Raw milk
Raw milk or unpasteurized milk is milk that has not undergone pasteurization, a process of heating liquid foods to kill pathogens for safe consumption and extension of shelf life.[1]
Proponents of raw milk have asserted numerous supposed benefits to consumption, including better flavor, better nutrition, contributions to the building of a healthy immune system and protection from allergies.[2] However, no clear benefit to consumption has been found; the medical community notes there is increased risk of contracting dangerous milk borne diseases from these products.[3] Substantial evidence of this increased risk, combined with a lack of any clear benefit, has led countries around the world to either prohibit the sale of raw milk or require warning labels on packaging when sold.
In countries where it is available for sale, its availability and regulations around its sale vary. In the European Union, individual member states can prohibit or restrict the sale of raw milk, but it is not banned outright; in some member states, the sale of raw milk through vending machines is permitted, though the packaging will typically instruct consumers to boil before consumption.[4] In the United States, some dairies have adopted low-temperature vat pasteurization, which they say produces a product similar to raw milk.[citation needed]
History of raw milk and pasteurization
[edit]Humans first learned to regularly consume the milk of other mammals following the domestication of animals during the Neolithic Revolution or the development of agriculture. This development occurred independently in several places around the world from as early as 9000–7000 BC in Mesopotamia[5] to 3500–3000 BC in the Americas.[6] The most important dairy animals—cattle, sheep and goats—were first domesticated in Mesopotamia, although domestic cattle had been independently derived from wild aurochs populations several times since.[7] From there dairy animals spread to Europe (beginning around 7000 BC but not reaching Britain and Scandinavia until after 4000 BC),[8] and South Asia (7000–5500 BC).[9]
Pasteurization is widely used to prevent infected milk from entering the food supply. The pasteurization process was developed in 1864 by French scientist Louis Pasteur, who discovered that heating beer and wine was enough to kill most of the bacteria that caused spoilage, preventing these beverages from turning sour. The process achieves this by eliminating pathogenic microbes and lowering microbial numbers to prolong the quality of the beverage.
After sufficient scientific study led to the development of germ theory, pasteurization was introduced in the United States in the 1890s. This move successfully controlled the spread of highly contagious bacterial diseases, including E. coli, bovine tuberculosis, and brucellosis (all thought to be easily transmitted to humans through the drinking of raw milk).[10] In the early days after the scientific discovery of bacteria, there was no product testing to determine whether a farmer's milk was safe or infected, so all milk was treated as potentially contagious. After the first tests were developed, some farmers took steps to prevent their infected animals from being killed and removed from food production, sometimes even falsifying test results to make their animals appear free of infection.[11] Recent advances in the analysis of milk-borne diseases have enabled scientists to track the DNA of the infectious bacteria to the cows on the farms that supplied the raw milk.[12]
The recognition of many potentially deadly pathogens, such as E. coli 0157 H7, Campylobacter, Listeria, and Salmonella, and their possible presence in poorly produced milk products has led to the continuation of pasteurization. The U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, and other health agencies of the United States strongly recommend that the public not consume raw milk or raw milk products.[13] Young children, the elderly, people with weakened immune systems, and pregnant women are more susceptible to infections originating in raw milk.[14]
Uses
[edit]Some cheeses are produced with raw milk, although local statutes vary regarding what health precautions must be followed, such as aging cheese for a certain amount of time.[15] A large proportion of the US population eats several different kinds of cheese made with raw milk, including aged Gouda cheese.
The first camembert was made from raw milk, and the Appellation d'origine contrôlée (AOC) variety "Camembert de Normandie" (approximately 10% of all camembert production) is required by law to be made only with unpasteurized milk. Many modern cheesemakers, however, use pasteurized milk for safety, compliance with regulations, or convenience.[16]
A thick mixture known as syllabub was created by milkmaids squirting milk directly from a cow into a container of cider, beer[17] or other beverage.[18]
Raw yak milk can ferment overnight to become yak butter.
