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Which foods cause food poisoning in the US
Attribution of foodborne illnesses, hospitalizations, and deaths to food commodities by using outbreak data, United States, 1998-2008.
Overview
Painter JA et al.. Emerg Infect Dis 2013 · PMID 23622497 · DOI 10.3201/eid1903.111866
Leafy vegetables caused the most outbreak illnesses (22%), poultry the most deaths.
Does the study support the specific claim? Partly · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Attribute illness
- How was the study done?
Model on outbreak data
- How many people, animals or samples were studied?
US 1998-2008
- What was actually found?
Leafy vegetables 22% illnesses
- How large was the observed effect?
6% deaths
- What do the results mean in everyday life?
Hygiene matters for greens and poultry.
- What are the study's limitations?
Outbreak-based
- What does it say about Elawady's specific claim?
Partly supports
- Do the results apply to Germany and Europe?
Moderate
- What can explicitly not be concluded from this study?
Cannot give per-serving risk.
Scientific in-depth review
1. Full reference
- Authors
- Painter JA et al.
- Journal
- Emerg Infect Dis
- Year
- 2013
- Identifier
- PMID 23622497 DOI 10.3201/eid1903.111866
- Verification
- verified – PubMed efetch 2026-10-25; full text read via Europe PMC (PMC3647642)
- Retracted
- no
- Corrections
- none
- Extent checked
- full text
- Conflicts of interest and funding
not stated in abstract
2. Research question
Attribute US foodborne illness burden to 17 commodities.
3. Study design and population
- Study design
- Other – Attribution model using outbreak data
- Population
US outbreak data
- Country
USA
- Period
1998-2008
- Sample size
Outbreaks 1998-2008 (bacterial 2,468 among others)
- Inclusion and exclusion criteria
Outbreaks with known food
4. Methods and endpoints
- Exposure / intervention
17 commodities
- Comparator
Between commodities
- Endpoints
Illnesses, hospitalisations, deaths
- Statistical methods
Attribution modelling
5. Actual results
- Results
Produce 46% of illnesses; leafy vegetables 2.2 million illnesses (22%), most of any commodity, largely norovirus; leafy vegetables 6.0% of deaths; poultry most deaths.
- Absolute risks
Not applicable (population burden)
- Authors' conclusion
Efforts needed to prevent contamination of produce and poultry.
6. Strengths
- National scope
7. Weaknesses
- Outbreak data may not represent sporadic illness
8. Risk of bias
- Orienting tool
- none applicable
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Model assumptions.
9. Assessment of the statistical interpretation
Attribution estimates.
10. Relevance to the specific claim
Context for C-VEG-03.
11. Independent contrary findings
Poultry most deaths.
12. Transferability to Germany and Europe
Moderate.
13. Overall methodological judgement
Confirms outbreak share; relativises severity.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | some concerns |
| Precision of results | moderate |
| Directness | direct |
| Reproducibility | partly replicated |
| Consistency with the overall evidence | consistent |
| Regional transferability | moderate |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
Per-serving risk.
15. Linked fact checks
- Leafy greens and cucurbits are at the centre of the modern fresh-produce outbreak record (E. coli, Salmonella, Listeria). – Studies supporting the claim