To confiscate or reinstate in food allergy


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Presented on behalf of the Irish Food Allergy Network at the Annual meeting of the Irish Association of Immunology & Allergy, July 2011, Meath.

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  • Key issue is that if may contain foods have caused anaphylaxis
  • Maria Said Anaphylaxis AustraliaWorldwide huge complex issue
  • To confiscate or reinstate in food allergy

    1. 1. Confiscate or reinstate? That is the question for Food Allergy in Ireland.Ruth Charles, Paediatric Dietitian, MINDI.Ballinderry Clinic, St. Francis Hospital, Mullingar,Co.<br />
    2. 2. Irish Food Allergy NetworkOctober 2009.<br />Increased presentation of allergy at dietetic OPD clinics. The associated burden of care and quality of life issues are significant. <br />No dedicated HSE funded Childhood Food Allergy (CFA) service in the Republic <br />Wealth of knowledge and experience currently exists.<br />General consensus reached on the need to network, collaborate, share resources, reconfigure existing structures and avoid duplication. <br />Stakeholders database. Affiliation with IAAI (EAACI).<br />
    3. 3. IFAN members: 61<br />Nutrition & Dietetics (Paediatrics, Adult & Community) 23<br />Nursing (Allergy, Respiratory, Dermatology) 23<br />Medicine (Paediatrics, Dermatology & Community Health) 7<br />Nutrition industry 3<br />Allergy Academia 2<br />Food and nutrition legislators, enforcers & trainers 2<br />Patient support groups 1<br />
    4. 4. IFAN Issues<br />Patient issues<br />DIAGNOSIS, management & rechallenge: who, where, how<br />No basic GP/A&E/HCP training<br />Awareness/understanding of allergy and implications lacking<br />Replication/duplication best avoided<br />Food issues<br />Food labelling<br />Eating outside the home<br />
    5. 5. Food labelling & the law<br />Legislation European Directives 2003/89/EC and 2006/142/EC  <br />All ingredients <br />Presence of 14 recognised allergens intentionally added to prepacked foods<br />Not applicable to low level unintentional contaminants or non prepacked.<br /><br />
    6. 6. EAACI Food Allergy & Anaphylaxis Meeting February 2011<br />Food Allergy & Anaphylaxis Alliance FAAA<br />Criteria for use of precautionary statements<br />Major allergens declared<br />Simple language clear terms<br />Consumer communication <br />European Federation of Allergy & Airways Disease EFA<br />Packaged and non packaged foods<br />Abolish precautionary labelling<br />Establish thresholds ( Taylor et al. Clin Exp Allergy,2004; Moneret-Vautrin. Curr Opin Allergy Clin Immunol. 2004; Crevel at al. Allergy 2008. Working groups: ILSI Europe, Europrevall, CONGEN etc)<br />
    7. 7. Food Allergens & labelling survey June 2011.<br />Survey: affected by Food allergy intolerances<br />Crude, 509, voluntary, biased, web based, 5 questions, 85% medically diagnosed.<br />Peanut & tree nuts, Egg & other, Milk<br />Analysis: 229, no label/precautionary egg, nut, soy<br />No allergen labelling 11/106 (nut 2, egg 5)<br />Precautionary labelling 7/108, 93.5% had undetectable egg, peanut, soy. <br />
    8. 8. Conclusions<br />Scepticism and low consumer confidence in precautionary labels is justified<br />Zero risk unfeasible<br />National and EU registry of severe allergic reactions (Worm at al, Allergy, 2010) : detect prevalence<br />Safety/labelling thresholds: processes for risk assessment & robust monitoring systems<br />Food Allergens & labelling survey June 2011.<br />
    9. 9. Where to next?<br />The patient & family<br />IFAN<br />huge knowledge and skill base<br />aims & objectives<br />Lead/chair<br />