FSIS releases new guide to help food processors control potential allergens, other hazards

The  U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) has released new guidelines to assist meat, poultry, and processed egg product producers in properly managing ingredients that could trigger adverse reactions among consumers with allergies or other sensitivities.

food.allergies“Our mission as a public health agency is to protect America’s most vulnerable populations, including children, from harm, and these new guidelines do just that,” said USDA Deputy Under Secretary for Food Safety Al Almanza. “Beyond keeping our families safe, these guidelines also provide a useful tool to help food companies avoid preventable, costly recalls.”

Food allergens are a public health issue impacting millions of Americans. The Centers for Disease Control and Prevention estimates that two percent of adults, and four to eight percent of children, in the United States have food allergies. Food allergens can cause serious symptoms and can result in anaphylaxis, a potentially life threatening reaction.

Over the last several years, in part due to new actions by FSIS, there has been an increase in recalls of FSIS regulated products due to undeclared allergens. These problems often are caught by FSIS inspectors during labeling checks and are the result of changes to ingredient suppliers, products being placed in the wrong package, or changes to product or ingredient formulations.

By following these new guidelines, establishments are more likely to ensure that product labels declare all ingredients, as required by law, and that products do not contain undeclared allergens or other undeclared ingredients.  The guidance covers prevention and control measures of potentially allergic ingredients, packaging, labeling, storage, checklists, and allergen training, among others.

The finalized guidelines are part of FSIS’ comprehensive and ongoing efforts to reduce the number of allergen-related recalls. In April 2015, FSIS inspectors met with management at every FSIS-regulated establishment in the country to discuss whether the establishment produces items containing allergens, and, if so, whether the establishment had a process in place to ensure proper labeling. FSIS inspectors then increased the number of allergen labeling-related inspection checks they conduct in these establishments in order to ensure products are properly labeled. The Agency believes that this action has made plants more conscious of properly labeling their products and prevented additional recalls this year.

The guidelines can be found online at: http://www.fsis.usda.gov/AllergenGuide

Over the past six years, USDA has collaborated extensively with other federal partners to safeguard America’s food supply, prevent foodborne illnesses and improve consumers’ knowledge about the food they eat. USDA’s FSIS is working to strengthen federal food safety efforts and develop strategies that emphasize a three-dimensional approach to prevent foodborne illness: prioritizing prevention; strengthening surveillance and enforcement; and improving response and recovery.

Food fraud consequences: 10-year-old died in Melbourne after drinking coconut milk as importer admits label charges

But why wasn’t the investigation and cause revealed earlier, to warn and hopefully prevent further cases. Maybe it has something to do with the legal system in Australia.

coconut.drinkMaybe it doesn’t.

A 10-year-old child died from an allergic reaction in Dec. 2013 after drinking a “natural” coconut drink imported by a Sydney firm.

The canned product from Taiwan, Greentime Natural Coconut Drink, is sold in most states and was recalled just over a month later following the tragedy. But it was never revealed that it was blamed for causing the fatal anaphylactic reaction in the child from Melbourne.

The NSW Food Authority said importer Narkena Pty Ltd, based in western Sydney, pleaded guilty in September to three labelling charges and will be sentenced later this month.

The authority said the company entered pleas of guilty to two charges that the drink was labelled in a way that falsely described the food and to one charge of selling food in a manner that contravened the Food Standards Code.

A spokeswoman for the Victorian Coroner said a decision about whether there would be an inquest would be made after the other court hearings were concluded. Lawyers are understood to be pursuing a civil action against the importer.

Despite the tragedy occurring some 22 months ago, it was only in August that a suppression order was applied for in relation to the case.

The child, as a minor, cannot be named by The Sun-Herald.

The child is understood to have had an allergy to dairy products. The NSW Food Authority said at the time that the recall was because the milk content was not declared on the label.

Narkena Pty Ltd did not respond to a request for comment.

