Abstract
Purpose
Prevalence of food allergy and perceptions on food allergen labeling in school foodservice among elementary, middle, and high school students were investigated in Korea.
Methods
A total of 1,000 elementary, middle, and high schools were selected in 16 cities and provinces of Korea and students attending the schools were surveyed using a questionnaire modified from the Korean International Study of Asthma and Allergies in Childhood questionnaire in July 2012. Responses from 27,679 students were used for data analysis.
Results
The ratio of the students who had experienced food allergy was 12.6%; 7.6% of the responding students had food allergy reactions last 12 months and 6.8% of the students had been diagnosed for food allergy by doctors. Eggs, milk, peach, and crabs were the most frequent allergenic foods for the elementary school 1st graders, 5th graders, middle, and high school students, respectively, who had experienced food allergy last 12 months. The students with food allergy read menus more frequently and were more interest in food allergen labeling in school foodservice than their counterparts. Both of the student groups with and without food allergy perceived food allergen labeling important for the students with food allergy and their parents.
Conclusion
The prevalence of food allergy and major allergenic foods varied by school years. The Korean students had positive perception on allergic food labeling in school foodservice. An effective food allergen labeling system for school foodservice should be developed and implemented that reflects prevalence, symptoms, and food allergens among Korean students.
References
2. Kim WK. Diagnosis and treatment of food allergy in children. Pediatr Allergy Respir Dis. 2006; 16:274–283.
3. Rona RJ, Keil T, Summers C, Gislason D, Zuidmeer L, Sodergren E, et al. The prevalence of food allergy: a meta-analysis. J Allergy Clin Immunol. 2007; 120:638–646.
4. Oh JW, Pyun BY, Choung JT, Ahn KM, Kim CH, Song SW, et al. Epidemiological change of atopic dermatitis and food allergy in school-aged children in Korea between 1995 and 2000. J Korean Med Sci. 2004; 19:716–723.
5. Son KY, Park KS, Hwang HH, Yun BS, Lee SJ, Kim MA, et al. Prevalence of allergic diseases among primary school children in Ilsan, Gyeonggi and changes of symptoms after environmental control in 2005. Pediatr Allergy Respir Dis. 2007; 17:384–393.
6. Sampson HA. Food allergy. Part 1: immunopathogenesis and clinical disorders. J Allergy Clin Immunol. 1999; 103(5 Pt 1):717–728.
7. Lee SY, Kim KW, Ahn K, Kim HH, Pyun BY, Park YM, et al. Consumer's use and satisfaction of allergic food labels. Pediatr Allergy Respir Dis. 2011; 21:294–301.
8. Dalal I, Binson I, Reifen R, Amitai Z, Shohat T, Rahmani S, et al. Food allergy is a matter of geography after all: sesame as a major cause of severe IgE-mediated food allergic reactions among infants and young children in Israel. Allergy. 2002; 57:362–365.
9. Rancé F, Kanny G, Dutau G, Moneret-Vautrin DA. Food hypersensitivity in children: clinical aspects and distribution of allergens. Pediatr Allergy Immunol. 1999; 10:33–38.
10. Goh DL, Lau YN, Chew FT, Shek LP, Lee BW. Pattern of food-induced anaphylaxis in children of an Asian community. Allergy. 1999; 54:84–86.
11. Hill DJ, Hosking CS, Heine RG. Clinical spectrum of food allergy in children in Australia and South-East Asia: identification and targets for treatment. Ann Med. 1999; 31:272–281.
12. Ahn K. Food Allergy: diagnosis and management. Korean J Asthma Allergy Clin Immunol. 2011; 31:163–169.
13. Seo WH, Jang EY, Han YS, Ahn KM, Jung JT. Management of food allergies in young children at a child care center and hospital in Korean. Pediatr Allergy Respir Dis. 2011; 21:32–38.
14. Food allergy & anaphylaxis alliance[Internet]. McLean: Food Allergy & Anaphylaxis Network;c2011. cited 2013 Mar 25. Available from: http://www.foodallergyalliance.org/.
15. Gendel SM. Comparison of international food allergen labeling regulations. Regul Toxicol Pharmacol. 2012; 63:279–285.
