Research about Preventing Food Allergic Reactions

Food allergies are a frequent concern globally, especially in developed countries such as Europe and America (Gowland and Walker, 2014) and this concern is growing rapidly, with prevention as the most recommended treatment (Pieretti et al., 2009). There are cases of allergic reaction ranging from mild to severe, two of which fatal cases happened in the United Kingdom in this last decade. This brings up a question of what we can do to further prevent allergies. This essay will try to summarize these two cases and provide suggestions of what methods or measures that can be taken to prevent more allergy cases from happening.

One case is of a boy named Owen Carey, who suffered a severe allergic reaction to milk in his burger at the Byron restaurant branch in Greenwich in 2017. According to an article in The Guardian (2019), Owen ordered a chicken burger, however, the menu did not inform that the meat was marinated in buttermilk. Although it was said that the restaurant did provide allergy warnings at the back of the menu, it was printed in black font against blue colour of the paper that made it difficult to be read (ibid.). The technical manager of the restaurant believed that the staffs have received adequate training and the restaurant has followed industry standards regarding food allergies at that time, therefore it was the customer's responsibility to inform the restaurant about their allergies so arrangements can be made (ibid.).

Another case is from last year, where a girl named Natasha Ednan-Laperouse had a fatal response to sesame in her baguette sandwich she had purchased from a Pret a Manger branch at Heathrow Airport. The Guardian (2018) has reported that the wrapper of her sandwich did not have any allergen advice, which is quite common for small sandwich shops. Natasha's father informed that the signs (that may contain allergy information) on the refrigerated cabinets were placed in the position which is insufficient for good visibility (ibid.). Her case is one of the ten cases of allergies of products from Pret a Manger that year (ibid.).

After some research, I have compiled a few suggestions that can be used to prevent any possible future allergy cases.

Firstly, labelling needs to be improved more. It is common knowledge that who is responsible for the food must ensure that the food is safe, authentic and labelled accordingly, yet labelling has often frustrated consumers with food allergy, mostly because it is not specific, transparent or visible enough to be understood clearly.

Generally, food allergen labelling in UK is regulated by the law in Food Standards Agency, which requires any product that contains one or more of 14 main allergens to be labelled. The 14 main allergens consist of: 1) celery; 2) cereals containing gluten (which includes wheat, rye, barley and oats); 3) crustaceans (such as prawns, crabs and lobsters); 4) eggs; 5) fish; 6) lupin; 7) milk; 8) molluscs (such as mussels and oysters); 9) mustard; 10) tree nuts (including almonds, hazelnuts, walnuts, brazil nuts, cashews, pecans, pistachios and macadamia nuts); 11) peanuts; 12) sesame seeds; 13) soybeans; 14) sulphur dioxide and sulphites (if the concentration exceeds ten parts per million).

The law also encourages food manufacturers to emphasize any allergens in ingredients list of a product, such as making them bold, underline them or to print them in a colour that stand out among other ingredients.

Additionally, Gowland (2002) states that there three categories of food allergen labelling:

1. Contains (where the allergen is the integral component of the product)
2. May contain traces of (possibility of a small amount of allergen; a temporary measure after thorough risk examination)
3. Free of (does not contain the allergen; particularly useful for food that has a clear connection to an allergen)

Despite this, according to Pieretti (2009), there is still a lot of ambiguity in food allergy labelling, especially for the term 'may contain' which is frequently not regulated. There have been several cases of costumers incorrectly interpret difference on the risk levels of the term 'shared equipment', 'shared facility' or 'may contain', that could lead to potential risks (ibid.). Furthermore, most labelling often does not contain specification of a certain allergen, for example, a consumer who is allergic to only hazelnut could get confused with the labelling 'may contain nuts' since it does not specify what type of nut inside the product, or a person could mistake the term 'may contain soy' as warning for soy allergy in general but it could be just a warning for soy lecithin allergy (ibid.). Therefore, it is perhaps the best for food products to have labelling containing a list of the entire ingredients and highlighting any possible allergens.

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Labelling is not only limited to food packaging but also applies to displays and places where food was distributed, even in on-line food shops. Start by putting food in a designated section based on allergens (for example putting all products containing sesame in a shelf labelled 'contains sesame'), display visible stickers, cards or signs on various places in the area and consider the colour contrast, angling, or position of the allergen information in terms of visibility. Following the example of arrangements in supermarkets, for places that has enough area, it is possible to divide into aisles based on ingredients, such as an aisle for meat products, an aisle for dairy products and so on.

Secondly, restaurants should put more effort into providing their employees with more adequate training regarding allergies. Aside from health factors, taking into account that this concern could have an effect on the number of people dining out (Ming Lee and Xu, 2015). This might have an impact on the rating of restaurants and cause a significant loss on revenue of the industry of restaurants as a whole (ibid.). As the number of people suffering from food allergy becoming increasingly prevalent, it is probably best for restaurants to properly consider the severity of this matter and be prepared to meet the needs of people with possible food allergies.

Studies by Ming Lee and Sozen (2016) have revealed that many employees think that the training is not interesting enough, lacks emphasis on the importance of allergy and fairly time-consuming. But now that technology has become more advanced, it may be possible to do training through mobile devices or a website which is more flexible, interactive and consumes less time and energy (ibid.), providing the employees with a good reward system could even motivate them further (Ming Lee and Sozen, 2016). This is not limited to only restaurants but food manufacturing industries as well.

