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EU Policy update – May 2014

Currently the European Union institutions are carrying out several consultations that are relevant to EFA’s activities. In this section, you will find information about the consultations on (1) fragrance allergens, (2) primary care definition, and (3) air quality, (4) allergenic foods and food ingredients for labelling purposes’, as well EFA’s position on the mentioned issues, prepared in close collaboration with our members. In addition, EFA’s briefing on Tobacco Products Directive is presented.

Consultation on fragrance allergens

EFA has recently presented its position, in consultation with members on fragrance allergen on an open consultation held by the European Commission. At EFA we know that cosmetic products cause a wide range of allergic reactions. Around 1 to 3% of the European citizens and 16% of eczema patients are affected by allergies caused by cosmetics containing fragrances. Some people experience itching, burning or stinging within minutes of using a product, other more adverse reactions to fragrances in perfumes and cosmetic products are also possible.

03. EU policy update (fragance allergens)Our position refers to the Scientific Committee on Consumer Safety (SCCS) new opinion on fragrance allergens and cosmetic products which only includes contact allergens. However, it has been  recognised that perfume also exposes the eyes and naso-respiratory tract and that 2 to 4% of the adult population is affected by respiratory or eye symptoms. Moreover, it is also known that exposure to fragrances may exacerbate pre-existing asthma. Therefore, taking into account respiratory allergens is crucial, as 113 million European citizens suffer from allergic rhinitis and 68 million from the allergic asthma. EFA’s response to the consultation recommends focusing not only on fragrances but also on preservatives to ensure a comprehensive approach on citizens’ safety.

The other changes that might take place as a result of the Commission consultation include an increased number of fragrance allergens (currently there are 26), which should be explicitly mentioned on cosmetic products. EFA encourages the Commission to further regulate the mix of fragrances that could be more problematic for allergic people that single products. The example of the pharmacovigilance system that is in place for the medicinal products could be followed and adopted both at the national and EU levels, thus allergic people could report experienced adverse reactions with cosmetics to their doctor and national authorities.

EFA’s response to the European Commission consultation can be found here.

Committee of Regions consultation on air quality

As a follow-up to the meeting held in the Committee of Regions on May 8th on the recently proposed package on air quality, a stakeholder/expert consultation was launched in the institution representing local and regional authorities at a European Union level. EFA responded by stating the importance of clean air for all, and especially for the more vulnerable people affected by allergy and respiratory diseases.

Air is crucial for every person’s life: an average human can live without breathing only around 5 minutes and an adult breathes 15 cubic meter of air every day. The quality of air we breathe is also very essential, as it determines our health and life quality.

02. Know your air for health (London smog)In its report on the quality of the air in Europe in 2013, the European Environment Agency (EEA) estimated that in urban areas 85% to 98% of the population is exposed to levels of pollution that are above the World Health Organisation (WHO) air quality guidelines, with more than 30% above the EU level which is much lower than WHO standards.

Short-term effects of air pollution are particularly affecting patients with respiratory and cardiovascular diseases. In particular, air pollution contributes to respiratory diseases: the APHEKOM study (Improving Knowledge and Communication for Decision Making on Air Pollution and Health in Europe) found out that living near polluted roads could be responsible for about 15-30% of all new cases of asthma in children; and of COPD in adults 65 years and older. Moreover, the Global Burden of Disease study showed that in 2010 over 430,000 premature deaths occurred and over 7 million years of healthy life were lost in Europe from exposure to fine particulate matter (PM2.5).

Together with other non-governmental organisations working in the environmental and public health field, EFA underlined four main priorities:

1. Adoption of more ambitious emission reduction commitments in the revision of the National Emission Ceiling (NEC) directive for existing and “new” pollutants;

2. Adoption of sector legislation to cut emissions from all major sources;

3. Enforcement and strengthening of ambient air quality limit values;

4. Reduction of indoor air pollution.

In addition, tobacco smoke also contributes to air pollution and has hazardous effects on our health. Tobacco kills nearly six million people each year, of which more than 600,000 are non-smokers dying from breathing second-hand smoke. To highlight the health risks associated with tobacco use and advocate for effective policies to reduce tobacco consumption on May 31st, together with the rest of the world, we celebrate World No Tobacco Day. EFA’s and our members’ activities during that day will be highlighted in the next edition of the newsletter.

European Food Safety Authority consultation on allergenic foods and food ingredients for labelling purposes

In May, the European Food Safey Authority (EFSA) launched a draft opinion on the evaluation of allergenic foods and food ingredients for labelling purposes. This document updates previous EFSA opinions on food ingredients or substances with known allergenic potential listed in Annex IIIa of Directive 2003/89/EC. The draft opinion includes sections on:

  • the prevalence of food allergies in unselected populations;
  • proteins identified as food allergens;
  • cross-reactivities;
  • the effects of food processing on allergenicity of foods and ingredients;
  • methods for the detection of allergens and allergenic foods;
  • doses observed to trigger adverse reactions in sensitive individuals;
  • approaches used to derive individual and population thresholds for selected allergenic foods.

Interested parties are invited to submit written comments by August 8th 2014. For more information please visit: http://bit.ly/1noUDca. EFA will respond and provide the perspective of patients with allergy. We will consult with members and keep you updated.

Tobacco Products Directive enters into force

In May, the Tobacco Products Directive entered into force. The new Directive introduces new provisions regarding health information and warnings, packaging, labelling, information on additives and manufacturing, and control of tobacco products.03. EU Policy Update (Tobacco Products Directive - EC Packaging example)

The Directive has a particular focus on youth and is aimed to limit the purchase capacity of tobacco products by this group, as 70% of the smokers start smoking before the age of 18 and 94% before the age of 25 years, therefore. To make cigarettes less attractive, small cigarette packs will be banned: from 2016, cigarette packs will be sold in a cuboid shape and contain at least 20 cigarettes, while roll-your-own tobacco packages will contain at least 30g of tobacco. Another novelty is that no flavorings will be allowed in cigarettes and roll-your-own tobacco products. A further analysis of the Directive’s provisions can be found here.

Member States have a two-year transposition period to implement the provisions contained in the Directive.

Consultation on primary care definition

The European Commission and the Expert Panel on Effective Ways of Investing in Health (EXPH) have finished a public consultation on the “Definition of a frame of reference in relation to primary care with a special emphasis on financing systems and referral systems”. The preliminary opinion is available here.

EFA commented and supported the response of our partner, the International Primary Care Respiratory Group (IPCRG), and provided the patients’ perspective highlighting the following aspects:

  • Not only doctors and other health professionals play a valuable role in healthcare. Healthcare assistance, nurses and pharmacists, could potentially play an important role in promoting early diagnosis; therefore this should be taken into account while developing definitions related to healthcare workers.
  • Differences between community-based care and primary care should be further identified. Furthermore, there is need to work on the role of referral systems, as there is often a lack of continuity between secondary and primary care, especially in case of highly prevalent long term conditions, such as asthma and chronic obstructive pulmonary disease (COPD). For instance, different responsibilities of general practitioners and specialists for respiratory care in Europe can create a complex situations for patients who must rely upon adequate cooperation between those working in primary care and other specialties.
  • Lack of consistent patient education on the use of inhaled medicines leads to significant and expensive waste, thus patients’ literacy should be increased. It may be stimulated by innovative technologies, such as mobile and electronic health. The use of information and communication technologies is expected to contribute to patients’ empowerment, and improving communication between patients and health professionals, while ensuring better disease monitoring.
  • Primary care should be patient-centered and this could be enhanced by patients’ involvement in decision-making on their treatment. Patient should be well-informed on various treatment options to make informed decisions.

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