Under European legislation, manufacturers and retailers must always label major allergens (including egg) wherever they appear in pre-packed food
Food allergies have affected human beings from early times. However, they were ignored by medical community and regulatory agencies until more recently. They are widely recognised in western countries. They are still not understood in many parts of the world especially in developing countries. Inadvertent exposure to allergen by sensitive individuals can be extremely serious and even deadly. |
International Food Allergen Icons
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The International Association for Food Protection holds copyright to the
International Food Allergen Icons.
There is scientific consensus that the following foods can cause serious allergic reactions in some individuals and account for more than 90% of all food allergies:
Peanuts |
In the UK about ten people die every year from an allergic reaction to food, and many more end up in hospital. In most cases, the food that causes the reaction is from a restaurant or takeaway.
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Soybeans |
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Milk |
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Eggs |
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Fish |
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Crustacea |
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Tree nuts |
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Wheat |
What foods cause allergic reactions? In theory any food could cause an allergic reaction but they are most commonly caused by the following: · Cereals containing gluten · Peanuts (also called groundnuts) · Nuts, such as almonds, hazelnuts, walnuts, Brazil nuts, cashews, pecans, pistachios and macadamia nuts · Fish · Shellfish · Sesame seeds · Eggs · Milk · Soya · Celery and celeriac · Mustard · Sulphur dioxide and sulphites at levels above 10mg/kg or 10mg/litre expressed as S02 Some people need to avoid certain foods because of a food intolerance e.g. gluten, a protein found in wheat, rye, barley and oats. Other people need to avoid lactose, the sugar found in milk.
What is an Allergen?
An allergen is a nonparasitic antigen capable of stimulating a type-I hypersensitivity reaction in atopic individuals.[1] Most humans mount significant IgE responses only as a defence against parasitic infections. However, some individuals mount an IgE response against common environmental antigens. This hereditary predisposition is called atopy. In atopic individuals, non-parasitic antigens stimulate inappropriate IgE production, leading to type I hypersensitivity. Sensitivities vary from one person to another and it is possible to be allergic to an extraordinary range of substances.
Types of allergies "(Immune globulin E ( IgE ))" Dust, pollen and pet dander are all common allergens, but it is possible to be allergic to anything from chlorine to perfume. Food allergies are not as common as food sensitivity, but some foods such as peanuts (really a legume), nuts, seafood and shellfish are the cause of serious allergies in many people.
Our bodies are protected from infections by our immune system. We produce molecules, called antibodies, which recognise the organisms causing an infection. There are a number of different sorts of antibody, and the one which causes an allergic reaction is called IgE. The IgE molecules are normally produced in response to infections caused by parasites, like those that cause malaria. We do not understand why, but some people make IgE to other things like pollen, giving rise to hay fever, and to some foods, giving rise to food allergies. The IgE acts like a tag, sticking to molecules in food or pollen called allergens. When someone who has an allergy eats a problem food the IgE attaches to the allergens, setting off an allergic reaction. One of the common effects that IgE triggers is the release of histamine, which causes the changes we see in our bodies as symptoms, like nettle rash, swelling or wheezing.
Allergens are usually proteins, and there are generally several kinds of allergen in each food. We do not know what makes some proteins, and not others, food allergens.
There is another collection of symptoms that people report suffer from when they eat certain foods, such as headaches, muscle and joint aches and pains, and tiredness, which are often collectively known as food intolerance. This collection of symptoms is less well defined and poorly understood, and hence is generally much harder to diagnose than classical allergy. The exceptions are the gluten intolerance syndrome, known as Coeliac's disease, and lactose intolerance. Coeliac's disease is triggered by eating wheat, barley and rye-containing foods, whilst lactose (a sugar found in milk) can cause intolerance to milk in certain individuals who lack the ability to break it down. Lactose intolerance is not an allergy, but causes some of the same symptoms as milk allergy, like cramping pains in the stomach and diarrhoea.
