Accidental Ingestion of Allergic Food at Eating-Out and Home Meal Replacement by Children with Food Allergy

Abstract

Introduction: In Japan, there are no regulations for allergy labeling in eating-out and home meal replacement (HMR). Consequently, patients with food allergy are at risk of accidental ingestion when using these services. It is necessary to understand the current situation of accidental food ingestion at eating-out and HMR to consider related legislation in the future. Methods: A Web-based survey was conducted from August to September 2021 among patients participating in the survey. The survey included information on the use of eating-out and HMR, frequency of accidental ingestion, medical institution visits and treatment, and reasons for accidental ingestion. Results: There were 1,141 valid responses, with 8 (5–15) years as the median age of the participants. Moreover, 769 (67.4%) participants had a history of anaphylaxis, 622 (54.5%) experienced accidental ingestion, of which 485 (42.5%) and 348 (30.6%) occurred while eating-out and at HMR, respectively. A total of 71 (14.6%) and 31 (8.9%) participants who had accidental ingestion while eating-out and at HMR, respectively, required hospitalization. Age, milk allergy, and a history of anaphylaxis were risk factors significantly associated with accidental ingestion. The reasons for the accidental ingestions were personal and store-side error for a total of 438 cases and of 356 cases, respectively. Discussion/Conclusion: It is necessary for both stores and patients to take measures to prevent accidental ingestion in eating-out and HMR. Additionally, the fact is that the lack of allergy labeling guidelines for eating-out and HMR is a major factor in the occurrence of accidental ingestion.