Source:Hefle SL, Furlong TJ, Niemann L, et al. Consumer attitudes and risks associated with packaged foods having advisory labeling regarding the presence of peanuts.
J Allergy Clin Immunol.
2007
;
120
(1):
171
–176; doi:10.1016/j.jaci.2007.04.013

Food allergies affect nearly 4% of American adults and 6%–8% of children.1 Avoidance of the offending foods is the only effective remedy currently available. With the passage of the Food Allergen Labeling and Consumer Protections Act (FALCPA), manufacturers are now required to clearly identify the presence of eight major food allergens (cow’s milk, egg, wheat, soy, peanut, tree nuts, fish, shellfish) on packaging, including those present in flavorings or spices.2 

Unfortunately, unintentional and incidental contamination of products occurs through errors in formulation and packaging, and via cross-contamination from shared equipment or facilities.3 FALCPA has no provisions for how potentially contaminated products should be identified. As a result, manufacturers voluntarily print advisory warnings such as “May contain…,” “Manufactured on shared equipment with…,” and “Processed in the same facility as…,” without any criteria upon which those statements must be based.

The objectives of this study from researchers at Mt. Sinai School of Medicine, New York, the University of Nebraska, and the Food Allergy and Anaphylaxis Network (FAAN) were to understand the degree to which consumers heed advisory warnings and to assess the risks to peanut-sensitive patients who eat products warning of possible peanut contamination. FAAN is a lay organization with more than 27,000 members.

During FAAN conferences in 2003 and 2006, food-allergic patients or their parents were presented with eight common food allergen advisory warning statements and asked how often they would purchase foods so labeled (“never,” “sometimes,” or “always”). Surveys were completed by 1,270 individuals, 96% of whom were parents of a child with food allergy. Overall, the proportion of people who would “never” purchase a product with an advisory warning decreased from 85% to 75% (P<.01) in the three-year interval. In the 2006 survey, thematically different advisories were regarded differently (P<.002). Warnings of “may contain…” were avoided by 86%, “…shared equipment…” by 70%, and “… facility that also processes…” by only 64% of respondents.

The investigators also purchased 200 packaged foods of various types; 21 products contained peanuts as a minor ingredient while 179 had allergy advisory warnings. Two lot numbers of each product were selected for a total of 400 food samples. The products were analyzed for the presence of residual peanut to a lower limit of detection of 2.5 ppm (2.5 μg per gram of food). If a serving of a product is assumed to be 100 g, then 2.5 ppm is equivalent to 0.25 mg of peanut protein per serving.

Among products listing peanut as a minor ingredient, only 7/21 (33%) had detectable peanut in at least one lot. Among products that only carried advisory warnings, detectable levels of peanut were found in 13/179 (7.3%). Products labeled “may contain…” contained 53–81 ppm, “shared equipment” less than five ppm, and “shared facility” three to 4,000...

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