Health professionals (including allied health professionals) have an important role in helping people manage their food allergies. The Allergen Collaboration has agreed to a number of key messages on food allergy for health professionals and these are listed below.
Key messages
- Anaphylaxis is a medical emergency and requires immediate treatment with adrenaline (epinephrine)
- People at risk of anaphylaxis need to be referred to a clinical immunology/allergy specialist or doctor with experience in food allergy management
- General practitioners or specialists should complete and provide ASCIA Action Plans and prescribe adrenaline autoinjector scripts if needed. In Australia, authorisation by a specialist for the initial adrenaline autoinjector prescription is required
- Educating patients (and their families/caregivers) about avoidance strategies and acute management is critical (e.g. label reading, reducing risk when eating out, recognising signs of an allergic reaction, following instruction on ASCIA Action Plans, knowing how to use the adrenaline autoinjector if one is prescribed)
- It is important to teach patients and their caregivers how to use their prescribed adrenaline autoinjector using a trainer device
Precautionary allergen labelling
See below for key messages about precautionary allergen labelling (PAL). Supporting information on this issue is available in the paper Precautionary allergen labelling (PAL) Information for health professionals.
- PAL is used to inform consumers of the possible unintended presence of allergens in packaged food.
- The use of PAL is voluntary and it is unregulated in Australia and New Zealand.
- Voluntary Incidental Trace Allergen Labelling (VITAL -) is a program that provides a standardised allergen risk assessment process for food industry.
- There are a range of PAL statements and products containing no PAL statements and they should all be regarded as having the same level of risk. consumers should be encouraged to contact the manufacturer to check if they use the VITAL process for the particular product they are wanting to consume.
- Manufacturers may change allergen statements including PAL statements on the label, but not change the packaging (e.g. the product may look the same but the allergen information has changed).
- Most food products do not indicate on their packaging that they have been assessed using the VITAL® process (more recently, manufacturers may use the VITAL® mark if they achieve VITAL® certification).
- industry guidance recommends a standardised format for the PAL statement ('May be present: allergen x, allergen y'). However, this standardised format does not assure the consumer that the VITAL® process has been used. Foods that have not undergone the VITAL® process can also use this format.
Health professionals should:
- Remind patients/consumers to read the entire product label, not just the ingredient information, allergy summary statement and PAL statement on each food pack, every time it is purchased.
- Encourage patients/consumers to contact the manufacturer if they are uncertain about whether the product is safe to consume. They should be encouraged to ask the manufacturer if they use the VITAL® process for the particular food product.
- Remind patients that if they choose to ignore PAL statements, they need to consider the risk of an allergic reaction which can be impacted by concurrent illness at the time and how much of the food with the PAL statement they eat and any other factors that can exacerbate an allergic reaction (e.g. exercise). If the patient is a child, parental supervision of the child is also required in case an allergic reaction occurs. If the patient is an adult, they should be advised to not eat the food whilst alone.
- Remind patients that some products are higher risk for cross contamination than others such as sticky products (e.g. nut butters, biscuits, chocolates and ice creams). Other high-risk products include products made by a manufacturer that also makes products containing an allergen.
- Patients should always have their ASCIA Action Plan and adrenaline injector (if prescribed) with them.
Resources
Australia New Zealand Food Standards Code
- Standard 1.2.3 Information requirements - warning statements, advisory statements and declarations lists the food allergens that must be declared on food labels
- Standard 1.2.1 Requirements to have labels or otherwise provide information requires the information to be provided when the food is packaged and unpackaged (for example, food sold in a restaurant).
- Food allergies and food intolerances information for consumers.
Australasian Society of Clinical Immunology and Allergy (ASCIA)
- Online training for health professionals
- ASCIA Action Plans and Treatment Plans
- ASCIA guidelines for adrenaline (epinephrine) autoinjector prescription
- How to give an EpiPen information and video
- Guidelines and position papers
- Dietary avoidance information sheets
Australia
Allergy & Anaphylaxis Australia
- Reporting an allergic reaction to food
- Food allergen cards
- Signs and symptoms of allergic reaction information and video
- How to give an EpiPen information and video
- Free national school curriculum resource
- Allergy & Anaphylaxis information and advice
National Allergy Council resources
- 250K.org.au online hub for pre-teens and teens, developed by young people for young people living with severe allergy to find and share information with other young people living with food allergy. Website includes 250K presentations and bookmarks
- Food allergy education - A community education website with practical information about how to manage food allergy.
- All about allergens - This free online training course has been developed to help everyone working in food service including early childhood education centres and school canteens, to manage food allergens.
Nuts for Life
- Information about nuts and allergies
New Zealand
- Information and links for Health Professionals (includes information about health professional membership, diagnosing allergies, infant formula algorithm, training and education, advice to alternative practitioners about allergy claims, ACC claims for anaphylaxis, Allergy Today, Allergy and anaphylaxis guidelines, Infant feeding and allergy prevention guidelines)
- The New Zealand Child and Youth Allergy Clinical Network (Paediatric Society of New Zealand and supported by the Ministry of Health)
- The purpose of the Allergy Clinical Network is to promote and support evidence based best practice for those involved in the health care of New Zealand children and young people with allergies, with a focus on quality improvement to make sure there is equal access to care and resources.
- Resources include recommendations for health professionals on prevention, diagnosis, referral and management of food allergy and anaphylaxis.