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Record W3209044395 · doi:10.1111/all.15167

Proposal of 0.5 mg of protein/100 g of processed food as threshold for voluntary declaration of food allergen traces in processed food—A first step in an initiative to better inform patients and avoid fatal allergic reactions: A GA²LEN position paper

2021· review· en· W3209044395 on OpenAlexaff
Torsten Zuberbier, Tamara Dörr, Werner Aberer, Montserrat Álvaro‐Lozano, Elizabeth Angier, Stefania Arasi, Syed Hasan Arshad, Barbara Ballmer‐Weber, Joan Bartra, Lisa A. Beck, Philippe Bégin, Carsten Bindslev‐Jensen, Jovanka Karadzinska Bislimovska, Jean Bousquet, Knut Brockow, Andrew Bush, Antonella Cianferoni, Michael J. Cork, Adnan Čustović, Ulf Darsow, Nicolette W. de Jong, Diana Deleanu, Stefano Del Giacco, A. Deschildre, Audrey Dunn Galvin, Motohiro Ebisawa, Montserrat Fernández‐Rivas, Marta Ferrer, Alessandro Fiocchi, Roy Gerth van Wijk, Maia Gotua, Kate Grimshaw, Josefine Grünhagen, Enrico Heffler, Michihiro Hide, Karin Hoffmann‐Sommergruber, Cristoforo Incorvaia, Christer Janson, Swen Malte John, Carla Jones, Marek Jutel, Norito Katoh, Benjamin Kendziora, Tamar Kinaciyan, Edward F. Knol, О М Курбачева, Susanne Lau, Richard Loh, Carlo Lombardi, Mika J. Mäkelä, Mary Jane Marchisotto, Μichael Μakris, Marcus Maurer, Rosan Meyer, Dragan Mijakoski, Јордан Минов, Joaquim Mullol, Caroline Nilsson, Anna Nowak‐Węgrzyn, Bright I. Nwaru, Mikela Odemyr, Giovanni Battista Pajno, Sushil Paudel, Nikolaos G. Papadopoulos, Harald Renz, Giampaolo Ricci, Johannes Ring, Barbara Rogala, Hugh A. Sampson, Gianenrico Senna, Brigita Šitkauskienė, Peter Smith, Katarina Stevanovic, Sasho Stoleski, Hania Szajewska, Akio Tanaka, Ana Todo‐Bom, Fatih Alexander Topal, Erkka Valovirta, Ronald van Ree, Carina Venter, Stefan Wöhrl, Gary Wong, Zuotao Zhao, Margitta Worm

Bibliographic record

VenueAllergy · 2021
Typereview
Languageen
FieldMedicine
TopicFood Allergy and Anaphylaxis Research
Canadian institutionsCentre Hospitalier Universitaire Sainte-Justine
FundersMedical Research Council
KeywordsDeclarationFood allergensAllergenFood allergyFood hypersensitivityFood securityFood processingEnvironmental healthFood scienceMedicineBusinessPolitical scienceImmunologyAllergyChemistryBiologyAgriculture

Abstract

fetched live from OpenAlex

BACKGROUND: Food anaphylaxis is commonly elicited by unintentional ingestion of foods containing the allergen above the tolerance threshold level of the individual. While labeling the 14 main allergens used as ingredients in food products is mandatory in the EU, there is no legal definition of declaring potential contaminants. Precautionary allergen labeling such as "may contain traces of" is often used. However, this is unsatisfactory for consumers as they get no information if the contamination is below their personal threshold. In discussions with the food industry and technologists, it was suggested to use a voluntary declaration indicating that all declared contaminants are below a threshold of 0.5 mg protein per 100 g of food. This concentration is known to be below the threshold of most patients, and it can be technically guaranteed in most food production. However, it was also important to assess that in case of accidental ingestion of contaminants below this threshold by highly allergic patients, no fatal anaphylactic reaction could occur. Therefore, we performed a systematic review to assess whether a fatal reaction to 5mg of protein or less has been reported, assuming that a maximum portion size of 1kg of a processed food exceeds any meal and thus gives a sufficient safety margin. METHODS: MEDLINE and EMBASE were searched until 24 January 2021 for provocation studies and case reports in which one of the 14 major food allergens was reported to elicit fatal or life-threatening anaphylactic reactions and assessed if these occurred below the ingestion of 5mg of protein. A Delphi process was performed to obtain an expert consensus on the results. RESULTS: In the 210 studies included, in our search, no reports of fatal anaphylactic reactions reported below 5 mg protein ingested were identified. However, in provocation studies and case reports, severe reactions below 5 mg were reported for the following allergens: eggs, fish, lupin, milk, nuts, peanuts, soy, and sesame seeds. CONCLUSION: Based on the literature studied for this review, it can be stated that cross-contamination of the 14 major food allergens below 0.5 mg/100 g is likely not to endanger most food allergic patients when a standard portion of food is consumed. We propose to use the statement "this product contains the named allergens in the list of ingredients, it may contain traces of other contaminations (to be named, e.g. nut) at concentrations less than 0.5 mg per 100 g of this product" for a voluntary declaration on processed food packages. This level of avoidance of cross-contaminations can be achieved technically for most processed foods, and the statement would be a clear and helpful message to the consumers. However, it is clearly acknowledged that a voluntary declaration is only a first step to a legally binding solution. For this, further research on threshold levels is encouraged.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.017
metaresearch head score (Gemma)0.025
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: none
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.017
Threshold uncertainty score0.089

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0170.025
Meta-epidemiology (narrow)0.0010.001
Meta-epidemiology (broad)0.0030.004
Bibliometrics0.0060.004
Science and technology studies0.0010.002
Scholarly communication0.0020.004
Open science0.0030.002
Research integrity0.0040.003
Insufficient payload (model declined to judge)0.0040.001

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.053
GPT teacher head0.327
Teacher spread0.274 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designNot applicable
Domainnot available
GenreReview

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations38
Published2021
Admission routes1
Has abstractyes

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