriers and strengthen rights (Saltes, 2013). In the food domain, a similar tension characterizes residue and contaminant monitoring: depending on design, such instruments can entrench the status quo or render certain exposures politically intolerable. Delinquent oncology, as it emerges here, emphasizes public action\u0026rsquo;s capacity to co-produce oncogenic exposures while shifting social costs elsewhere.\u003c/p\u003e\n\u003cp\u003eHan\u0026rsquo;s (2022) analysis of China shows how artificial food risks are unevenly distributed: advantaged groups turn to supposedly safer circuits, whereas poorer populations, with fewer economic and informational resources, remain trapped in cheaper, more hazardous products. There is little evidence that North American or European trajectories escape this logic: consumption of nitrate-rich processed foods is often concentrated among working-class groups, caught in a double bind, participating in the food market without the capital needed to shield themselves from its risks.\u003c/p\u003e\n\u003cp\u003eThis dimension raises questions about a weakened moral foundation of public action that implicitly rests on a hierarchy of lives and diseases considered acceptable. Cancers induced or aggravated by legally regulated exposures are diluted in chronic disease statistics, without spectacular images or salient political events, and are ill-suited to crisis staging (Fraser et al., 2019). The E251 case confirms, while reframing, Beck\u0026rsquo;s (1994) critique of organized irresponsibility.\u003c/p\u003e\n\u003cp\u003eFrom the standpoint of public action theories, sodium nitrate also exposes the limits of conceptions overly centered on decision as the nodal moment. Commaille (2019) reminds us that the sociology of public action invites attention to multiple, multi-level, heterogeneous actor configurations. Public policy must be analyzed as a system of action in which actions and non-actions, substantive content and instruments, administrative outputs and social effects are intertwined (M\u0026eacute;ny \u0026amp; Thoenig, 1989). Within this perspective, the fixation of thresholds and the authorization or prohibition of an additive, often framed as the decent decision, run the risk of obscuring downstream risk normalization: standardized industrial processes, control routines, and labeling schemes. E251 thus leads us to revisit DeLeon\u0026rsquo;s (2006) critique of technocratic political science: promises of rational control collide with action regimes marked by legitimacy crises, sporadic scandals, and institutional compromises. The policy-process frameworks (Weible \u0026amp; Sabatier, 2017) remain heuristic tools for deciphering this case.\u003c/p\u003e\n\u003cp\u003eThe coalition approach reveals, around sodium nitrate, a pro-productivist coalition (agro-industry, economic ministries, experts focused on microbiological safety), and a more diffuse coalition centered on health and the environment. The structural weakness of the latter, faced with a technically complex and low-visibility issue, contributes to the stability of the path followed. Punctuated-equilibrium theory (True et al., 2007) suggests that only highly mediatized crises (drinking-water scandals, revelations of massive contamination) open windows for punctual policy corrections. In their absence, equilibrium takes the form of a succession of marginal adjustments.\u003c/p\u003e\n\u003cp\u003eThe notion of regulatory capture must, however, be nuanced considering Carpenter (2013). His reconstruction of FDA history shows that \u003cem\u003eStiglerian\u003c/em\u003e capture through entry barriers poorly describes early phases of pharmaceutical regulation. More recently, by contrast, budgetary vulnerability, fee dependence, and cultural capture of evaluative categories have become central. By analogy, E251 regulation is less a matter of frontal capture, where industry directly imposes its norms, than of progressive stabilization, in which agencies internalize an implicit compromise: better to accept a supposedly controlled carcinogen than risk botulism scares or destabilize export-oriented sectors.\u003c/p\u003e\n\u003cp\u003ePalier and Surel\u0026rsquo;s (2005) \u0026laquo; three I\u0026rsquo;s \u0026raquo; framework helps restate this finding. Institutions (EU directives, standards, health agencies), interests (agro-industry, exports, jobs), and ideas (food modernity, microbiological safety) interlock to stabilize a regime in which a potentially carcinogenic additive paradoxically becomes a safety instrument. This stabilization unfolds within a path-dependent dynamic (Pierson, 2000): once industrial infrastructures, operational protocols, and dietary habits have been organized around the additive, technological, economic, and political switching costs become very high.