The threshold concept in food safety and its applicability to food allergy

Down the years there have been many clinical reports of exquisite sensitivi ty to low doses of food allergens. There are many factors that may contribu te to a variation of threshold in an individual exposed to an allergen duri ng the course of his or her daily life. Some of these factors are intrinsic and unavoidable. Other factors map be predictable but not easily controlla ble, such as asthma, exposure to allergens during the pollen season and pre dicting situations that may be risky. Other factors may be out of the contr ol of the individual. The most important one of these is the adequate train ing and awareness of manufacturers and caterers who aim to provide safe and nutritious meals to their allergic and nonallergic customers alike. Clinic al histories of reactions in the community and the use of labial exposure d uring food challenge show that most non-ingestion exposures to peanut usual ly result in easily treated minor reactions. Formal, oral food challenges h ave shown that low dose reactivity is relatively common but studies have no t yet had the power to investigate whether peanut allergy is more commonly associated with very low dose reactivity than other foods. This means that industry must not concentrate only on peanut and tree nuts when looking at issues of contamination just because they are associated with the majority of severe reactions. There are more milk and egg allergic children in the g eneral population and they deserve the same protection from allergen exposu re as sufferers of peanut or tree nut allergies.