title: Perceptions of precautionary labelling among parents of children with food allergy and anaphylaxis.
abstract: OBJECTIVE
  To examine the behaviour and perception of parents of food-allergic children with and without a history of anaphylaxis in relation to precautionary labelling on packaged foods and to understand consumers' perception of the "may be present" statement advocated by VITAL (voluntary incidental trace allergen labelling).
  
  
  METHODS
  Questionnaire-based study of parents of a consecutive series of 497 children who attended the Department of Allergy and Immunology at the Royal Children's Hospital, Melbourne, from 1 August to 31 October 2011, of whom 293 met our criteria of having an existing medically diagnosed food allergy, and of whom 246 had enough information provided to be included in our analysis.
  
  
  METHODS
  Parents' responses about their behaviour and perceptions relating to precautionary food labels, and a comparison between parents of children with a past history of anaphylaxis and those with a past history of mild to moderate IgE allergic reactions.
  
  
  RESULTS
  Avoidance of foods with precautionary labels differed depending on the wording of the precautionary statement, with 74 parents (65%) ignoring the statement "made in the same factory" compared with 24 (22%) for "may be present". There was no evidence of a difference in participants' behaviour or perceptions depending on whether or not their child had a history of anaphylaxis.
  
  
  CONCLUSIONS
  Consumers are choosing a gradient level of risk based on the wording of the precautionary statements and appear to be complacent about precautionary labelling. Many statements are now being disregarded by a sizeable proportion of parents of food-allergic children, including those caring for children with a past history of anaphylaxis. This may be due to inadequacies in food labelling legislation. Policies that promote greater clarity and consistent use of precautionary statements may help to deal with this complacency.
authors.affiliation: Victoria University, Melbourne, VIC, Australia. katie.allen@rch.org.au
authors.forename: Giovanni A
authors.initials: GA
authors.lastname: Zurzolo
authors.forename: Jenifer J
authors.initials: JJ
authors.lastname: Koplin
authors.forename: Michael L
authors.initials: ML
authors.lastname: Mathai
authors.forename: Mimi K L
authors.initials: MK
authors.lastname: Tang
authors.forename: Katrina J
authors.initials: KJ
authors.lastname: Allen
mesh_terms: D000707:Anaphylaxis / Q000517:prevention & control*; D001294:Attitude to Health; D002648:Child; D005260:Female; D005512:Food Hypersensitivity / Q000517:prevention & control*; D005515:Food Labeling / Q000592:standards; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology*; D011795:Surveys and Questionnaires