Five coconut drinks have been recalled in the last four weeks, all because they contained undeclared cow’s milk according to Allergy and Anaphylaxis Australia.

Last month, The Sun-Herald reported Aiden Henderson, nine, who is allergic to dairy products, went into anaphylactic shock after drinking the flavoured drink Coco Joy. It is also imported by a Sydney firm and was recalled after the incident.

Maria Said, president of Allergy & Anaphylaxis Australia said she was dismayed that although the coconut drink the child consumed immediately before the anaphylaxis that took his life was found to contain cow’s milk, it had taken almost two years for other similar products to be investigated.

“Surely someone in the food science industry would have known the cow’s milk was used for a functional purpose in coconut drink and if that was the case, it would likely be in other coconut drinks,” she said.

“Another child’s near-death experience after drinking a different coconut drink in July 2015 prompted NSW Food Authority to test other coconut drink products, some of which have now also been recalled due to undeclared cow’s milk. The spate of coconut drink-related recalls continues as it should have from Jan 2014.”

 

UK restaurant owner faces manslaughter charge in fatal peanut allergy case

The owner of an Indian restaurant accused of the manslaughter of a customer who suffered a fatal allergic reaction to peanuts after eating a meal is due to appear in court.

paul.wilson.peanut.allergyMohammed Zaman, 52, owner of the Indian Garden in Easingwold, North Yorkshire, is due to enter pleas at Teesside Crown Court today after he was charged over the death of Paul Wilson (right).

The 38-year-old customer suffered a severe anaphylactic reaction and died after buying a curry from the restaurant in January last year. It was claimed he requested no nuts.

As well as manslaughter by gross negligence, the restaurant boss is charged with perverting the course of justice by forging a food safety training certificate, an immigration offence relating to the employee who served the contaminated meal, and food safety offences.

Zaman, from Huntington, York, was granted bail at a previous hearing.

Is the food industry doing enough to control allergens?

Friend of the barfblog.com, Roy Costa, writes that a recent spat of food product recalls due to undeclared allergenic agents illustrates the problem the food industry has in preventing allergen exposures.

food_allergy_genericWhile food manufacturers usually have allergen controls in place, protecting those in the population with food allergies can be particularly challenging. Undeclared allergens are considered a significant chemical hazard in food and thus a critical control in many processes, yet most product recalls are due to undeclared allergens.

The US Food and Drug Administration (FDA), requires manufacturers to list on the food label the eight most common ingredients that trigger food allergies. At-risk consumers rely on the labels on foods to guide them in making healthy choices, and to protect themselves from allergens. Therefore, the failure to properly label foods when they contain allergenic ingredients, or when they have the potential to contain an allergenic compound is a massive failure of company’s food safety system.

Allergens are proteins and other substances known to react with a susceptible person’s immune system to precipitate an allergic reaction; there are approximately 15 million at- risk consumers in the US population. Persons with allergies may develop sometimes-serious medical consequences, such as breathing difficulties or go into anaphylactic shock after exposure to a host of allergens in food.

There are eight major allergens that cause 90% of allergic reactions:

  • Milk
  • Eggs
  • Peanuts
  • Tree nuts (such as almonds, cashews, walnuts)
  • Fish (such as bass, cod, flounder)
  • Shellfish (such as crab, lobster, shrimp)
  • Soy
  • Wheat

Food labeling laws require food allergens to be identified even in very small amounts — but only when they’re contained as an ingredient. Manufacturers aren’t required to include warnings about food allergens accidentally introduced during manufacturing or packaging (cross-contamination). The label lists the type of allergen — for example, the type of tree nut (almond, walnut) or the type of crustacean shellfish (crab, shrimp) — as well as any ingredient that contains a protein from the eight major food allergens. The labels also include any allergens found in flavorings, colorings or other additives.

