World Allergy Organization Consensus on the Use and Practice of Precautionary Allergen Labelling (ACT-UP!): An International e-Delphi

The World Allergy Organization (WAO) invites expressions of interest in participating in and supporting two new initiatives within its program on the use and practice of precautionary allergen labelling (ACT-UP!).

Harmonizing Observations Worldwide: Measuring Usual Consumption Habits.
An ACT-UP! initiative to harmonize food consumption surveys for evidence-based Precautionary Allergen Labelling.

The HOW MUCH initiative will develop a core, consensus-based set of criteria for food consumption surveys to support the consistent application of allergen reference doses in precautionary allergen labelling (PAL). Reliable information on the quantities of food consumed per eating occasion is essential to estimate allergen exposure and translate reference doses into practical PAL decisions. Current survey methods and available data vary considerably across countries.

The project will review and compare existing survey methods, convene international experts, and develop a harmonized, practical approach applicable across different populations and settings. Its intended output is a WAO-endorsed scientific document supporting regulators, food business operators, patient organizations and healthcare professionals.

PAL-ID
The Patient Identikit for Individualized Decisions on Precautionary Allergen Labelling

PAL-ID, a new initiative within its program on the use and practice of precautionary allergen labelling (ACT-UP!), will develop an internationally agreed clinical “identikit” to guide individualized advice on foods carrying precautionary allergen labelling (PAL). Its purpose is to help clinicians and patients identify circumstances in which consumption may be considered following appropriate assessment, and those in which continued avoidance is warranted.

PAL-related decisions require consideration of the patient’s clinical history, reaction threshold where known, sensitization profile, comorbidities and relevant cofactors, alongside product-related information and the patient’s preferences. A structured framework could support more consistent counselling, reduce unnecessary dietary restrictions and improve the quality of shared decision-making.

Through evidence review and an international Delphi consensus, PAL-ID will identify and prioritize the clinical, laboratory and contextual factors relevant to these decisions. The intended outputs include a practical clinical framework, a scientific publication and educational resources for clinicians and patients. Development and validation of predictive models would be addressed in subsequent work.

WHO MAY PARTICIPATE
Expressions of interest are welcomed from scientific and professional organizations, researchers, food business operators and their associations, patient organizations, public authorities and other interested stakeholders.

Participation may include contributing expertise, sharing relevant consumption data or methodological experience, supporting implementation, or providing financial support. Scientific independence and governance will be maintained in accordance with WAO policies, with transparent acknowledgement of support.

HOW TO EXPRESS INTEREST
Submit your organization’s name, contact person, relevant expertise and proposed contribution through this form by 31 December, 2026.

Or send your questions/comments by email to: ACT-UP@worldallergy.org

We look forward to working with you on these important initiatives!