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


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
Issue number2-3
Pages (from-to)256-265
Publication statusPublished - 2010


  • EuroPrevail
  • Stakeholders
  • Food allergy risk
  • Patients


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