Health effects
[edit]Infectivity
[edit]The potential pathogenic bacteria from raw milk include tuberculosis, diphtheria, typhoid, Campylobacter, Listeria, Brucella, E. coli, Salmonella, and streptococcal infections[19] and make it potentially unsafe to consume.[20][21] Moreover, a review published in 2012 by the Belgian Federal Agency for the Safety of the Food Chain alongside experts from several Belgian universities and institutions concluded that "raw milk poses a realistic health threat due to a possible contamination with human pathogens. It is therefore strongly recommended that milk should be heated before consumption."[22]
Even with precautions and cold storage (optimally 3–4 °C or 37–39 °F),[23] raw milk has a shelf life of 3 to 5 days.[24]
The 2020–2024 H5N1 outbreak spread to dairy cattle in 2024, and influenza was detected in commercial milk supplies in the United States. The United States Food and Drug Administration warned (as has been its long-standing position) that consumers should avoid raw milk because its ability to transmit influenza to humans is unknown, but pasteurization is believed to inactivate the virus.[25] A high mortality rate was observed among cats that drank raw milk from cows displaying symptoms of H5N1 infection.[26][27]
Epidemiology
[edit]Before pasteurized milk was adopted in the US, public health officials were concerned with cow milk transmission of bovine tuberculosis to humans, with an estimated 10% of all tuberculosis cases in humans being attributed to milk consumption.[28] Along with specific diseases, officials continue to be concerned about outbreaks. With modern pasteurization and sanitation practices, milk accounts for less than 1% of reported outbreaks caused by food and water consumption. By comparison, raw milk was associated with 25% of all disease outbreaks from food/water during the time before World War II in the U.S.[28] From a public health standpoint, pasteurization has decreased the percentage of milk associated food/water borne outbreaks.
Between 2007 and 2016, there were 144 outbreaks connected to raw milk consumption in the United States.[29] Because raw milk production skips the pasteurization process, the germs that are normally removed remain in the milk product. Exposure to raw milk containing harmful germs threatens infection, resulting from bacteria including Campylobacter, Cryptosporidium, E. coli, Listeria, and Salmonella. Additionally, depending on the severity of the infection, there may be further threats to human health. Infection has the potential to induce serious illnesses such as Guillain-Barré syndrome and Hemolytic Uremic Syndrome (HUS). Because of the vulnerability of developing and degrading immune systems, children, pregnant women, the elderly, and those who are immunocompromised are at a heightened risk of experiencing infection from raw milk consumption.[29]
Outbreaks have occurred from consuming food products made with raw milk. One of the potential pathogens in raw milk, Listeria monocytogenes, can survive the pasteurization process and contaminate post-pasteurization environments. Milk and dairy products made with that milk then become recontaminated. Consistent contamination persists by bacteria survival in biofilms within the processing systems.
One food item that has commonly used raw milk in its production in the past is cheese. Several different types of cheeses made with raw milk are consumed by a large portion of the United States population, including soft cheeses.[30] Since Gouda cheese has a 60-day aging period before its consumption, it has previously been hypothesized that no bacteria would persist through that time. A review study published in the Journal of Food Protection showed that E. coli 0157:H7 can persist through the aging period of Gouda cheese. The study's evidence included three outbreaks before 2013 associated with this specific strain of E. coli in Gouda.[31]
Nutrition and allergy
[edit]"With the exception of an altered organoleptic [flavor] profile, heating (particularly ultra-high temperature and similar treatments) will not substantially change the nutritional value of raw milk or other benefits associated with raw milk consumption."[22]
Raw milk advocates, such as the Weston A. Price Foundation, say that raw milk can be produced hygienically and that it has health benefits that are destroyed in the pasteurization process.[3] Research shows only very slight differences in the nutritional values of pasteurized and unpasteurized milk.[13][22]
Proponents of raw milk in the US typically argue that while pasteurization may kill dangerous bacteria, it also kills off good bacteria claimed to have health benefits not present in pasteurized milk.[32] The United States Food and Drug Administration has stated that this is false, and that pasteurizing milk does not destroy any of its nutritional value.[21]
One study used mice to evaluate the difference in nutritional values between raw and pasteurized milk. Mice were separated into two groups: a pasteurized milk group and a raw milk group. Each group consisted of breeding pairs. The study's conclusion measured no significant difference in pasteurized to raw milk-consuming mice weights. Birth weights were measured from each group, and no significant differences were observed. Overall, the study showed no significant measurable difference in nutritional value in the growth and fertility of mice.[33]