Symptoms of Food allergy: Reactions to foods are usually rapid, appearing within an hour (or sometimes even seconds) of consumption, although in some cases they may be delayed and appear up to four hours after eating. Skin rashes, such as nettle rash (also called urticaria or hives) can appear which are generally short lived, disappearing within a few days. Longer lasting, chronic skin reactions (such as scaly patches) can also be experienced. Some of these longer lasting rashes are called atopic dermatitis. An itchy nose and eyes, sneezing and a runny nose may be experienced, as can asthmatic symptoms, such as wheezing, breathlessness and coughing. These types of symptom are not seen so often with food allergies. Itching and swelling around the lips and mouth may occur on contact with a food. Other symptoms include nausea, cramping pains, bloating, vomiting and diarrhoea. An uncommon allergic reaction, which can be life-threatening, is called anaphylaxis. It can be triggered by consuming very small amounts of food (just a bite is enough) and the symptoms usually appear within minutes and last for several hours. Asthma, skin rashes, nausea, vomiting and diarrhoea are among the symptoms which can be experienced. An unusual from of this condition can be triggered by eating problem foods within 2-3 hours of vigorous exercising and is called exercise-induced anaphylaxis. Prompt administration of adrenaline after eating suspected problem foods has helped minimise life-threatening episodes.
Triggers There are a number of groups of foods that are responsible for causing the majority of food allergies. The list below gives some information on these allergens. A more comprehensive list can be obtained from The Food Allergy Network or the Anaphylaxis Campaign to view their list of food warnings. This carries information on the latest warnings released by manufacturers (UK) about peanut and other accidental cross contamination.
Cow's Milk: Two percent of infants under one year old suffer from cow's milk allergy, making it the most common food allergy of childhood. In general children lose this sensitivity as they grow up with nine out of ten losing it by the age of three; it is unusual to find adults that suffer from this allergy. Symptoms are frequently vomiting and diarrhoea in children, with 30-50% also having skin rashes of some type. A small number of children have an anaphylactic reaction to milk which tends to be lifelong. The major allergens in milk are the caseins and the whey protein b -lactoglobulin. People are usually allergic to more than one kind of milk protein. The proteins from cow's milk are very similar to those from goats and sheep, and can cause the same sorts of reaction in cow's milk-allergic subjects. Thus goat's or sheep's milk cannot be used as a cow's milk substitute in allergic individuals. Eggs: The main allergens are the egg white proteins ovomucoid, ovalbumin, and ovotransferrin. The eggs of other poultry, such as ducks, are very similar to those of hens and can cause reactions in egg-allergic individuals. Allergy to eggs is usually found in young children rather than adults, and like cow's milk allergy, fades with time. Occasionally children suffer from a severe form of allergy which is not outgrown. Fish and shellfish: Allergies to shellfish are mostly experienced by adults and are unusual in children. Reactions to fish are found in children and adults. The incidence of seafood allergy is higher in those countries with a high consumption of fish and shellfish. Severe reactions are more frequently found with these foods, including anaphylaxis. NOTE cooking does not destroy the allergens in fish and shellfish, and some individuals maybe allergic to the cooked, but not raw, fish. The major allergens in fish are the flesh proteins called parvalbumins which are very similar in all kinds of fish. This is why people allergic to cod tend to be allergic to fish such as hake, carp, pike, and whiting as well. Shellfish allergens are usually found in the flesh and are part of the muscle protein system, whilst in foods such as shrimps, allergens have also been found in the shells.
Different types of shellfish Biologically speaking, shellfish are aquatic invertebrates rather than fish. They can be divided into four main groups:
Crustaceans (e.g. lobster, crab, crayfish, shrimp, prawn)
Molluscs: (a) Bivalves (e.g. mussels, oysters, scallops, clams) (b) Gastropods (e.g. limpets, periwinkles, snails) (c) Cephalopods (e.g. squid, cuttlefish, octopus)
People who have reacted to one type of shellfish are likely to react to other members of the same group. If you react to crab, avoid that and the rest of the crustacean group. If you react to squid, avoid that and the rest of the cephalopod group. Shellfish from the other groups may not necessarily present a problem, although they may do for some people. It is advisable to avoid them anyway. A special reason for being cautious is that there is a relatively high risk of cross-contamination among different types of seafood. Kosher food is shellfish-free. Always read the labels and check with food companies if you are unsure.
Iodine People with shellfish allergy are sometimes warned against iodine, an element present in a wide range of items including shellfish, seaweed, cleaning products, and X-ray dyes. However, iodine allergy is unrelated to shellfish allergy. The allergen present in shellfish is not iodine.
The cod worm Some people who think they are reacting to seafood are actually having an allergic reaction to a worm-like parasite called Anisakis (also known as the cod worm). This parasite, relatively common in Spain, can cause urticaria, gastrointestinal upset or even anaphylaxis when present in fresh cephalopods, or hake, anchovy or cod. If you react to a particular fish on one occasion, but subsequently eat it with no problem, you should consider the possibility that the cod worm was responsible.
