'Because these new estimates of foodborne 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.

2 Data from the Centers for Disease Control and Prevention, Food-Related Illness and Death in the United States by Mead et al.

3 The total estimated costs include specific chronic complications in the case of Campylobacter (Guillain-Barre syndrome), E. coli 0157:H7 (hemolytic uremic syndrome), and Listeria monocytogenes (congenital and newborn infections resulting in chronic disability or impairment). Estimated costs for L. monocytogenes exclude less serious cases that do not require hospitalization.

4ERS currently measures the productivity losses due to nonfatal foodborne illnesses by the value of forgone 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 probably understates 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, such as the approach based on measuring quality adjusted life years (QALYs). As yet, there is no consensus among economists about how to use these methods to value willingness to pay to avoid the disability, pain, and suffering associated with foodborne illnesses. ERS's 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.

borne illness (Table 7.3). In their estimates for human foodborne illness costs, both ERS and CFSAN include medical costs, productivity losses from missed work, and an estimate of the value of premature deaths. CFSAN also includes an estimate of the cost of pain and sulfering due to illness.

The vast majority of foodborne illnesses are classified as "acute." These are usually self-limiting and of short duration, although the cases can range from mild to severe. Gastrointestinal problems and vomiting are common acute symptoms of many foodborne illnesses. Deaths from acute foodborne illness, although rare, are more likely to occur in the very young (including the fetus), the elderly, or patients with compromised immune systems (such as those suffering from AIDS and cancer) (CAST, 1994).

TABLE 7.3. CFSAN Estimated Annual Costs Due to Selected U.S. Foodborne Pathogens, 20001


Billion 2000 dollars

Bacterial Infections


Clostridium perfringens Shigella

E. coli 0157:H7 Listeria monocytogenes

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