Many manufacturers voluntarily include warnings, but these advisory labels aren’t always clear. Manufacturers have different ways of saying a food allergen may be present. For example, labels may say, “manufactured in a factory that also processes wheat” or “may contain soy.” Work is needed to make the format of these advisory labels more consistent so that it’s easier to identify which products contain allergens. Medical authorities advise consumers in doubt about whether a product contains something they are allergic to, to avoid it until and they check with their doctor.

food.allergiesWhen foods contain an undeclared allergen, or when allowable levels of a food additive, such as sulfites, used as a preservative are exceeded, such foods are deemed adulterated and a recall is initiated.

A product recall is a crisis for a company; it results in serious economic loss and legal entanglements, and can be a major challenge to the viability of a brand.

Hazard Analysis Critical Control Point (HACCP) controls during manufacturing

Product contamination and adulteration can take several forms; we classify substances as foodborne hazards if they are reasonably likely to cause illness or injury when out of control. We can classify them into 4 broad categories, such as chemical, physical, biological and radiological (thanks Fukashima). We develop controls for the particular hazards that are expected to occur, and critical controls for the likely ones with the most potential for harm. Food safety plans built on the principles of Hazard Analysis Critical Control Point (HACCP) must consider the likelihood of occurrence of these chemical hazards in most food manufacturing processes. While producers of commodities such as eggs, fresh meat or fresh produce do need to list allergens, most other foods require some type of allergen control and/or label.

Control starts with identifying the specific allergenic ingredients. Then, an operator must determine how they are handled and how they flow through a production system. Such studies often reveal points where cross contamination with allergens may occur. Controlling cross contamination between allergenic and non-allergenic ingredients on production lines is necessary when the line runs both allergenic and non-allergenic food, or when a variety of allergens are run. However, cross contamination controls begin at the time a firm receives an allergen-containing ingredient and continue during its storage, internal transport and during packing.

Proper cleaning between product runs is the most fundamental control. Visual inspection of the equipment to detect particles remaining post-cleaning is a useful effort, but unseen residues of allergens may linger and cross contaminate the next product run, as even the best cleaning may not result in 100% removal of particles. The cleaning process must also consider the forms, i.e., pastes or films, encountered and match that with the appropriate cleaner. Some plants must use dry cleaning methods when water in a production environment is detrimental, such as when manufacturing confectionaries, or in bakery environments. Such dry methods can be ineffective and can lead to cross contamination. Even when detergents and water can be applied to equipment, applications may be uneven, leaving traces behind. As better laboratory methods of detection have increased the specificity of tests, investigators looking for allergens can detect smaller and smaller amounts of them.

In-plant allergen testing of equipment, however, can provide verification that allergens are not present on a surface after cleaning. Some tests used in a plant environment are not allergen-specific, and utilize quick colorimetric tests for proteins, sugars or other markers of allergen contamination. Operators instead should use ELISA kits (enzyme-linked immunosorbent assay); while much more sophisticated and expensive they can be validated and possibly validate the protein or sugar swab methods. ELISA tests may be a better choice for in plant testing. Such testing can be qualitative as well as quantitative (a 5 ppm Level of Detection typically). Operators should also develop protocols to establish the baseline information needed to interpret results. Establishing baseline acceptance criteria requires establishing the levels of allergens in products when various levels of allergens are detected on surfaces of equipment. Off-site labs having more sophisticated methods usually conduct such validation studies. Such validation data may allow operators to accept some trace levels and avoid the pitfall of chasing molecules around a plant, when such levels are shown not to affect the final product.

Operators must designate cleaning tools for specific areas to avoid the tool as a form of cross contamination and Sanitation Standard Operating Procedures must be developed. Such SSOP should contain the designation of a cleaning crew and sanitation employees need ongoing training. The SSOP should contain the items requiring cleaning, the types of cleaners used, dilution values for detergents and degreasers, how to maintain effective levels, water temperature, tools used, how often the cleaning is carried out, and the timing of visual inspections and verification. As in all HACCP based-systems the results of the testing program are recorded and verified.