Fruits: In general allergic reactions to fruits and vegetables are slight, and are often limited to the mouth, and are called the "oral allergy syndrome" (OAS). Roughly 40% of people having OAS are also allergic to tree and weed pollens. Thus people who are allergic to birch pollen are much more likely to be allergic to apples. There allergens in fruits and vegetables are not as complicated as other foods. Many of them are very similar to the allergens in pollens, which is why people with pollen allergies are also allergic to certain fruits. Many fruit allergens are destroyed by cooking, and thus cooked fruits are often safe for fruit allergic people to eat. Latex gloves allergies, especially amongst health professionals, are increasing. As many of the latex allergens are like those found in certain tropical fruits, such as bananas, these people can get an allergic reaction to handling or eating these foods . Legumes: This group of foods includes Soya beans and peanuts. Peanuts are one of most allergenic foods and frequently cause very severe reactions, including anaphylaxis. Allergy to peanuts is established in childhood and usually lasts throughout life. Both these foods have multiple allergens which are present in both the raw and cooked foods. Peanut allergy can be so severe that only very tiny amounts of peanut can cause a reaction. Thus the traces of nuts found in processed oils, or the carry over of materials on utensils used for serving foods, can be enough in some individuals, to cause a reaction. The main allergens in peanuts and Soya are the proteins used by the seed as a food store for it to grow into a seedling. (0.0007mg of peanut (or 0.000175mg of protein) has been shown to trigger an allergic response in the most sensitive of individuals). How common is it? The prevalence of peanut allergy among children is believed to have tripled during the 1990s. A research team based on the Isle of Wight found in 2002 that around one in 70 children across the UK was allergic to peanuts, compared with one in 200 ten years before. This rise may reflect the early age at which peanut products are introduced to young children. When at a slightly later age tree nuts are introduced into the diet, these too cause allergy problems in a growing number of cases.
Tree nuts: This group includes true tree nuts, such as Brazil nuts, hazelnuts, walnut and pecan. Whilst not as intensively studied as peanuts, indications are that tree nuts can cause symptoms as severe which can occasionally be fatal. Children who become sensitised to tree nuts tend to remain allergic throughout life. Hazelnut and almond allergies are more like those people get to fruit, and are linked to pollen allergies. Nut allergens can be both destroyed by, or resistant, to cooking and it is thought that roasting may create new allergens. The allergens can be the seed storage proteins, or other molecules which are also found in pollen. Cereals: Both children and adults suffer. Wheat allergy appears to be particularly associated with exercise induced anaphylaxis. The more of a cereal (wheat, rye, barley, oats, maize or rice) we eat the more likely we are to suffer an allergy. Thus rice allergy is found more frequently in populations eating ethnic diets. Seed storage proteins (such as wheat gluten) and other proteins present in grain to protect it from attack by moulds and bacteria, have been found to be major allergens.
Cleaning practices that are satisfactory for hygiene purposes may not be adequate for removing some allergens and their validity for such a purpose should be assessed (for example via residue / environmental swab testing). Equipment may need to be dismantled and manually cleaned to ensure hard to clean areas are free from allergen residues. Separate equipment should be considered for products containing nut allergens. |
As professional handlers of food we have responsibilities to allergen sufferers in providing allergen-safe food. Cleaning is an addition to other methods of allergen control – segregation should always be the first line of defence. Allergen management is about segregation, awareness, training and the correct application of controls including testing.
IMPLEMENTATION Of Legislation:
Directive 2003/89
The relevant Regulations elsewhere in the UK are:-
The Food Labelling (Amendment) (No. 2) (Scotland) Regulations 2005 (SI No 456)
The Food Labelling (Amendment) (Wales) (No. 2) Regulations 2005 (SI No. 2835 (W.200))
The Food Labelling (Amendment No. 2) Regulations (Northern Ireland) 2005 (SI. No. 396)
The relevant Regulation elsewhere in the UK are:
The Food Labelling Amendment (No. 3) (Scotland) Regulations 2005 (SI No. 542.)
The Food Labelling (Amendment) (Wales) (No. 2) (Amendment) Regulations 2005 (SI No. 3236 (W.241))
The Food Labelling (Amendment No.2) (Amendment) Regulations (Northern Ireland) 2005 (SI No.475)
Background on Legislative Changes
The 2004 Regulations implemented Directive 2003/89/EC, which is an amendment to Directive 2000/13/EC. These came into force across the UK on 25 November 2004. These Regulations established a list of allergens that have to be indicated on the label whenever they or their derivatives are used as deliberate ingredients in pre-packed food, including alcoholic drinks, (Annex IIIa of Directive 2000/13/EC or Schedule AA1 of the Food Labelling Regulations 1996 (as amended)).
