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 GA²LEN position paper.

Publication

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 GA²LEN position paper.

Journal Paper/Review - Nov 24, 2021

Zuberbier Torsten, Dörr Tamara, Aberer Werner, Alvaro-Lozano Montserrat, Angier Elizabeth, Arasi Stefania, Arshad Hasan, Ballmer-Weber Barbara, Bartra Joan, Beck Lisa, Bégin Philippe, Bindslev-Jensen Carsten, Bislimovska Jovanka, Bousquet Jean, Brockow Knut, Bush Andrew, Cianferoni Antonella, Cork Michael J, Custovic Adnan, Darsow Ulf, de Jong Nicolette, Deleanu Diana, Del Giacco Stefano, Deschildre Antoine, Dunn Galvin Audrey, Ebisawa Motohiro, Fernández-Rivas Montserrat, Ferrer Marta, Fiocchi Alessandro, Gerth van Wijk Roy, Gotua Maia, Grimshaw Kate E C, Grünhagen Josefine, Heffler Enrico, Hide Michihiro, Hoffmann-Sommergruber Karin, Incorvaia Cristoforo, Janson Christer, John Swen Malte, Jones Carla, Jutel Marek, Katoh Norito, Kendziora Benjamin, Kinaciyan Tamar, Knol Edward, Kurbacheva Oksana, Lau Susanne, Loh Richard, Lombardi Carlo, Mäkelä Mika, Marchisotto Mary Jane, Makris Michael, Maurer Marcus, Meyer Rosan, Mijakoski Dragan, Minov Jordan, Mullol Joaquim, Nilsson Caroline, Nowak-Wegrzyn Anna, Nwaru Bright I, Odemyr Mikela, Pajno Giovanni Battista, Paudel Sushil, Papadopoulos Nikolaos G, Renz Harald, Ricci Giampaolo, Ring Johannes, Rogala Barbara, Sampson Hugh A, Senna Gianenrico, Sitkauskiene Brigita, Smith Peter Kenneth, Stevanovic Katarina, Stoleski Sasho, Szajewska Hania, Tanaka Akio, Todo-Bom Ana, Topal Fatih Alexander, Valovirta Erkka, Van Ree Ronald, Venter Carina, Wöhrl Stefan, Wong George K C, Zhao Zuotao, Worm Margitta

Citation

Zuberbier T, Dörr T, Aberer W, Alvaro-Lozano M, Angier E, Arasi S, Arshad H, Ballmer-Weber B, Bartra J, Beck L, Bégin P, Bindslev-Jensen C, Bislimovska J, Bousquet J, Brockow K, Bush A, Cianferoni A, Cork M, Custovic A, Darsow U, de Jong N, Deleanu D, Del Giacco S, Deschildre A, Dunn Galvin A, Ebisawa M, Fernández-Rivas M, Ferrer M, Fiocchi A, Gerth van Wijk R, Gotua M, Grimshaw K, Grünhagen J, Heffler E, Hide M, Hoffmann-Sommergruber K, Incorvaia C, Janson C, John S, Jones C, Jutel M, Katoh N, Kendziora B, Kinaciyan T, Knol E, Kurbacheva O, Lau S, Loh R, Lombardi C, Mäkelä M, Marchisotto M, Makris M, Maurer M, Meyer R, Mijakoski D, Minov J, Mullol J, Nilsson C, Nowak-Wegrzyn A, Nwaru B, Odemyr M, Pajno G, Paudel S, Papadopoulos N, Renz H, Ricci G, Ring J, Rogala B, Sampson H, Senna G, Sitkauskiene B, Smith P, Stevanovic K, Stoleski S, Szajewska H, Tanaka A, Todo-Bom A, Topal F, Valovirta E, Van Ree R, Venter C, Wöhrl S, Wong G, Zhao Z, Worm M. 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 GA²LEN position paper. Allergy 2021; 77:1736-1750.

Type

Journal Paper/Review (English)

Journal

Allergy 2021; 77

Publication Date

Nov 24, 2021

Issn Electronic

1398-9995

Pages

1736-1750

Brief description/objective

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.