Anaphylaxis Campaign

Supporting people at risk of severe allergies

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Breaking News on Food Labelling

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Tuesday 25th June 2019

The Anaphylaxis Campaign are delighted to hear the announcement by the Department for Environment, Food and Rural Affairs (DEFRA) that food businesses will be required to provide a full ingredients list on pre-packaged foods for direct sale.

Lynne Regent, CEO of the Anaphylaxis Campaign said:

‘We are thrilled that DEFRA are taking forward full ingredients labelling on pre-packaged food for direct sale. We believe this is the right step forward to protect individuals with severe food allergies.’

Please read the full press release from DEFRA below.

 

GOVE TO INTRODUCE ‘NATASHA’S LAW’

  • Government makes full ingredients labelling mandatory
  • ‘Natasha’s Law’ to protect food allergy sufferers
  • Legislation in place by summer, with two-year implementation for businesses

A new law will require food businesses to include full ingredients labelling on pre-packaged foods, Environment Secretary Michael Gove announced today in a drive to protect the country’s two million food allergy sufferers.

Following the tragic death of Natasha Ednan-Laperouse, the teenager who died after suffering an allergic reaction to a Pret a Manger baguette, the Environment Secretary confirmed legislation will be brought forward by the end of summer to strengthen allergen labelling rules.

Under current laws, food prepared on the premises in which it is sold is not required to display allergen information in writing, meaning allergy sufferers sometimes lack confidence buying food out.

The new legislation, known as ‘Natasha’s Law’, will tighten the rules by requiring foods that are pre-packed directly for sale to carry a full list of ingredients – giving allergy sufferers greater trust in the food they buy.

 

Environment Secretary Michael Gove said:

“Nadim and Tanya Ednan-Laperouse have been an inspiration in their drive to protect food allergy sufferers and deliver Natasha’s Law.

“These changes will make food labels clear and consistent and give the country’s two million food allergy sufferers confidence in making safe food choices.”

The government will introduce legislation by the end of summer mandating full ingredients labelling for foods prepacked for direct sale, and the new laws will come into force by summer 2021 – giving businesses time to adapt to the change.

The introduction of ‘Natasha’s Law’ follows a consultation in January proposing four options, including full ingredient list labelling; allergen-only labelling; ‘ask the staff’ labels on products; and promoting best practice to businesses.

The consultation received overwhelming support from consumers for full ingredients labelling, with more than 70 per cent of individuals backing this option. The Food Standards Agency’s recent advice also recommended government should implement full ingredients labelling.

 

Chair of the Food Standards Agency Heather Hancock said:

“We want the UK to become the best place in the world for people living with food hypersensitivities.

“The impact of food allergy and intolerance on quality of life can be as great or even greater than almost all other foodborne diseases.

“Whilst it’s impossible to eliminate the risks entirely, we believe this change will mean better protection for allergic consumers.”

The reforms cover labelling requirements for foods that are prepared and packed on the same premises from which they are sold – such as a packaged sandwich or salad made by staff earlier in the day and placed on a shelf for purchase.

Currently, these foods are not required to carry labels, and if asked by a consumer allergen information must be given in person by the food business.

Food businesses across the country have already taken steps to improve food labelling and outlets are being urged to do all they can ahead of the implementation date to help consumers make safe food choices.

The Food Standards Agency (FSA) will continue to provide food businesses with guidance on allergens, and through its Easy to Ask campaign it works to empower young people to ask food businesses about allergens when eating out so they can make safe food choices.

Chartered Institute of Environmental Health Calls for Allergens to be Included in Food Hygiene Rating Scheme

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On Thursday 30th May, The Chartered Institute of Environmental Health published an article calling for allergen hygiene to be scored in the Food Hygiene Rating Scheme and national guidance provided on how allergen responsibilities are split between environmental health and trading standards.

The Anaphylaxis Campaign believes that the Food Hygiene Rating Scheme needs to be made fit for purpose for the allergic community. At present the scheme provides consumers with information about hygiene standards which allow consumers to make informed choices about the places they eat at. Individuals with a food allergy are not able to make informed choices about a food business based on their compliance with allergen labelling laws. Inclusion of a food business’ compliance with legislation relating to allergens and their allergen management will go some way to improving allergic consumers’ confidence in a food business and highlight the importance of compliance with food business operators.