\u003c/p\u003e\n\u003cp\u003eCold-chain logistics, manufacturing methods, consumption practices, and administrative routines thus generate increasing returns that make abandoning E251 difficult even where alternatives exist. Public action finds itself in a paradoxical situation: the system can identify risks yet remains trapped on a path where the radical option (a ban) appears too costly or uncertain. Mahoney and Thelen (2010) and Muller (2005) nonetheless warn against inferring absolute irreversibility: transformations can emerge through progressive revision of rules and referentials.\u003c/p\u003e\n\u003cp\u003eCognitively, sodium nitrate is underpinned by a sectoral referential focused on microbiological risk prevention, itself articulated with a more general referential of productivity and market efficiency. As long as this pairing remains hegemonic, long-term carcinogenicity is reclassified as an acceptable risk. Actors such as epidemiologists, NGOs, and some international organizations seek to introduce alternative frames (dietary sobriety, primacy of environmental health, strengthened precautionary principle). These competing referential remain minority positions, but the removal of nitrites by some retailers, local experiments with bans in school cafeterias, and stricter labeling requirements signal early stages of institutional redesign: recomposed alliances, challenges to the dominant referential, and rising political costs associated with maintaining the status quo.\u003c/p\u003e\n\u003cp\u003eThis case brings to light certain blind spots in political science, already noted by DeLeon (2006). Emerging in part from a desire to respond to legitimacy crises (Vietnam, Watergate, energy crises) (pp. 44\u0026ndash;50), the field still struggles to apprehend extended forms of violence and diffuse blind policies that shape issues such as food toxicity. By focusing on decision quality, policy coherence, or instrument effectiveness, one risks sidelining the moral question: how many cancers induced by legally regulated exposures does a society deem acceptable, and for which groups? Delinquent oncology designates precisely this blind zone where instrumental rationality encounters its own ethical limits.\u003c/p\u003e\n\u003cp\u003eThe analysis centers on a specific additive, in predominantly North American (Canada, United States) and European contexts, and relies mainly on documentary materials rather than on direct investigation of decision-making arenas or industrial sectors. Other substances (glyphosate, endocrine disruptors, persistent pesticides) and other configurations (the Global South, peasant agricultures, Indigenous food systems) could corroborate, nuance, or challenge this diagnosis. In Canada, for example, in northern British Columbia, the Lheidli T\u0026rsquo;enneh First Nation announced in November 2025 a ban, albeit largely symbolic, on herbicide use, particularly glyphosate, over a territory that includes the city of Prince George and the Robson Valley. Such initiatives hint at alternative configurations of power and normativity around toxic risks.\u003c/p\u003e\n\u003cp\u003eThe emphasis on institutions and risk regimes here also partly sidelines consumers\u0026rsquo; everyday practices, existing forms of resistance, and possible transformations of food systems. Nonetheless, sodium nitrate plays a revealing role: it exposes tensions between the risk society, the government of bodies, and path dependence, showing how complex public action can simultaneously protect, expose, treat, and allow the proliferation of cancers deemed acceptable. It is from this diagnosis, and its blind spots, that one can begin to sketch, in other contexts, the conditions for a less delinquent public response to the health crisis it currently helps to produce.\u003c/p\u003e"},{"header":"VI. Conclusion","content":"\u003cp\u003eThis article examined how an additive now associated with heightened cancer risks and chronic water pollution can remain widely used and regulated at the core of contemporary food systems, and what the sodium nitrate (E251) case reveals about the fragilities of food and environmental risk-management policies in Canada, the United States, and Europe. Three main conclusions emerge. First, health and environmental evidence can no longer be treated as peripheral signals: large cohort studies and meta-analyses (Chazelas et al., 2022; Essien et al., 2022; Mendy \u0026amp; Thorne, 2024; Bouvard et al., 2015; Ma et al., 2018) establish robust links between additive nitrates and nitrites, waterborne nitrates, and excess cancer risks, while research on the Nitrates Directive and groundwater (Goodchild, 1998; Musacchio et al., 2020; Wiering et al., 2023) demonstrates the persistence, and sometimes aggravation, of contamination levels.