Three studies have found an inverse relationship between consumption of raw milk and asthma and allergies.[34][35][36] However, all of these studies have been performed in children living on farms and living a farming lifestyle, rather than comparing urban children living typical urban lifestyles and with typical urban exposures based on consumption or nonconsumption of raw milk. Aspects of the overall urban vs. farming environment lifestyle have been suggested as having a role in these differences. For this reason, the overall phenomenon has been named the "farm effect". A recent scientific review concluded that "most studies alluding to a possible protective effect of raw milk consumption do not contain any objective confirmation of the raw milk's status or a direct comparison with heat-treated milk. Moreover, it seems that the observed increased resistance seems to be rather related to the exposure to a farm environment or to animals than to raw milk consumption."[22] For example, in the largest of these studies,[37] exposure to cows and straw as well as raw milk were associated with lower rates of asthma and exposure to animal feed storage rooms and manure with lower rates of atopic dermatitis; "the effect on hay fever and atopic sensitization could not be completely explained by the questionnaire items themselves or their diversity."[37]
Legal status
[edit]Regulation of the commercial distribution of packaged raw milk varies around the world. Some countries have complete bans, but many do not restrict the purchase of raw milk directly from the farmer. Raw milk is sometimes distributed through a program in which the consumer owns a share in the dairy animal or the herd and, therefore, can be considered to be consuming milk from their own animal, which is legal.[38] Raw milk is sometimes marketed for animal or pet consumption or for other uses such as soap making in places where sales for human consumption are prohibited.
Africa
[edit]Although milk consumption in Africa is fairly low compared to the rest of the world, in tribes where milk consumption is popular, such as the Maasai tribe, milk is typically consumed unpasteurized.[citation needed]
Asia
[edit]In rural areas of Asia, where milk consumption is popular, milk is typically unpasteurized. In large Asian cities, raw milk is typical, especially from water buffalo. In most countries of Asia, laws prohibiting raw milk are nonexistent or rarely enforced.[citation needed] Milk labeled as "raw" (nama) is available in Japan. Still, the designation means it is 100% raw whole milk before being pasteurized. Unpasteurized milk is very uncommon in Japan.[39] In Singapore, the sale of raw milk for human consumption is prohibited due to safety concerns outlined by the Singapore Food Agency.[40]
In India, milk is often drunk raw, although milk supplied in major cities is sometimes pasteurized. Pasteurized or not, milk is often boiled in homes before consumption.[citation needed]
Europe
[edit]In the European Union, raw milk and products made with raw milk must be labeled to indicate this.[41] Under EU hygiene rules, member states can prohibit or restrict the placing on the market of raw milk intended for human consumption.[42] Individual member states can also implement stricter requirements. Usually, special sanitary regulations and frequent quality tests (at least once per month)[further explanation needed] are mandatory.[43]
France
[edit]Raw milk cheeses make up about 18 percent of France's total cheese production and are considered far superior to cheeses made from pasteurized milk.[44] Many French cuisine traditionalists consider pasteurized cheeses almost a sacrilege. Many traditional French cheeses have solely been made from raw milk for hundreds of years.[45] Unpasteurised cheese in France is the major source of staphylococcal food poisoning.[46][47]
Germany
[edit]In Germany, packaged raw milk may be sold in shops under the name Vorzugsmilch.[48] The raw milk has to be packed before vending, with the necessary information (producer, shelf life, and special warnings) written on the product. The distribution license has stringent quality restrictions; as of 2012[update], just 80 farmers in Germany had a license.[49]
Unpackaged raw milk may only be sold under specific conditions. It must:
- only be sold at the farm where it was produced
- be from the day of or the day before production
- have a warning label "Raw Milk – boil before use"
Packed raw milk is sold widely in all health food stores, supermarkets, gourmet delis, and delicatessen sections of department stores. Raw milk is legally sold in the entire country, and the same goes for raw milk cheeses, which are especially sought out and promoted by the health food and slow food movements.[50]
Ireland
[edit]In the Republic of Ireland, the sale and production of raw milk is legal and regulated by the Department of Agriculture. While raw milk was previously banned in Irish law, since 2015, raw milk production has been regulated in accordance with the European Communities (Food and Feed Hygiene) Regulations (2009).[51] Farmers wishing to produce more than 30 litres (6.6 imp gal; 7.9 US gal) of raw milk for human consumption are required to register with the department's Milk Hygiene Division and consent to random sampling of their products as well as regular inspections of their production facilities.[52] The sale and consumption of raw milk has been discouraged by various food safety experts, including the Food Safety Authority of Ireland.[53]
Nordic states
[edit]Shops are not permitted to sell unpasteurised milk to consumers in Norway,[54] Sweden,[55] Finland,[56] and Denmark.[57][58] All four countries allow limited "barn door" sales subject to strict controls. As of 2015[update], just one distributor in Denmark is licensed to supply restaurants with raw milk from approved farms.[59] Pasteurisation of milk became common practice in Denmark and Sweden in the mid-1880s.[60]
Slovenia
[edit]Raw milk has been available from refrigerated milk vending machines (mlekomati) all over the country since 2010. The milk sold in the machines is subject to stringent regular control.