Click here to read the full article.

FDF Publishes Updated Gluten Labelling Guidance

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On Monday 3rd June 2019, the Food and Drink Federation released the following press statement:

 

The Food and Drink Federation (FDF) has today published ‘Gluten Labelling Guidance: Best Practice for Prepacked Foods which Include or Exclude Cereals Containing Gluten’ (https://www.fdf.org.uk/Gluten-Labelling.aspx?tr=53NvsCS). This updated UK best practice guidance provides advice to food business operators on how to label food products that include cereals containing gluten, and which claims can be made relating to the absence or reduced presence of gluten (e.g. gluten-free). The Gluten Free Industry Association (GFIA) now joins Coeliac UK, Anaphylaxis Campaign and the British Retail Consortium (BRC) as supporting partners of this guidance.

The document has been developed to illustrate examples of different labelling situations, with special consideration given to oats and wheat species. It provides information about the distinction between coeliac disease and cereal allergy, advice on precautionary allergen labelling, and a flow diagram for making gluten absence claims. It also includes an overview of the relevant EU and UK legislation and guidance.

Heather Hancock, Chairman of the Food Standards Agency, said:

“The Food Standards Agency welcomes the FDF’s work to achieve greater consistency in how the presence of cereals containing gluten and gluten-free claims are labelled on prepacked foods. Having a trusted consistent approach will make it easier for people with coeliac disease or with allergies to these cereals to find and understand the labelling information they need. And that means they can make safer food choices. I am very pleased to see further progress in this important area of public health and consumer protection.”

Alex Turtle, Food Law, Labelling and Enforcement Manager, FDF, said:

“To be able to choose a safe prepacked food, allergic consumers need clear information about its composition; whether it includes any cereals containing gluten or has been produced gluten-free. It is vitally important that food manufacturers provide legally compliant labels that present consistent allergen information. FDF is committed to providing best-practice regulatory guidance and we hope that this updated, more comprehensive, guidance continues to support food manufacturers, of all sizes, to make informed labelling declarations regarding their products.”

Norma McGough, Director of Policy, Research and Campaigns at Coeliac UK, said:

“The Charity supports the updated FDF best practice guidance for the food industry. By distinguishing the presence of allergens (i.e. gluten-containing cereals) with the absence of gluten in foods (i.e. gluten-free), the guidance helps highlight the important distinction between an allergy to cereals and coeliac disease. We also welcome approaches to limit use of precautionary statements relating to the presence of cereals containing gluten in prepacked products.”

 

Lynne Regent, CEO of the Anaphylaxis Campaign, said:

“The Anaphylaxis Campaign welcomes this new gluten labelling guidance introduced by the FDF. We hope that food manufacturers take on board the advice on how to safely label food products, which covers the labelling of cereals containing gluten and products that are gluten-free. We believe that food allergic individuals must be able to make informed decisions and to assess risk and self-manage their condition when purchasing food.”

 

If you have any questions, please either email [email protected] or call 01252 542029.

Anaphylaxis Campaign’s Statement Regarding Inquest into the Death of Karanbir Cheema

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Friday 10th May 2019

The coroner has ended the inquest on Karanbir Cheema and has delivered her narrative and recommendations.

Our deepest sympathies go out to the family of Karanbir Cheema who passed away following a tragic incident which occurred at William Perkin Church of England High School in Greenford, West London on the 28th June 2017.  Karanbir was known to have severe eczema, bronchial asthma for which he was prescribed an inhaler, and was allergic to milk, peanuts, eggs, gluten and wheat.

Following the outcome from the inquest, the coroner has made a significant number of recommendations as a result of this case. These recommendations affect a number of bodies including the London Ambulance Service, the Hospital Trust and the William Perkin Church of England High School. This is a difficult occasion for the family of Karanbir Cheema, but we understand that the recommendations taken forward will bring about a positive result for those affected by severe allergies.

Lynne Regent, Chief Executive of the Anaphylaxis Campaign, said:

“We were deeply saddened to hear about the death of Karanbir Cheema as a result of this tragic incident. We have actively been supporting his family over this difficult time and have been by their side throughout inquest into his death. The coroner has called for a number of positive actions that we believe will positively benefit the allergic community.’

