Thresholds for food allergens and their value to different stakeholders

R. W.R. Crevel, B. K. Ballmer-Weber, T. Holzhauser, J. O.B. Hourihane, A. C. Knulst, A. R. Mackie, F. Timmermans, S. L. Taylor

Research output: Contribution to journalReview articlepeer-review

108 Scopus citations


Thresholds constitute a critical piece of information in assessing the risk from allergenic foods at both the individual and population levels. Knowledge of the minimum dose that can elicit a reaction is of great interest to all food allergy stakeholders. For allergic individuals and health professionals, individual threshold data can inform allergy management. Population thresholds can help both the food industry and regulatory authorities assess the public health risk and design appropriate food safety objectives to guide risk management. Considerable experience has been gained with the double-blind placebo-controlled food challenge (DBPCFC), but only recently has the technique been adapted to provide data on thresholds. Available data thus vary greatly in quality, with relatively few studies providing the best quality individual data, using the low-dose DBPCFC. Such high quality individual data also form the foundation for population thresholds, but these also require, in addition to an adequate sample size, a good characterization of the tested population in relation to the whole allergic population. Determination of thresholds at both an individual level and at a population level is influenced by many factors. This review describes a low-dose challenge protocol developed as part of the European Community-funded Integrated Project Europrevall, and strongly recommends its wider use so that data are generated that can readily increase the power of existing studies.

Original languageEnglish (US)
Pages (from-to)597-609
Number of pages13
JournalAllergy: European Journal of Allergy and Clinical Immunology
Issue number5
StatePublished - May 2008
Externally publishedYes


  • Food allergens
  • Food allergy
  • Risk assessment
  • Thresholds

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology


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