As of 2018,[update] raw milk is also available in shops. The Slovenian National Institute of Public Health advises that consuming fresh milk from a milk machine that is not heat-treated (boiled) can pose a health risk.[61]
United Kingdom
[edit]About 150 producers of raw milk are listed with the Food Standards Agency in England, Wales, and Northern Ireland.[62] They sell raw, or "green top" milk directly to consumers either at the farm, at a farmers' market, or through a delivery service, as it is legal to supply unpasteurized raw milk directly to consumers, but illegal to be sold to a shop. The bottle must display the warning "this product has not been heat-treated and may contain organisms harmful to health", and the milk must conform to higher hygiene standards than dairies producing only pasteurised milk.[63][64]
It is an offence to place raw milk or cream on the market for direct consumption in Scotland following a spate of deaths in 1983.[65][66]
North America
[edit]Canada
[edit]The sale of raw milk directly to consumers has been prohibited in Canada[67] under the Food and Drug Regulations since 1991.
No person shall sell the normal lacteal secretion obtained from the mammary gland of the cow, genus Bos, or of any other animal, or sell a dairy product made with any such secretion, unless the secretion or dairy product has been pasteurized by being held at a temperature and for a period that ensure the reduction of the alkaline phosphatase activity so as to meet the tolerances specified in official method MFO-3, Determination of Phosphatase Activity in Dairy Products, dated November 30, 1981.
— Section B.08.002.2 (1)[68]
Provincial laws also forbid the sale and distribution of raw milk. For instance, Ontario's Health Protection and Promotion Act, subsection 18(1) reads: "No person shall sell, offer for sale, deliver or distribute milk or cream that has not been pasteurized or sterilized in a plant that is licensed under the Milk Act or in a plant outside Ontario that meets the standards for plants licensed under the Milk Act."
In January 2010, Michael Schmidt was found not guilty on 19 charges relating to the sale of raw milk in the Ontario Court of Justice.[69] On appeal to the Ontario Court of Justice, that decision was overturned. Schmidt was convicted on thirteen counts and imposed fines totaling $9,150 and one year of probation.[70] A subsequent appeal to the Ontario Court of Appeal was dismissed.[71]
In British Columbia, Alice Jongerden, Michael Schmidt and Gordon Watson—persons involved in the operation of her raw milk dairy—attempted to avoid enforcement of a judgement against them under the Public Health Act by challenging the constitutionality of the legislation, which deems raw milk to be a hazardous product, on the grounds that it violated the Canadian Charter of Rights and Freedoms.[72] This argument, and other defenses invoked by her and defendants in her business, was rejected in 2013 by the Supreme Court of British Columbia, which instead found Schmidt and Watson guilty of civil contempt, and sentenced them to a 3-month suspended sentence imprisonment with a probationary period of 1 year during which "Any repetition of this contempt ... will trigger the imposed sentence imprisonment of 3 months."[73] They were also charged special costs.
