{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T03:52:23Z","timestamp":1775706743276,"version":"3.50.1"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,11,28]],"date-time":"2024-11-28T00:00:00Z","timestamp":1732752000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100006388","name":"H\u00f4pitaux Universitaires de Gen\u00e8ve","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006388","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Patients with food allergies need personalized information on their risk of reaction in \u201creal\u2010life\u201d situations. This multicentric study aimed to investigate the link during accidental reactions between the nature and amount of food allergens consumed in \u201creal\u2010life situation\u201d and the severity of the symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients were prospectively recruited from December 1, 2020, to December 31, 2021, at the emergency departments in the Geneva University Hospitals and local pediatric emergency facilities, through an allergy outpatient clinic, at school and daycare facilities and trough their primary care physicians. Medical history of patients presenting reactions suggestive with immediate food allergy and suspected food samples were collected. Allergy diagnostic tests were retrospectively and prospectively collected. The samples were analyzed for their allergen content.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We recruited 147 subjects with an accidental immediate\u2010type allergic reaction to a food. We were able to collect 115 reaction\u2010eliciting food samples allowing to quantify the allergen amount causing the reaction, as well as correlating this amount to the severity of the reaction. Children represented a large part of the reactors, and most reactions were to common food allergens such as tree nuts, cow's milk as well as peanuts and hen's egg. Reactions were mostly to prepackaged foods and seven reactions were to products with precautionary allergy labeling, or without labelling to the eliciting allergen. Reactions were of various degrees of severity, and independent to the amount of allergen ingested.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The severity of reactions did not show a direct correlation with allergen quantity, emphasizing individual sensitivity. Some reactions occurred with allergen amounts significantly below the legal limit for mandatory labelling of 1\u2009g\/kg (1000\u2009ppm) in Switzerland. The study also highlighted considerable variability in allergen concentrations in foods labeled with possible \u201ccontaminations\u201d or \u201ctraces\u201d. These findings raise questions about the accuracy of allergen labeling and regulations in Switzerland.<\/jats:p><\/jats:sec>","DOI":"10.1111\/all.16413","type":"journal-article","created":{"date-parts":[[2024,11,28]],"date-time":"2024-11-28T05:43:40Z","timestamp":1732772620000},"page":"238-247","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The Severity of Allergic Reactions in a Real\u2010World Environment Is Independent of the Eliciting Amounts of Foods"],"prefix":"10.1111","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2555-2550","authenticated-orcid":false,"given":"Alexandre","family":"Piletta\u2010Zanin","sequence":"first","affiliation":[{"name":"Pediatric Allergy Unit, Department of Woman, Child and Adolescent University Hospitals of Geneva (HUG)  Geneva Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Scherl","sequence":"additional","affiliation":[{"name":"Official Food Control Authority of the State of Geneva (SCAV) Health Department  Geneva Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Avigael","family":"Benhamou","sequence":"additional","affiliation":[{"name":"Pediatric Allergy Unit, Department of Woman, Child and Adolescent University Hospitals of Geneva (HUG)  Geneva Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel","family":"Braendle","sequence":"additional","affiliation":[{"name":"Pediatric Admissions and Emergency Division, Department of Woman, Child and Adolescent Hug  Geneva Switzerland"},{"name":"Pediatric Emergency Division Hirslanden Clinique Des Grangettes  Ch\u00eane\u2010Bougerie 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Immunology Service, Department of Medicine Hug  Geneva Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergio","family":"Manzano","sequence":"additional","affiliation":[{"name":"Pediatric Admissions and Emergency Division, Department of Woman, Child and Adolescent Hug  Geneva Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haig","family":"Nigolian","sequence":"additional","affiliation":[{"name":"Allergy and Immunology Service, Department of Medicine Hug  Geneva Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Didier","family":"Ortelli","sequence":"additional","affiliation":[{"name":"Official Food Control Authority of the State of Geneva (SCAV) Health Department  Geneva Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean\u2010Pierre","family":"Pahud","sequence":"additional","affiliation":[{"name":"Intercommunal Grouping for Extra\u2010Curricular Activities Association of Geneva Municipalities  Geneva Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aude Tonson","family":"la Tour","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Division H\u00f4pital de la Tour  Meyrin Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herv\u00e9","family":"Spechbach","sequence":"additional","affiliation":[{"name":"Emergency Division, Department of Acute Medicine Hug  Geneva Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Edder","sequence":"additional","affiliation":[{"name":"Official Food Control Authority of the State of Geneva (SCAV) Health Department  Geneva Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe A.","family":"Eigenmann","sequence":"additional","affiliation":[{"name":"Pediatric Allergy Unit, Department of Woman, Child and Adolescent University Hospitals of Geneva (HUG)  Geneva 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F\u00fcr Risikobewertung. \u2018VITAL 3.0\u2019: New and updated proposals for reference doses of food allergens: BfR Opinion No 015\/2020 of 9 March 2020","year":"2020"},{"key":"e_1_2_9_30_1","unstructured":"VITAL \u201cRelease of VITAL Online Version 3.0.0. Allergen Bureau eAlert \u201d(2019) https:\/\/mailchi.mp\/allergenbureau\/vital_v3000?e=7a3012eec4."},{"key":"e_1_2_9_31_1","volume-title":"Risk Assessment of Food Allergens\u2014Part 3: Review and Establish Precautionary Labelling in Foods of the Priority Allergens","year":"2023"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.13423"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41538-021-00093-4"}],"container-title":["Allergy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/all.16413","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T13:33:15Z","timestamp":1755696795000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/all.16413"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,28]]},"references-count":32,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1111\/all.16413"],"URL":"https:\/\/doi.org\/10.1111\/all.16413","archive":["Portico"],"relation":{},"ISSN":["0105-4538","1398-9995"],"issn-type":[{"value":"0105-4538","type":"print"},{"value":"1398-9995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,28]]},"assertion":[{"value":"2023-11-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}