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Consumer Attitudes and Response to New Food Allergen Labeling
S182 Abstracts
696
Occupational Rhinitis in Damp and Moldy Workplace K. Karvala, H. Nordman, R. Luukkonen, E. Nykyri, S. Lappalainen, E. Toskala; Finnish Institute of Occupational Health, Helsinki, FINLAND. RATIONALE: Numerous studies confirm the association between exposure to indoor air dampness and molds and different health outcomes. Upper respiratory tract problems are the most commonly reported workrelated symptoms in damp indoor environments. The mechanisms and the specific cause are mostly unknown. In Finland the nasal provocation test (NPT) is a routine procedure to confirm the diagnosis of occupational rhinitis. The aim of the study was to assess the reliability of diagnoses made in a series of patients examined because of upper respiratory symptoms related to work in damp and moldy environments, and to assess the applicability of NPT in diagnostics. METHODS: In 1995-2004, altogether 2222 patients were examined because of work-related symptoms appearing in damp and moldy indoor environments. In all, 578 NPTs with microbial extracts were performed to 356 patients. Sixty diagnoses of occupational rhinitis were set based on a positive NPT. The retrospective review included 56 of the cases. The control group consisted of 56 symptomatic patients working in moldy environments, but having negative NPTs. RESULTS: Only 10% of the performed NPTs were positive. The NPTnegative patients were as symptomatic as the cases with positive NPTs and exposure levels did not differ significantly. In 17% specific IgE to molds could be demonstrated. CONCLUSIONS: Several mold-species in moisture damaged work environments induce specifically occupational rhinitis. Although a positive NPT with mold-extracts supports the diagnosis, the sensitivity of the test is low. The use of NPTs cannot be encouraged in diagnosing occupational rhinitis caused by damp and moldy workplaces. Funding: Finnish Work Environment Fund
697
MONDAY
Frequency and Language Used in Allergen Advisory Labels (``May contain''): A Survey of 20,241 Commercially Available Products M. M. Pieretti1, R. Pacenza2, T. Slotkin2, S. H. Sicherer1; 1Mt. Sinai School of Medicine, New York, NY, 2Food Allergy Initiative, New York, NY. RATIONALE: Previous studies indicate that consumers with food allergy are increasingly ignoring allergen advisory labeling (e.g., ‘‘may contain peanut’’) that are currently unregulated and are placed voluntarily by manufacturers. We sought to determine the frequency of, and the language used in, advisory labels among commercially available products. METHODS: Using a team of trained product surveyors, we examined 20,241 unique manufactured food products (from an original assessment of 49,604 products) from 99 food stores/supermarkets across the United States. Products were categorized into 24 general food types, and evaluated for use of allergen advisory warnings. Advisory statements were broadly categorized among three statement types: ‘‘may contain,’’ ‘‘shared equipment,’’ or ‘‘within plant.’’ RESULTS: Overall, 17% of 20,241 products surveyed contained advisory labeling. The categories of foods with the highest use of advisory labeling are: chocolate candy (54% of 622 products), cookies (53% of 1510), baking mixes (40% of 978) and pancake mixes (32% of 308). The categories of foods with the lowest use of advisory labels are: canned fish (2%), spices (1%), and baby foods (1%). The language of the advisory statements was distributed as follows: ‘‘may contain’’-38%, ‘‘shared equipment’’-33%, and ‘‘within plant’’-29%. CONCLUSIONS: A large proportion of convenience foods contain allergen advisory labeling, and various terms are used to impart allergen warnings. These data support the notion that the unregulated use of allergen advisory labeling presents the food-allergic consumer with frequent but unclear warnings, which could be a factor leading to increased risk taking in using these products despite the label warnings. Funding: Food Allergy Initiative
J ALLERGY CLIN IMMUNOL FEBRUARY 2008
698
Food Allergic Consumer (FAC) Experience in Restaurants and Food Establishments N. Wanich1, C. Weiss2, T. J. Furlong2, S. H. Sicherer1; 1Mt. Sinai School of Medicine, New York, NY, 2Food Allergy & Anaphylaxis Network, Fairfax, VA. RATIONALE: Limitations on dining outside of the home cause a significant negative impact on quality of life for families with a food allergic individual (FAI). We evaluated FAC’s experiences regarding restaurant/take-out meals. METHODS: Surveys were completed by adults attending the 2007 Food Allergy & Anaphylaxis Network conferences (New York, Chicago), answering with regard to their family’s most severely affected FAI. RESULTS: Respondents’ (n 5 294; 94% Caucasian; 50% annual income >$100,000) FAI was a median age 5 yrs (83% had multiple food allergies). Overall, 34% of the FAIs experienced at least one restaurant reaction (36% had 3 or more reactions); of total reactions, 70% were to peanut and 64% to tree nuts. The current rate of ‘‘never eat’’ was 20% for fast food, 25% for informal dining, and 19% for formal dining establishments. Regarding notification, 70% reported ‘‘always’’ alerting staff and 14% do so using something in writing. Only 71% were aware that restaurant chains may offer website allergy information and 26% that 800 numbers may exist for allergy information. Regarding FAC experience with various forms of allergen notification, inconsistent information was noted. When queried about restaurant ingredient lists, most participants (78%) felt that ‘‘contains’’ statements are very useful, but did not prefer various advisory statements (e.g., ‘‘may contain’’). CONCLUSIONS: A significant percentage of FAI’s have experienced allergic reactions in restaurants and avoid dining out altogether. We identified deficits in communication about food allergy for both the FAC and establishments that, if rectified, may improve safety and quality of life.