Meanwhile, Canada permits the sale of raw milk cheese aged over 60 days. In 2009, the province of Quebec modified regulations to allow raw milk cheeses aged less than 60 days, provided stringent safeguards were met.[74]
United States
[edit]In the early 20th century, many states within the United States allowed the sale of raw milk that was certified by a "medical milk commission",[76] effectively allowing an alternative of extra inspection for pasteurization. Most states impose restrictions on raw milk suppliers due to safety concerns. 43 U.S. states allow the sale of raw milk.[77] Cow shares can be found, and raw milk purchased for animal consumption in many states where retail for human consumption is prohibited. The sale of raw milk cheese is permitted if the cheese has been aged for 60 days or more.[78]
The FDA reports that, in 2002, consuming partially heated raw milk and raw milk products caused 200 Americans to become ill in some manner.[79]
Many[who?] governmental officials and most public health organizations hold to the need for pasteurization. Before pasteurization, many dairies, especially in cities, fed their cattle on low-quality feed, producing milk rife with dangerous bacteria. Pasteurizing it was the only way to make it safely drinkable.[80] The Cornell University Food Science Department has compiled data indicating that pathogenic microorganisms are present in between 0.87% and 12.6% of raw milk samples.[81]
Proponents also invoke the benefits of direct-marketing when promoting the sale of raw milk. The ability of the farmer to eliminate intermediaries and sell directly to the consumer allows for greater profitability. Many manufacturers sell small-scale pasteurization equipment, allowing farmers to bypass the milk processors and sell pasteurized milk directly to the consumer. Additionally, some small U.S. dairies are now beginning to adopt low-temperature vat pasteurization.[82] Advocates of low-temperature vat pasteurization note that it produces a product similar to raw milk in composition.
Food freedom advocates cite libertarian arguments in claiming a basic civil right of each person to weigh the risks and benefits in choosing the food one eats, including the choice to consume raw milk.[83][84][85]
Oceania
[edit]Australia
[edit]The sale of raw milk for drinking purposes is illegal in all states and territories in Australia, as is all raw milk cheese. This has been circumvented somewhat by selling raw milk as bath milk.[86] An exception to the cheese rule has been made recently for two Roquefort cheeses.[87] There is some indication of share owning cows, allowing the "owners" to consume the raw milk,[88] but also evidence that the government is trying to close this loophole.[89]
On 8 November 2015, four-year-old Apu Khangura died of hemolytic–uremic syndrome, and seven other children became seriously ill following the consumption of raw milk. In response, the Victorian government created new regulations that require producers to treat raw milk to reduce pathogens or to make the product unpalatable to taste, such as making it bitter.[90][91]
New Zealand
[edit]Raw milk for drinking and raw milk products can be made and sold in New Zealand but are highly regulated to offset the pathogen risk. Producers of raw milk for sale to consumers must be registered. Raw milk must either be collected by the purchaser from the producer's farm or delivered to the purchaser's home.[92]
See also
[edit]References
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- ^ a b Smith, Terri Peterson (31 August 2010). "Got E. coli? Raw Milk's Appeal Grows Despite Health Risks". Scientific American.
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- ^ Blum, Deborah (19 July 2010). "The Raw-Milk Deal". Slate.
- ^ a b Nutrition, Center for Food Safety and Applied (12 August 2021). "Consumers – The Dangers of Raw Milk: Unpasteurized Milk Can Pose a Serious Health Risk". www.fda.gov.
- ^ "Raw Milk and Cheeses: Health Risks are Still Black and White". Archived from the original on 2011-10-30. Retrieved 2018-12-29.
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- ^ Smith, Tim (2005). Making artisan cheese: 50 fine cheeses that you can make in your own kitchen. Beverly, Massachusetts: Quarry Books. ISBN 1-59253-197-0.
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- ^ a b "The Dangers of Raw Milk: Unpasteurized Milk Can Pose a Serious Health Risk". fda.gov. (US) Food and Drug Administration. 12 August 2021.
- ^ a b c d Claeys, Wendy L.; Sabine Cardoen; Georges Daube; Jan De Block; Koen Dewettinck; Katelijne Dierick; Lieven De Zutter; André Huyghebaert; Hein Imberechts; Pierre Thiange; Yvan Vandenplas; Lieve Herman (May 2013). "Raw or heated cow milk consumption: Review of risks and benefits". Food Control. 31 (1): 251–62. doi:10.1016/j.foodcont.2012.09.035.
- ^ p. 17 in: Isao Yumoto (2013). Cold-Adapted Microorganisms. Caister Academic Press. ISBN 978-1908230904.
