Human Illness Costs of Foodborne Bacteria

Abstract

The economic costs of human illness caused by two bacterial contaminants of food (Salmonella and Listeria) have been used to extrapolate costs to other bacterial caused human illness. A bacterium-by-bacterium estimate is necessary because each enters the food chain in different ways and at different locations. Also, each bacterium and its toxins respond differently to control procedures. Future benefit/cost analyses of foodborne disease control will need to consider the costs of foodborne disease, potential benefits from control, the responsiveness of the specific bacterium and toxins to the alternative control measures, and the costs of control measures at different points in the food chain. This study provides a first approximation of human illness costs (medical costs and productivity losses) for specific bacteria contaminating the U.S. food supply. The National Academy of Sciences has called for using risk assessment in setting priorities in food safety programs. Economics can enhance the risk assessment and risk management process by providing a uniform measure for evaluating the costs and benefits to be gained from strategies to control contamination of food. From an economic efficiency perspective, too much inspection for low probability health risks or inspection not directly related to reducing health risks can be as costly as too little inspection with consequent foodborne disease costs. The key to optimal regulation is to determine when marginal social costs equal marginal social benefits. Economic cost of disease estimates assign different relative importance to diseases than other health indices. Mushkin compared rankings of economic costs with other health status measures for seventeen disease categories. The importance of the diseases varies markedly with the measure used: foodborne disease falls in the category of infectious and parasitic diseases, which ranks seventh in importance for number of disability days, eleventh for number of deaths, and fourteenth in economic costs to society of the seventeen disease categories (Mushkin). The literature on the social cost of foodborne disease is new and limited to either broad estimates (Garthright, Archer, and Kvenberg; Archer and Kvenberg; Todd 1985a, p. 159) or estimates for a specific foodborne disease outbreak (Todd 1985a, b; Cohen et al.; Shandera et al.); neither are very useful for benefit/cost analyses. The former are too general and do not permit a correlation between a specific pathogen and various control options. The latter are narrow and do not capture the wide range of outcomes (mild illness to death) for he specific bacterium. Data exist for two foodborne bacteria that take account of all known acute cases, yielding cost-of-illness estimates for the whole bacterial disease profile. Thes tw diseases represent extremes on a continuum of likely foodborne disease outc mes. Using these data in combination with epidemiological data on incidence and severity, t is paper extrapolates costs to other foodb rne bacteria to make a first approximation of the cost of all bacterial pathogens.