Supplementary Material for: Accidental ingestion of allergic food at eating-out and home meal replacement by children with food allergy

Introduction In Japan, there are no regulations for allergy labeling in eating-out and home replacement meal (HRM). Consequently, patients with food allergy are at risk of accidental ingestion when using these services. It is necessary to understand the current situation of accidental food ingestion at eating-out and HRM to consider related legislation in the future. Methods A web-based survey was conducted from August to September 2021 among patients participating in the survey. The survey included information on the use of eating-out and HRM, frequency of accidental ingestion, medical institution visits and treatment, and reasons for accidental ingestion. Results There were 1141 valid responses, with 8 (5–15) years as the median age of the participants. Moreover, 769 (67.4%) participants had a history of anaphylaxis, 622 (54.5%) experienced accidental ingestion, of which 485 (42.5%) and 348 (30.6%) occurred while eating-out and at HRM, respectively. A total of 71 (14.6%) and 31 (8.9%) participants who had accidental ingestion while eating-out and at HRM, respectively, required hospitalization. Age, milk allergy, and a history of anaphylaxis were risk factors significantly associated with accidental ingestion. The reasons for the accidental ingestions were personal and store-side error for a total of 438 cases of 356 cases, respectively. Discussion/Conclusion It is necessary for both stores and patients to take measures to prevent accidental ingestion in eating-out and HRM. Additionally, the fact that the lack of allergy labeling guidelines for eating-out and HRM, is a major factor in the occurrence of accidental ingestion.