Risk assessmentindependent cross-checkabstract checked★ key study I-VEG-134 standard review
EFSA: raw leafy greens top plant-food hazard
Scientific Opinion on the risk posed by pathogens in food of non-animal origin. Part 1 (outbreak data analysis and risk ranking of food/pathogen combinations).
Overview
EFSA Panel on Biological Hazards (BIOHAZ). EFSA J 2013 · PMID 42124987 · DOI 10.2903/j.efsa.2013.3025
EFSA ranked Salmonella in raw leafy greens as the highest-risk plant food combination; outside the 2011 sprout outbreak, plant foods caused 5% of outbreak deaths.
Does the study support the specific claim? Yes · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Rank pathogen risks in plant foods.
- How was the study done?
Risk ranking.
- How many people, animals or samples were studied?
EU outbreaks 2007-2011.
- What was actually found?
Leafy greens top; melons ranked.
- How large was the observed effect?
FoNAO 10% outbreaks.
- What do the results mean in everyday life?
Wash and handle salads safely; serious cases are uncommon.
- What are the study's limitations?
Outbreak data.
- What does it say about Elawady's specific claim?
Supports the claim.
- Do the results apply to Germany and Europe?
EU.
- What can explicitly not be concluded from this study?
No per-serving risk.
Scientific in-depth review
1. Full reference
- Authors
- EFSA Panel on Biological Hazards (BIOHAZ)
- Journal
- EFSA J
- Year
- 2013
- Identifier
- PMID 42124987 DOI 10.2903/j.efsa.2013.3025
- Verification
- verified – PubMed efetch 2026-10-26; Crossref 2026-10-26
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
EFSA (public agency)
2. Research question
Which food-of-non-animal-origin/pathogen combinations pose the greatest risk in the EU?
3. Study design and population
- Study design
- Risk assessment – EFSA scientific opinion: outbreak data analysis and risk ranking of food/pathogen combinations
- Population
EU outbreak data (EU Zoonoses Monitoring)
- Country
European Union
- Period
2007-2011
- Sample size
EU-wide outbreak data
- Inclusion and exclusion criteria
not stated in abstract
4. Methods and endpoints
- Exposure / intervention
Food of non-animal origin (FoNAO)
- Comparator
Food of animal origin
- Endpoints
Outbreaks, cases, hospitalisations, deaths; risk ranking
- Statistical methods
Multi-criteria ranking model (7 criteria)
5. Actual results
- Results
FoNAO associated with 10% of outbreaks, 26% of cases, 35% of hospitalisations and 46% of deaths (2007-2011); excluding the 2011 VTEC O104 outbreak: 10%, 18%, 8% and 5%. Top-ranked combination: Salmonella and leafy greens eaten raw; then Salmonella with bulb/stem vegetables, tomatoes, melons, and pathogenic E. coli with fresh pods, legumes or grain.
- Absolute risks
not reported
- Authors' conclusion
Leafy greens eaten raw are the top-ranked FoNAO hazard combination in the EU.
6. Strengths
- EU-wide data; explicit ranking
7. Weaknesses
- Outbreak-based; dominated by one 2011 event
8. Risk of bias
- Orienting tool
- none applicable
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- not assessable
- Rationale
Agency risk assessment.
9. Assessment of the statistical interpretation
Without the single sprout outbreak, FoNAO accounted for 5% of outbreak deaths (stats/C-VEG-03_outbreaks.py).
10. Relevance to the specific claim
European confirmation that leafy greens (and melons) rank highest among plant foods for pathogen risk, with modest share of severe outcomes outside 2011.
11. Independent contrary findings
Painter 2013 (deaths mainly poultry).
12. Transferability to Germany and Europe
EU.
13. Overall methodological judgement
Supports the claim and its limits.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | not assessable |
| Precision of results | not applicable |
| Directness | direct |
| Reproducibility | unknown |
| Consistency with the overall evidence | consistent |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
none
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