Gowland, Mary (2018) Food allergy : innovation in advocacy, research and training to support and protect those at risk. (PhD thesis), Kingston University, .
Abstract
The profile of severe allergy and particularly food allergy has developed significantly since the early 1990s. The establishment of the Anaphylaxis Campaign in 1994 in the UK led to a serendipitous relationship between advocacy and research. Investigating the impact of food allergy through early member surveys informed Campaign initiatives and government and food industry policies, both to improve food information and the control of allergen risks, and access to specialist health care and the management of allergic emergencies. Their success in turn depended on individuals and organisations understanding their own roles in reducing allergy risks and being ready to work together to contribute to further research and advocacy. Collaborative and trusted partnerships within and beyond the UK continue to shape food and healthcare regulation and best practice, and contribute to standards for patient and consumer support, clinical and academic research. Formal and informal education and training, strategies to make scientific and clinical research accessible and applicable in food production and healthcare, and active use of social and other media shape knowledge and understanding for individuals at risk, those caring for them and those responsible for supplying their food. There are elusive knowledge gaps and research questions which require further attention. Primary prevention of food allergy seems to be possible through protocols for early dietary intervention, but the longer-term allergy profile for these children is not yet known. Initiatives are underway to reverse food allergy through immunotherapy, both through supervised consumption of everyday foods and through pharmaceutically prepared updosing for consumption or via the skin. The impact of severe allergy on quality of life indicates a need for tailored psychological support for some children, young people and adults. The role of local and national food control bodies to advise and supervise food businesses in controlling and communicating the presence of food allergens is key to ensuring consumer protection for those at risk. Investigations following severe and fatal reactions which may have involved food allergy require a collaborative approach, the timely collection of samples (wherever possible), careful selection and use of appropriate legislation, analytical support and reporting. Work continues to define allergen thresholds, and to understand their inter-relationship with symptom severity. Studies currently underway attempt to take into account some of the co-factors associated with severity. Progress towards the adoption and acceptance of allergen thresholds in food production and labelling, voluntarily or through regulation depends on improved stakeholder understanding and a high degree of trust, particularly for those making risk decisions about their own food, or food for those in their care.
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