 We wish to make it clear that the Anaphylaxis Campaign are not legal experts; the primary reasons we attend inquests are to offer support to families, and to identify if there are specific lessons that can be learned to take forward into the work we do to support people at risk of severe allergic reactions.

 

 

Anaphylaxis Campaign’s resources to help schools be allergy aware

As part of our Making Schools Safer Project, we have been in contact with over 26,000 schools in the UK to give them access to our free resources including;

  • Our online e-learning course AllergyWise for Schools which is designed to ensure that all staff:
  • Understand how to safeguard children with allergies.
  • Are fully aware of the signs and symptoms of anaphylaxis.
  • Know how to provide emergency treatment.
  • Our KS1-2 Schools allergy awareness resource pack which is designed to facilitate an allergy awareness session for infant and primary school age children.
  • Our KS3-5 Schools allergy awareness resource pack which is designed to facilitate an allergy awareness presentation for secondary school age children.

The Anaphylaxis Campaign believes it is vital for all schools to not only have training for all staff but to also raise pupil’s awareness of the seriousness of living with a food allergy. We hope our resources will support this and help schools become more allergy aware.

All our schools’ resources are available to view and download on our website:

AllergyWise for Schools

KS1-2 resource pack

KS3-5 resource pack

About the Anaphylaxis Campaign

The Anaphylaxis Campaign is the only UK wide charity solely focused on supporting people at risk of severe allergic reactions. We empower people living with severe allergies to be more confidently in control of their lives.

We provide information and support to people living with severe allergies, their families and carers, through our national helpline, volunteer-led local support groups and free online AllergyWise training courses. We also campaign and fundraise to achieve our ultimate aim, to create a safer environment for all people at risk of severe allergies.

If you have any concerns or questions, please contact our helpline team at [email protected] or call 01252 542029.

For further information, please contact our press office via [email protected] or call 01252 893864.

Anaphylaxis Campaign’s Response to Pret’s Allergy Plan

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2nd May 2019

Yesterday Pret a Manger launched their five-point allergy plan designed to help every customer with allergies or intolerances get the best possible information about Pret food and drink.

Pret will from this week provide full ingredient labels on all freshly made products in 20 London shops, with further roll-outs planned in the coming months.

The five-point plan also includes the launch of new tablets in every shop with full ingredient information allowing customers to proactively search through Pret’s menu, filtering out ingredients to find products they can consume based on their individual dietary needs. The tablets will be rolled out in Pret stores over 2019.

Pret has also announced that it has reformulated over 70 Pret recipes to remove one or more allergens in a step to reduce the barriers to eating out for people with allergies. Pret has committed to share quarterly incident updates on food safety and has plans to build on its existing allergy training programme for their staff.

The Anaphylaxis Campaign welcomes the positive changes introduced by Pret and hopes that the importance placed on allergen management and transparency has a wider positive impact on the industry.

 

 

If you have any further questions, please contact [email protected] or phone the helpline on 01252 542029.

If you have any media queries, please contact [email protected].

Cow’s Milk Allergy – A Study

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David Reading reminds corporate members how serious allergy to cow’s milk can be, and reports on the latest findings with regard to thresholds and reference doses.

A ten-year-old boy took one bite of a pre-packed apple dessert and suffered anaphylaxis. It transpired that the pie contained 0.006 per cent milk protein. It had been correctly labelled, but the boy – who knew he was allergic to cow’s milk – made a mistake and did not check. Fortunately he recovered thanks to prompt medical treatment. A six-year-old girl suffered a severe reaction in a restaurant to an ice cream labelled as “non-dairy”. After the girl recovered, enquiries revealed that a major ingredient of the ice cream was skimmed milk. These two cases – taken from our files – demonstrate clearly how serious milk allergy can be. Although allergy to peanuts and tree nuts is still frequently in the news, it must not be forgotten that other foods are occasional causes of anaphylaxis.

Cow’s milk allergy is one of the most common food allergies in the UK and throughout the world. The first adverse reactions to cow’s milk were described 2,000 years ago, but it was only in the mid to late 20th century that research groups began analysing of cow’s milk allergens. The completion of our recent fact sheet on cow’s milk allergy reminded us how complex this subject is.