\u003c/p\u003e\n\u003cp\u003eSecond, this body of evidence coexists with marked normative inertia: agency opinions (Mortensen et al., 2017; Kaur et al., 2025) exemplify a kind of inverted precautionary principle, in which gradual adjustments to ADIs and additive lists effectively reconfirm an architecture based on the routine use of nitrate preservatives, within a policy cycle that remains durably jammed (Howlett et al., 2020; M\u0026eacute;ny \u0026amp; Thoenig, 1989; Jann \u0026amp; Wegrich, 2007). Third, the hypothesis of metastasized coalitions is supported: the advocacy coalition framework (Sabatier \u0026amp; Jenkins-Smith, 1999; Weible et al., 2017, 2025) reveals a dominant pro-additive coalition (agro-industry, economic administrations, microbiological-safety experts) facing more diffuse and under-resourced health\u0026ndash;environment coalitions (Clark, 2018; Moodie et al., 2013; Nestle, 2016; Lacy-Nichols \u0026amp; Williams, 2021), such that E251 appears less as an oversight than as the ordinary product of a continuous political process.\u003c/p\u003e\n\u003cp\u003eTheoretically, the sodium nitrate case is proposed as an analyzer of a delinquent oncology of public action. By combining bounded rationality and incrementalism (Simon, 1959; Lindblom, 1979; Jones, 1999), path dependence and gradual change (Pierson, 2000; Mahoney \u0026amp; Thelen, 2010), non-decision and blame avoidance (Bachrach \u0026amp; Baratz, 1963; Weaver, 1986), capture and coalitions (Dal B\u0026oacute;, 2006; Carpenter, 2013; Sabatier \u0026amp; Jenkins-Smith, 1999; Weible et al., 2017, 2025), the risk society (Beck, 1994; Chatalova et al., 2016), and the biopolitics of regulation (Foucault, 1976; Lascoumes \u0026amp; Le Gal\u0026egrave;s, 2004), the article advances the idea of an enlarged rationality of public decision-making. The goal is no longer simply to explain trade-offs through utility calculations, but to grasp regimes of disease normalization and socially unequal exposure.\u003c/p\u003e\n\u003cp\u003eThe notions of tumor policies, metastasized coalitions, and toxic continuity aim to capture configurations in which technical sophistication, the multiplication of actors, and normative density coexist with a persistent inability to reduce risk in practice: instrumentation becomes pathological, organizing a biopolitical management of an acceptable cancer rather than a collective detoxification effort. This diagnosis calls for a shift in criteria for evaluating public policies. Beyond internal coherence or cost-benefit balance, it is necessary to interrogate implicit choices about which lives and diseases are considered bearable, which groups are more exposed (working-class populations, consumers dependent on cheap food, rural and Indigenous communities), and how responsibility is shifted to individuals via labeling and better choice rhetoric.\u003c/p\u003e\n\u003cp\u003eNormatively, this points toward a strengthened precautionary principle (reversing the burden of proof on additives and cumulative exposures, empowering more independent and better-resourced agencies, opening threshold revisions to public deliberation), integrated nitrogen cycle management (from soil to plate) that links agricultural, environmental, and health policies, and more substantial support for health-environment coalitions. For research, several extensions emerge: expanding the analysis to other sentinel substances (endocrine disruptors, persistent pesticides) and other geopolitical configurations, and documenting through fieldwork the mechanisms of diffuse capture and non-decision, as well as ordinary practices of consumption and resistance (community kitchens, short food chains, public canteens). In this perspective, the institutionally therapeutic remediation sketched here is not a closed program but an invitation to imagine regulatory regimes that are no longer fully orchestrated in the backstage of lobbying and that, rather than governing the unacceptable, gradually commit to reducing it.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eA.E.M wrote the manuscript.