Risk Management for Food Allergy

Risk Management for Food Allergy

1st Edition - November 13, 2013

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  • Editors: Charlotte Madsen, Rene Crevel, Clare Mills, Steve Taylor
  • Hardcover ISBN: 9780123819888
  • eBook ISBN: 9780123819895

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Risk Management for Food Allergy is developed by a team of scientists and industry professionals who understand the importance of allergen risk assessment and presents practical, real-world guidance for food manufacturers. With more than 12 million Americans suffering from food allergies and little indication of what is causing that number to continue to grow, food producers, packagers and distributors need to appropriately process, label and deliver their products to ensure the safety of customers with allergic conditions. By identifying risk factors during processing as well as determining appropriate "safe" thresholds of ingredients, the food industry must take increasingly proactive steps to avoid direct or cross-contamination as well as ensuring that their products are appropriately labeled and identified for those at risk. This book covers a range of critical topics in this area, including the epidemiology of food allergy, assessing allergen thresholds and risk, specifics of gluten management and celiac disease, and much more. The practical advice on factory risk management, catering industry practices, allergen detection and measurement and regulatory controls is key for food industry professionals as well as regulators in government and other public bodies.

Key Features

  • Science-based insights into the potential risks of food allergens
  • Focused section on determining thresholds
  • Practical guidance on food allergen risk management, including case studies


Persons involved in managing the risk of food allergy in industry, government and other public bodies (control) and catering (not patients managing their own risk)

Table of Contents

  • Food Science and Technology International Series

    List of Contributors



    History of ‘Allergy’ Labeling

    Where are we now – The Book

    The Authors

    Section 1: Food Allergy: Causes, Prevalence, and Impacts

    Chapter one. Living with Food Allergy: Cause for Concern



    Qualitative Studies on the Impact of Food Allergy on HRQL

    Children and Teens: The Evolution of Uncertainty

    The Parental Perspective: Living with Uncertainty

    The Parental Perspective: Quantitative

    The Child, Adolescent, and Adult Perspective: Quantitative


    Improving Risk Management and HRQL: A Better Way?


    Chapter two. Which Foods Cause Food Allergy and How Is Food Allergy Treated?



    Foods Involved in Allergic Reactions

    Symptoms and Severity of Food Allergy



    Chapter three. The Epidemiology of Food Allergy



    Time Trends of Food Allergy Prevalence and Health Care Utilization

    Risk Factors for Food Allergy

    The Natural History of Food Allergies

    The Consequences of Food Allergy



    Section 2: Allergen Thresholds and Risk Assessment

    Chapter four. How to Determine Thresholds Clinically


    Introduction and Definitions

    Meal, Source Material, and the Matrix Issue

    Factors Affecting the Outcome of Challenges

    Inclusion and Exclusion Criteria for Patients to Undergo Titrated Challenges

    Safety Aspects of Titrated DBPCFC

    Pre- and Post-Challenge Assessments of Patients

    Which Symptom Defines the Individual Threshold Dose?

    Challenge Protocols and Dosing

    An Open Food Challenge Always Has to Follow a Negative DBPCFC


    Chapter five. Thresholds or ‘How Much Is Too Much?’



    What is Meant by Thresholds in the Context of Food Allergy and Allergens?

    Thresholds Before EuroPrevall: What Data Were Available and How Useful Were They for Risk Assessment?

    How Have Threshold Data Been Generated? Protocols and Their Evolution

    Factors Affecting the Outcome of Challenge Studies and the Type of Data Generated

    Tools for the Analysis of Threshold Data



    Chapter six. From Hazard to Risk – Assessing the Risk



    Why and When is it Necessary to Estimate the Risk from Allergenic Food?

    Safety Assessment in Food Allergy Using One Data Point (NOAEL or LOAEL) and an Estimated Food Consumption

    Safety Assessment in Food Allergy Based on All Available Challenge Data and an Estimated Intake Food Consumption (Benchmark Dose/Margin of Exposure Approach)

    Exposure Assessment

    Risk Assessment in Food Allergy Based on the Distribution of Input Data (Challenge, Contamination, Consumption) (Probabilistic Approach)

    Examples of Risk Assessments Using All Three Approaches

    Summary of Risk Assessment Examples

    Uncertainty Factors

    Severity Considerations in Risk Assessment

    VITAL Program

    Concluding Remarks


    Section 3: Risk Management of Gluten

    Chapter seven. Celiac Disease and Risk Management of Gluten




    Definition of Celiac Disease

    Gluten Sensitivity

    Wheat (Food) Allergy

    Diagnosis of Celiac Disease

    A Public Health Problem

    Time, Place, and Person

    Clinical Presentation

    Associated Diseases

    A Multifactorial Etiology

    Etiopathogenetic Considerations

    Case Identification

    Living with Celiac Disease

    Risk Assessment in Celiac Disease

    Adherence Problems

    How to Keep Celiac Customers Happy and Safe?

