May contain traces question

I will give the brief explanation as to why, quite bluntly, I am astonished that any reputable 'allergist' would even CONSIDER allowing an allergic child of their own to consume 'may contain' items.
That physician is a fool. JMHO.
"May contain _______." Means [i]just that.[/i] It may. Or it may not. Different types of food items carry different risks, but if you see that on a label, it's [i]usually[/i] there for a reason.
Yes, this is a terrible pain. But we ignore such warnings at our peril-- because we are, in fact, gambling every time we allow one of them. Feel lucky today?
I don't [i]ever[/i] feel that lucky. And nobody I know who has watched their child anaphylax seems to, either.
FAAN just recently announced the results of a study on advisory warnings like these. They found that when a product bears [i]either[/i] advisory label "May contain" or "in a facility" that there is a real risk associated with that product.
Maybe someone else could find a couple of links for Stella?
I know there is a study specific to bakery goods that indicated some 20% of them to be cross-contaminated... but this is from several years ago.
There are more recent references that give a clearer picture about how much risk this actually seems to be.
There are a fair number of people who became members here who were eating 'may contains' because they really didn't know how high the risk is. I hope that your allergist's colleague is one of those. But I sure wouldn't want to take my own child to see any allergist like that. [img]http://uumor.pair.com/nutalle2/peanutallergy/eek.gif[/img]

Maybe you could show your allergist this when you go back the next time. If it were me, I'd ask him to pass it along to his colleague. [img]http://uumor.pair.com/nutalle2/peanutallergy/wink.gif[/img]
[url="http://www.aaaai.org/media/jaci/2007/07/hefle_et_al.stm"]http://www.aaaai.org/media/jaci/2007/07/hefle_et_al.stm[/url]
And if that were not enough, check this thread out (it has the link to the older Hefle study):
[url="http://uumor.pair.com/nutalle2/peanutallergy/Forum1/HTML/005703.html"]http://uumor.pair.com/nutalle2/peanutallergy/Forum1/HTML/005703.html[/url]
And my very, very favorite link on this subject-- for ANYONE WHO EVEN [i]THINKS[/i] BAKERY ITEMS MIGHT BE SAFE:
[url="http://www.cfsan.fda.gov/~dms/alrgltr.html"]http://www.cfsan.fda.gov/~dms/alrgltr.html[/url]
That's the brief. This is the full report of the study's findings:
[url="http://www.cfsan.fda.gov/~dms/alrgpart.html"]http://www.cfsan.fda.gov/~dms/alrgpart.html[/url]
I like this one particularly well because it shows just how sloppy things really are in the 'real world.' Nobody told these companies they were coming. This is what was actually being sold to consumers just like us.
[This message has been edited by Corvallis Mom (edited September 03, 2007).]

I think there is a member on one of the UK PA forums who asks would you eat something or give it to your child to eat if the label stated that there was a possibility of it containing ground glass or dog poop or cyanide? Is the risk worth it?
I have seen footage of "cleaning" practices in factories (a cursory sweep of crumbs with a little hand broom) and believe me, it's enlightening. We were recently in a town near us that has a small candy making factory and you could look in a window to see them making whatever the candy of the day was. It happened to be peanut brittle! There were peanuts absolutely EVERYWERE, on all surfaces, the floor, their shoes, crushed into powder. I practically clapped a hand over my son's mouth and nose as we ran for it. There is no way they would ever be able to get that place clean of peanut for the next batch of candy.
I take any "may contain" labels absolutely seriously every time. I want to be totally consistent with teaching my son avoidance, and when exceptions start being made then I think that can be very confusing to the child, and IMPO very dangerous.

One day while shopping I gave my PA son yogert covered pretzels not even reading the label thinking these have to be okay. Well I was wrong the next minute I looked at him and he was covered in hives. Luckily I always carry benedryl with me and gave him some and he was fine after a while. when we got back into the car I then read the label and sure enought it said process in a plant with peanut!! I now read ALL labels! I know he has eaten other things that said processed in a plant with peanut and was fine. It's a risk I now will not take. I know its hard.

I have.

When I was first diagnosed with PA, I read that the largest number of reactions were caused by bakery items. Second on the list - ice cream shops.
Thanks for the links Corvallis Mom. A friend's husband was just diagnosed with walnut & hazelnut allergy, so I've forwarded the links to them.

We don't. We also don't allow any high risk items, bakery items, ice cream, or anything else we see as at greater risk for cross contamination.
You need to decide for yourself what your comfort level is and what food(s) are worth the risk.

One additional note of interest about the FDA study (the latter two links I posted)that is [i]HIGHLY[/i] significant for people who have very very high sensitivity-- the lower LOD (Limit of Detection) for the ELISA method that was used in this study was 10 parts per million. This would not have picked up a sample that was contaminated at a level lower than this. (Say, 1-5 ppm, which is about what a lot of peanut oils are.)
For a person like my daughter, this would still be considered [i]very high level[/i] contamination, relative to her sensitivity. (IN other words, if [i]she[/i] had acted as their detection device instead.... odds are good that the numbers would have been MUCH higher.... like 50% of samples, not 25%.)
This same methodological flaw exists in both Hefle studies. (IMO its a methodological flaw..... the FDA panel on advisory labelling agrees with me, though.... since the PA persons [i]most[/i]likely to suffer extremely severe reactions also apparently have the lowest dose thresholds...) This is the logic behind Keebler and General Mills' labelling policies. They don't KNOW what a 'safe' exposure level is for my child-- just that it is likely to be well below the limit of detection for most current methods of determination.
A second mthodological flaw in any study like this is with respect to sample inhomogeneity--- if a company uses equipment to make whizzbangs after it makes peanut-yuckies, it is the case that [i]not all of the whizzbangs will be equally contaminated.... It is even possible for a series of materials to be relatively UN-contaminated, but then become contaminated as material is dislodged from crevices.[/i] Just because the company 'tests' doesn't mean it can't happen. Just that it didn't in the test sample.
Roulette indeed.

Dd had a reaction to soy ice cream that was a may contain peanuts, but was not stated (since the law does not require the manufacturer to state it). It`s hard enough to avoid the items that are truly may contain, but not stated on the label. I`d never give her one that actually states it is a may contain. I also think that your allergist is out of touch with reality. I`d go online and see if he is even a real board certified allergist.