Katrina J Allen1, Benjamin C Remington2, Joseph L Baumert2, Rene W R Crevel3, Geert F Houben4, Simon Brooke-Taylor5, Astrid G Kruizinga4, Steve L Taylor2. 1. Murdoch Childrens Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia; Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Australia. Electronic address: katie.allen@rch.org.au. 2. Food Allergy Research & Resource Program (FARRP), University of Nebraska, Lincoln, Neb. 3. Safety & Environmental Assurance Centre, Unilever, Colworth Science Park, Sharnbrook, Bedford, United Kingdom. 4. TNO, Zeist, The Netherlands. 5. Allergen Bureau of Australia, Hobart, Australia.
Abstract
BACKGROUND: There has been a dramatic proliferation of precautionary labeling by manufacturers to mitigate the perceived risk from low-level contamination from allergens in food. This has resulted in a significant reduction in choice of potentially safe foods for allergic consumers. OBJECTIVES: We aimed to establish reference doses for 11 commonly allergenic foods to guide a rational approach by manufacturers based on all publically available valid oral food challenge data. METHODS: Reference doses were developed from statistical dose-distribution modeling of individual thresholds of patients in a dataset of more than 55 studies of clinical oral food challenges. Sufficient valid data were available for peanut, milk, egg, and hazelnut to allow assessment of the representativeness of the data used. RESULTS: The data were not significantly affected by the heterogeneity of the study methodology, including little effect of age on results for those foods for which sufficient numbers of adult challenge data were available (peanut and hazelnut). Thus by combining data from all studies, the eliciting dose for an allergic reaction in 1% of the population estimated for the following were 0.2 mg of protein for peanut, 0.1 mg for cow's milk, 0.03 mg for egg, and 0.1 mg for hazelnut. CONCLUSIONS: These reference doses will form the basis of the revised Voluntary Incidental Trace Allergen Labeling (VITAL) 2.0 thresholds now recommended in Australia. These new levels will enable manufacturers to apply credible precautionary labeling and provide increased consumer confidence in their validity and reliability, as well as improving consumer safety.
BACKGROUND: There has been a dramatic proliferation of precautionary labeling by manufacturers to mitigate the perceived risk from low-level contamination from allergens in food. This has resulted in a significant reduction in choice of potentially safe foods for allergic consumers. OBJECTIVES: We aimed to establish reference doses for 11 commonly allergenic foods to guide a rational approach by manufacturers based on all publically available valid oral food challenge data. METHODS: Reference doses were developed from statistical dose-distribution modeling of individual thresholds of patients in a dataset of more than 55 studies of clinical oral food challenges. Sufficient valid data were available for peanut, milk, egg, and hazelnut to allow assessment of the representativeness of the data used. RESULTS: The data were not significantly affected by the heterogeneity of the study methodology, including little effect of age on results for those foods for which sufficient numbers of adult challenge data were available (peanut and hazelnut). Thus by combining data from all studies, the eliciting dose for an allergic reaction in 1% of the population estimated for the following were 0.2 mg of protein for peanut, 0.1 mg for cow's milk, 0.03 mg for egg, and 0.1 mg for hazelnut. CONCLUSIONS: These reference doses will form the basis of the revised Voluntary Incidental Trace Allergen Labeling (VITAL) 2.0 thresholds now recommended in Australia. These new levels will enable manufacturers to apply credible precautionary labeling and provide increased consumer confidence in their validity and reliability, as well as improving consumer safety.
Authors: Geert F Houben; Joseph L Baumert; W Marty Blom; Astrid G Kruizinga; Marie Y Meima; Benjamin C Remington; Matthew W Wheeler; Joost Westerhout; Steve L Taylor Journal: Food Chem Toxicol Date: 2020-11-07 Impact factor: 6.023
Authors: Shelley Dua; Monica Ruiz-Garcia; Simon Bond; Stephen R Durham; Ian Kimber; Clare Mills; Graham Roberts; Isabel Skypala; James Wason; Pamela Ewan; Robert Boyle; Andrew Clark Journal: J Allergy Clin Immunol Date: 2019-07-15 Impact factor: 10.793
Authors: Benjamin C Remington; Joost Westerhout; Marie Y Meima; W Marty Blom; Astrid G Kruizinga; Matthew W Wheeler; Steve L Taylor; Geert F Houben; Joseph L Baumert Journal: Food Chem Toxicol Date: 2020-03-13 Impact factor: 6.023
Authors: Nandinee Patel; Daniel C Adelman; Katherine Anagnostou; Joseph L Baumert; W Marty Blom; Dianne E Campbell; R Sharon Chinthrajah; E N Clare Mills; Bushra Javed; Natasha Purington; Benjamin C Remington; Hugh A Sampson; Alexander D Smith; Ross A R Yarham; Paul J Turner Journal: J Allergy Clin Immunol Date: 2021-02-09 Impact factor: 10.793
Authors: Katrina J Allen; Paul J Turner; Ruby Pawankar; Stephen Taylor; Scott Sicherer; Gideon Lack; Nelson Rosario; Motohiro Ebisawa; Gary Wong; E N Clare Mills; Kirsten Beyer; Alessandro Fiocchi; Hugh A Sampson Journal: World Allergy Organ J Date: 2014-04-30 Impact factor: 4.084