Sebastien La Vieille

Health Canada | HC · Branch of Health Products and Food (HPFB)

Background Despite the widespread use of precautionary allergen labelling (PAL) by manufacturers, PAL remains poorly understood by consumers and allergists in Canada. The aim of this study was to investigate the perceptions of allergic consumers and allergists on PAL. Methods An online survey was sent to consumers registered in Food Allergy Canada...

In most countries, the use of precautionary allergen labelling (PAL) is not governed by regulation. PAL was initially identified as a judicious risk management measure to address instances of « unavoidable » cross-contact with priority food allergens during food processing. However, PAL has gradually been devalued, in part due to overuse and incons...

Background: Limited data exist on the economic burden of food allergy (FA). Objective: To assess FA-related direct (healthcare and out-of-pocket) and indirect (lost productivity) costs and their determinants in Canadian children and adults self-reporting FA. Methods: FA-individuals self-reporting a convincing history and/or physician diagnosis were...

Most Canadian food allergy data has focused on Health Canada’s priority food allergens. This study describes which non-priority (emerging) food allergens were most commonly reported by Canadian parents and categorized/confirmed by allergists. A secondary aim was to describe severity of allergic reactions to emerging allergens. Parents reported alle...

Introduction We conducted a nationwide Canadian telephone survey on food allergy prevalence between February 2016 and January 2017, targeting vulnerable populations (New, Indigenous, and lower-income Canadians). Objective To examine the independent effect of demographic characteristics on food allergy. Methods Canadian households with vulnerable...

The impact of caffeinated energy drinks (CEDs) on the cardiovascular (CV) response to exercise has not been well described. A systematic review and meta-analysis was conducted on the acute effects of CEDs on CV responses during dynamic, aerobic exercise in 296 healthy adult males (224) and females (72) in 21 randomized controlled trials. During exe...

Despite the intensive use of sesame in the Middle Eastern diet, studies on this allergen in this region are lacking. A survey on the occurrence of sesame in Lebanese food products that did not contain this allergen as an ingredient, a food consumption survey conducted in Beirut schools, and the most recent sesame eliciting dose estimates were used...

Regional and national legislation mandates the disclosure of “priority” allergens when present as an ingredient in foods, but this does not extend to the unintended presence of allergens due to shared production facilities. This has resulted in a proliferation of precautionary allergen (“may contain”) labels (PAL) which are frequently ignored by fo...

In Canada, caffeinated energy drinks (CEDs) currently sold under Temporary Marketing Authorizations must meet strict eligibility criteria. These criteria, which include compositional and labelling requirements, were developed based on the outcome of a health risk assessment conducted by Health Canada (HC) in 2013. HC updated its assessment by revie...

Precautionary allergen labeling (PAL) is widely used by food industries. Occurrence studies revealed that few analyzed products contained the allergen(s) present in the statement, but little is known in Canada. To improve manufacturing practices and better manage allergen cross-contamination, occurrence data is needed to determine the exposure of a...

The risk of having an allergic reaction in milk-allergic individuals consuming products with precautionary allergen labelling (PAL) for milk has been rarely studied in products such as dark chocolate, cookies, and other baked goods. A probabilistic risk assessment model was developed to estimate potential risks. Milk occurrence and contamination le...

In 2 randomized studies addressing peanut allergy (Canada-Food Allergy Risk Management 1 [NCT01812798] and Peanut Immunotherapy Starting in Canada, Evaluation and DiScovery [NCT0 1601522]), we quantified peanut allergen thresholds to food challenge using Bayesian stacked model averaging to inform policy and clinical practice. About 50% of patients...

Food allergies are life-threatening conditions that allergic individuals can avoid by consulting the food labels before consuming. Precautionary allergen labelling (or PAL), to warn against possible allergen cross-contamination, is widely used by food industries, reducing the food choices for allergic individuals. In Canada, there is limited inform...

Introduction : Biphasic anaphylactic reactions are a concern in emergency medicine. Risk factors associated with this type of reaction remain ill-defined. The aim of this study was to investigate elements associated with biphasic anaphylactic reactions and to determine the impact of anaphylaxis treatments on biphasic reactions. Methods : From the m...

Background Studies assessing the use of antihistamines and corticosteroids for the treatment of anaphylaxis have not supported a conclusive effect. Objective To assess prehospital management of anaphylaxis by measuring the effect of epinephrine use compared with antihistamines and corticosteroids on negative outcomes of anaphylaxis (intensive care...

Background Lupine is a member of the legume family and is often used in many food products in Europe (e.g. pasta, pizza, sauces, etc.) as a wheat or soy substitute. Lupine cross-reacts with peanut, and cases of allergic reactions to lupine in peanut-allergic patients have been reported in Europe mainly. In contrast, lupine as an ingredient in food...