16. Ministry of Education. Statistics on school foodservice. Seoul: Ministry of Education;2011.
17. Kim DS, Ban JS, Park EA, Lee JY, Lee JO, Chang EY, et al. Survey of food allergy in elementary school students in Dongjak-gu using questionnaire. Korean J Asthma Allergy Clin Immunol. 2011; 31:254–259.
18. US Food and Drug Administration, Center for Food Safety and Applied Nutrition. Food Labeling and consumer protection Act of 2004 (Title II of Public law 108-282). Silver Spring: US Food and Drug Administration;2004.
19. Ministry of Food and Drug Safety. Allergenic food labeling Act 2013-132. Seoul: Ministry of Food and Drug Safety;2013.
20. Ahn HS, Lee SM, Lee MY, Choung JT. A study of the dietary intakes and causative foods in allergic children. Pediatr Allergy Respir Dis. 1999; 9:79–92.
21. Guidelines for education and foodservice management of food allergies[Internet]. Seoul: Seoul Metropolitan Government;c2004. cited 2013 Jan 3. Available from: http://fsi.seoul.go.kr/front/bbs/bbsView.do?currPage=1&listSize=10&searchType=titles&searchValu=&bbsCode=1021&bbsSeq=1350.
22. Jee HM, Kim KW, Kim CS, Sohn MH, Shin DC, Kim KE. Prevalence of asthma, rhinitis and eczema in Korean children using the International Study of Asthma and Allergies in Childhood (ISAAC) Questionnaires. Pediatr Allergy Respir Dis. 2009; 19:165–172.
23. Jung YH, Ko H, Kim HY, Seo JH, Kwon JW, Kim BJ, et al. Prevalence and risk factors of food allergy in preschool children in Seoul. Korean J Asthma Allergy Clin Immunol. 2011; 31:177–183.
24. Hong SJ, Ahn KM, Lee SY, Kim KE. The prevalences of asthma and allergic diseases in Korean children. Pediatr Allergy Respir Dis. 2008; 18:15–25.
25. Han JS, Hong SO, Kim JS, Han JP, Kim NS. Frequency of food allergy in Korea and the causative food allergens. J Korean Soc Food Sci Nutr. 1997; 26:1–9.
27. Burks AW, Tang M, Sicherer S, Muraro A, Eigenmann PA, Ebisawa M, et al. ICON: food allergy. J Allergy Clin Immunol. 2012; 129:906–920.
28. Mukoyama T, Nishima S, Arita M, Ito S, Urisu A, Ebisawa M, et al. Guidelines for diagnosis and management of pediatric food allergy in Japan. Allergol Int. 2007; 56:349–361.
29. Lack G. Clinical practice: food allergy. N Engl J Med. 2008; 359:1252–1260.
30. Sampson HA. Food allergy: accurately identifying clinical reactivity. Allergy. 2005; 60:Suppl 79. 19–24.
31. Kim KE. Causative foods, clinical features and diagnosis of food allergy. Pediatr Allergy Respir Dis. 2000; 10:2 Suppl. 94–100.
32. Kim S, Yoon J, Kwon S, Kim J, Han Y. Current status of managing food allergies in schools in Seoul, Korea. J Child Health Care. 2012; 16:406–416.
33. Liew WK, Williamson E, Tang ML. Anaphylaxis fatalities and admissions in Australia. J Allergy Clin Immunol. 2009; 123:434–442.
34. Gupta R, Sheikh A, Strachan DP, Anderson HR. Time trends in allergic disorders in the UK. Thorax. 2007; 62:91–96.
36. Mehl A, Wahn U, Niggemann B. Anaphylactic reactions in children: a questionnaire-based survey in Germany. Allergy. 2005; 60:1440–1445.
37. Smit DV, Cameron PA, Rainer TH. Anaphylaxis presentations to an emergency department in Hong Kong: incidence and predictors of biphasic reactions. J Emerg Med. 2005; 28:381–388.
38. Roh EJ, Chung EH, Lee MH, Lee SJ, Youn YS, Lee JH, et al. Clinical features of anaphylaxis in the middle area of South Korea. Pediatr Allergy Respir Dis. 2008; 18:61–69.