Food allergy: Stakeholder perspectives on acceptable risk

Charlotte Bernhard Madsen, René Crevel, Chun-Han Chan, Anthony E. J. Dubois, Audrey DunnGalvin, Bertine M. J. Flokstra-de Blok, M. Hazel Gowland, Sue Hattersley, Jonathan O’B Hourihane, Pia Nørhede, Sylvia Pfaff, Gene Rowe, Sabine Schnadt, Berber J. Vlieg-Boerstra

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

We have reached a point where it is difficult to improve food allergy risk management without an agreement on levels of acceptable risk. This paper presents and discusses the perspectives of the different stakeholders (allergic consumers, health professionals, public authorities and the food industry) on acceptable risk in food allergy. Understanding where these perspectives diverge and even conflict may help develop an approach to define what is acceptable. Uncertainty about food allergy, its consequences and how to manage them is the common denominator of the stakeholders’ views. In patients, uncertainty is caused by the unpredictability of reactions and the concern about whether avoidance strategies will be effective enough. Variability of symptoms and the lack of markers do not allow stratification of patients according to their reactivity, and force health professionals to give the same advice to all patients despite the fact that the risk to each is not identical. Regulators and the food industry struggle with the fact that the lack of management thresholds forces them to make case-by-case decisions in an area of uncertainty with penalties for under- or over-prediction. As zero risk is not a realistic possibility, consensus on acceptable risk will be needed.
Original languageEnglish
JournalRegulatory Toxicology and Pharmacology
Volume57
Issue number2-3
Pages (from-to)256-265
ISSN0273-2300
DOIs
Publication statusPublished - 2010

Keywords

  • EuroPrevail
  • Stakeholders
  • Food allergy risk
  • Patients

Cite this

Madsen, C. B., Crevel, R., Chan, C-H., Dubois, A. E. J., DunnGalvin, A., Flokstra-de Blok, B. M. J., ... Vlieg-Boerstra, B. J. (2010). Food allergy: Stakeholder perspectives on acceptable risk. Regulatory Toxicology and Pharmacology, 57(2-3), 256-265. https://doi.org/10.1016/j.yrtph.2010.03.003
Madsen, Charlotte Bernhard ; Crevel, René ; Chan, Chun-Han ; Dubois, Anthony E. J. ; DunnGalvin, Audrey ; Flokstra-de Blok, Bertine M. J. ; Gowland, M. Hazel ; Hattersley, Sue ; O’B Hourihane, Jonathan ; Nørhede, Pia ; Pfaff, Sylvia ; Rowe, Gene ; Schnadt, Sabine ; Vlieg-Boerstra, Berber J. / Food allergy: Stakeholder perspectives on acceptable risk. In: Regulatory Toxicology and Pharmacology. 2010 ; Vol. 57, No. 2-3. pp. 256-265.
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abstract = "We have reached a point where it is difficult to improve food allergy risk management without an agreement on levels of acceptable risk. This paper presents and discusses the perspectives of the different stakeholders (allergic consumers, health professionals, public authorities and the food industry) on acceptable risk in food allergy. Understanding where these perspectives diverge and even conflict may help develop an approach to define what is acceptable. Uncertainty about food allergy, its consequences and how to manage them is the common denominator of the stakeholders’ views. In patients, uncertainty is caused by the unpredictability of reactions and the concern about whether avoidance strategies will be effective enough. Variability of symptoms and the lack of markers do not allow stratification of patients according to their reactivity, and force health professionals to give the same advice to all patients despite the fact that the risk to each is not identical. Regulators and the food industry struggle with the fact that the lack of management thresholds forces them to make case-by-case decisions in an area of uncertainty with penalties for under- or over-prediction. As zero risk is not a realistic possibility, consensus on acceptable risk will be needed.",
keywords = "EuroPrevail, Stakeholders, Food allergy risk, Patients",
author = "Madsen, {Charlotte Bernhard} and Ren{\'e} Crevel and Chun-Han Chan and Dubois, {Anthony E. J.} and Audrey DunnGalvin and {Flokstra-de Blok}, {Bertine M. J.} and Gowland, {M. Hazel} and Sue Hattersley and {O’B Hourihane}, Jonathan and Pia N{\o}rhede and Sylvia Pfaff and Gene Rowe and Sabine Schnadt and Vlieg-Boerstra, {Berber J.}",
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Madsen, CB, Crevel, R, Chan, C-H, Dubois, AEJ, DunnGalvin, A, Flokstra-de Blok, BMJ, Gowland, MH, Hattersley, S, O’B Hourihane, J, Nørhede, P, Pfaff, S, Rowe, G, Schnadt, S & Vlieg-Boerstra, BJ 2010, 'Food allergy: Stakeholder perspectives on acceptable risk', Regulatory Toxicology and Pharmacology, vol. 57, no. 2-3, pp. 256-265. https://doi.org/10.1016/j.yrtph.2010.03.003