Cross contamination may occur during storage and internal transport

Storage of allergen containing materials together in the same area can also lead to cross contamination when the operation has not effectively designated the proper storage areas. Storage of allergenic foods above non-allergenic, or a mix up of ingredients or finished products can lead to cross contamination through the environment. Ideally a facility should store sensitive items in separate enclosed areas, but not all plants have the capacity for separate storage. In these situations, careful monitoring and a visual marking or signage is helpful.

Even forklifts and pallet jacks could play a role along with totes and other containers.

Because we have risks in allergen control, and our controls may not always be successful, the label should provide the at-risk consumer with enough information for making a decision. As mentioned earlier however, the use of language such as “may contain…” or “made in a plant that also processes…” make food choices more difficult and impacts the quality of life for such consumers.

Labels are applied to final unit packages by hand, or by a label machine, typically. Rolls of labels have to be run for each batch of product. The timing and staging often lead to the packing of several products at once and different label sets on the plant floor. When the products differ as to allergens it is easy to make an error in the application of labels. Errors can also occur in the printing of labels, and allergenic ingredients may be inadvertently left out if the operator has not done his due diligence and did not realize the product or ingredient contained an allergen. Highly refined oils are hidden ingredients in many products and may contain trace amounts of proteins, for example.

Foodservice allergen control

Patrons of restaurants are often highly at risk to be exposed to allergens. No such menu labeling requirements are required in the USFDA Food Code. Restaurants handle a complex variety of foods and it is nearly impossible to know for every recipe and every product, what allergens may or may not be there or to separate them. Furthermore, the operating conditions of restaurants are very different then processing plants and there is very little that can be done about preparing and storing various allergen sensitive foods together.

The last line of defense is the waiter or waitress who is often the only person except for the cook who can answer a question about whether a food contains a certain ingredient or not. Even then, it may be impossible to know in every case, every allergenic ingredient.

The effectiveness of industry allergen control programs

As illustrated by the recent spate of recalls, the food industry’s response to allergen control has been less than completely successful and more needs to be done. The industry needs better testing regimens and adherence to properly developed cleaning protocols. As in the case with preventing microbial contamination, a company must provide the resources necessary, and have the experience and technical ability to monitor and control a sometimes-complex array of policies, procedures and validation methods.

And for a variety of reasons, some unknown, the situation is getting worse:

  • According to a study released in 2013 by the Centers for Disease Control and Prevention, food allergies among children increased approximately 50% between 1997 and 2011.
  • Researchers are trying to discover why food allergies are on the rise in developed countries worldwide, and to learn more about the impact of the disease in developing nations. More than 17 million Europeans have a food allergy, and hospital admissions for severe reactions in children have risen seven-fold over the past decade, according to the European Academy of Allergy and Clinical Immunology (EAACI).

As with all things food, the hopeful implementation of FDA’s FSMA will strengthen the backbone of allergen control efforts in the future, but the industry should recognize more is needed now.

 

Mom of peanut allergy victim: Her last words were ‘I’m sorry’

Louis and Joanne Giorgi sat together in the backyard of their Carmichael home Wednesday morning. They held each others’ hands and clutched tissues as they spoke publicly for the first time since their 13-year old daughter died from an allergic reaction to a dessert treat they had no idea contained peanuts.

“To have lost her is devastating,” Joanne Giorgi told KCRA 3’s Mike TeSelle.

KCRA Channel 3 reports Natalie Giorgi’s parents are speaking publicly in hopes of using their daughter’s death as a push for change, and a vehicle for educating the public about peanut-victim2-JPGthe seriousness of food allergies.

“This can be a catalyst for a paradigm shift, much the way seat belt use has changed since when we were kids,” Louis Giorgi said.

Natalie Giorgi died July 26 after eating a Rice Krispie treat that had been prepared with peanut products at Camp Sacramento on the final day of a multi-family camping trip, her parents said.

Giorgi had a documented allergy to peanuts.