Immediate allergic reactions to cow’s milk – sometimes referred to as “a true allergy” – are just part of a wider picture. Helpline staff working for food companies should, perhaps, be aware that customer complaints of “allergic” reactions to milk may have other causes. Immediate cow’s milk allergy – fairly common among children – is well understood by doctors. It occurs when the body’s immune system wrongly perceives some of the proteins in cow’s milk to be a threat and, as a result, produces antibodies of the Immunoglobulin E class (known as IgE for short). These antibodies are specifically targeted against one or more of the cow’s milk proteins.

Subsequently, whenever the person with the allergy comes into contact with milk, these antibodies trigger certain chemicals such as histamine to be released from special immune system cells in the blood and tissues where they are stored. It is the sudden release of these chemicals in the body that causes the symptoms. Symptoms can be mild but for some there is a potential for anaphylaxis.

However there are numerous other conditions triggered by milk, making the overall subject much more complex. These include:

  • Delayed cow’s milk allergy (non-IgE milk allergy)
  • Cow’s milk-induced proctocolitis
  • Cow’s milk protein-induced enteropathy syndrome
  • Eosinophilic Gastrointestinal Disorder (EGID)
  • Food protein-induced enterocolitis syndrome (FPIES)
  • Lactose intolerance

To find out about immediate cow’s milk allergy and these other conditions click here.

The question the food industry will be asking relates to labelling: What is the level of cow’s milk beneath which the risk of an allergic reaction is negligible and Precautionary Allergen Labelling (PAL) is not required? The answer is that scientific studies have reached firm conclusions on this. In 2011, the VITAL Scientific Expert Panel (VSEP) was tasked with identifying reference doses for allergens by the Allergen Bureau of Australia-New Zealand. It was able to access the results of 17 published studies, as well some unpublished data, encompassing in total 351 food challenges, most of them in children.

This data was sufficient to define a robust reference dose of 0.1mg of milk protein per serving, which would protect 99% of those with a milk allergy against any reaction (Taylor et al 2014). As was done successfully with peanut, challenges with single doses of milk (protective of 95% rather than 99%, for statistical reasons) are currently underway to validate the milk reference dose.

Another key question is: Is there any sign that regulators are reaching the point when they can offer robust guidance to the food industry on action levels? The answer is that while regulatory bodies have welcomed the proposed reference doses (for milk and other allergens) as a major step forward, formal adoption has been much slower. Authorities in Belgium and Germany have produced documents supporting their use in allergen management. Anecdotally, other regulatory authorities have used them as a starting point for their risk assessment and management actions.

In the UK, the Food Standards Agency is supportive and insists that the use of PAL must be based on a thorough risk assessment. A current initiative to bring allergen management within the ambit of the Codex Alimentarius, with which the FSA is actively involved, may also help to move things forward in the future.

 

References

Taylor SL, Baumert JL, Kruizinga AG, Remington BC, Crevel RW, Brooke-Taylor S, Allen KJ, Houben G (2014). Establishment of Reference Doses for residues of allergenic foods: Report of the VITAL Expert Panel. Food Chem.Toxicol. 63, 9–17.

AFFSCA (2017) Avis 24-2017: Doses de référence pour les allergens. http://www.afsca.be/comitescientifique/avis/2017/_documents/Avis24-2017_SciCom2017-01_dosesdereferenceallergenes.pdf {In French with English summary}.

Companies that produce food for vegans are facing an interesting allergy-related dilemma

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The question arises where a product made for vegans is made on a line on which non-vegan foods are also produced – products that contain ingredients such as milk, egg or fish.

The problem here is that adding an allergy warning – ‘may contain’ milk, egg or fish – could deter many vegans from buying such products. But if there is no warning, then people with allergies could be placed at risk. There is no point in arguing that people with very severe food allergies will be well-informed enough about cross-contamination issues to be suspicious of vegan products. Not all people with allergies have that degree of understanding.

However difficult the problem is for producers of vegan foods, it is our view that ‘may contain’ statements must always be present whenever there is a genuine risk of allergen cross-contact. This may annoy both vegans and people with food allergies. The latter will probably conclude that the companies concerned are just ‘covering their backs’.

On its website, the Vegan Society makes it clear it is not against foods labelled as vegan also carrying a ‘may contain’ warning about animal allergens. To encourage manufacturers to give a serious commitment to avoiding cross-contamination with animal ingredients, the Vegan Trademark licence agreement asks companies to confirm that they strive to minimise cross-contamination from animal substances used in non-vegan products as far as is reasonably practicable.

