World Allergy Organization Journal (Oct 2024)
Time to ACT-UP: Update on precautionary allergen labelling (PAL)
- Paul J. Turner,
- Antonio Bognanni,
- Stefania Arasi,
- Ignacio J. Ansotegui,
- Sabine Schnadt,
- Sébastien La Vieille,
- Jonathan O’B. Hourihane,
- Torsten Zuberbier,
- Philippe Eigenmann,
- Motohiro Ebisawa,
- Mario Morais-Almeida,
- Julie Barnett,
- Bryan Martin,
- Linda Monaci,
- Graham Roberts,
- Gary Wong,
- Ruchi Gupta,
- Sophia Tsabouri,
- Clare Mills,
- Simon Brooke-Taylor,
- Joan Bartra,
- Michael Levin,
- Marion Groetch,
- Luciana Tanno,
- Elham Hossny,
- Barbara Ballmer Weber,
- Vincenzo Fierro,
- Ben Remington,
- Jennifer Gerdts,
- M. Hazel Gowland,
- Derek Chu,
- Marjan Van Ravenhorst,
- Jennifer Koplin,
- Alessandro Fiocchi
Affiliations
- Paul J. Turner
- National Heart & Lung Institute, Imperial College London, London, UK
- Antonio Bognanni
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada; Clinical Epidemiology and Research Center (CERC), Humanitas University & Humanitas Research Hospital, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milano, Italy; Department of Medicine, Evidence in Allergy Group, McMaster University, Hamilton, ON, Canada
- Stefania Arasi
- Allergy Unit, Pediatric Hospital Bambino Gesù IRCCS, Rome, Italy
- Ignacio J. Ansotegui
- Hospital Quironsalud Bizkaia, Bilbao, Spain
- Sabine Schnadt
- Deutscher Allergie- und Asthmabund (DAAB), Moenchengladbach D, Germany
- Sébastien La Vieille
- Food Directorate, Health Canada, Ottawa, ON, Canada; Food Science Department, Laval University, Québec, QC, Canada
- Jonathan O’B. Hourihane
- Paediatrics and Child Health, Royal College of Surgeons Ireland, Dublin, Ireland; Children's Health Ireland, Dublin, Ireland
- Torsten Zuberbier
- Charite University, Berlin, Germany
- Philippe Eigenmann
- Pediatric Allergy Unit, University of Geneva, Switzerland
- Motohiro Ebisawa
- Sagamihara National Hospital, Sagamihara, Japan
- Mario Morais-Almeida
- Allergy Center, CUF Descobertas Hospital, Lisbon, Portugal
- Julie Barnett
- Department of Psychology, University of Bath, UK
- Bryan Martin
- Medicine and Pediatrics, The Ohio State University in Columbus, Columbus, OH, USA
- Linda Monaci
- Institute of Sciences of Food Production, National Research Council (ISPA-CNR), Bari, Italy
- Graham Roberts
- University Hospital Southampton, Southampton, UK
- Gary Wong
- The Chinese University of Hong Kong, Hong Kong, PR China
- Ruchi Gupta
- Northwestern University, Chicago, IL, USA; Food Allergy Research & Education (FARE), McLean, VA, USA
- Sophia Tsabouri
- EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) and Child Health Department, University of Ioannina School of Medicine, Ioannina, Greece
- Clare Mills
- University of Manchester, Manchester, UK
- Simon Brooke-Taylor
- Brooke-Taylor & Co Pty Ltd, Milawa, Victoria, Australia
- Joan Bartra
- Allergy Department, Hospital Clinic and IDIBAPS. Universitat de Barcelona, Spain; RICORS de Enfermedades Inflamatorias (ISCIII), Madrid, Spain
- Michael Levin
- Division of Paediatric Allergy, Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
- Marion Groetch
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Luciana Tanno
- Sanas Epidemiology and Research, Sao Paulo, Brazil
- Elham Hossny
- Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt
- Barbara Ballmer Weber
- Department of Dermatology, University Hospital Zürich, Zürich, Switzerland and Clinic for Dermatology and Allergology, Kantonsspital St. Gallen, St. Gallen, Switzerland
- Vincenzo Fierro
- Allergy Unit, Pediatric Hospital Bambino Gesù IRCCS, Rome, Italy
- Ben Remington
- Food Allergy Research and Resource Program, Department of Food Science and Technology, University of Nebraska, Lincoln, NE, USA; Remington Consulting Group B.V, Utrecht, the Netherlands
- Jennifer Gerdts
- Food Allergy Canada, Toronto, Ontario, Canada
- M. Hazel Gowland
- Allergy Action, St Albans, UK
- Derek Chu
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, Evidence in Allergy Group, McMaster University, Hamilton, Ontario, Canada
- Marjan Van Ravenhorst
- Allergenen Consultancy BV, Scherpenzeel (Gld), the Netherlands
- Jennifer Koplin
- Child Health Research Centre, University of Queensland, Brisbane, Queensland, Australia; Centre for Food and Allergy Research, Melbourne, Victoria, Australia
- Alessandro Fiocchi
- Allergy Unit, Pediatric Hospital Bambino Gesù IRCCS, Rome, Italy; Corresponding author.
- Journal volume & issue
-
Vol. 17,
no. 10
p. 100972
Abstract
Background: Precautionary Allergen (“may contain”) Labelling (PAL) is used by industry to communicate potential risk to food-allergic individuals posed by unintended allergen presence (UAP). In 2014, the World Allergy Organization (WAO) highlighted that PAL use was increasing, but often applied inconsistently and without regulation — which reduces its usefulness to consumers with food allergy and those purchasing food for them. WAO proposed the need for a regulated, international framework to underpin application of PAL. In 2019, the World Health Organization (WHO) and the Food and Agriculture Organization (FAO) of the United Nations convened an expert consultation to address the issue of PAL, the outputs of which are now being considered by the Codex Committee on Food Labelling (CCFL). Objectives: To summarise the latest data to inform the application of PAL in a more systematic way, for implementation into global food standards. Methods: A non-systematic review of issues surrounding precautionary labelling and food allergens in pre-packaged products. Results: Approximately, 100 countries around the world have legislation on the declaration of allergenic ingredients. Just a few have legislation on UAP. Given the risks that UAP entails, non-regulated PAL creates inconvenience in real life due to its unequal, difficult interpretation by patients. The attempts made so far to rationalize PAL present lights and shadows. Conclusions: At a time when CCFL is considering the results of the FAO/WHO Expert Consultation 2020–2023, we summarise the prospects to develop an effective and homogeneous legislation at a global level, and the areas of uncertainty that might hinder international agreement on a regulated framework for PAL of food allergens.