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common enzyme deficiency in the world and renders those affected susceptible to potentially severe oxidative hemolysis. Although the resulting hemolysis is most often associated with drug exposure, it has also been reported after consumption of certain foods. With the exception of revi...

Introduction: Data is sparse on drug-induced anaphylaxis (DIA) and there have not been studies assessing the differences in clinical characteristics and management of DIA between adults and children. Objective: We assessed the percentage, diagnosis, and management of DIA among all anaphylaxis visits in three pediatric and one adult emergency dep...

Food-related allergic reactions are the leading cause of anaphylaxis and emergency department visits and hospital admissions for food-induced anaphylaxis in children are increasing. Strict avoidance of food allergens is the main strategy in prevention of food-induced anaphylaxis and there are continuous efforts to educate patients and caregivers an...

Background: There are no data on the percentage of visits due to anaphylaxis in the emergency department (ED), triggers, and management of anaphylaxis across different provinces in Canada. Objective: To compare the percentage of anaphylaxis cases among all ED visits, as well as the triggers and management of anaphylaxis between two Canadian pedi...

Objectives: To determine the recurrence rate of anaphylaxis in children medically attended in an emergency department (ED), we performed a prospective cohort study to evaluate prehospital and ED management of children with recurrent anaphylaxis and to assess factors associated with recurrent anaphylaxis. Study design: As part of the Cross-Canada...

As part of the multicenter C-CARE (Cross-Canada Anaphylaxis Registry) project, this study aimed to describe the characteristics of anaphylactic reactions and assess if emergency physicians follow treatment guidelines. Methods: A cohort study was conducted in the emergency department of Sacré-Cœur Hospital, a university-affiliated, urban tertiary ca...

Table of contents A1 Role of fibrocytes in allergic rhinitis Marie-Ève Côté, Marie-Ève Boulay, Sophie Plante, Jamila Chakir, Louis-Philippe Boulet A2 Patterns of aeroallergens sensitization in Northern Alberta Hanan Ahmed, Maria-Beatriz Ospina, Kyriaki Sideri, Harissios Vliagoftis A3 Addressing acceptable risk for adolescents with Food-Induced Anap...

This paper provides an overview of the latest scientific data related to the safety of uncontaminated oats (<20 ppm of gluten) in the diet of individuals with celiac disease (CD). It updates the previous Health Canada position posted on the Health Canada website in 2007 and a related paper published in 2009. It considers a number of recent studies...

Data on anaphylaxis cases in pre-hospital settings is limited. As part of the Cross Canada Anaphylaxis Registry (C-CARE), we assessed anaphylaxis cases managed by paramedics in Outaouais, Quebec. A software program was developed to prospectively record demographic and clinical characteristics as well as management of cases meeting the definition of...

Background: The diagnosis of anaphylaxis currently relies on suggestive clinical history after exposure to a potential triggering factor because no reliable diagnostic marker is available to confirm the diagnosis. Objectives: We aimed to evaluate tryptase levels in children with anaphylaxis and to examine predictors of elevated tryptase level (d...

Studies suggest an increase in food allergy prevalence over the last decade, but the contributing factors remain unknown. The aim of this study was to evaluate the association between the most common food allergies and atopic history, sociodemographic characteristics and lifestyle habits. We conducted a case-control study nested within the SPAACE s...

Background: The Cross-Canada Anaphylaxis Registry (C-CARE) assesses the triggers and management of anaphylaxis and identifies predictors of the development of severe allergic reactions and of epinephrine use. Here, we present data from an urban adult tertiary care emergency department (ED) in Montreal, Canada. Methods: Potential anaphylaxis case...

Background Studies suggest that individuals of low education and/or income, new Canadians (immigrated <10 years ago), and individuals of Aboriginal identity may have fewer food allergies than the general population. However, given the difficulty in recruiting such populations (hereafter referred to as vulnerable populations), by using conventional...

BACKGROUND Studies suggest that rates of anaphylaxis, the most severe form of an allergic reaction, are increasing in Pediatric Emergency Departments (PED). Significant gaps still exist regarding the prevalence, triggers and temporal trends of anaphylaxis in Canada. OBJECTIVES The Cross-Canada Anaphylaxis Registry (C-CARE) was created with the pri...

Avoiding exposure to gluten is currently the only effective treatment for celiac disease. However, the evidence suggests that for most affected individuals, exposure to less than 10 mg/day is unlikely to cause histological changes to the intestinal mucosa. The daily diet of people with celiac disease does not rely solely on gluten-free pre-packaged...

