New research shows that many consumers may not be aware that  uncooked flour causes foodborne illnesses 

TAMPA FL, December 7, 2022 — In the last decade, raw or uncooked flour has been identified as an emerging source of food poisoning. One of the problems may be this: in a recent survey, as many as two thirds of participants admitted to eating raw cookie dough. New research shows that consumers may be unaware that, like eggs, flour is a raw food that can be contaminated by bacteria like Salmonella and E. coli.   

Two new studies on the costs and hazards of eating uncooked flour will be presented during a symposium on food safety risks at the Society for Risk Analysis Annual Meeting, Dec. 4-8 in Tampa, Florida. In her presentation, “Do Not Eat Raw Dough – A Case Study of Communicating Food Safety Risks with Consumers,” Betty Feng of Purdue University describes her research on consumer awareness of the risks of handling raw flour. In a second study, Rubait Rahman of Michigan State University identifies outbreaks associated with flour and flour-based products from 2001 to 2021 and estimates the economic burden of foodborne illnesses associated with these products. 

The Centers for Disease Control (CDC) estimates that one in six Americans gets a foodborne disease every year and Salmonella and E. coli are among the top five pathogens that send people to the hospital. Both bacteria have recently been identified as the cause of flour-based illnesses. (In 2021, an E. Coli outbreak in 12 states was linked to a cake mix.)  

Last year, Feng and colleagues reported that 85 percent of consumers surveyed were unaware of flour recalls or illness outbreaks, and only 17 percent of those who use flour to bake believed they would be affected. Despite the fact that both the CDC and the FDA have recently published fact sheets on the dangers of eating raw dough, 66 percent of the consumers surveyed said they eat raw cookie dough or batter.  

Feng will present more details on this research along with the results of a recent eye-tracking study in which only two out of 47 participants found the flour-safety messages on all 10 commercially available baking-mix or flour packages. “Our research showed that flour safety messages on the current packages are not effective to convey information and change consumer behavior,” says Feng. 

In a separate study, “Foodborne Illness Outbreaks in Flour and Flour-Based Food Products from Microbial Pathogens in the US and Their Economic Burden from 2001-2021,” Rahman and colleagues find that nine foodborne illness outbreaks associated with flour and flour-based food products occurred in the United States over the past 20 years (2001-2021). These outbreaks resulted in 752 cases of reported illnesses, 30 percent of which required hospitalization. Most of those reported illnesses, caused by Salmonella and E. coli infections, involved the consumption of raw flour or unsafe handling of a flour-based product. 

But the team’s research indicates that more than 19,000 cases of foodborne illness associated with these products can occur every year in the U.S. – more than 500 times the reported number of cases. Their analysis accounts for factors such as underreporting and underdiagnosis, resulting in a public health burden far exceeding the statistics officially reported.  

Based on their estimate of the number of cases from 2001-2021, Rahman and his colleagues find that the average economic cost of flour food poisoning can be as high as $258 million each year. This includes costs associated with direct medical care, productivity losses, premature mortality, and includes measures for pain and suffering resulting from these illnesses.  

“Many of these costs can be avoided by creating better public awareness of the risks of consuming raw flour and flour-based products,” says Rahman.