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{{cite web}}
: CS1 maint: multiple names: authors list (link) - ^ Pien Huang; Chiara Eisner (May 15, 2024). "A bird flu outbreak among dairy cows sparks new warnings about unpasteurized milk". NPR.
- ^ Burrough, Eric; Magstadt, Drew; Main, Rodger (29 April 2024). "Highly Pathogenic Avian Influenza A(H5N1) Clade 2.3.4.4b Virus Infection in Domestic Dairy Cattle and Cats, United States, 2024". Emerging Infectious Diseases. 30 (7): 1335–1343. doi:10.3201/eid3007.240508. PMC 11210653. PMID 38683888. Retrieved 30 April 2024.
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- ^ Loss, G; Apprich, S; Waser, M; Kneifel, W; Genuneit, J; Büchele, G; Weber, J; Sozanska, B; Danielewicz, H; Horak, E; van Neerven, RJ; Heederik, D; Lorenzen, PC; von Mutius, E; Braun-Fahrländer, C (2011). "The protective effect of farm milk consumption on childhood asthma and atopy: the GABRIELA study". J. Allergy Clin. Immunol. 128 (4): 766–73. doi:10.1016/j.jaci.2011.07.048. hdl:1874/407013. PMID 21875744.
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- ^ Drew Falkenstein (November 12, 2009). "Cow Share Agreements: Fooling Nobody". Food Safety News.
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- ^ "Corrigendum to Regulation (EC) No 853/2004 of the European Parliament and of the Council of 29 April 2004 laying down specific hygiene rules for food of animal origin" (PDF). 25 June 2004. Retrieved 14 September 2015.
In addition to the requirements of Directive 2000/13/EC, except in the cases envisaged in Article 13(4) and (5) of that Directive, labelling must clearly show: (a) in the case of raw milk intended for direct human consumption, the words 'raw milk'; (b) in the case of products made with raw milk, the manufacturing process for which does not include any heat treatment or any physical or chemical treatment, the words 'made with raw milk'.
- ^ European Food Safety Authority: Raw drinking milk: what are the risks?
- ^ "EU Food Laws (Frame)". www.reading.ac.uk.
- ^ Nytimes.com: The French Resist Again: This Time, Over Cheese
- ^ "Cheese etiquette; discovering cheese; wine and cheese; raw milk; fromages français". www.understandfrance.org.
- ^ Jodi A. Lindsay. Genomics of Staphylococcus pp. 237–65 in Genomics of Foodborne Bacterial Pathogens. Editors: Martin Wiedmann, Wei Zhang. Springer, 2011. ISBN 978-1441976857. p. 242
- ^ Mody RK and Griffin PM. Foodborne Illness. Chapter 103 in Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases: Expert Consult Premium Edition. Editors John E. Bennett, Raphael Dolin, and Martin J. Blaser. Elsevier Health Sciences, 2014 ISBN 978-1455748013. p. 1289
- ^ Information about raw milk production by the German raw milk industry (no English version available) Archived 2011-07-19 at the Wayback Machine
- ^ "Erzeugerbetriebe - Bundesverband der Vorzugsmilcherzeuger und Direktvermarkter von Milch und Milchprodukten". Archived from the original on 2016-03-07. Retrieved 2012-09-15.
- ^ One of the leading German newspapers, Der Tagesspiegel, writes about raw milk, raw cheeses and the controversy in the US compared to the legal and normal status in Germany and Europe (no English version)
- ^ "S.I. No. 432/2009 – European Communities (Food and Feed Hygiene) Regulations 2009, Section 32.2". Irish Statute Book. Irish Government. Retrieved 25 August 2020.
- ^ DAFM. "Trader Notice – Testing of Raw Milk for TBC/SCC" (PDF). Agriculture.gov.ie. DAFM. Retrieved 25 August 2020.
- ^ Barry, Aoife (January 13, 2015). "Put down that glass of raw milk, say Ireland's food safety experts". The Journal. Retrieved 25 August 2020.
- ^ Norwegian Food Safety Authority (Norwegian)
- ^ National Food Agency, Sweden (Swedish)
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External links
[edit]- Health Risks are Still Black and White (CDC)
- The Dangers of Raw Milk (FDA)
- Dunning, Brian (October 8, 2013). "Skeptoid #383: 5 False Arguments for Raw Milk". Skeptoid.