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ERS* Updates Foodborne Illness Costs

Food Safety v.23, i.3, USDA Sep/Dec00

*Economic Research Service, United States Department of Agriculture

Using revised estimates of the annual number of foodborne illnesses in 1998 released by CDC in September 1999, ERS updated foodborne ill-ness costs for four major pathogens: Campylobacter (all serotypes), Salmonella (nontyphoidal serotypes only), E. coli O157:H7, and Listeria monocytogenes. The new estimates of the number of cases, hospitalizations, and deaths from these foodborne pathogens were derived, in part, from data gathered by the FoodNet surveillance system. For the first time, ERS also included the costs due to other Shiga toxin-producing strains of E. coli, collectively known as E. coli non-O157:H7 STEC. ERS estimates that the annual economic costs of medical care, productivity losses, and premature deaths due to foodborne illnesses caused by these five pathogens are $6.9 billion (see table).

Estimated Annual Costs of Five Foodborne Pathogens Total $6.9 Billion

Pathogen Estimated annual foodborne illnesses 1 Estimated annual foodborne illness costs 2
Cases Hospitalizations Deaths
  ----------------  Number  ---------------- $ billion 3
Campylobacter spp. 1,963,141 10,539 99 1.2
Salmonella, nontyphoidal 1,341,873 15,608 553 2.4
E. coli O157:H7 62,458 1,843 52 .7
E. coli, non-O157 STEC 31,229 921 26 .3
Listeria monocytogenes 2,493 2,298 499 2.3
Total 3,401,194 31,209 1,229 6.9

1 From Centers for Disease Control and Prevention (see Mead et al.,1999).
2 The total estimated costs include specific chronic complications in the case of Campylobacter (Guillain-Barré syndrome), E. coli O157:H7 (Hemolytic uremic syndrome), and Listeria monocytogenes (congenital and newborn infections resulting in chronic disability or impairment). Estimated costs for Listeria monocytogenes exclude less severe cases not requiring hospitalization.
3 August 2000 dollars.
Source: USDA’s Economic Research Service.

Along with new data on illnesses, cases, and deaths, ERS also revised the methodology for valuing premature deaths. In the past, ERS valued a premature death by using a "risk premium" revealed by labor market studies of the higher wages paid to people employed in high-risk occupations. This single value was applied to all premature deaths, regardless of the age at which the death occurred. The value of a premature death was $6.5 million in August 2000 dollars. Using new data on the age distribution of deaths caused by the five pathogens, ERS now adjusts the economic cost of premature deaths to account for age at time of death. Under the age-adjusted approach, the assumed cost of each death ranges from $8.9 million for a child who dies before his or her first birthday to $1.7 million for a person who dies at age 85 or older.

Because the five microbial pathogens have different health out-comes for different age groups, adjusting for the age of death raises the cost of some foodborne illnesses and lowers the cost of others. For example, the annual cost of food-borne illnesses caused by Salmonella decreases from $3.7 billion to $2.4 billion, when adjusted for age at the time of death, because over two-thirds of the deaths from salmonellosis occur in people over 65. On the other hand, adjusting foodborne illness costs for E. coli O157:H7 by age at time of death increases the estimates by $68 million because most deaths occur in children under the age of 5.

ERS currently measures the productivity losses due to nonfatal food-borne illnesses by the value of fore-gone or lost wages, regardless of whether the lost wages involved a few days missed from work or a permanent disability that prevented an individual from returning to work. Using the value of lost wages for cases resulting in disability under-states an individual's willingness to pay to avoid disability because it does not account for the value placed on avoiding pain and suffering.

The willingness-to-pay measure derived from labor market studies that ERS uses to value a premature death is not an appropriate measure of willingness to pay to avoid disability because it measures the higher wages paid to workers to accept a higher risk of premature death, not disability. Methods have been suggested to adjust willingness to pay to reduce the risk of premature death downward to estimate willingness to pay to avoid disability, but there is no consensus among economists. ERS' conservative estimates of the annual costs due to foodborne illnesses (particularly the chronic conditions associated with Campylobacter) would be substantially increased if willingness to pay to avoid disability, pain, and suffering were also taken into account.

As these new estimates of food-borne illness costs are based on new data and improved methodologies for valuing these costs, the estimates presented here are not directly comparable to earlier ERS estimates of the costs of foodborne disease. In addition, because the underlying data are for a single year, the new cost estimates should not be used to infer whether these costs are decreasing or increasing over time. ERS will continue to update and refine these cost estimates. Research is also underway to estimate the costs of arthritis caused by exposure to foodborne pathogens.

For more information, contact Paul Frenzen at 202-694-5351 or pfrenzen@ers.usda.gov , or contact Jean Buzby at 202-694-5370 or jbuzby@ers.usda.gov

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