699
Consumer Attitudes and Response to New Food Allergen Labeling S. S. Ahn1, T. J. Furlong2, C. Weiss2, S. H. Sicherer1; 1Mt. Sinai School of Medicine, New York, NY, 2Food Allergy & Anaphylaxis Network, Fairfax, VA. RATIONALE: Food allergic consumers (FAC) depend upon clear, accurate ingredient labels. We examined FAC’s opinions and responses subsequent to the Food Allergen Labeling and Consumer Protection Act (FALCPA). METHODS: Surveys (n 5 471) were completed by participants (97% parents of children with food allergy) attending the Food Allergy & Anaphylaxis Network 2007 conferences in Baltimore, Chicago and New York. RESULTS: Allergies included: peanut-83%, tree nut-69%, and egg-49%. FACs read labels ‘‘always’’ on purchase (90%) and upon preparing to use (85%) packaged foods. Participants with an opinion rated toll-free numbers (61% ‘‘very helpful’’) and package information (67% ‘‘very helpful’’) as more helpful for allergen information than corporate websites (40%), response to letters/email to the company (43%) and company sponsored brochures (30%). FACs ‘‘agree-strongly agree’’ that since FALCPA it is easier to find allergens on labels (95%) and are more confident about label accuracy (74%). Only 28% of participants correctly knew that FALCPA exempts raw meat products. Increased use of advisory statements (‘‘may contain’’) was noted by 63%. Similar to our survey in 2006 and in contrast to responses in 2003, advisory statements are increasingly ignored (e.g., in 2007 versus 2003, refusal to purchase ‘‘may contain’’ dropped from 95% to 92% and for ‘‘in a facility’’ from 77% to 64%). CONCLUSIONS: The new labeling laws have resulted in strong consumer satisfaction and a modest increase in confidence, but FACs are noting an increase in advisory labels, increasingly ignoring them, and may not understand the full details of the law.
696
Occupational Rhinitis in Damp and Moldy Workplace K. Karvala, H. Nordman, R. Luukkonen, E. Nykyri, S. Lappalainen, E. Toskala; Finnish Institute of Occupational Health, Helsinki, FINLAND. RATIONALE: Numerous studies confirm the association between exposure to indoor air dampness and molds and different health outcomes. Upper respiratory tract problems are the most commonly reported workrelated symptoms in damp indoor environments. The mechanisms and the specific cause are mostly unknown. In Finland the nasal provocation test (NPT) is a routine procedure to confirm the diagnosis of occupational rhinitis. The aim of the study was to assess the reliability of diagnoses made in a series of patients examined because of upper respiratory symptoms related to work in damp and moldy environments, and to assess the applicability of NPT in diagnostics. METHODS: In 1995-2004, altogether 2222 patients were examined because of work-related symptoms appearing in damp and moldy indoor environments. In all, 578 NPTs with microbial extracts were performed to 356 patients. Sixty diagnoses of occupational rhinitis were set based on a positive NPT. The retrospective review included 56 of the cases. The control group consisted of 56 symptomatic patients working in moldy environments, but having negative NPTs. RESULTS: Only 10% of the performed NPTs were positive. The NPTnegative patients were as symptomatic as the cases with positive NPTs and exposure levels did not differ significantly. In 17% specific IgE to molds could be demonstrated. CONCLUSIONS: Several mold-species in moisture damaged work environments induce specifically occupational rhinitis. Although a positive NPT with mold-extracts supports the diagnosis, the sensitivity of the test is low. The use of NPTs cannot be encouraged in diagnosing occupational rhinitis caused by damp and moldy workplaces. Funding: Finnish Work Environment Fund
697
MONDAY
Frequency and Language Used in Allergen Advisory Labels (``May contain''): A Survey of 20,241 Commercially Available Products M. M. Pieretti1, R. Pacenza2, T. Slotkin2, S. H. Sicherer1; 1Mt. Sinai School of Medicine, New York, NY, 2Food Allergy Initiative, New York, NY. RATIONALE: Previous studies indicate that consumers with food allergy are increasingly ignoring allergen advisory labeling (e.g., ‘‘may contain peanut’’) that are currently unregulated and are placed voluntarily by manufacturers. We sought to determine the frequency of, and the language used in, advisory labels among commercially available products. METHODS: Using a team of trained product surveyors, we examined 20,241 unique manufactured food products (from an original assessment of 49,604 products) from 99 food stores/supermarkets across the United States. Products were categorized into 24 general food types, and evaluated for use of allergen advisory warnings. Advisory statements were broadly categorized among three statement types: ‘‘may contain,’’ ‘‘shared equipment,’’ or ‘‘within plant.’’ RESULTS: Overall, 17% of 20,241 products surveyed contained advisory labeling. The categories of foods with the highest use of advisory labeling are: chocolate candy (54% of 622 products), cookies (53% of 1510), baking mixes (40% of 978) and pancake mixes (32% of 308). The categories of foods with the lowest use of advisory labels are: canned fish (2%), spices (1%), and baby foods (1%). The language of the advisory statements was distributed as follows: ‘‘may contain’’-38%, ‘‘shared equipment’’-33%, and ‘‘within plant’’-29%. CONCLUSIONS: A large proportion of convenience foods contain allergen advisory labeling, and various terms are used to impart allergen warnings. These data support the notion that the unregulated use of allergen advisory labeling presents the food-allergic consumer with frequent but unclear warnings, which could be a factor leading to increased risk taking in using these products despite the label warnings. Funding: Food Allergy Initiative
J ALLERGY CLIN IMMUNOL FEBRUARY 2008
698
Food Allergic Consumer (FAC) Experience in Restaurants and Food Establishments N. Wanich1, C. Weiss2, T. J. Furlong2, S. H. Sicherer1; 1Mt. Sinai School of Medicine, New York, NY, 2Food Allergy & Anaphylaxis Network, Fairfax, VA. RATIONALE: Limitations on dining outside of the home cause a significant negative impact on quality of life for families with a food allergic individual (FAI). We evaluated FAC’s experiences regarding restaurant/take-out meals. METHODS: Surveys were completed by adults attending the 2007 Food Allergy & Anaphylaxis Network conferences (New York, Chicago), answering with regard to their family’s most severely affected FAI. RESULTS: Respondents’ (n 5 294; 94% Caucasian; 50% annual income >$100,000) FAI was a median age 5 yrs (83% had multiple food allergies). Overall, 34% of the FAIs experienced at least one restaurant reaction (36% had 3 or more reactions); of total reactions, 70% were to peanut and 64% to tree nuts. The current rate of ‘‘never eat’’ was 20% for fast food, 25% for informal dining, and 19% for formal dining establishments. Regarding notification, 70% reported ‘‘always’’ alerting staff and 14% do so using something in writing. Only 71% were aware that restaurant chains may offer website allergy information and 26% that 800 numbers may exist for allergy information. Regarding FAC experience with various forms of allergen notification, inconsistent information was noted. When queried about restaurant ingredient lists, most participants (78%) felt that ‘‘contains’’ statements are very useful, but did not prefer various advisory statements (e.g., ‘‘may contain’’). CONCLUSIONS: A significant percentage of FAI’s have experienced allergic reactions in restaurants and avoid dining out altogether. We identified deficits in communication about food allergy for both the FAC and establishments that, if rectified, may improve safety and quality of life.
699
Consumer Attitudes and Response to New Food Allergen Labeling S. S. Ahn1, T. J. Furlong2, C. Weiss2, S. H. Sicherer1; 1Mt. Sinai School of Medicine, New York, NY, 2Food Allergy & Anaphylaxis Network, Fairfax, VA. RATIONALE: Food allergic consumers (FAC) depend upon clear, accurate ingredient labels. We examined FAC’s opinions and responses subsequent to the Food Allergen Labeling and Consumer Protection Act (FALCPA). METHODS: Surveys (n 5 471) were completed by participants (97% parents of children with food allergy) attending the Food Allergy & Anaphylaxis Network 2007 conferences in Baltimore, Chicago and New York. RESULTS: Allergies included: peanut-83%, tree nut-69%, and egg-49%. FACs read labels ‘‘always’’ on purchase (90%) and upon preparing to use (85%) packaged foods. Participants with an opinion rated toll-free numbers (61% ‘‘very helpful’’) and package information (67% ‘‘very helpful’’) as more helpful for allergen information than corporate websites (40%), response to letters/email to the company (43%) and company sponsored brochures (30%). FACs ‘‘agree-strongly agree’’ that since FALCPA it is easier to find allergens on labels (95%) and are more confident about label accuracy (74%). Only 28% of participants correctly knew that FALCPA exempts raw meat products. Increased use of advisory statements (‘‘may contain’’) was noted by 63%. Similar to our survey in 2006 and in contrast to responses in 2003, advisory statements are increasingly ignored (e.g., in 2007 versus 2003, refusal to purchase ‘‘may contain’’ dropped from 95% to 92% and for ‘‘in a facility’’ from 77% to 64%). CONCLUSIONS: The new labeling laws have resulted in strong consumer satisfaction and a modest increase in confidence, but FACs are noting an increase in advisory labels, increasingly ignoring them, and may not understand the full details of the law.