Putting a Price Tag on Food Unsafety

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Illness from contaminated food, ranging from minor stomachaches and queasiness to life-threatening E. coli infections, are a serious public-health threat in the U.S., resulting in 5,000 deaths and 325,000 hospitalizations each year, according to the Centers for Disease Control and Prevention (CDC). When tallied up, the consequences of foodborne illness — including doctor visits, medication, lost work days and pain and suffering — cost the U.S. an estimated $152 billion annually. That figure was reported on Wednesday in a new study by the Produce Safety Project, an initiative of the Pew Charitable Trust.

"These are preventable deaths," says Rosa DeLauro, a Democratic Representative from Connecticut who has taken the lead on food safety in Congress. "Those numbers represent real sickness, pain and even death for American families."

The new estimate of cost is well above previous calculations of the impact of food-safety problems, and the new study suggests that foodborne illness will continue to take an increasing toll on public health if the nation's frayed food-safety net is not repaired. President Barack Obama called for new food-safety regulations a year ago, and the House of Representatives passed a bill to overhaul the system last July. The onus now is on the Senate, which is still waiting to act. "This study underlines how important this battle is," says Jim O'Hara, director of the Produce Safety Project. "We live in a world of limited resources, and we need to know where the risks are and what interventions we need to put in place."

Previous reports have pegged the total cost of foodborne illness at between $6.9 billion and $35 billion, based on past estimates by the U.S. Department of Agriculture (USDA) and Food and Drug Administration (FDA). But those numbers are almost surely based on serious undercounting. Most cases of foodborne illness are never officially reported — for every one case of E. coli that goes into the books, another 20 are undocumented. What's more, the FDA and USDA focus on just a handful of reportable pathogens: E. coli, campylobacter, salmonella and listeria, which excludes the many cases of food poisoning for which doctors do not identify a cause.

Rather than relying on such underestimates, the Produce Safety Project study used CDC data showing that there are 76 million new cases of foodborne illness in the U.S. each year. Study author Robert Scharff, a professor at Ohio State University and a former FDA economist, then tried to account for the overall cost of illness, factoring in every expense, from onetime costs for prescription medication to losses in "quality of life" — a dollars-and-cents picture of exactly how miserable that bout with a bad falafel made you. "The study really illustrates just how serious foodborne illness is as a problem in society," says Scharff, who also ranked all 50 states by total costs of illness and costs per case.

On average, each case of foodborne illness cost $1,850; in Hawaii, where everything is more expensive, each case incurred $2,008 in damages, the highest in the U.S. (Rounding out the top 10 states with the highest costs: Florida, Connecticut, Pennsylvania, South Carolina, the District of Columbia, Mississippi, New York, Massachusetts and New Jersey.)

Despite the headlines generated by food scares and outbreaks of contaminants — such as the salmonella outbreak that led to a massive recall of peanut products beginning in January 2009 — food safety rarely gets the attention it deserves. That's partially because the food-safety system in the U.S. is impenetrably complex; some 15 federal agencies are responsible for keeping the nation's food supply safe, which means that oversight in many cases falls through the gaps between the FDA, CDC and USDA. The USDA, for instance, is responsible for the safety of meat and poultry; the FDA handles other cases of food contamination; and the CDC tracks human illness in general.

Meanwhile, the food system itself has grown more complex. Bagged salad, for instance, which has proven to be a persistent risk for contamination, can include produce from several different farms, which makes it difficult to trace outbreaks of illness to their source. Our food system is 21st century, but our government's food-safety system is stuck in the 1900s.

Public-health officials and legislators hope that reports like this one, which can put a dollar figure on the pain and suffering caused by foodborne illness, may help prompt change. Late last year, the Committee on Health, Education Labor and Pensions unanimously approved the FDA Food Safety Modernization Act, which is currently in front of the Senate. "It's our job to go to war against foodborne illness," says DeLauro. "We can't afford to wait." At $152 billion a year, the meter is running.