“We had been there before. We had eaten their Rice Krispie treats before. We had never had a problem before,” Louis Giorgi said.

Giorgi said immediately after taking one bite of the treat, his daughter told her parents.

She had been dancing with friends when she took the bite.

“We gave her Benadryl like we’d been told,” Natalie’s father said.

Over the next several minutes, the Giorgis said their daughter showed no signs of a reaction whatsoever.

“I kept asking, ‘are you OK?’ She kept telling me she was fine, and she wanted to go back to dancing with her friends,” Natalie’s mom said. 

Natalie kept asking her parents to go back to her friends, but they kept telling her she had to stay with them, to make sure she was OK.

“Then suddenly, she started vomiting,” Louis said. “It spiraled downhill out of control so quickly.”

Natalie’s father, a physician, administered both of the EPI-Pens — used to slow or stop an allergic reaction — that the family carried with them.

A third was obtained from the camp and administered. None of them stopped her reaction. Her dad called 911.

“I did everything right, in my opinion. I couldn’t save her,” Louis Giorgi said.

Emergency responders who arrived later couldn’t save her, either.

“She had been fine, and had been talking to us. This was a worst-case scenario. One of the last things she said was, ‘I’m sorry mom,'” Natalie mother said as she wiped a tear away from her cheek.

The Giorgis said one of the many reasons they are sharing Natalie’s story is to convince skeptical parents that food allergies in children is very real.

More information can be found at Nateam.org.

This is nuts: parents blast NZ TV prank

An on-screen prank that involved smearing peanut butter on the face of a children’s television presenter pretending to have a nut allergy has outraged parents of children suffering from the affliction.

The New Zealand Herald reports What Now presenter Adam Percival had his face covered in peanut butter during yesterday adam.percivalmorning’s show on TV2 as part of a segment about allergies.

Despite Percival not being allergic to nuts, the segment drew harsh criticism from parents who labeled it “irresponsible” and feared terrible consequences if children imitated the prank.

One concerned mother said she would lay a complaint with the industry watchdog, the Broadcasting Standards Authority (BSA).

What Now took to Facebook to defend the segment, saying Percival was safe and the prank was a way to highlight the issue.

“Our intention is never to make fun of anybody who has allergies, but to make sure we highlight the fact that having an allergy is a serious issue,” said the post.

It had generated more than 60 comments by 6.30 last night.

Dion McCracken, whose son has a serious nut allergy, was not convinced by the explanation.

“Great for Adam. A shame for my son who may now be exposed to kids at school thinking your prank was a great idea,” he said.

“If one kid that watched the prank thinks it’s funny to smear peanut butter on an allergy kid, there is a very real threat of anaphylaxis and rapid death.

“What Now didn’t have ill intent, but they’ve just taught thousands of Kiwi kids that doing this isn’t a big deal. It really is.”

Claire Eveleigh said she was going to lay a complaint.

“It’s very scary that you are defending yourself on a topic you clearly do not know much about. Not knowing is OK … but broadcasting on TV about it is not OK … I will be making a complaint to the BSA about this.”

1 child sickened; Sydney company fined $48K for failing to declare allergen in cakes

It’s how they roll down here – in some states.

A Sydney cake manufacturing business and its Director who sold food containing undeclared allergens on multiple occasions, one time resulting in a child suffering an allergic reaction, have been convicted and fined a combined $48,000 plus $21,000 in professional costs in the Chief Industrial Magistrates Court.

Sunfield Australia and its Director Vivien Sun were each prosecuted under the Food Act 2003 for producing and selling sunfield.australiacakes containing nut and egg that were not declared on the label.

NSW (that’s New South Wales, it’s a state in Australia) Food Authority CEO Polly Bennett said the result was particularly pleasing given the danger to health posed by allergic reactions.

“More than 160,000 people in NSW suffer a food allergy of some sort and statistics show one in ten babies born in Australia today will develop a food allergy,” Ms Bennett said.