Food allergy: Stakeholder perspectives on acceptable risk. / Madsen, Charlotte Bernhard; Crevel, René; Chan, Chun-Han; Dubois, Anthony E. J.; DunnGalvin, Audrey; Flokstra-de Blok, Bertine M. J.; Gowland, M. Hazel; Hattersley, Sue; O’B Hourihane, Jonathan; Nørhede, Pia; Pfaff, Sylvia; Rowe, Gene; Schnadt, Sabine; Vlieg-Boerstra, Berber J.

In: Regulatory Toxicology and Pharmacology, Vol. 57, No. 2-3, 2010, p. 256-265.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Food allergy: Stakeholder perspectives on acceptable risk

AU - Madsen, Charlotte Bernhard

AU - Crevel, René

AU - Chan, Chun-Han

AU - Dubois, Anthony E. J.

AU - DunnGalvin, Audrey

AU - Flokstra-de Blok, Bertine M. J.

AU - Gowland, M. Hazel

AU - Hattersley, Sue

AU - O’B Hourihane, Jonathan

AU - Nørhede, Pia

AU - Pfaff, Sylvia

AU - Rowe, Gene

AU - Schnadt, Sabine

AU - Vlieg-Boerstra, Berber J.

PY - 2010

Y1 - 2010

N2 - We have reached a point where it is difficult to improve food allergy risk management without an agreement on levels of acceptable risk. This paper presents and discusses the perspectives of the different stakeholders (allergic consumers, health professionals, public authorities and the food industry) on acceptable risk in food allergy. Understanding where these perspectives diverge and even conflict may help develop an approach to define what is acceptable. Uncertainty about food allergy, its consequences and how to manage them is the common denominator of the stakeholders’ views. In patients, uncertainty is caused by the unpredictability of reactions and the concern about whether avoidance strategies will be effective enough. Variability of symptoms and the lack of markers do not allow stratification of patients according to their reactivity, and force health professionals to give the same advice to all patients despite the fact that the risk to each is not identical. Regulators and the food industry struggle with the fact that the lack of management thresholds forces them to make case-by-case decisions in an area of uncertainty with penalties for under- or over-prediction. As zero risk is not a realistic possibility, consensus on acceptable risk will be needed.

AB - We have reached a point where it is difficult to improve food allergy risk management without an agreement on levels of acceptable risk. This paper presents and discusses the perspectives of the different stakeholders (allergic consumers, health professionals, public authorities and the food industry) on acceptable risk in food allergy. Understanding where these perspectives diverge and even conflict may help develop an approach to define what is acceptable. Uncertainty about food allergy, its consequences and how to manage them is the common denominator of the stakeholders’ views. In patients, uncertainty is caused by the unpredictability of reactions and the concern about whether avoidance strategies will be effective enough. Variability of symptoms and the lack of markers do not allow stratification of patients according to their reactivity, and force health professionals to give the same advice to all patients despite the fact that the risk to each is not identical. Regulators and the food industry struggle with the fact that the lack of management thresholds forces them to make case-by-case decisions in an area of uncertainty with penalties for under- or over-prediction. As zero risk is not a realistic possibility, consensus on acceptable risk will be needed.

KW - EuroPrevail

KW - Stakeholders

KW - Food allergy risk

KW - Patients

U2 - 10.1016/j.yrtph.2010.03.003

DO - 10.1016/j.yrtph.2010.03.003

M3 - Journal article

C2 - 20303375

VL - 57

SP - 256

EP - 265

JO - Regulatory Toxicology and Pharmacology

JF - Regulatory Toxicology and Pharmacology

SN - 0273-2300

IS - 2-3

ER -

Madsen CB, Crevel R, Chan C-H, Dubois AEJ, DunnGalvin A, Flokstra-de Blok BMJ et al. Food allergy: Stakeholder perspectives on acceptable risk. Regulatory Toxicology and Pharmacology. 2010;57(2-3):256-265. https://doi.org/10.1016/j.yrtph.2010.03.003