Written comments of the Texas Medical Association on House Bill 91
Senate Committee on Intergovernmental Relations
by Rep. Dan Flynn
May 25, 2015
The Texas Medical Association, on behalf of our 48,000-plus physician and medical student members and the millions of Texans that we serve, is pleased to offer testimony on House Bill 91. The physicians of this great state are committed to improving the health of all Texans. As such, we believe it is our duty to warn policy makers when initiatives threaten the health of our communities as does HB 91.
Milk is highly susceptible to contamination with bacteria. It is for this reason that our state's dairy farmers and processors follow uniform, scientifically proven food safety regulations and standards that eliminate bacterial and viral contamination. Pasteurization is one of the most effective public health practices put into place in the United States. The consumption of unpasteurized milk was a significant major cause of disease outbreaks before pasteurization was routinely practiced in the U.S. It is largely because of the safety assured with pasteurization, that today, the public does not know that drinking raw milk or other unpasteurized dairy products can make some people very sick with a foodborne illness.
Unpasteurized raw milk can contain bacteria that cause gastrointestinal illnesses and serious diseases. Most raw milk-related outbreaks in the past several years have been associated with the campylobacter pathogen - a leading cause of foodborne illnesses. And while some consumers have mild reactions to these pathogens, these present a much higher risk for pregnant women, infants, children, and anyone who has a weakened immune system (older persons or people with cancer or HIV/AIDS, or who have had an organ transplant).
The most recent national review of U.S. outbreaks associated with raw milk showed that the number of disease outbreaks increased from 2007 to 20121, and most of these outbreaks (77 percent) occurred in states where raw milk sales are legal. These outbreaks sickened almost 1,000 and required 73 hospitalizations.
There is lack of science and practice on what would make raw milk safe. We encourage you to task one of our state public health institutions with this question. If the wider distribution and sale of raw milk is legalized, the Texas Department of State Health Services (DSHS) will need to convene state and national experts to develop rules to determine an adequate level of safety for raw milk products. In the end, DSHS will need to adopt evidence-based standards that will minimize the threat to health. This would entail identifying minimum temperature and testing requirements for these products. It also would involve establishing new requirements for the transport of raw milk, which presents a great opportunity for contamination of both raw and pasteurized milk.
Sales in farmers markets present unique concerns because of the diverse environments across the state. DSHS or local public health officials will need to establish standards or guidelines to address variable factors such as outdoor temperature, environmental conditions, sampling of the milk and milk products, and transportation of raw milk products to ensure the raw milk sold at farmers markets does not become further contaminated.
While we are grateful for the minimal labeling that is provided for in HB 91, we would urge additional steps to inform the public about the risks of consuming unpasteurized dairy products. Raw milk should encounter the same level of testing as other milk products.
If the state relaxes the current restrictions on the sale of raw milk, it is a fact more people will become ill from raw milk consumption. This will result in greater costs to the state and local government for investigation, inspection, and the care of those who will need to be hospitalized. These illnesses and hospitalizations are preventable.
While many individuals believe consuming raw milk will help improve their health, no studies with scientific merit have confirmed health benefits from drinking raw milk over pasteurized milk. And no studies have demonstrated that the presumed benefits of some having easier access to raw milk outweighs the risk of making potentially unsafe food more accessible to many vulnerable populations.
We continue to warn this committee of the assured future outbreaks of foodborne illness due to wider distribution of raw milk. States are in the best position to consider the balance of allowing individuals to make choices on the consumption of raw milk and raw milk products and the risk to public health. We look forward to working with Representative Flynn and the members of the House Public Health Committee to identify a balance of expanding existing access to raw milk products and the risk to public health throughout the state.
1Emerging Infectious Diseases, Increased Outbreaks Associated with Nonpasteurized Milk, United States, 2007-2012, Vol, 21, No. 1, January 2015, www.cdc.gov/eid.