Survey Examines Public Responses to 2006 Spinach Recall

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Health & Medicine Week

February 26, 2007

Every year, the U.S. Food and Drug Administration (FDA) issues dozens of food-related recalls, withdrawals and advisories. But few receive the attention that the advisory regarding E.coli-contaminated spinach received in September 2006. The broad scale of the resulting recall and related media attention provided a unique opportunity for researchers at the Rutgers Food Policy Institute (FPI) to study the U.S. food recall system. The results of this study were published on FPI's web site, www.foodpolicyinstitute.org.

To investigate the public's reactions to this incident, a nationally representative sample of 1,200 Americans were interviewed by telephone from November 8 to 29, 2006. The results of the nationwide telephone survey describe the level of consumer awareness and knowledge of the recall and foodborne illness. The results also provide insight into consumer behavior during the recall and likely future behavior in response to the recall.

"We examined both the successes and of the failures of this particular recall," said William Hallman, Director of the Food Policy Institute. "Our survey not only provides data to improve communications about future food recalls, but also enables us to explore how our systems might work in the case of intentional food contamination."

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 87% of Americans. More than eight in ten (84%) of those who had heard about the recall said that they had also talked about it with others. In addition, the data clearly indicate that the majority of consumers did stop eating spinach because of the recall.

"As a result, the main public health goal of the recall was met," said Hallman, "However, fewer Americans were aware of important details related to the recall. Many were confused about the types of spinach affected, where it was grown, the organism that caused the contamination, the symptoms of the resulting illness, and perhaps most significantly, whether or not the recall had ended."

While nearly all (95%) of those who had heard about the recall knew that bagged fresh spinach had been recalled, only about two-thirds (68%) knew that loose fresh spinach was also part of the recall. However, they were confused about the safety of frozen and canned spinach during the recall, as only 57% and 71%, respectively, knew they were not affected by the recall.

Only half (52%) knew that the contaminated spinach had been grown in California, and only half (52%) could identify E. coli as the contaminant that made people ill. In addition, while 87% of Americans correctly recognized that abdominal cramps are a common symptom of E. coli infection, only about two-thirds (64%) of Americans correctly recognized the key symptom, bloody diarrhea. Instead, Americans are more likely to incorrectly associate the symptoms of nausea (88%) and vomiting (87%) with an E. coli infection. Moreover, though not generally associated with E. coli infections, more than three-quarters (77%) of Americans identified fever as a symptom, and nearly one-quarter (22%) reported that rashes were a symptom despite the fact that they are not commonly associated with any foodborne illness.

"Most Americans know little about the symptoms of foodborne illnesses," said Hallman, "E. coli infections are no exception." Although the recall caught the attention of the American public, not everyone followed the advice of the FDA. More than one-in-ten (13%) of those who ate spinach before the recall reported that they ate fresh spinach during the recall, and nearly three-quarters (74%) of them knew about the recall at the time.

Some Americans went to the other extreme, generalizing the warnings about spinach to other similar foods. Nearly one-fifth (18%) of those aware of the recall said they stopped buying other bagged produce because of the spinach recall. In addition, nearly half (48%) reported that the spinach recall caused them to wash their food more thoroughly.

"Clearly, the recall had a bigger effect on the public than just throwing away a few bags of spinach," Hallman notes, "Consumers confidence in the safety of other produce seems to have been affected."

While almost all Americans got the initial message that they should not eat fresh spinach, many fewer got the message that it is safe to eat it again. As of November 2006, many people were confused about the status of the recall. Thirteen percent believed that it was still in effect, and 18% said they did not know if it was still ongoing.

However, most spinach-eaters who knew about the recall said that they were already eating spinach again (44%) or may go back to eating spinach (47%), many within the next several months. Most Americans view their likelihood of getting sick from eating spinach as lower after the recall than during or even prior to the recall. Nonetheless, 5% of spinach-eaters who were aware of the recall said that they will never go back to eating spinach.

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