Examination of Witnesses (Questions 381-399)
Mrs Sue Hattersley, Miss Gill Fine, Ms Andrea Martinez-Inchausti,
Dr Ian Leitch and Mr Les Bailey
31 JANUARY 2007
Q381Chairman: Good morning and thank you for
coming. Can I welcome those of you who are giving evidence to
us today and also members of the public who have come to listen
in on this session. This is the sixth hearing of our inquiry into
allergy. There is an information note of the declared interests
of members of the Committee so we will not be repeating those
today during our evidence session. I would like to ask those of
you who are here to start off by giving us a short introduction
with your name and where you are from. I also remind you that
this session is being webcast today, so it is being broadcast.
Could I invite you to start, Mr Bailey.
Mr Bailey: I am Les Bailey from the Local Authorities
Coordinators of Regulatory Services. We are the central local
government body that acts to try to co-ordinate the activities
of local authority environmental health and trading standards
departments. I deal with food standards, food composition and
food labelling issues, which includes allergens. My previous background
is in trading standards.
Dr Leitch: I am Ian Leitch. I come from an environmental
health background from Omagh District Council. I am presently
project manager for a food allergy project to train environmental
health officers in food allergen control. That is sponsored by
Safefood which is the Ireland food safety body and by the EU through
a programme called CAWT which stands for Co-operation and Working
Together and it is for training in the border regions. I come
from an environmental health background with a particular interest
in allergen control.
Ms Martinez-Inchausti: My name is Andrea Martinez-Inchausti
and I represent the retailers. I am here representing the British
Retail Consortium which is the trade association that represents
retailers to both governmental and non-governmental bodies. I
work as the Assistant Director of Food Policy and I deal with
the majority of the technical legislative issues. My background
is veterinarian.
Miss Fine: My name is Gill Fine. I am Director
of Consumer Choice and Dietary Health at the Food Standards Agency.
The Agency was set up in 2000 to protect the health of the public
in relation to food and drink and also to reflect their interests.
I head up a group of three divisions, one of which covers food
allergy as part of its remit. My background is as a nutritionist.
Mrs Hattersley: I am Sue Hattersley. I am also
from the Food Standards Agency. I head up the Allergy and Intolerance
Branch within the Agency so I have the overall responsibility
for that area of work.
Q382 Chairman: Could I start of by
asking you as a panel whether there is any evidence that there
may be a link between changes in the modern diet and an increase
in the incidence of asthma and allergy? Would you like to start,
Mrs Hattersley?
Mrs Hattersley: There is evidence that the prevalence
of different food allergies does vary in different countries,
depending on dietary practices. We know that weaning practices
have changed very significantly in the UK over the last 50 years.
There is evidence that different weaning practices across different
countries might lead to different incidence of food allergy. If
you look for instance, at Jewish children in the UK, there is
a very different incidence of peanut allergy in that group compared
to Jewish children in Israel, where they use a peanut snack as
a weaning food. There are very clear dietary differences in different
countries. We also know that the introduction of new foods into
the diet can lead to new allergies and we have done some research
on kiwi which is an emerging allergen in the UK. We also know
that cooking practices can change the allergenicity of certain
foods. Roasted peanut, for example, is much more allergenic that
raw peanut, but cooked egg is less allergenic than raw egg.
Ms Martinez-Inchausti: I would agree with what
Sue has said. What has also triggered an increased amount of allergies
has been the increase of awareness both by paediatricians or practitioners
and consumers, and the development of methods to diagnose those
allergies has also triggered an increase in the numbers.
Q383 Chairman: I wonder whether there
is any evidence that sulphites and preservatives, possibly even
including things like trans fats in pre-packaged foods affect
allergy sufferers, and in which foods are they found?
Mrs Hattersley: We know that sulphites can trigger
asthma attacks in people who already have asthma and that is why
sulphites are included on the list of allergens that have to be
declared in pre-packed foods. If sulphites are added to foods
that now has to be labelled so that people can avoid those foods.
Q384 Chairman: Could foods be modified
to remove such substances from them so that we would remove the
substances potentially contributing to allergic disorders?
Mrs Hattersley: It is very difficult. There
has been some work done to look to see whether they could remove
some of the allergenic proteins from peanuts but we know that
there is not just one protein in the peanut, there are perhaps
half a dozen different allergenic proteins. If you try to breed
a peanut that has less of one protein it may be producing more
of the other proteins and very often in the nuts and seeds it
is the storage proteins which are allergenic so there tends to
be very high levels of those proteins in the foods.
