When Ohio voters were asked last year to approve a constitutional amendment to help maintain a safe food supply, they overwhelmingly said yes, reports Columbus Dispatch.

But statistics show that as many as 350,000 of seven billion eggs produced in Ohio each year may be contaminated with salmonella indicate that safe may be a relative term. That is about one in every 20,000 eggs, according to Ohio Farm Bureau officials.

The $600-million-a-year Ohio-produced egg market is likely to be a focal point in Round Two of a fight between the Ohio Farm Bureau and the Humane Society of the United States (HSUS). Caged and cage-free will become part of the campaign vocabulary as the Humane Society pushes for a fall vote on a constitutional amendment to improve farm animal care.

Eggs are big business in Ohio, second only to Iowa in annual production. There are 27 million egg-laying hens in the state. The industry employs 5,000 people and has an annual payroll of $50 million.

With that volume, food-borne illnesses can be a problem, with a big price tag.

According to Columbus Dispatch, Ohio State University researchers said last year that food-borne illness of all kinds costs the state $5.8 billion annually. They estimated that there are 47,000 cases of salmonella poisoning in Ohio each year, although most go unreported.

According to the Centers for Disease Control and Prevention, the US each year has 76 million illnesses, 325,000 hospitalisations and 5,000 deaths from food-borne contaminants.

Salmonella is the most common food-borne illness. It comes from eating eggs, meat and poultry contaminated with the salmonella bacteria. It can cause abdominal pain, diarrhoea, fever, headache, nausea and vomiting.

Ohio has a higher salmonella infection rate than surrounding states, according to public health statistics. There is even a strain named after the state – Salmonella Ohio.

HSUS lost the first round of the ballot-box battle last fall when voters approved state Issue 2, a constitutional amendment that established the Ohio Livestock Care Standards Board. The society opposed the issue as inadequate but did not actively campaign against it.

This time, the two sides face off in a campaign that could collectively cost $20 million.

In a sense, the battle resumed last week when Wayne Pacelle, president and chief executive officer of HSUS, travelled the state with a group of supportive farmers. Receiving less attention, but backed by stacks of statistics and studies, was Dr Michael Greger, the society's top medical expert.

Mr Greger told Columbus Dispatch that the proposed reforms are as much about food safety and community health as they are about animal welfare.

In particular, Ohio's egg crop is a health risk, Dr Greger said, largely because of the battery-cage units – about the size of an 8½-by-11 sheet of paper – where laying hens spend most of the 13 months of their lives. They are unable to move around or flex their wings and are surrounded by other cages holding tens or even hundreds of thousands of other hens.

It is an atmosphere where salmonella thrives, Dr Greger said, because of an abundance of faecal material, dust, rodents and insects, and difficulty in sanitising the cages.

By comparison, numerous US and international studies have shown that having cage-free or free-range hens cuts the odds of salmonella contamination by 43 per cent, Dr Greger said.

What does that mean for egg lovers? Dr Greger cited a study by the American Journal of Epidemiology that concluded people who eat eggs produced by chickens in cages – the vast majority of those in Ohio – are twice as likely to get salmonella poisoning.

According to Columbus Dispatch, representatives with the Ohio Farm Bureau and other agri-business groups say Dr Greger's arguments are misleading, his facts are misstated, and many of the studies he cites were done in Europe, where standards differ from those in the US.

Jim Chakeres, executive vice president of the Ohio Poultry Association, said salmonella and other food-borne illnesses are a concern for farmers.

He said: "Egg farmers take food safety very seriously. Anything that is a potential threat is serious to us. That being said, we have measures to take to prevent food-borne illness."

He added that incidents of salmonella from eggs have decreased over the years.

In addition, the Ohio Department of Health has operated a voluntary Egg Quality Assurance Program for the past 13 years. Spokesman Kaleigh Frazier cited statistics showing that only two of 219,000 eggs tested in the past decade were positive for salmonella.

If an egg tests positive, the farm must dispose of all eggs or send them to be pasteurised.

A spokeswoman for Ohioans for Livestock Care, the organisation that spearheaded the campaign last fall, said: "Studies show that eggs laid by hens in modern housing systems have a lower prevalence of salmonella." She added that free-range chickens often lay their eggs in their own waste, increasing the risk of contamination; for caged birds, the waste drops away from the eggs.

Further Reading

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You can read more of Dr Greger's opinion on Twitter by clicking here.