    Support Strategies

    Perspectives for the Future

    Case Stories


    Section 4: Practical Food Allergen Risk Management

    Chapter eight. Food Allergen Risk Management in the Factory – From Ingredients to Products



    Allergen Risk Management: Principles and Systems

    Employee Training and Awareness

    Ingredients/Raw Materials – Suppliers, Storage, and Handling

    Production – Material Flow, Factory and Equipment Design, Product Scheduling, and Rework

    Production – Cleaning and Cleaning Validation



    Chapter nine. Managing Food Allergens: Case Histories and How They Were Handled



    Case Study 1 – Supply Chain

    Case Study 2 – Supply Chain, Manufacturing – ‘All Nuts are Equal’

    Case Study 3 – Labeling

    Case Study 4 – Manufacturing (Large Company)

    Case Study 5 – Manufacturing (Rework)

    Case Study 6 – Manufacturing and Design – ‘Nut Snow’

    Case Study 7 – Manufacturing (Small Company)

    Case Study 8 – Allergen Awareness ‘No Protein = No Food Allergen: True or False?’

    Case Study 9 – Product Development, Training, Allergen Awareness: – ‘Food Allergens: Never Heard of Them!’

    Case Study 10 – Training, Allergen Awareness, and Supplier Verification

    Case Study 11 – Auditor’s Allergen Awareness and Understanding

    Case Study 12 – An Ethical Dilemma



    Chapter ten. Catering – How to Keep Allergic Consumers Happy and Safe



    Why Do Consumers Currently Not Have the Information They Need to Make Safe Choices When Eating Out?

    What Is the Current Legal Position and Are Any Changes Expected?

    Best Practice Guidance Published by the UK Food Standards Agency in 2008 on the Provision of Allergen Information for Non-Pre-Packed Foods

    The Responsibilities of the Food Allergic Consumer

    Future Developments and Recommendations


    Chapter eleven. Food Allergen Risk Management in the United States and Canada



    US National Food Allergen Risk Management

    US State and Local Allergen Risk Management

    Canadian National Allergen Risk Management


    Chapter twelve. The Importance of Food Allergy Training for Environmental Health Service Professionals



    The Effectiveness of an Avoidance Diet

    Legislative Basis for the Risk Management of Food Allergens

    The Role of the EHO in the Risk Management of Food Allergens

    Deficits in Training Resources for Catering Staff

    Deficits in Food Allergy Awareness Among Catering Staff

    A Food Allergy Training Program for the Island of Ireland


    Chapter thirteen. Detecting and Measuring Allergens in Food



    Immunochemical Methods for the Detection of Food Allergens

    Mass Spectrometry

    Polymerase Chain Reaction (PCR)



    Chapter fourteen. Effect of Processing on the Allergenicity of Foods



    Effects of Processing Major Allergenic Foods of Plant Origin

    Whole Food Effects of Food Processing



    Chapter fifteen. Communication with Food Allergic Consumers: A Win-Win Experience



    Start with the Basic Fact That Education and Sensitivity Training Related to Food Allergic Consumers Must Be Holistic and Inclusive

    Putting the Program into Practice and Selling the Benefits Beyond Your Company

    Conclusion and Summary


    Chapter sixteen. May Contain – To Use or Not?



    History and Origins of Precautionary Labeling

    Legal and Regulatory Status of Precautionary Allergen Labeling

    How to Determine the Tolerable Level of Risk

    VITAL and a Threshold-Based Approach to Risk Assessment

    The Future of Precautionary Statements


    Chapter seventeen. Regulatory Controls for Food Allergens



    How Best to Protect the Public at Risk from Adverse Reactions to the Major Food Allergens?

    Why Do We Need Specific Allergen Labeling Rules?


    European Legislation Regarding Food Allergen Risk Communication

    ‘Gluten-Free’ and Other ‘Free from’ Claims

    Regulatory Lists Around the World

    What is not Covered by Legislation?



    Chapter eighteen. Keeping Updated



    The Allergen Bureau (Australia)

    The American Academy of Allergy, Asthma, and Immunology

    Canadian Food Inspection Agency

    Catering for Allergy (UK)

    The European Academy of Allergy and Clinical Immunology

    The European Food Safety Authority

    Food Allergy Information (EU)

    The Food Allergy Research and Resource Program (US)

    Food Allergy Support (UK)

    Food and Drug Administration (US)

    The Food Standards Agency (UK)

    The InformAll Database (UK)

    Food Science and Technology International Series


Product details

  • No. of pages: 330
  • Language: English
  • Copyright: © Academic Press 2013
  • Published: November 13, 2013
  • Imprint: Academic Press
  • Hardcover ISBN: 9780123819888
  • eBook ISBN: 9780123819895

About the Editors

Charlotte Madsen

Affiliations and Expertise

National Food Institute, Technical University of Denmark, Soborg, Denmark

Rene Crevel

Affiliations and Expertise

Unilever, Safety & Environmental Assurance Centre, Bedford, UK

Clare Mills

Affiliations and Expertise

Manchester Institute of Biotechnology, University of Manchester, UK

Steve Taylor

Affiliations and Expertise

University of Nebraska, Lincoln, NE, USA

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