Q385 Lord Taverne: What research
is the FSA supporting to identify the characteristics of foods
which can lead to the development of food allergy and intolerance?
Mrs Hattersley: We know that most food allergens
are proteins so we have done some research to look at the characteristics
of proteins that make them allergenic and there are certain characteristics
which tend to be associated with allergenic proteins. They tend
to be resistant to digestion; they tend to be present in very
large amounts; they tend to have multiple binding sites for the
IgE antibodies. Some non-allergenic proteins also have very similar
characteristics so we think there are other factors involved as
well. Other molecules attaching to the protein affect the allergenicity
as well, so it is still an area of on-going research.
Q386 Lord Taverne: I gather that
some of your research has been into early life exposure and pregnancy
exposure which suggests that low level environmental exposure
to allergens can actually lead to sensitisation, rather the opposite,
as it were, of some early exposure leading to immunity which we
found with farm animals and possibly with peanuts.
Mrs Hattersley: There is certainly some evidence
indicating that low level environmental exposure to some of the
allergens, particularly peanut, may cause sensitisation, whereas
if you have higher dose oral exposure then that may lead to tolerance.
This is the evidence that we are getting from the study of Jewish
children in Israel, where they use the peanut snack as a weaning
food. It found that if you have a high level oral exposure that
actually leads to the development of tolerance, whereas if you
have just a very low level exposure—sometimes dermal exposure—that
may be leading to sensitisation.
Q387 Lord Taverne: Dermal exposure
to peanuts?
Mrs Hattersley: Yes. We know that peanut oil
used to be used in creams for eczema. Also a lot of natural cosmetic
and toiletry products have nut oils in them, so that may be another
route of exposure. Also, if other people in the household are
eating peanuts then there may be peanuts on people's hands and
it is in the general environment so that may be leading to sensitisation
at those very low levels.
Q388 Lord Taverne: What about the
effect of latex-containing packaging? Is that possibly something
which could trigger dermatitis or exacerbate it?
Mrs Hattersley: We know that there is an increase
in latex allergy in healthcare workers, for example, who wear
a lot of latex gloves. There is also work being done to look at
latex allergy in food handlers because some food handlers wear
gloves. The Agency has done some research to try to develop a
methodology for looking at levels of latex in packaging materials,
to see whether that transfers into the food. At the moment we
are starting to develop that methodology and there is a further
project underway at the moment trying to develop that further
so that we have a reliable test to see how much latex might be
getting into the food.
Q389 Lord Taverne: What is your method
of dealing with proposals for research into allergy? Do you take
unsolicited proposals or do you only support contract studies?
Mrs Hattersley: Normally we issue open calls
for research proposals, the Agency will do that on a regular basis.
Three or four times a year we will issue calls for proposals,
which may include calls on food allergy. People submit their proposals
and they are independently appraised before we contract any research.
People can also come to us if they have particular research ideas.
One of the examples was the work that we did on kiwi allergy.
Somebody came to us asking whether they could do a pilot study
to look at the characteristics of kiwi allergy and we funded that.
Then we funded further study into it because it looked like there
was an issue there. It can be via either route.
Q390 Earl of Selborne: Still on the
subject of research funding for proposals, there must be a lot
of international work in this field and I wonder whether the FSA
is confident that it can keep in track with other relevant research
in other countries, particularly for example with something like
the kiwi fruit you have just referred to. Presumably one would
go to South Africa or New Zealand or somewhere to look at some
of the work on relevant populations.
Mrs Hattersley: In running our programme we
have an independent adviser who is an expert in the allergy field
so he helps us to keep up to date with the literature. We also
scan the literature ourselves to see what work is being done elsewhere.
As I said, when we call for proposals for new research we do have
them independently appraised by external experts, so again it
is bringing their expertise in to look at the work people propose
to do so that we make sure we do not duplicate work that has already
been done elsewhere.
Q391 Viscount Simon: You mentioned
IgE. In your submissions in the T07 research programme you put
IgG. I wonder if you could explain the difference and why it is
included in your research programme.
Mrs Hattersley: The IgE response is typical
of the allergic reaction, in that you are producing those particular
types of immunoglobulin proteins in response to the challenge
with the allergen, but it is not just the specific IgE that is
produced in response to, say, peanut or egg that seems to be relevant
to the level of response seen in an individual. We think that
IgG may help moderate that response but it remains unclear how,
and certainly there are what are called T regulatory cells which
are particular types of lymphocytes which also help moderate the
immune response. It is a matter of looking at how that response
is triggered and all the other factors that might moderate it.