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eDeclaration of no funding\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eI, hereby solemnly declare that I have not received any financial support from any organization or individual for the preparation of this manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAgamben, G. (2020). HOMO SACER: Sovereign Power and Bare Life. In \u003cem\u003eThe Omnibus Homo Sacer\u003c/em\u003e (pp. 1-160). 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Ravinet Dictionnaire des politiques publiques : 5e \u0026eacute;dition enti\u0026egrave;rement revue et corrig\u0026eacute;e (5\u0026lt;sup\u0026gt;e\u0026lt;/sup\u0026gt; \u0026eacute;d., p. 540-546). Presses de Sciences Po. https://doi-org.proxy.bib.uottawa.ca/10.3917/scpo.bouss.2019.01.0540.\u003c/li\u003e\n\u003cli\u003eYin, R. K. (2014). Case Study Research Design and Methods (5th ed.). Thousand Oaks, CA: Sage. 282 pages.\u003c/li\u003e\n\u003cli\u003eYin, R. K. (2018). \u003cem\u003eCase study research and applications. Design and methods (6 ed.)\u003c/em\u003e. \u003cem\u003eSAGE\u003c/em\u003e.\u003c/li\u003e\n\u003cli\u003eZittoun, P. (2013). Entre d\u0026eacute;finition et propagation des \u0026eacute;nonc\u0026eacute;s de solution: l\u0026rsquo;influence du discours en \u0026laquo; action \u0026raquo; dans le changement d\u0026rsquo;une politique publique. Revue fran\u0026ccedil;aise de science politique, 63(3‑4) \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Sodium nitrate (E251), tumor policies, risk regulation, regulatory capture, captured public policies","lastPublishedDoi":"10.21203/rs.3.rs-8253274/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8253274/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThis article examines how a food additive associated with elevated cancer risks and persistent water pollution can be maintained at the heart of contemporary food systems. Drawing on a qualitative, comparative case study of Canada, the United States, and Europe, the analysis mobilizes legal and regulatory texts, agency opinions, litigation, NGO and industry positions, as well as the scientific literature on E251. The theoretical framework combines bounded rationality and incrementalism (Simon, \u003cspan citationid=\"CR83\" class=\"CitationRef\"\u003e1959\u003c/span\u003e; Lindblom, 1984), path dependence and gradual change (Pierson, \u003cspan citationid=\"CR74\" class=\"CitationRef\"\u003e2000\u003c/span\u003e; Mahoney \u0026amp; Thelen, \u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e2010\u003c/span\u003e), blame avoidance and non-decision (Bachrach \u0026amp; Baratz, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e1963\u003c/span\u003e; Weaver, \u003cspan citationid=\"CR91\" class=\"CitationRef\"\u003e1986\u003c/span\u003e), regulatory capture and advocacy coalitions (Dal B\u0026oacute;, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2006\u003c/span\u003e; Sabatier \u0026amp; Jenkins-Smith, \u003cspan citationid=\"CR79\" class=\"CitationRef\"\u003e1999\u003c/span\u003e), as well as policy instrumentation and the biopolitics of acceptable risk (Almas, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e1999\u003c/span\u003e; Foucault, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e1976\u003c/span\u003e; Lascoumes \u0026amp; Le Gal\u0026egrave;s, \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e2004\u003c/span\u003e). Three main findings emerge: the accumulation of health and environmental evidence without substantial revision of the standards applicable to E251; the structuring role of pro-additive coalitions in stabilizing regulatory compromises that constrain the scope of reform; and the construction, through regulatory instruments, of a carcinogenic risk rendered politically manageable and socially differentiated. On this basis, the article advances the notions of tumor policies, toxic continuity, and delinquent oncology in public action to capture regulatory regimes that organize the chronic management of toxicity rather than its effective reduction.\u003c/p\u003e","manuscriptTitle":"The art of governing public policy pathologies","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-10 18:23:54","doi":"10.21203/rs.3.rs-8253274/v1","editorialEvents":[{"type":"communityComments","content":1}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"dcee5376-7245-4b7f-a55e-91890cbeb884","owner":[],"postedDate":"December 10th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-01-12T00:23:35+00:00","versionOfRecord":[],"versionCreatedAt":"2025-12-10 18:23:54","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8253274","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8253274","identity":"rs-8253274","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}