“Unfortunately at the most serious end of the scale these allergies can prove fatal.

“Consumers rely upon the labels to provide accurate information about the foods they buy and consume.

“The importance of that label cannot be underestimated, for some people it can literally be a matter of life and death.

“Most concerning in this matter is the fact that the company and its Director were on notice of the problems with their labelling following earlier investigations by the Authority.

“Just as the wider community does, the NSW Food Authority expects manufacturers to respect their customers, respect the law and meet their responsibilities.”

The company Sunfield Australia was convicted of 9 offences and the Director Vivien Sun convicted of 7 offences including:
Fail to comply with the Food Standards Code in the conduct of a food business: s21(1); Sell food that was labelled in a manner that contravened the Food Standards Code:s21(3) and Sell food that the person ought reasonably know was falsely described and is likely to cause physical harm to a consumer who relies on the description: s15(4)

An initial investigation by the NSW Food Authority in March 2010 found the Company sold cakes containing undeclared nuts. Despite a formal recall of the products, a number of cakes with the incorrect labels were found by the Authority to be still on sale after the recall.

In August 2010, the Company sold cakes containing undeclared egg which resulted in a child suffering an allergic reaction. Following an investigation by the Authority and a subsequent recall of these products, the Authority again found cakes with the incorrect labelling still on sale after the recall.

These matters followed an earlier incident in 2006, where the company was fined for failing to declare walnuts in their product.

In passing sentence, the presiding Magistrate noted that the offences were of a serious nature. Consumers rely on the information contained in labels, and it was well known that allergic reactions can sometimes prove fatal, making general deterrence a significant component of any penalty imposed. In the circumstances, the delay by the Company in implementing the recall after the illness of the child was particularly egregious.

The Court also rejected submissions by the offenders that they did not realise the seriousness of their actions, given that by August 2010, they were well aware of their obligations.

The company has been placed on the NSW Food Authority’s Name and Shame register.

Ooey, Ooey, Ooey, Ooey Allergies

The Wiggles, Australia’s highest-grossing and soon to be retired musical act, played a farewell gig last week after an 18 month reunion of their original lineup. The make-up album brought a song about allergies that Sam, our two-year-old, likes with the line, You can have a reaction to foods that you eat, it can be really serious with shellfish nuts and seeds.

I don’t have any food allergies that I know of, but I’ve had a couple of reactions to ASA (the compound found in Aspirin) resulting in a body full of hives for six weeks. That sucked, but it was just an inconvenience. Food allergy sufferers have reactions somewhere on a continuum between this nuisance and death. If The Wiggles are an indicator, the recognition and public discussion around allergens has increased but along with the attention comes a potentially dangerous attitude that an allergy isn’t severe, or the kid’s parents are overly protective.

And then comes the bullying. NJ.com reports that Dr. Eyal Shemesh and colleagues at the Icahn School of Medicine at Mount Sinai have published a study in Pediatrics that shows that kids with allergies are bullied at a higher rate than their peers, which might cause them to avoid interventions.

The suffering is often done in silence. Nearly half of parents surveyed said they were unaware of the bullying, though both the bullied children and their parents reported experiencing higher stress levels and lower quality of life.

“Parents and pediatricians should routinely ask children with food allergy about bullying,” said Dr. Eyal Shemesh, Associate Professor of Pediatrics and Psychiatry at the Icahn School of Medicine at Mount Sinai. “Finding out about the child’s experience might allow targeted interventions, and would be expected to reduce additional stress and improve quality of life for these children trying to manage their food allergies.”

Food service staff, the front-line folks for allergy protection, can’t tell whether an allergic reaction is going to lead to patron’s slight discomfort or worse. Allergen control and food safety practices are similar, but at the root of both issues is the organization and employee’s recognition of risks, reduction methods and evaluating whether everyone is really doing it. In the June 2013 issue of Food Control, Ji Hee Choi and Lakshman Rajagopal discuss knowledge, attitude and self-reported practices of food service employees regarding food allergies. When asked on a survey, food service staff report that allergens are important – but they couldn’t always identify what the allergens of concern are, and seemed to not retain specific allergen knowledge from training.

