Rutgers spinach report: Conclusion

From the Rutgers Food Policy Institute:


CONCLUSIONS

The results of the survey show that the FDA’s main message to consumers warning that bagged fresh spinach had been contaminated and should not be eaten was heard by most Americans. Moreover, the data clearly indicate that the majority of consumers did stop eating spinach during the recall. As a result, the main public health goal of the recall was met. However, fewer Americans were aware of important details related to the recall. Many were confused about the types of spinach affected, the organism that caused the contamination, the symptoms of the resulting illness, and perhaps most significantly, whether or not the recall had ended.


TK: As surely FDA bears some credit for the effectiveness of the recall, it must take its share of culpability for the lack of consumer knowledge about the particulars of the recall and the end of the recall.


As a result, the data suggest that there were also some unintended consequences of the recall. While most consumers stopped eating spinach as a result of the recall, the data show that many stopped buying other bagged produce as well. This is reflected in the decline in sales of spinach and other produce reported by industry. However, our data are likely to underestimate the full effect of the recall on produce sales. All of the respondents to the survey were interviewed by November 29, 2006. Soon after, on December 6, 2006, the FDA announced that it was investigating E. coli O157:H7 infections associated with multiple Taco Bell restaurants in four states. This outbreak sickened 71 people, resulting in the hospitalization of 53, and in 8 cases of hemolytic uremic syndrome by the time it was considered over on December 14, 2006. Green onions contaminated with E. coli were originally suspected as the cause of the outbreak, and were voluntarily recalled from Taco Bell restaurants; however, the FDA narrowed its investigation by focusing its efforts on finding the sources of shredded iceberg lettuce served at the restaurants. The result of two serious, widely publicized E. coli contamination incidents occurring in rapid succession has likely amplified consumer awareness and concerns about the safety of eating fresh produce. In part, this may be due to a violation of consumer expectations regarding foods such as spinach and lettuce that have typically been viewed as healthy, and are often eaten as a way of maintaining one’s personal well-being. In addition, because these types of produce are often eaten in a raw form, consumers have little ability to make the products safer once they have been purchased. Indeed, the one post-purchase action consumers can take, thoroughly washing produce, was dismissed as ineffective in the case of the spinach contamination. Most food product recalls are limited in scope and are normally issued to recover the products of a single manufacturer or distributor, and are often restricted to the food manufactured or processed at a single location, to specific lot numbers, and distributed within a circumscribed area. Thus, the broad nature of the recall, suggesting that all fresh spinach across the country should be considered as potentially contaminated and therefore unsafe to eat, combined with a message that no amount of washing would make it safe, distinguished it from the more routine advisories and notice of recalls typically issued by the FDA.

TK: What a message to try to recover from: all spinach is unsafe and no amount of washing will do you any good!


The unusual nature of the spinach recall, suggesting that anyone who ate fresh spinach was vulnerable to becoming ill, that there was little that consumers could do to avoid getting sick other than to stop eating it, and the potentially serious consequences of being infected with E.coli O157:H7 likely lead to both the extensive media coverage it received and to the large number of conversations Americans report having had about it. In addition, there remains considerable ambiguity concerning the vector responsible for the presence of the E. coli on the contaminated spinach. Although a genetic match for the particular strain of E. coli O157:H7 responsible for making some people sick was found in samples taken from a stream and from feces of cattle and wild pigs present on ranches implicated in the outbreak19, it is unlikely that investigations will ever reveal the exact mechanism by which the
spinach was contaminated and speculations about its cause continue. The fact that a definitive cause of the outbreak has not been definitively identified or remediated may help to explain the reluctance of some consumers to resume eating spinach or other produce grown in the same way, or in the same geographic areas as the contaminated spinach.

TK Another consumer frustration: no bottom line answer as to what caused outbreak, leading to mistrust.


For some consumers, the spinach recall may be a type of “signal event” indicating a wider problem that they do not yet see as having been solved. This may have been reinforced by the lack of a definitive statement by the government indicating that spinach was now “safe” to eat. Instead, the FDA issued a press release on September 22, 2006 indicating that “the public can be confident that spinach grown in the non-implicated areas can be consumed.” This also likely generated much less press coverage than the original press releases warning consumers that they should not eat any fresh spinach.Whether due to a lack of a definitive statement, lack of press coverage, or lack of attention by consumers, it is clear that many Americans did not get or believe the message that spinach is now safe to eat. As of November 2006, nearly half of those who had heard about the spinach recall were not completely confident that it had ended.

TK: FDA is in a tough spot, no doubt, but their decision to accelerate and elevate news about foodborne illness outbreaks is apparently rife with muddy communication.

In addition, only a little more than half thought it definitely true that authorities had declared that at fresh spinach available in supermarkets “safe to eat.” The ambiguity regarding the end of the recall and lack of closure to the incident may explain why, though most people say they will go back to eating spinach, many said that they would wait an average of two months before doing so. In part, this waiting period would likely be used by consumers to make sure that the contamination problem was truly over. The E. coli O157:H7 infections associated with Taco Bell restaurants occurred during this “wait and see” period likely reinforced some consumers’ beliefs that contamination problems involving produce had not yet been resolved. The fact that produce sales have not yet recovered following these outbreaks supports this speculation. Finally, while purposeful contamination was not suspected in this incident, it may be possible to draw some applicable lessons. Since the probable goal of intentional contamination is to create maximum uncertainty about the safety of the food supply, had the spinach been purposefully adulterated, the ambiguity surrounding the cause, scope, and impacts of the contamination would likely have been significantly greater. Moreover, without apprehending the perpetrators accompanied by definitive information and action designed to prevent further contamination by others, it might not be possible for the government to give an “all clear” signal that would be accepted by consumers. In the absence of such a definitive signal, consumers would likely continue to mistrust the safety of the product and would likely generalize their concerns to other
products.

TK: Collateral damage in the produce aisle: the worst of all worlds. As bad as E. coli outbreak was, a terror attacks on U.S. fresh produce would be far worse.

Moreover, the length of the “wait and see” period imposed by consumers concerned with the safety of these products would likely be considerably longer.