“May contain“ often refers to cross-contamination. For some people small amounts of allergens will not cause a problem.
Companies who want to sell their products to people with allergies should be required to actually spend the time and money to be reasonably sure that their products won't kill them. Instead companies want to be able to avoid that expense and just slap on a "Probably safe, but who knows?" label and hope that people with allergies will just buy the product and take their chances.
Honestly, I side with the companies on this one. It's just a matter of incentives - if the consequence of "getting it wrong" (i.e. saying a product is free of an allergen but then through some chance of cross-contamination that it ends up killing somebody) are enormous, I think it's hard to fault a company that then decides to explicitly add nuts, sesame, etc. to a product and explicitly state "You should not eat this if you have allergies."
More to your point, though, when you say "Which is one reason why some people will be tempted to roll the dice and end up dead or in the ER", I think that's huge hyperbole. Every single person I've ever known that has a severe allergy never "rolls the dice", and on the contrary they are extremely diligent about double checking that what they eat is allergen free. On the flip side, I've known people that have mild allergies to products (e.g. symptoms are on the level of lactose intolerance) who don't worry about avoiding trace amounts of allergens. Why conflate these 2 cases? I have certainly never known actual people with these differing levels of allergies to confuse their issues.
The problem with making it okay to just put a "this may or may not kill you" label on products is that more and more companies will do it just to shield themselves from liability regardless of what is in their foods (it's cheaper to add a label and not add an unnecessary ingredient than to add the ingredient and also label your product) so we seem to agree there. When every company has a "this might kill you, but maybe not" label just to cover their asses, large amounts of products are then made off limits to people who don't want to take the risk. When every company is using the "may contain" label as a shield and people start to think "Every company just puts that label on everything even when it's perfectly safe" they will take more chances too.
> Every single person I've ever known that has a severe allergy never "rolls the dice",...I've known people that have mild allergies to products (e.g. symptoms are on the level of lactose intolerance) who don't worry about avoiding trace amounts of allergens.
Again, the problem is that when people with mild allergies to products keep eating them it can cause them to have a severe allergic reaction and that leads to deaths and ER visits. It's not hyperbole, it's fact. Repeated exposure can increase severity and sensitivity and so people who feel safe with trace amounts because they have "always" only had a mild reaction in the past do roll the dice and some of them lose. Those people are also less likely to have epi pens to save them when they finally do run into trouble.
All the people you've known are welcome to keep playing that game, but generally the smart thing is to always avoid foods that you know cause your immune system to react no matter how mildly unless you're doing it under care of a doctor.
Where can one learn more about this? I thought allergy immunotherapy was about repeated exposure to the allergen. I'm not up to speed on allergies. Does anyone know how many sesame related allergy deaths there are in the U.S.?
https://www.aaaai.org/tools-for-the-public/latest-research-s...
"After primary sensitization, the allergic immune response is boosted with repeated exposure" (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4414527/)
Lots of other things can effect sensitivity/severity too including age, stress, hormones, etc.
That's why if you're going to try to increase your tolerance to something you're allergic to through exposure it should always be done under the care of a doctor who will explain the risks, including the risk that your allergy becomes worse and your sensitivity to it higher. If the exposure isn't being done under observation you'll likely be given an epi pen. Desensitization therapy can help some people, but because of the risks it's often done for people who already have severe reactions and it can require a potentially lifelong commitment to taking some daily amount of the allergen in order to keep the benefits. It's not for everyone, but I wouldn't tell someone not to at least look into it with their doctor, especially with foods that are very hard to avoid.