Allergies, food labelling & saving lives

If you have serious food allergies, deciding whether packaged food is safe to eat can be like playing Russian roulette with your health.

Food manufacturers are increasingly prepared to warn consumers that their products “may” contain allergens like peanuts, but for reasons of legal liability there are no labels telling an allergy sufferer that a food is safe.

Instead consumers are left to rely on the ingredients listed on products without warning labels. And that, says new research, is something of a stab in the dark.

Researchers at the Murdoch Children’s Research Institute (MCRI) surveyed allergy health practitioners to ask them whether in the last three months any of their patients had suffered an anaphylactic reaction to a packaged food.

Among the nearly 200 practitioners who replied there were six cases of patients who suffered anaphylaxis after eating a product that had no precautionary labelling and therefore might have been presumed to be safe to eat.

The results are published in the Journal of Paediatrics and Child Health.

“This is an accident waiting to happen,” says study author and Director of the Centre for Food and Allergy Research at the Murdoch Children’s Research Institute, Professor Katie Allen.

“Everyone deserves the right to know what they are eating and to feel safe when they eat their food.”

The patients suffered serious symptoms from breathing difficulties to swelling, and most needed an adrenaline shot. The culprit allergens include peanuts, milk, eggs and tree nuts.

“Food manufacturers are labelling products to tell people if they may be potentially dangerous, but they aren’t telling people what is safe,” says Professor Allen who is an allergist based at the Royal Children’s Hospital and an honorary researcher at the University of Melbourne.

The lead author on the study is Dr Giovanni Zurzolo, a postdoctoral fellow at MCRI and Victoria University.

Professor Allen says that “when it comes to food that doesn’t have allergy warnings, the food might be safe or, as this study highlights, it may be unsafe. But the consumer has no idea which one is which.”

Anaphylaxis is a potentially fatal immune response and a growing problem as the incidence of food allergies grows.

Between 2005 and 2014, the rate of admissions to US emergency departments of people suffering food related anaphylaxis jumped by 124 per cent. In Australia, overall hospital admission rates from anaphylaxis triggered by food grew by 50 per cent between 2005 and 2012. Among children aged 5-14 the rate increased by 110 per cent.

Professor Allen says food manufacturers are understandably reluctant to label a product as safe from allergens because it is impossible to give a guarantee like this without imposing prohibitively costly product testing and regulation.

“To be 100 per cent safe we’d have to be eating food as carefully manufactured as astronaut food and the community can’t afford that.”

But she says food manufactures can, and should, indicate whether their production processes have passed a risk-assessment on their ingredients and then allow the consumer to make an informed decision. It is what she calls “permissive labelling.”

She says 20 per cent of packaged food in Australian supermarkets is already assessed under the industry’s own Voluntary Incident Trace Allergen Labelling system (VITAL™). All the industry needs to do is simply label such risk-assessed products with a tick, or perhaps “V” for VITAL™, she says.

“What people need to know is whether a product is reasonably safe to eat. Even if manufacturers are not prepared to provide that guarantee they should at least give the consumer guidance by labelling whether the ingredients have been risk-assessed or not and allow the consumer to make an informed choice.”

Instead, she says, the industry is just focused on putting more precautionary warning labels on their products that an allergen “may be present”. Based on supermarket surveys,

Professor Allen and colleagues have found that the proportion of packaged food products with precautionary allergen labels grew from 55 per cent in 2009 to 65 per cent by 2014. Among snack foods, 95 per cent had precautionary allergen labels. The proportions she says are likely to be higher now.

However, it could be that a risk assessment on many of these same products may show that the risk of allergens being present is minimal, and therefore permissive labelling could be used instead of precautionary labelling, she says.

“The industry is risk-averse and is over-using these precautionary labels when they need to be simply telling people whether a product is reasonably safe to eat,” Professor Allen says.

The survey respondents were all members of the Australasian Society of Clinical Immunology and Allergy. From the 198 respondents there were 14 reported cases of anaphylaxis in all.

“Considering thousands of meals would have been eaten during the course of the study by patients in allergy care this suggests that anaphylaxis to packaged goods remains uncommon irrespective of labelling.

However, anaphylaxis is a preventable outcome in those with food allergy and consumers need assistance to ensure clear guidelines about what to eat or not rather than leaving it to guesswork.

“It just isn’t good enough that this occurs. Some manufacturers aren’t putting a warning on their products when they should.

“It isn’t common but it is happening and that is a safety issue. But the other issue is that people need labelling that makes it clearer what products they can feel reasonably safe eating.”

Banner image: iStock