title: Detection of relevant amounts of cow's milk protein in non-pre-packed bakery products sold as cow's milk-free.
abstract: BACKGROUND
  Currently, there is no mandatory labelling of allergens for non-pre-packed foods in the EU. Therefore, consumers with food allergy rely on voluntary information provided by the staff. The aim of this study was to characterize allergic reactions to non-pre-packed foods and to investigate whether staff in bakery shops were able to give advice regarding a safe product choice.
  
  
  METHODS
  Questionnaires were sent to 200 parents of children with a food allergy. Staff of 50 bakery shops were interviewed regarding selling non-pre-packed foods to food-allergic customers. Bakery products being recommended as 'cow's milk-free' were bought, and cow's milk protein levels were measured using ELISA.
  
  
  RESULTS
  A total of 104 of 200 questionnaires were returned. 25% of the children experienced an allergic reaction due to a non-pre-packed food from bakery shops and 20% from ice cream parlours. Sixty percent of the bakery staff reported serving food-allergic customers at least once a month, 24% once a week. Eighty four percent of the staff felt able to advise food-allergic consumers regarding a safe product choice. Seventy three 'cow's milk-free' products were sold in 44 bakery shops. Cow's milk could be detected in 43% of the bakery products, 21% contained >3 mg cow's milk protein per serving.
  
  
  CONCLUSIONS
  Staff in bakery shops felt confident about advising customers with food allergy. However, cow's milk was detectable in almost half of bakery products being sold as 'cow's milk-free'. Every fifth product contained quantities of cow's milk exceeding an amount where approximately 10% of cow's milk-allergic children will show clinical relevant symptoms.
authors: Department of Pediatric Pneumology and Immunology, Charité Universitätsmedizin, Berlin, Germany.
authors: V
authors: V
authors: Trendelenburg
authors: N
authors: N
authors: Enzian
authors: J
authors: J
authors: Bellach
authors: S
authors: S
authors: Schnadt
authors: B
authors: B
authors: Niggemann
authors: K
authors: K
authors: Beyer
mesh_terms: D000485:Allergens / Q000032:analysis*; D000818:Animals; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005062:European Union; D005260:Female; D005515:Food Labeling / Q000592:standards; D059022:Food Safety; D006801:Humans; D007223:Infant; D008297:Male; D016269:Milk Hypersensitivity; D008894:Milk Proteins / Q000009:adverse effects*; D011795:Surveys and Questionnaires
chemical_list: D000485:Allergens; D008894:Milk Proteins
keywords: accidental reactions; allergen labelling; cow's milk allergy; food-allergic consumers; non-pre-packed foods