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  • Zuberbier, T.Charite Univ Med Berlin, Dept Dermatol & Allergy, Berlin, Germany.;Humboldt Univ, Berlin, Germany.;Berlin Inst Hlth, Comprehens Allergy Ctr, Berlin, Germany (författare)

Proposal of 0.5 mg of protein/100 g of processed food as threshold for voluntary declaration of food allergen traces in processed food-A first step in an initiative to better inform patients and avoid fatal allergic reactions: A GA(2)LEN position paper

  • Artikel/kapitelEngelska2022

Förlag, utgivningsår, omfång ...

  • 2021-11-24
  • Wiley,2022

Nummerbeteckningar

  • LIBRIS-ID:oai:gup.ub.gu.se/310443
  • https://gup.ub.gu.se/publication/310443URI
  • https://doi.org/10.1111/all.15167DOI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-486012URI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:148166584URI

Kompletterande språkuppgifter

  • Språk:engelska

Ingår i deldatabas

Klassifikation

  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • Background Food anaphylaxis is commonly elicited by unintentional ingestion of foods containing the allergen above the tolerance threshold level of the individual. While labeling the 14 main allergens used as ingredients in food products is mandatory in the EU, there is no legal definition of declaring potential contaminants. Precautionary allergen labeling such as "may contain traces of" is often used. However, this is unsatisfactory for consumers as they get no information if the contamination is below their personal threshold. In discussions with the food industry and technologists, it was suggested to use a voluntary declaration indicating that all declared contaminants are below a threshold of 0.5 mg protein per 100 g of food. This concentration is known to be below the threshold of most patients, and it can be technically guaranteed in most food production. However, it was also important to assess that in case of accidental ingestion of contaminants below this threshold by highly allergic patients, no fatal anaphylactic reaction could occur. Therefore, we performed a systematic review to assess whether a fatal reaction to 5mg of protein or less has been reported, assuming that a maximum portion size of 1kg of a processed food exceeds any meal and thus gives a sufficient safety margin. Methods MEDLINE and EMBASE were searched until 24 January 2021 for provocation studies and case reports in which one of the 14 major food allergens was reported to elicit fatal or life-threatening anaphylactic reactions and assessed if these occurred below the ingestion of 5mg of protein. A Delphi process was performed to obtain an expert consensus on the results. Results In the 210 studies included, in our search, no reports of fatal anaphylactic reactions reported below 5 mg protein ingested were identified. However, in provocation studies and case reports, severe reactions below 5 mg were reported for the following allergens: eggs, fish, lupin, milk, nuts, peanuts, soy, and sesame seeds. Conclusion Based on the literature studied for this review, it can be stated that cross-contamination of the 14 major food allergens below 0.5 mg/100 g is likely not to endanger most food allergic patients when a standard portion of food is consumed. We propose to use the statement "this product contains the named allergens in the list of ingredients, it may contain traces of other contaminations (to be named, e.g. nut) at concentrations less than 0.5 mg per 100 g of this product" for a voluntary declaration on processed food packages. This level of avoidance of cross-contaminations can be achieved technically for most processed foods, and the statement would be a clear and helpful message to the consumers. However, it is clearly acknowledged that a voluntary declaration is only a first step to a legally binding solution. For this, further research on threshold levels is encouraged.

Ämnesord och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

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  • Arshad, H.Univ Hosp Southampton NHS Fdn Trust, NIHR Southampton Biomed Res Ctr, Southampton, Hants, England.;Univ Southampton, Fac Med, Clin & Expt Sci, Southampton, Hants, England.;St Marys Hosp, David Hide Asthma & Allergy Res Ctr, Newport, Wight, England (författare)
  • Ballmer-Weber, B.Univ Hosp Zurich, Dept Dermatol, Zurich, Switzerland.;Kantonsspital St Gallen, Clin Dermatol & Allergol, St Gallen, Switzerland (författare)
  • Bartra, J.Hosp Clin Barcelona, Serv Neumol & Allergia Resp, Unitat Allergia, Barcelona, Spain.;Inst Invest Biomed August Pi & Sunyer IDIBAPS, Barcelona, Spain (författare)
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  • Begin, P.CHU St Justine, Montreal, PQ, Canada (författare)
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  • Bousquet, J.Charite Univ Med Berlin, Dept Dermatol & Allergy, Berlin, Germany.;Humboldt Univ, Berlin, Germany.;Berlin Inst Hlth, Comprehens Allergy Ctr, Berlin, Germany.;Univ Hosp Montpellier, Montpellier, France.;MACVIA France, Montpellier, France (författare)
  • Brockow, K.Tech Univ Munich, Sch Med, Dept Dermatol & Allergy Biederstein, Munich, Germany (författare)
  • Bush, A.Imperial Coll, London, England.;Royal Brompton Hosp, London, England (författare)
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  • Deschildre, A.Univ Lille, CHU Lille, Lille, France.;Hop Jeanne de Flandre, Pediat Pulmonol & Allergy Unit, Lille, France (författare)
  • Galvin, A. D.Univ Coll Cork, Cork, Ireland.;Sechenov Univ Moscow, Moscow, Russia.;Anaphylaxis Ireland, Cork, Ireland (författare)
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  • Fernandez-Rivas, M.Univ Complutense UCM, Hosp Clin San Carlos, Fac Med, Allergy Dept,IdISSC, Madrid, Spain (författare)
  • Ferrer, M.Clin Univ Navarra, Dept Allergy, Pamplona, Spain (författare)
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  • van Wijk, R. G.Erasmus MC, Sect Allergol & Clin Immunol, Dept Internal Med, Rotterdam, Netherlands,Univ Bologna, Dept Med & Surg Sci, Pediat Unit, Bologna, Italy,Univ Amsterdam, Acad Med Ctr, Dept Expt Immunol, Amsterdam, Netherlands.;Univ Amsterdam, Acad Med Ctr, Dept Otorhinolaryngol, Amsterdam, Netherlands (författare)
  • Gotua, M.Ctr Allergy & Immunol, Tbilisi, Georgia (författare)
  • Grimshaw, K.Salford Royal Fdn Trust, Dietet Dept, Salford Care Org, Salford, Lancs, England (författare)
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  • Hoffmann-Sommergruber, K.Med Univ Vienna, Dept Pathophysiol & Allergy Res, Vienna, Austria (författare)
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  • Janson, C. (författare)
  • John, S. M.Univ Osnabrueck, Dept Dermatol Environm Med Hlth Theory, Osnabruck, Germany.;Univ Osnabrueck, Inst Interdisciplinary Dermatol Prevent & Rehabil, Osnabruck, Germany (författare)
  • Jones, C. (författare)
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  • Katoh, N.Kyoto Prefectural Univ Med, Dept Dermatol, Kyoto, Japan (författare)
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  • Kurbacheva, O.NRC Inst Immunol FMBA, Moscow, Russia (författare)
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  • Maurer, M. (författare)
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  • Mullol, J. (författare)
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  • Ricci, G. (författare)
  • Ring, J.Tech Univ Munich, Sch Med, Dept Dermatol & Allergy Biederstein, Munich, Germany.;Christine K Hne Ctr Allergy Res & Educ CK Care, Davos, Switzerland (författare)
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  • Charite Univ Med Berlin, Dept Dermatol & Allergy, Berlin, Germany.;Humboldt Univ, Berlin, Germany.;Berlin Inst Hlth, Comprehens Allergy Ctr, Berlin, GermanyMed Univ Graz, Dept Dermatol, Graz, Austria (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:Allergy: Wiley77:6, s. 1736-17500105-45381398-9995

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