An International First: Stakeholder Consensus Statement for Food Allergen Management in Packaged Foods and Food Service for Australia and New Zealand.

Food-allergic consumers encounter inadequate, confusing, and ambiguous allergen information for packaged and unpackaged foods. Key Australian and New Zealand allergy organizations convened multiple forums to facilitate discussions among consumers, food manufacturers, food retailers, regulatory bodies, researchers, and health professionals to develop a unified approach to improving food allergen management. The following stakeholder consensus statement provides a foundation for advocacy for improved food allergen management and safety.

Anaphylaxis to foods purchased from food establishments in Australia.

Aim: Food establishments that sell non-packaged foods are not required to have a food label directly on the food product detailing the ingredients. This practice could increase the risk of anaphylaxis among individuals with food allergy. The aim of the study is to understand whether anaphylaxis occurs commonly in individuals with food allergy as a consequence of eating food products purchased from food establishments.

Anaphylaxis to packaged foods in Australasia.

Aims: To examine reports of anaphylaxis in Australasia from consumption of packaged food products with or without precautionary allergen labelling (PAL), where the known allergen triggers were not a listed ingredient.

Methods: A questionnaire was sent to all members of the Australasian Society of Clinical Immunology and Allergy (n = 548). Participants were asked to complete a survey reporting whether they have had seen any patients over the last 3 months reporting anaphylaxis following ingestion of a packaged food where the suspected food allergen was not a listed ingredient.

Are food allergic consumers ready for informative precautionary allergen labelling?

Precautionary allergen labelling (PAL) has resulted in consumer confusion. Previous research has shown that interpretive labels (using graphics, symbols, or colours) are better understood than the traditional forms of labels. In this study, we aimed to understand if consumers would use interpretive labels (symbol, mobile phone application and a toll-free number) with or without medical advice that was advocated by the food industry rather than the normal PAL.

Peanut Allergen Threshold Study (PATS): Novel single-dose oral food challenge study to validate eliciting doses in children with peanut allergy.

Background: Eliciting doses (EDs) of allergenic foods can be defined by the distribution of threshold doses for subjects within a specific population. The ED is the dose that elicits a reaction in 5% of allergic subjects. The predicted ED for peanut is 1.

Is advising food allergic patients to avoid food with precautionary allergen labelling out of date?

Purpose Of Review: Precautionary allergen labelling (PAL) continues to be used by the food manufacturing industry to alert the food allergic consumer that cross-contact may have occurred during the supply chain for ingredients or the manufacturing process. This review will summarize recent evidence regarding use and interpretation of precautionary labels by industry, healthcare professionals, and food allergic consumers. Consumers find precautionary labels difficult to interpret and often distrust them as disclaimers of product liability.

Peanut Allergen Threshold Study (PATS): validation of eliciting doses using a novel single-dose challenge protocol.

Background: The eliciting dose (ED) for a peanut allergic reaction in 5% of the peanut allergic population, the ED05, is 1.5 mg of peanut protein. This ED05 was derived from oral food challenges (OFC) that use graded, incremental doses administered at fixed time intervals.

Perceptions of precautionary labelling among parents of children with food allergy and anaphylaxis.

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).

Design, Setting And Participants: 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.

Main Outcome Measures: 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.

Precautionary allergen labelling following new labelling practice in Australia.

Aims: We aimed to assess the prevalence and types of precautionary labelling statements for common food allergens on the packages of products for which these allergens were not listed as an ingredient and to investigate the uptake of the Voluntary Incidental Trace Allergen Labelling, a new risk management tool developed in Australia to assist with declaring the possible presence of allergens in food products by manufacturers. We also aimed to examine changes in the prevalence of precautionary labelling for egg, peanuts and tree nuts over a 3-year period.

Methods: All packaged processed goods in a large supermarket in Melbourne, Australia, were examined for precautionary labelling between May and July 2011.

Hidden allergens in foods and implications for labelling and clinical care of food allergic patients.

The prevalence of precautionary labelling remains high. This prevalence restricts food choices, in some cases perhaps unnecessarily, for food allergic consumers. During processing, cross-contamination does often occur in food products due to the way that modern processing facilities operate; however, zero risk of cross contamination is not a realistic expectation.