Accidental food allergy reactions to food are frequent and can be severe and even fatal. Food allergy is a serious health problem affecting 1-3% of the population. For many patients with food allergy, these allergies are best managed by avoidance of the allergenic food.
Legislation on food labeling is implemented in most regions of the world to help patients with food allergy. In Europe the presence of 14 ingredients must be listed on food labels of prepackaged foods and be available for unpacked foods. However, allergens can accidentally end up in food as a result of contamination during transport, storage or processing of food. For this “may contain” precautionary allergen labeling (PAL) is often used in cases in which the absence of allergens cannot be guaranteed. This has led to widespread use of PAL on prepackaged foods, even when the chance and expected level of contamination is very low. At the same time, several studies have shown that products without PAL contained undeclared allergens at detectable levels, presenting a potential health risk for the allergic population. In addition, precautionary statements vary widely in wording, adding to confusion for food allergy patients. PAL has lost its credibility and allergic patients frequently ignore them.
Recently a study published in JACI, followed an adult patient population with food allergies for 1 year in the Netherlands.
- 46% of the population had an average of 2 unexpected reactions.
- Non-ingredient allergens were a major cause of unexpected allergic reactions with regularly more than 1 culprit allergen involved.
- Highest concentrations were found for milk, peanut and sesame.
- The major food categories causing accidental food allergy reactions were bread, cookies, cakes and chocolates.
In conclusion, both patient neglect of PAL statements and omissions of using a PAL statement by food manufacturers contribute to accidental reactions. The study shows that choosing a safe food product is problematic for allergic patients, especially for the majority of multiple allergies.