TMA Testimony on the Dangers of Raw Milk

Testimony:   House Bill 75 by Rep. Dan Flynn (R-Van)

House Public Health Committee

Presented by: Kimberly Avila Edwards, MD
April 20, 2011  

Good afternoon, Madame Chair Kolkhorst and members of the committee. My name is Kimberly Avila Edwards, MD. I am the medical director of the Texas Center for the Prevention and Treatment of Childhood Obesity, located at Dell Children’s Medical Center. I am here today as a practicing pediatrician and as a representative of the nearly 48,000 physicians of the Texas Medical Association, the Texas Pediatric Society, and the Texas Academy of Family Physicians.   

I am here today to speak on House Bill 75 and to express our strong opposition to this bill.  

Physicians Oppose the Expansion of Raw Milk Sales

Physicians oppose expanding the availability of unpasteurized milk and milk products. Pasteurization is one of the most important life-saving public health achievements. Pasteurized milk is one of the safest and most beneficial food products that any Texan can consume. Our state’s dairy farmers and processors follow uniform, scientifically proven food safety regulations and standards that eliminate bacterial and viral contamination. Because milk has been pasteurized routinely for more than a century, the public no longer understands the purpose of pasteurization. Before Dr. Louis Pasteur discovered pasteurization in the late 1800s and applied it to eliminate milk-borne pathogens, thousands of people became ill and many died from bacteria commonly found in milk. It is because of the success of pasteurization that most people don’t know there is a risk when they drink raw milk or other unpasteurized dairy products. Pasteurization is one of the hallmark achievements in the history of public health. 

Health Risks Associated With Raw Milk Consumption

Raw milk, which is not pasteurized, can contain bacteria that cause serious sicknesses including tuberculosis and brucellosis. Raw milk presents a higher risk for pregnant women, infants, children, and anyone who has a weakened immune system — such as a person with cancer or HIV/AIDS, or who has had an organ transplant. 

Bacteria even can originate from clinically healthy animals from which milk is derived or from environmental contamination occurring during the collection and storage of milk. The consumption of raw milk increases the risk of contracting disease from a foodstuff that is otherwise very nutritious and healthy. Despite concerns to the contrary, pasteurization does not change the nutritional value of milk.

Some people believe that being exposed to the microorganisms in untreated milk equates to being “organic” or “healthy.” They describe this as a so-called health benefits from consuming raw milk products. For example, proponents for raw milk may endorse the “hygiene hypothesis” or “old friend’s hypothesis” — a view that being exposed to microorganisms in the environment helps our immune system build tolerance, making us less likely to get sick. No demonstrated health benefit from consuming raw milk has ever been established in a peer-reviewed scientific research document. There is, however, clear evidence of the many risks associated with raw milk.  

Over a decade, from 1998 to 2008, 86 milk-borne nationwide outbreaks were reported to the Centers for Disease Control and Prevention (CDC) due to raw milk or raw milk products. Presently, it is our understanding that a Texas dairy that sells raw milk was recently shut down because of a particular bacteria outbreak traced to their product. 

People who do not directly purchase raw milk can become ill. A mother that drinks contaminated raw milk will also expose her infant through breast milk or through cross-contamination. Bacteria can pass quickly from one person to another. Raw milk can be consumed by multiple people who are NOT the original purchaser, demonstrating the problems associated with relying on a bottle “label” for consumer education and product warning.   

The wording of the proposed label in the committee substitute to House Bill 75, “Please consult with your physician to determine if this product presents a health risk,” is not practical when applied to the real-world setting, where multiple end-consumers of milk (household members, friends, extended family members, neighbors, etc.) use the product.  

We still must have processing and monitoring of some foods for them to be safe for the general public to consume. Milk is one of the foods that must undergo such processing. We have decades of evidence to support this as true.    

Benefits of Milk

Pasteurization simply keeps Texans safe and decreases the risks. We are left with a nutritionally complete food that is one of the most important components of our diet. As a pediatrician, I can tell you that milk is the only food that newborns and babies need until they are about 6 months old. And while we strongly encourage breastfeeding for babies, milk should be a part of all children’s diet while their bodies are still developing and until they are at least adolescents. In fact, milk or milk products should remain a key part of every person’s diet throughout his or her life. They are not only a component of good nutrition but also are associated with a reduced risk of some chronic conditions such as cardiovascular disease and diabetes.   

When we encourage our patients to drink milk, we do so with the understanding that they can go to any store and have equal access to a safe product. Whichever brand they take from the shelf will have been through the same scientifically proven process that removed the dangerous bacteria. And that is a guarantee for all patients.   

Conclusion

There is no validated evidence to provoke a change in Texas’ public policy on raw milk sales, or to support that presumed benefits of consuming raw milk outweigh the well-established risks.   

We believe current Texas statute is effective in protecting pregnant women, children, and infants as well as the general public. Individuals who want raw milk have access to raw milk. We do not wish to eliminate access to raw milk for those who are willing to take the risks. However, expanding access to raw milk to a commonly visited locale such as a farmers market with little education for consumers unnecessarily expands the risk of illness. This would be counterproductive to a movement we embrace — which is to improve Texans’ access to fresh vegetables and foods for better diets. 

Our physicians strongly encourage you to maintain the effective public health policies we have in place today. Expanding the sales of raw milk and raw milk products will result in greater cost to an already burdened health care system. We implore you as members of the Public Health Committee to ensure that our state’s public policies follow scientific evidence and do not promote harm for a large segment of our Texas population.  

Common microbes associated with raw milk and milk products 

Germ

Risk for humans

Where pathogen is found

Salmonella

Increasing number of salmonella infections are an antibiotic-resistant type.

Cow feces or hair

Listeria

Causes septicemia and meningitis; causes spontaneous abortion or stillbirth.

Soil, plants, and water

Escherichia coli 0157

Hemorrhages and hemolytic uremic syndrome .

Cow feces

Mycobacterium bovis

Spread to humans and causes tuberculosis and resistant to certain TB drugs.

Causes tuberculosis in cows

Campylobacter

Most common cause of diarrheal illness in U.S.

Found in the cow if there she has an udder infection, or if the milk becomes contaminated with feces

Brucella

Causes brucellosis, which can cause flulike illness that may lead to severe infection of the central nervous system or lining of the heart.

Passed among animals

Giardia

Causes giardiasis, a diarrheal disease.

Intestinal parasites of cattle, transmitted through feces

82nd Texas Legislature Testimonies 


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