Both the IgG and the regulatory cells seem to be implicated in
the development of tolerance and we are trying to do some research
to see why it is that some people outgrow their allergies (egg
and milk allergies are often outgrown by the time the child is
five) and so if we can understand how that tolerance develops
then we might be able to do something to moderate the types of
reactions that happen.
Q392 Chairman: What is the research
budget for food allergy research in the UK?
Miss Fine: The research budget for the allergy
work is around £1 million each year and that represents about
five per cent of the Agency's research budget. I should add, in
response to the work on the international side, we are very keen
that we get the best value for money from the research, so increasingly
we are looking to see how we can work collaboratively with activities
that are happening in Europe and internationally.
Q393 Viscount Simon: Is £1 million
a year enough?
Miss Fine: Research is quite a hungry beast
and the Agency funds research across a wide range of food issues.
We are very keen that we carry on with the research in this area.
£1 million is a significant amount but whether it is ever
enough I think is very hard to say.
Q394 Chairman: How does that compare
to the US or European budgets, do you know?
Mrs Hattersley: I am not sure about the budgets
in the US but we are part of a very large EU framework programme
which I think has about £12.5 million worth of research looking
at the prevalence of food allergy and it is also looking at things
like the food matrix and whether the type of food that the allergen
is in makes a difference. They are also looking at quality of
life issues. We are collaborating with them but by funding one
particular arm of the study in the UK we have access to all that
information so the collaborative research is a very good way of
making our money go further.
Q395 Lord Colwyn: I am aware that
the UK has been pressing for improved labelling of allergenic
ingredients in food. How do current labelling regulations recognise
allergens in foods? Who decides at what level an allergen must
be listed? We have a list from the FSA here and I notice, for
instance, that kiwi fruit is not even included.
Miss Fine: The current regulations require declaration
of ingredients when they have been deliberately added and there
is no threshold for that. If a manufacturer or retailer is using
a food or ingredient that contains these allergens it must be
declared on the label. The way in which that list is determined
is that, because labelling is an EU competency, the European Commission
asks the European Food Safety Authority for advice on which of
the allergens are of public health concern across all Member States
and that is where the initial list of 12 allergens came from.
Subsequently there have been another two added in December last
year. I think the key thing here is that it has helped to improve
the clarity of the label for consumers so whereas before it would
say "casein" in the ingredients it now says "casein
from milk" so it helps the consumer understand more clearly
where those particular allergens are coming from.
Q396 Lord Colwyn: What are the other
two that have been added?
Miss Fine: Molluscs and lupins have been added
to the list. There will be a period of time before which the manufacturers
and retailers have to declare it but they have now been added
to the list.
Q397 Lord Colwyn: Obviously sensitivity
levels for allergens vary amongst individuals. Would it be a good
idea to define a level above which the packaging must list any
particular allergen?
Mrs Hattersley: The legislation for the pre-packed
food is that the allergen has to be labelled regardless of the
level of addition, if it is deliberately added as an ingredient.
The science at the moment is not yet able to let us set thresholds
for the allergens in food. We have guidance on the advisory labelling
to cover possible cross-contamination but at the moment we do
not really have enough evidence to set even the clinical thresholds
for the allergens (below which an individual would not react).
As you say, individuals vary very considerably in their response,
so it is how you would turn that information into a management
level that the industry could use. We do not yet have the scientific
evidence to be able to do that but we are actually working with
this European consortium that we mentioned earlier and are holding
a conference this summer to look at that whole question of how
you actually set the threshold levels for the food because you
have to work out the safety factors that you need to include in
those calculations to protect the most sensitive individuals.
Risk assessment in that way is fairly well established for chemicals,
for toxicological evaluations, but no-one has yet tried to apply
that to allergens so this conference is going to be pulling together
experts from around the world so there will be European and American
experts there to help us discuss how you actually do that risk
assessment. It is something that is in progress and we know it
is something that does need to be done.
Q398 Lord Colwyn: You refer to "we";
that means the FSA does it?
Mrs Hattersley: Yes[17]
Q399Lord Colwyn: Who else is researching these
threshold levels?
Mrs Hattersley: Academics are doing research
in that area and certainly other government authorities are doing
work as well.
17 Guidance on Allergen Management and Consumer Information
("May Contain" Labels)-We should also like to clarify
that "May Contain" was produced by the Food Standards
Agency, working in collaboration with stakeholders, including
the Food and Drink Federation and the British Retail Consortium.
We are grateful to them for producing the first draft of the document,
which was based on their own previous guidance. Back
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