Food Allergen Labeling and Purchasing Habits in the United States and Canada.
BACKGROUND
Mandatory labeling of products with top allergens has improved food safety for consumers. Precautionary allergen labeling (PAL), such as "may contain" or "manufactured on shared equipment," are voluntarily placed by the food industry.


OBJECTIVE
To establish knowledge of PAL and its impact on purchasing habits by food-allergic consumers in North America.


METHODS
Food Allergy Research & Education and Food Allergy Canada surveyed consumers in the United States and Canada on purchasing habits of food products featuring different types of PAL. Associations between respondents' purchasing behaviors and individual characteristics were estimated using multiple logistic regression.


RESULTS
Of 6684 participants, 84.3% (n = 5634) were caregivers of a food-allergic child and 22.4% had food allergy themselves. Seventy-one percent reported a history of experiencing a severe allergic reaction. Buying practices varied on the basis of PAL wording; 11% of respondents purchased food with "may contain" labeling, whereas 40% purchased food that used "manufactured in a facility that also processes." Twenty-nine percent of respondents were unaware that the law requires labeling of priority food allergens. Forty-six percent were either unsure or incorrectly believed that PAL is required by law. Thirty-seven percent of respondents thought PAL was based on the amount of allergen present. History of a severe allergic reaction decreased the odds of purchasing foods with PAL.


CONCLUSIONS
Almost half of consumers falsely believed that PAL was required by law. Up to 40% surveyed consumers purchased products with PAL. Understanding of PAL is poor, and improved awareness and guidelines are needed to help food-allergic consumers purchase food safely.
Food Allergy Research & Education, Inc, McLean, Va.
Mary Jane
MJ
Marchisotto
Food Allergy Canada (formerly Anaphylaxis Canada), Toronto, Ontario, Canada.
Laurie
L
Harada
Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill.
Opal
O
Kamdar
Edward J. Hines Jr VA Hospital, Spinal Cord Injury QUERI, Center for Management of Complex Chronic Care, Hines, Ill; Northwestern University Feinberg School of Medicine, Chicago, Ill.
Bridget M
BM
Smith
Division of Allergy and Clinical Immunology, McMaster University, Hamilton, Ontario, Canada.
Susan
S
Waserman
Icahn School of Medicine at Mount Sinai, New York, NY.
Scott
S
Sicherer
Centre of Food and Allergy Research, Murdoch Children's Research Institute, the Royal Children's Hospital, Melbourne, Australia; Department of Allergy and Clinical Immunology, the Royal Children's Hospital, Melbourne, Australia; Department of Gastroenterology and Clinical Nutrition, the Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, the Royal Children's Hospital, University of Melbourne, Melbourne, Australia; Institute of Inflammation and Repair, University of Manchester, Manchester, UK.
Katie
K
Allen
Department of Pediatrics, University of Padua, Padua, Italy.
Antonella
A
Muraro
Food Allergy Research & Resource Program, University of Nebraska, Lincoln, Neb.
Steve
S
Taylor
Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill; Northwestern University Feinberg School of Medicine, Chicago, Ill. Electronic address: r-gupta@northwestern.edu.
Ruchi S
RS
Gupta
D000328:Adult; D000485:Allergens / Q000276:immunology; D002170:Canada / Q000453:epidemiology; D002648:Child; D003258:Consumer Behavior / Q000706:statistics & numerical data*; D005260:Female; D005502:Food / Q000009:adverse effects; D005512:Food Hypersensitivity / Q000453:epidemiology* / Q000276:immunology; D005515:Food Labeling / Q000706:statistics & numerical data*; D006184:Habits; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
D000485:Allergens
Canada; Consumer knowledge; Food allergy; Precautionary labeling; United States