TY - JOUR
T1 - Peanut Can Be Used as a Reference Allergen for Hazard Characterization in Food Allergen Risk Management
T2 - A Rapid Evidence Assessment and Meta-Analysis
AU - Turner, Paul J.
AU - Patel, Nandinee
AU - Ballmer-Weber, Barbara K.
AU - Baumert, Joe L.
AU - Blom, W. Marty
AU - Brooke-Taylor, Simon
AU - Brough, Helen
AU - Campbell, Dianne E.
AU - Chen, Hongbing
AU - Chinthrajah, R. Sharon
AU - Crevel, René W.R.
AU - Dubois, Anthony E.J.
AU - Ebisawa, Motohiro
AU - Elizur, Arnon
AU - Gerdts, Jennifer D.
AU - Gowland, M. Hazel
AU - Houben, Geert F.
AU - Hourihane, Jonathan O.B.
AU - Knulst, André C.
AU - La Vieille, Sébastien
AU - López, María Cristina
AU - Mills, E. N.Clare
AU - Polenta, Gustavo A.
AU - Purington, Natasha
AU - Said, Maria
AU - Sampson, Hugh A.
AU - Schnadt, Sabine
AU - Södergren, Eva
AU - Taylor, Stephen L.
AU - Remington, Benjamin C.
N1 - Publisher Copyright:
© 2021 The Authors
PY - 2022/1
Y1 - 2022/1
N2 - Regional and national legislation mandates the disclosure of “priority” allergens when present as an ingredient in foods, but this does not extend to the unintended presence of allergens due to shared production facilities. This has resulted in a proliferation of precautionary allergen (“may contain”) labels (PAL) that are frequently ignored by food-allergic consumers. Attempts have been made to improve allergen risk management to better inform the use of PAL, but a lack of consensus has led to variety of regulatory approaches and nonuniformity in the use of PAL by food businesses. One potential solution would be to establish internationally agreed “reference doses,” below which no PAL would be needed. However, if reference doses are to be used to inform the need for PAL, then it is essential to characterize the hazard associated with these low-level exposures. For peanut, there are now published data relating to over 3000 double-blind, placebo-controlled challenges in allergic individuals, but a similar level of evidence is lacking for other priority allergens. We present the results of a rapid evidence assessment and meta-analysis for the risk of anaphylaxis to a low-level allergen exposure for priority allergens. On the basis of this analysis, we propose that peanut can and should be considered an exemplar allergen for the hazard characterization at a low-level allergen exposure.
AB - Regional and national legislation mandates the disclosure of “priority” allergens when present as an ingredient in foods, but this does not extend to the unintended presence of allergens due to shared production facilities. This has resulted in a proliferation of precautionary allergen (“may contain”) labels (PAL) that are frequently ignored by food-allergic consumers. Attempts have been made to improve allergen risk management to better inform the use of PAL, but a lack of consensus has led to variety of regulatory approaches and nonuniformity in the use of PAL by food businesses. One potential solution would be to establish internationally agreed “reference doses,” below which no PAL would be needed. However, if reference doses are to be used to inform the need for PAL, then it is essential to characterize the hazard associated with these low-level exposures. For peanut, there are now published data relating to over 3000 double-blind, placebo-controlled challenges in allergic individuals, but a similar level of evidence is lacking for other priority allergens. We present the results of a rapid evidence assessment and meta-analysis for the risk of anaphylaxis to a low-level allergen exposure for priority allergens. On the basis of this analysis, we propose that peanut can and should be considered an exemplar allergen for the hazard characterization at a low-level allergen exposure.
KW - Anaphylaxis
KW - Eliciting dose
KW - Food allergy
KW - Precautionary allergen labeling
KW - Reference dose
KW - Threshold
UR - http://www.scopus.com/inward/record.url?scp=85114693574&partnerID=8YFLogxK
U2 - 10.1016/j.jaip.2021.08.008
DO - 10.1016/j.jaip.2021.08.008
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
C2 - 34438104
AN - SCOPUS:85114693574
SN - 2213-2198
VL - 10
SP - 59
EP - 70
JO - Journal of Allergy and Clinical Immunology: In Practice
JF - Journal of Allergy and Clinical Immunology: In Practice
IS - 1
ER -