Precautionary allergen labelling: perspectives from key stakeholder groups

Abstract

Precautionary allergen labelling (PAL) was introduced by the food industry to help manage and communicate the possibility of reaction from the unintended presence of allergens in foods. However, in its current form, PAL is counterproductive for consumers with food allergies. This review aims to summarize the perspectives of all the key stakeholders (including clinicians, patients, food industry and regulators), with the aim of defining common health protection and risk minimization goals. The lack of agreed reference doses has resulted in inconsistent application of PAL by the food industry and in levels of contamination that prompt withdrawal action by enforcement officers. So there is a poor relationship between the presence or absence of PAL and actual reaction risk. This has led to a loss of trust in PAL, reducing the ability of consumers with food allergies to make informed choices. The result has been reduced avoidance, reduced quality of life and increased risk-taking by consumers who often ignore PAL. All contributing stakeholders agree that PAL must reflect actual risk. PAL should be transparent and consistent with rules underpinning decision-making process being communicated clearly to all stakeholders. The use of PAL should indicate the

Evidence‐based approaches to the application of precautionary allergen labelling: Report from two iFAAM workshops

“…Reference doses have been developed to guide labelling decisions in the Voluntary Incidental Trace Allergen Labelling (VITAL™) system originally deployed in Australia . Reference doses refer to the amount of allergen that most (usually set at 95 or 99%) individuals with food allergy can tolerate without developing any objective allergic reaction . With information about the size of a typical meal of the specific food product, the reference dose can be used to calculate the concentration of allergen (action level) that is likely not to cause a reaction in 95 or 99% of the population with allergy.…”

“…Precautionary allergen labelling (PAL), often known as ‘may contain’ labelling, was introduced by the food industry to help manage and communicate the risk of reaction from the unintended presence of allergens in foods (recent review ). In its current form, PAL is counterproductive for consumers with food allergies as there is no standardized, consistent approach to applying PAL or to the wording that is used.…”

“…In its current form, PAL is counterproductive for consumers with food allergies as there is no standardized, consistent approach to applying PAL or to the wording that is used. Many products with a PAL do not contain the implicated food allergen while some products without a PAL contain quantities of common food allergens that are capable of inducing an allergic reaction in a significant proportion of the at‐risk population . With this inconsistency, PAL has suffered a loss of credibility and trust and thus does not have the ability to facilitate an informed choice.…”

The Emperor Has No Symptoms: The Risks of a Blanket Approach to Using Epinephrine Autoinjectors for All Allergic Reactions

“…Food-allergic individuals often receive differing advice on their level of reactivity from clinicians, who themselves have differing levels of expertise and experience of food allergy and anaphylaxis, which, incidentally, are not the same thing 23 . A food-allergic individual's perception of his and/or her own risk—and likelihood of reaction—may differ from that of an experienced clinician.…”

Preacutionary labelling of cross-reactive foods: The case of rapeseed

“…On both the sides of Atlantic, the regulatory problem is now the opposite: whether too many foods containing allergenic foods are being labeled as allergenic, and whether this would potentially restrict potentially safe food choices for allergic consumers [4]. …”