Cross-contamination of foods and implications for food allergic patients.

Cross-contamination presents a risk of unknown magnitude for food allergic consumers. Published cases likely represent the tip of a rather large iceberg. Cross-contamination can occur in homes, restaurants, food manufacturing plants, and on farms. The frequency of cross-contamination as the cause of accidental exposures to allergenic foods is unknown. Food allergic individuals can react to ingestion of trace levels of the offending food, although a highly variable range of threshold doses exist among populations of food allergic individuals. The magnitude of the risk posed to food allergic consumers by cross-contamination is characterized by the frequency of exposure to cross-contaminated foods, the dose of exposure, and the individual's threshold dose. The food and food service industry (and food preparers in homes as well) have the responsibility to provide and prepare foods that are safe for food allergic consumers, but quality of life may be improved with the recognition that safe (though very low) thresholds do exist.