Characterise the patterns and prevalence of food allergies across Europe in infants, children and adults
Since the prevalence of food allergies is age dependent, particularly affecting infants and young children, cohorts are being set up in different age groups with a birth cohort covering children from birth to the age of 21/2 years, with community surveys in school age children and adults. Studies in unselected populations are being complimented by a cross-sectional study in the allergy out-patient clinics. This will also provide the project with a cohort of individuals with well characterised food allergies which are necessary for developing and validating new diagnostic tools. All the studies are being undertaken in different centres chosen to represent the different cultural and climatic regions of Europe from the Mediterranean to Iceland and from the UK to Bulgaria. These studies will also give information about the major allergenic foods across Europe. In all the clinical cohorts food allergies will be diagnosed by assessing sensitization to foods by determining serum IgE using a total panel of 24 foods including almost all those on Annex IIIa of the labeling directive). Other foods, such as peach, which is known to be a problem food in the Mediterranean area, and kiwi, an emerging food allergen have also been included.

Develop methods to improve the quality of food allergy diagnosis, reducing the need for food challenge tests
A collection of well defined food allergens has been prepared to allow development of component resolved diagnostics. Allergens have been purified from the panel of 24 foods. This will allow us to identify whether severe reactions are more commonly associated with particular allergens, and/or with a particular subpopulation and hence reduce the needs for food challenge tests.

Investigate the relationship between genetic and environmental factors, such as allergies to pollen, food consumption patterns, and the development of food allergy
Food allergy can be a result of direct sensitization to foods or of cross-reactivity to inhalant allergens. Patterns of allergy in the EuroPrevall cohorts will be related to patterns of pollen exposure and food consumption. Genetic predisposition plays an important role in the development of allergies, but very little is known about the genetics of food allergy. Genetic aspects will be studied specifically in relation to children with food allergies identified in the birth cohorts, and their parents to identify potential inherited factors.

Provide information regarding the effect of the food matrix and the role of food processing in modulating the allergenic properties of foods
Understanding how food processing and the food matrix may affect allergenic potential, either in terms of sensitization or elicitation of allergic reactions is important in making effective risk assessments of novel foods as well as managing known defined allergenic risks. The development of the “real” food matrices for DBPCFC will also pave the way to discovering if the minimum eliciting doses (thresholds) for a given food is altered by the food matrix by using the same food (peanut) in the desert matrix and comparing it with the chocolate matrix and a third ketchup matrix.

Determine the impact of food allergies on the quality of life and its economic cost for food allergic people and their families, workplace and employers, and healthcare
Complimentary studies with regards the socioeconomic impact of food allergies are also being undertaken. One part of this work is focussed on allergen labelling. There is some evidence that food allergic consumers experience stress as result of poor communication and labelling practices. Despite the new labelling legislation, allergic consumers are still not completely sure about the safety of products, caused by fear of cross-contamination, unlabelled products, precautionary labelling (“may contain” labels), and difficulties in understanding product labels. The project will also determine the impact of food allergy on the quality of life of allergy sufferers and their families. In addition to this the economic costs to the individual, families, together with related health service costs will be determined.