As everyone in the industry knows, precautionary allergen labelling (PAL) is not a legal requirement but is necessary where any product poses a real risk. It is our view that a thorough risk assessment should be undertaken before any decision about PAL is made. The problem here, of course, is that food industry regulators have not yet provided clarity on thresholds (that is, the amount of allergen below which the risk of an allergic reaction is negligible). Although scientists have reached clear conclusions on the thresholds for certain individual foods, the industry has not yet received guidance on action levels they need to use to keep cross-contact below those levels and avoid the need for PAL.

The issue is a matter for the regulatory authorities to attend to. The thresholds proposed need to be reviewed by the European Food Safety Authority (EFSA) and the FSA in the UK before they can be adopted into official guidance. Stakeholders are actively working to ensure that the European Commission gives this matter a high priority.

For now, we advise that companies producing food for vegans should bite the bullet and realise that PAL is necessary where food products pose a genuine risk.

 

Links

FSA guidance on allergen management and consumer information: www.reading.ac.uk/foodlaw/label/allergens-maycontain-2006.pdf

Food and Drink Europe guidance on food allergen management: https://www.fooddrinkeurope.eu/uploads/publications_documents/Guidance_on_Food_Allergen_Management.pdf

CIEH/TiFSiP white paper on improving the use of ‘may contain’ allergen statements: https://www.cieh.org/media/1234/lmproving-the-use-of-may-contain-allergen-statements.pdf

Vegan Society statements on allergens: https://www.vegansociety.com/resources/nutrition-and-health/allergen-labelling-0

 

New research reveals challenges facing young people with food allergies and intolerances

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Survey shows over half of young people with a food allergy or intolerance have avoided eating out in the last six months due to their condition.

The results are from a bespoke survey, released by the Food Standards Agency (FSA), in partnership with Allergy UK and the Anaphylaxis Campaign, on the views of young people living with food allergies and intolerances. The survey also revealed that while 67% of respondents reported being aware of the legal requirement of food businesses to provide information on the top 14 allergens, only 14% felt extremely confident asking for allergen information when dining out and 14% reported feeling not at all confident.

The FSA, working with Allergy UK (AUK) and Anaphylaxis Campaign (AC), has launched easy to ASK, a campaign designed to empower young people to ask food businesses about allergens when eating out, so that they can make safe choices. The campaign follows several allergy-related deaths among young people – data shows that children and young adults are disproportionately more prone to die from an allergic reaction than adults.

‘We are delighted to be working with the Food Standards Agency on the Ask the Question project. It is unfortunate that most serious allergy related instances and even deaths happen when young people are eating out, or buying takeaway food. We have communicated extensively with young allergy sufferers to make sure they take responsibility for their condition when eating out, but it is also vital that foodservice establishments take the initiative to help prevent tragic accidents. Ask the Question is a timely development which will provide important materials for foodservice staff and will give allergic consumers more confidence when they go out to eat. We are happy to provide access to our extensive range of information resources to any food business that needs further help and advice.’ Chief Executive, Lynne Regent.

Easy to ASK is also a reminder to businesses to be up front about the provision of accurate allergen information, particularly with this vulnerable group. Asking a customer if they have food allergies could save a life. The campaign includes the simple mnemonic:

  • Always ask about allergies
  • Speak up
  • Keep safe

Research reveals worrying challenges

When meeting new people, 5% of respondents with a food allergy and 11% with a food intolerance reported not telling anyone about their condition at all, potentially risking allergic reactions or fatal consequences. When asked why, some respondents said they felt embarrassed and some said that their condition was too complicated to explain.

Other findings include:

  • 59% reported they tend to visit the same places when eating out
  • 55% reported always researched the menu online before going to a new or unfamiliar place
  • only 9% reported always contacting a restaurant in advance to check they provide allergen information

Food businesses step up

Commenting on the easy to ASK campaign, FSA Chairman Heather Hancock, said:
“We’ve seen real progress in how food businesses approach customers with allergies. However, 60% of the young people surveyed tell us they’ve avoided eating out in the past six months because of their condition.