It is also important to train the employees to establish good communication to the costumers so they will feel more at ease to inform the restaurant of any additional inputs, requests and requirements (Ming Lee and Xu, 2015) and to always remember to ask for allergy information beforehand. Making modified versions of the menus for people with allergies, advertising allergens in social platforms and listing out all possible allergens in the menu offered, for both in the restaurant and uploaded to their website is also recommended (Ming Lee and Sozen, 2016), preferably with font colour that can be clearly visible against the background colour.

Thirdly, educating the public about the importance of allergy. It would be even better if this matter was taught since young of an age. Starting from informing the public about basics of allergy, the importance of allergen warnings and learning simple prevention method such as avoiding cross-contamination with any possible allergen (Gowland et al, 2002) and bringing EpiPen in case of emergencies. It is also encouraged for consumers to adopt a habit of read any food labelling very carefully and to always remember to inform food retailers or restaurant employees for any allergy or diet requirements, even bring a food allergen card to further consolidate their stance if their request is met with doubt (Ming Lee and Xu, 2015). This also includes advertising allergy prevention in TV or the streets (posters or banners in public places).

And last but not least, proposing to the government to try creating or enforcing more strict laws or regulations regarding allergens in food processing industries. This includes establishing less leniency and declare a failure to adhere to the laws to be met with a more severe penalty to back it up.

Several laws have been established, however not a small number of people who still think that there is still error in these laws. Most laws require advisory labelling to be truthful and not misleading, however, they often do not provide specific and additional guidelines and some may not be specific enough which could lead to false assumptions by consumers (Pieretti et al., 2009) or even the manufacturers themselves, who could perhaps find a loophole around the rules. This could lead to harmful aftermath.

One of the recommended solutions is to implement higher standards of hygiene in food manufacturing and monitor it regularly (Gowland et al., 2002). Because even though most hard labour now being done by machines, it is still going to have some probability of contamination by allergens and human error. The government must try to make a law that minimizes the risk of error and make allergen warnings as transparent, comprehensive and precise as much as possible. Another suggested solution would be enforcing a law in which food manufacturers, food distributors and restaurants should have a first aid kit containing at least one EpiPen for drastic measures.

Recently, new laws have been created in honour of the two victims above. 'Natasha's Law' which requires food businesses to provide labelling on pre-packaged food which contains the list of the full ingredients and emphasizing allergens that may be inside their product (BBC, 2019) and 'Owen's Law' emphasizes the importance of clarity in food allergy labelling in restaurants (Leigh Day, 2019).

From above, it clear that food allergy still has errors despite its developments. There are several suggested methods, however, it would be great if further research can be conducted to prevent incident as such as the two cases from occurring again in the future.

References

1. BBC News, 13 September 2019, Byron burger allergy death: Owen Carey’s family demand law change. http://www.bbc.co.uk/news/uk-england-49688459
2. Hazel Gowland, M. (2002). Food allergen avoidance: Risk assessment for life. Proceedings of the Nutrition Society, Volume 61, Issue 1, pages 39-43. https://doi.org/10.1079/PNS2001128
3. Hazel Gowland, M. and J. Walker, M. (2014). Food allergy, a summary of eight cases in the UK criminal and civil courts: effective last resort for vulnerable consumers? Journal of the Science of Food and Literature 2015, Volume 95, Issue 10, pages 1979-1990. https://doi.org/10.1002/jsfa.6988
4. Leigh Day, 13 September 2019, Family call for ‘Owen’s Law’ following inquest conclusion. http://www.leighday.co.uk/News/2019/September-2019/Family-call-for-Owens-Law-following-inquest-con
5. Ming Lee, Y. and Sozen, E. (2016) Food allergy knowledge and training among restaurant employees, International Journal of Hospitality Management, Volume 57, pages 52-59. https://doi.org/10.1016/j.ijhm.2016.05.004
6. Ming Lee, Y. and (Michelle) Xu, H. (2015) Food Allergy Knowledge, Attitudes, and Preparedness Among Restaurant Managerial Staff, Journal of Foodservice Business Research, Volume 18, Issue 5, pages 454-469. https://doi.org/10.1080/15378020.2015.1093452
7. M. Pieretti, M., Chung. D., Pacenza, R., Slotkin, T. and H. Sicherer, S. (2009) Audit of manufactured products: Use of allergen advisory labels and identification of labeling ambiguities, Journal of Allergy and Clinical Immunology, Volume 124, Issue 2, pages 337-341. https://doi.org/10.1016/j.jaci.2009.05.032
8. The Guardian, 28 September 2018, Pret allergy death: inquest should be watershed moment, says father. http://www.theguardian.com/uk-news/2018/sep/28/pret-a-manger-gove-tighten-up-food-labelling-rules-teenagers-death-natasha-ednan-laperouse?CMP=share_btn_link
9. The Guardian, 12 September 2019, Teenager who died after burger ‘should have asked about allergens’, says Byron. http://www.theguardian.com/uk-news/2019/sep/12/byron-restaurant-denies-wrongdoing-over-teenagers-allergy-death?CMP=share_btn_link