title: 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 possible, unintended presence of an allergen in a consumed portion of a food product at or above any proposed action level. This will require combined work by all stakeholders to ensure everyone understands the approach and its limitations. Consumers with food allergy then need to be educated to undertake individualized risk assessments in relation to any PAL present.
authors: Department of Paediatrics and Child Health, School of Applied Psychology, University College Cork, Cork, Ireland.
authors: A
authors: A
authors: DunnGalvin
authors: Food Allergy Branch, Food Standards Agency, Bedford, UK.
authors: C-H
authors: CH
authors: Chan
authors: Safety and Environmental Assurance Centre, Unilever, Colworth Science Park, Sharnbrook, Bedford, UK.
authors: R
authors: R
authors: Crevel
authors: Clinical and Experimental Sciences Academic Unit, University of Southampton Faculty of Medicine, Southampton, UK.
authors: K
authors: http://orcid.org/0000-0003-3649-7963
authors: K
authors: Grimshaw
authors: MoniQA, Vienna, Austria.
authors: R
authors: R
authors: Poms
authors: German Allergy and Asthma Association (Deutscher Allergie- und Asthmabund (DAAB)), Mönchengladbach, Germany.
authors: S
authors: S
authors: Schnadt
authors: Food Allergy Research & Resource Program, University of Nebraska, Lincoln, NE, USA.
authors: S L
authors: SL
authors: Taylor
authors: Section of Paediatrics (Allergy and Infectious Diseases), MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, Imperial College London, London, UK.
authors: P
authors: P
authors: Turner
authors: Centre of Food and Allergy Research, Murdoch Children's Research Institute, Melbourne, Vic., Australia.|Department of Paediatrics, Royal Children's Hospital, Melbourne, Vic., Australia.
authors: K J
authors: KJ
authors: Allen
authors: Anaphylaxis Campaign, Farnborough, UK.
authors: M
authors: M
authors: Austin
authors: ILSI Europe, Brussels, Belgium.
authors: A
authors: A
authors: Baka
authors: Food Allergy Research & Resource Program, University of Nebraska, Lincoln, NE, USA.
authors: J L
authors: JL
authors: Baumert
authors: Center for Analytical Chemistry, University of Natural Resources and Life Sciences, Vienna, Austria.
authors: S
authors: S
authors: Baumgartner
authors: Department of Paediatric Pneumology & Immunology, Charité University Medical Centre, Berlin, Germany.
authors: K
authors: K
authors: Beyer
authors: Hylobates Consulting srl, Rome, Italy.
authors: L
authors: L
authors: Bucchini
authors: Servicio de Alergia, Hospital Clínico San Carlos, IdISSC, Madrid, Spain.
authors: M
authors: M
authors: Fernández-Rivas
authors: Allergen Bureau & Nestle, Rhodes, New South Wales, Australia.
authors: K
authors: K
authors: Grinter
authors: TNO, Zeist, The Netherlands.
authors: G F
authors: GF
authors: Houben
authors: Paediatrics and Child Health, University College Cork, Cork, Ireland.
authors: J
authors: J
authors: Hourihane
authors: Anaphylaxis Ireland, Cork, Ireland.
authors: F
authors: F
authors: Kenna
authors: TNO, Zeist, The Netherlands.
authors: A G
authors: AG
authors: Kruizinga
authors: Division of Asthma, Allergy and Lung Biology, King's College London, MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, Guy's and St Thomas' NHS Foundation Trust, London, UK.
authors: G
authors: G
authors: Lack
authors: National Food Institute, Technical University of Denmark, Søborg, Denmark.
authors: C B
authors: CB
authors: Madsen
authors: Institute of Inflammation and Repair, Manchester Academic Health Science Centre, Manchester Institute of Biotechnology, The University of Manchester, Manchester, UK.
authors: E N
authors: EN
authors: Clare Mills
authors: Centre for Pediatrics and Child Health, Institute of Human Development, University of Manchester, Manchester, UK.|Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece.
authors: N G
authors: NG
authors: Papadopoulos
authors: Camden BRI, Redhill, UK.
authors: A
authors: A
authors: Alldrick
authors: Anaphylaxis Campaign, Farnborough, UK.
authors: L
authors: L
authors: Regent
authors: Allergen Bureau & DTS Facta, Hobart, Australia.
authors: R
authors: R
authors: Sherlock
authors: INRA, AgroParisTech, Paris, France.
authors: J-M
authors: JM
authors: Wal
authors: Clinical and Experimental Sciences Academic Unit, University of Southampton Faculty of Medicine, Southampton, UK.|David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of Wight.|NIHR Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust.
authors: G
authors: G
authors: Roberts
mesh_terms: D000485:Allergens; D005512:Food Hypersensitivity / Q000517:prevention & control; D019649:Food Industry; D005515:Food Labeling / Q000592:standards*; D006282:Health Personnel; D006801:Humans; D018570:Risk Assessment
chemical_list: D000485:Allergens
keywords: consumers; food allergen; food allergy; precautionary allergen labelling; quantitative risk assessment