From the discussion:
Respondents in this study were knowledgeable about what a food allergy is and how to handle customers with food allergies; however, most respondents were not knowledgeable about the top eight food allergens from a given list of allergens…
 Employees scored higher on attitudinal statements related to the importance of foodservice staff providing accurate information to customers with food allergies to prevent incidences of food allergy reactions. However, employees were not confident about effectively handling food allergy emergencies. Employees’ positive attitudes toward food allergies and handling patrons with food allergies might be explained by the possession of food safety certification, which could also be a proxy for training received. However, no significant differences in knowledge scores were observed between employees who had received food safety certification and those who were not certified. This indicates that while certification and training maybe crucial for improving knowledge, it might not always be the case, as employees might not retain the knowledge or the training may not have contained updated information about food allergies.

Training matters, but not much (if retention counts) – and self reported practices don’t always match real life. The studied staff know something is up with allergens (maybe because the consequences are high), but don’t know exactly what to focus on. The less-trusting patrons of a food business who are looking for verification that their food is allergen-free can explore a bevy of apps to track symptoms, explore product ingredients or do uh, colormetric assays to look for traces of proteins (test reliability might be problematic).

From NPR’s The Salt:

Ozcan’s lab on a phone looks like it could take care of the inaccuracy problem. But the prototype requires users to undertake a mini chemistry experiment. They would have to grind up the food, mix it in a test tube with hot water and a solvent, and then mix it with a series of testing liquids. That process takes about 20 minutes.

 

Food allergies linked to hygiene hypothesis? ‘If fewer allergies is more infection, no parent would expose their child to more infection’

People from well-educated families are almost twice as likely to suffer from some dangerous food allergies as others — possibly because their bodies’ natural defences have been lowered by rigorous hygiene and infection control, suggests a new Canadian study.

The research from McGill University also found that immigrants were about half as likely to be afflicted by the allergies, perhaps reflecting differences in diet and environment between their countries of origin and Canada.

The study, just published in the Journal of Allergy, was meant to address an enduring medical mystery: Why have so many people in certain industrialized countries developed violent reactions to peanuts, shellfish and other foods in recent decades?

The link to higher education may be explained by what is called the hygiene hypothesis, the unproven idea that smaller families, cleaner homes, more use of antibiotics to treat infections and vaccines to prevent them have curbed development of the immune system, said Dr. Moshe Ben-Shoshan, who led the research. That in turn could make some people more susceptible to allergy.

If the hypothesis does actually explain some food reactions, though, parents may not be able to do much about it, admitted the allergist at Montreal Children’s Hospital. The benefits of such health products as antibiotics and vaccines easily outweigh the risk of children developing serious allergies, said Dr. Ben-Shoshan.
“We can’t suggest we become dirtier and expose our children to more bacteria,” he said. “If the price of having fewer allergies is more infection, I don’t know any parent who would expose their child to more infection.”

The study’s findings are far from conclusive but they, and the hygiene hypothesis as an explanation, seem plausible, said Dr. Stuart Carr, president of the Canadian Society of Allergy and Clinical Immunology. He also cautioned, however, that translating the knowledge into preventive action would be complicated.

Allergies are no laughing matter

I have food allergies but they are not life-threatening, I just get hives like Woogie from “There’s Something About Mary.”

However, some people get serious allergic reactions and a waiter shouldn’t ignore that or make fun of it. Makes me wonder what else they don’t know about the industry they work in.

In response to a reader’s dining experience, FloFab replied  “Obviously that wait person has been badly trained and the restaurant could use a wake-up call.”

It’s important for restaurants to properly train their staff members to keep people from getting sick; be it from foodborne pathogens or allergies.