Data on anaphylaxis cases in pre-hospital settings is limited. As part of the Cross Canada Anaphylaxis Registry (C-CARE), we assessed anaphylaxis cases managed by paramedics in Outaouais, Quebec. A software program was developed to prospectively record demographic and clinical characteristics as well as management of cases meeting the definition of...

A large national investigation into the extent of gluten cross-contamination of naturally gluten-free ingredients (flours and starches) sold in Canada was performed. Samples (n = 640) were purchased from eight Canadian cities and via the internet during the period 2010-2012 and analysed for gluten contamination. The results showed that 61 of the 64...

Celiac disease can present with mild or nongastrointestinal symptoms, and may escape timely recognition. The treatment of celiac disease involves a gluten-free diet, which is complex and challenging. To evaluate clinical features and symptom recovery on a gluten-free diet in a Canadian adult celiac population. All adult members (n=10,693) of the tw...

Background Data suggest that Aboriginal people may experience lower rates of food allergy compared with the general population. However, there have not been any population-based studies to estimate the prevalence of food allergy among Aboriginal People in Canada. Given this gap in the literature, the goal of this study is to estimate the prevalence...

Since 2005, European food regulations require major allergens, including peanut, to be declared on the label where the allergen is intentionally present in the food. However, even if not mentioned in the list of ingredients, peanut allergen may be inadvertently present in a large range of packaged food and consequently may affect many peanut allerg...

Objective: Strict adherence to a gluten-free diet is the only treatment for coeliac disease. The gluten-free diet is complex, costly and impacts on all activities involving food, making it difficult to maintain for a lifetime. The purpose of this cross-sectional study was to evaluate the difficulties experienced, the strategies used and the emotio...

Background Poor response rates in prevalence surveys can lead to nonresponse bias thereby compromising the validity of prevalence estimates. We conducted a telephone survey of randomly selected households to estimate the prevalence of food allergy in the 10 Canadian provinces between May 2008 and March 2009 (the SCAAALAR study: Surveying Canadians...

Peanut allergy is a public health concern, owing to the high prevalence in France and the severity of the reactions. Despite peanut-containing product avoidance diets, a risk may exist due to the adventitious presence of peanut allergens in a wide range of food products. Peanut is not mentioned in their ingredients list, but precautionary labeling...

La prévention occupe aujourd'hui une place grandis-sante dans les politiques de santé, à l'heure des réflexions sur les systèmes de santé, leur organisation et leur pérennité. D'abord envisagée comme la prévention de maladies particulières (par exemple diabète et maladies cardio-vasculaires), elle englobe les différents dépistages orga-nisés à l'éc...

The mission and tasks of the European Food Safety Authority (EFSA) include the responsibility to set up a system for identifying emerging risks. In 2007, the EFSA Scientific Cooperation (ESCO) Working Group (WG) on Emerging Risks received a mandate by the EFSA to propose an operational strategy to achieve this task. Since then, 11 meetings have bee...

Les implications sanitaires de certaines proliférations microalgales responsables de la production de toxines en milieu marin (phycotoxines) ne sont appréhendées en France que depuis une vingtaine d'années. Les effets de ces toxines chez l'homme, survenant après consommation le plus souvent de coquillages mais aussi de poissons tropicaux ayant accu...

The labelling of pre-packaged food products, subjected to the requirements of directive 2003/89/CE, is now more exhaustive than previously. However, the unintentional presence of allergens in these products is still an issue. The French food safety agency has raised questions about the implementation of good manufacturing practices in French food i...

A total of 1873 strains from human origin and 4283 strains from non-human origin of Salmonella enterica serotypes Typhimurium, Enteritidis, Heidelberg, Hadar and Virchow, collected over three years 1993, 1997 and 2000, were examined in order to determine the rate of antimicrobial resistance to 12 antimicrobial drugs. The objective of the study was...

In France, main allergens of animal origin are eggs, cow milk, fish and shellfish. They are more represented in allergy of childhood while allergy to the crop products more often meet in adult population. However clinical symptomatology with the ingestion of these allergens is nonspecific. A food consumption survey and biological analyses are thus...

In 2001, the epidemiological surveillance of the most human food infectious diseases and of the concerned animal diseases is done, in France, by several methods. Most human infectious diseases are monitored by one or more of the five following broad categories of networks: reporting of notifiable diseases, the CNRs, the network of sentinel doctors,...

In June 1999, a surveillance network of food alerts was created within French Agency for Food Safety (AFSSA). The aims of this surveillance network are: 1) to inform about food alerts inside agency management and to the others partners involved in food safety; 2) to follow information and to perform statistical analysis to identify a health t