The Food Labelling (Amendment) (England) (No. 2) Regulations 2005 and parallel legislation elsewhere in the UK7 implemented Commission Directive 2005/26/EC and established a list of food ingredients or substances provisionally excluded from Annex IIIa of Directive 2000/13/EC of the European Parliament and of the Council. These Regulations expired on 25 November 2007.
The Food Labelling (Amendment) (England) (No.2) (Amendment) Regulations 2005 and parallel legislation elsewhere in the UK8 implemented Directive 2005/63/EC, which amended the list of ingredients provisionally exempt from the allergen labelling rules to include fish gelatine used as a carrier for vitamin or carotenoid preparations and flavours. These Regulations also expired on 25 November 2007.
The 2007 Regulations implemented Commission Directive 2006/142/EC, of 22 December 2006, amending Annex IIIa of Directive 2000/13/EC of the European Parliament and of the Council by adding two more allergens to the list of
The relevant Regulations elsewhere in the UK are:-
The Food Labelling (Amendment) (No. 2) (Scotland) Regulations 2005 (SI No 456)
The Food Labelling (Amendment) (Wales) (No. 2) Regulations 2005 (SI No. 2835 (W.200))
The Food Labelling (Amendment No. 2) Regulations (Northern Ireland) 2005 (SI. No. 396)
ingredients which must under all circumstances appear on the labelling of foodstuffs. These Regulations were rescinded by the 2008 Regulations, which included a revised list of ingredients which must under all circumstances appear on the labelling of foodstuffs.
The 2007 Regulations came into force on 23 December 2007, from which date products complying with the new rules may be sold and manufacturers have 12 months to make the necessary label changes. It will not be permitted as from 23 December 2008 to produce products with labels that do not comply with these provisions. However, products that were labelled before this date may be sold while the stocks last.
The 2008 Regulations came into force on 31 May 2008 and implemented Commission Directive 2007/68/EC which further amended Annex IIIa to Directive 2000/13/EC. These Regulations set out a list of permanent exemptions from the allergen labelling rules in the case of ingredients derived from specified allergens in Schedule AA1 of the Food Labelling Regulations 1996 (as amended) that are no longer allergenic. This legislation confirms the exemption status of many of the ingredients originally set out in the Food Labelling (Amendment) (England) (No.2) Regulations 2005 and parallel legislation elsewhere in the UK.
Directives 2003/89/EC and 2005/26/EC have been implemented in England by the Food Labelling (Amendment) (England) (No.2) Regulations 2004), the Food Labelling (Amendment) (England) (No.2) Regulations 2005 and by parallel legislation in Scotland, Wales and Northern Ireland. Guidance on the first of these pieces of legislation and its practical implementation has been published by the Food Standards Agency at www.food.gov.uk/foodindustry/guidancenotes/labelregsguidance
Food labelling, allergies and the law: Food must not be placed on the market if it is ‘injurious’ (harmful) to people’s health. See Article 14 of EC Regulation 178/2002 (General Food Law Regulation).
Useful links:
www.food.gov.uk/safereating/allergyintol/
The Informal Database. Available at: http://foodallergens.ifr.ac.uk
UK Food Standards Agency. Advice for caterers on allergy and intolerance. Available at:
http://www.food.gov.uk/safereating/allergyintol/caterers
Labelling
http://www.food.gov.uk/multimedia/pdfs/publication/allergyjamjar1008.pdf
Further information.
• The Food Standards Agency’s Voluntary Guidance on Allergen Management and Consumer Information is available at:
www.food.gov.uk/multimedia/pdfs/maycontainguide.pdf
• Guidance on the legislation on the labelling of allergenic ingredients is available at:
www.food.gov.uk/foodindustry/guidancenotes/labelregsguidance/allergenlabelguide2008
• Relevant legislation includes:
The Food Safety Act 1990 and subsequent amendments
The Food Labelling (Amendment) (No.
2) Regulations 2004 (and subsequent
amendments), which implement Directives
2000/13/EC,
2005/26/EC, 2005/63/EC, 2006/142/EC and
2007/68/EC.
Food safety requirements and presentation under Articles 14 and 16 of EC Regulation 178/2002 (General Food Law Regulation)
Useful contacts
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In
England: Aviation
House 125 Kingsway
London WC2B
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In
Wales: |
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In Scotland: Food
Standards Agency Scotland St
Magnus House 6th Floor |
| In Northern
Ireland:
Food Standards Agency
Northern Ireland 10 A-C
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