“Living with a food allergy or intolerance is not easy and can have fatal consequences. Many in this age group will be students starting out at university or college, in new surroundings and with new friends. It’s crucial that they feel confident to speak up and ask for allergen information, and that the people around them make that easier.

“Food businesses have an important part to play in making this age group feel more at ease. They are required always to provide accurate allergen information. Through our easy to ASK campaign, we’re raising awareness and understanding to boost the confidence of young people, and we’re encouraging food businesses to make it easier for everyone to ask the question, speak up and help keep those at risk safe.”

Speaking for the Anaphylaxis Campaign, Lynne Regent, CEO, commented:
“We are delighted to be working with the Food Standards Agency on the easy to ASK campaign. It is unfortunate that most serious allergy related instances and even deaths happen when young people are eating out, or buying takeaway food.

“We have communicated extensively with young people with an allergy to make sure they take responsibility for their condition when eating out, but it is also vital that foodservice establishments take the initiative to help prevent tragic accidents.

“The easy to ASK campaign is a timely development which will provide important materials for foodservice staff and will give allergic consumers more confidence when they go out to eat. We are happy to provide access to our extensive range of information resources to any food business that needs further help and advice.”

Survey report

Young people and food allergies/intolerances was conducted by the Food Standards Agency in partnership with Allergy UK and Anaphylaxis Campaign. The survey is based on responses from 2599 young people aged 16-24 in the UK.

Many respondents skipped some of the questions. Therefore, tables are based on the respondents to the relevant question, rather than all 2599 respondents.

Statement regarding the death of Sadie Bristow

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The Anaphylaxis Campaign is saddened to learn of the death of talented young tennis player Sadie Bristow, a 9-year-old from Canterbury, following a tragic accident in August this year as a result of a severe allergic reaction. Sadie Bristow was known to have a milk allergy and nut allergy and have asthma and eczema.

Our general advice on managing a severe allergy is:

Carrying your medication

If you have been prescribed treatments for your allergy — such as injectable adrenaline — the golden rule is, carry it everywhere at all times, with no exceptions. It’s important to make sure others are aware of what to do when a reaction occurs, such as relatives and close friends.

Asthma control

If you have asthma as well as allergies, your asthma should be well controlled. Poorly-controlled asthma will raise the chances of any allergic reaction being severe. If your asthma needs more treatment than usual, you should take extreme care to avoid those foods or substances that might cause a reaction. You will also need to discuss your asthma with your GP.

If you suspect a reaction is serious or becoming serious, use your injector immediately, any delay could be extremely serious. Dial 999 or get someone else to do it. Immediately after your adrenaline has been administered, you will need to get to hospital because the symptoms can return and you may need further treatment.

Symptoms to look out for:

Children may appear weak and ‘floppy’. Swollen lips and/or eyes, itchy skin or a rash like hives, wheezing and finding it hard to breathe or speak, feeling faint, dizzy or confused, vomiting or having diarrhoea are just some of the symptoms of severe allergy and need immediate action. This is by no means a full list of symptoms, so always speak to your doctor about what you should watch out for.

Sometimes there are other factors that on the day can increase the severity of your reaction. These are called co-factors and these can include exercise, feeling unwell with a viral illness, alcohol and tablets, such as some painkillers.

For some people with allergies, more serious reactions such as anaphylaxis may only occur if they have eaten a specific food, or taken the medication to which they are allergic, then they exercise. People with asthma and allergies are known to be more at risk of severe reactions than those without.

Lynne Regent, Chief Executive of the Anaphylaxis Campaign, said:

“We are deeply saddened to learn about the death of Sadie Bristow as a result of this tragic incident. Our heartfelt condolences go out to Sadie’s family and friends at this difficult time. Sadly, we also know teenagers and young people are a particular at risk group.

“We continue to highlight our advice for all people living with allergies or intolerances to always carry two adrenaline auto-injectors if prescribed, ensure that you have well managed asthma and for people with food allergies, they must read the ingredient list every time they buy a product, even if they have bought it before.

“We would welcome anyone with an interest in managing allergies to become a member of the Anaphylaxis Campaign to receive information, advice as well as our personalised alerts, factsheets and our online courses.”

 

If you have any concerns or questions, please contact our helpline team at [email protected] or call 01252 542 029.

For further information, please contact our press office via [email protected] or call 01252 893 862.