Following at least three deaths, the United Kingdom government has launched a consultation — referred to as a public comment period in the United States — on food allergen labeling laws.

Outlets selling pre-packaged food directly for sale could be required to follow new rules. An estimated 2 million people in the U.K. have a food-related allergy. The consultation is open until March 29.

Natasha Ednan-Laperouse died in 2016 after an allergic reaction to a Pret a Manger baguette. Celia Marsh is also believed to have died after an allergic reaction to a product bought from the same chain in December 2017 but the inquest is ongoing. Megan Lee died in 2016 after ordering a takeaway meal that contained peanuts. The takeaway restaurant’s owner and manager were recently jailed for manslaughter. An unnamed man died in 2017 following a severe anaphylactic shock after eating an Indian takeaway containing peanuts in North Yorkshire.

The Food Standards Agency (FSA) in England, Northern Ireland and Wales is working with the Department for Environment, Food & Rural Affairs (Defra), Food Standards Scotland (FSS) and the Department for Health and Social Care on amendments to the Food Information Regulations 2014 (FIR).

The rules address celery, crustaceans, eggs, fish, gluten, lupin, milk, mollusks, mustard, peanuts, sesame seeds, soybeans, Sulphur dioxide and sulphites, and nuts.

Under current laws, food prepared on the site wher it is sold is not required to be labeled with allergen information. Health officials say that can cause consumers to assume the food does not contain allergens, which may not be the case.

Proposals could see full ingredients labeling required by law. Products such as packaged sandwiches or salads made by staff would be included. The proposed changes do not cover precautionary statements on unintentional presence of food allergens due to cross-contamination or non-prepacked food ordered via phone or the internet, such as a takeaway pizza.

Heather Hancock, FSA chair, said the review is looking at whether businesses should do more to keep customers safe.

“Clear, accurate and visible allergen labeling is vital to protect the thousands of people at risk of allergic reactions, when buying their daily sandwich, salad or snack to eat on the go. Food businesses have a duty to protect people with food allergies and we welcome the real progress that many have made,” she said.

Four options have been put forward:

mandating full ingredient lists on labeling;

mandating allergen-only labeling on food packaging;

mandating “ask the staff” labels on all products, with supporting information for consumers available in writing; and

promoting best practices regarding communicating allergen information to consumers.

Michael Gove, environment secretary, said: “We want to ensure that labels are clearer and that the rules for businesses are more consistent – so that allergy sufferers in this country can have confidence in the safety of their food. Many businesses are already bringing changes on board independently, and in the meantime they should continue doing all they can to give consumers the information they need.”

Labeling costs have been estimated to be £10.99 ($14.50 U.S.) per stock keeping unit (SKU) for small and micro businesses and £1,978.59 ($2,600) per SKU for medium and large businesses if option three is chosen. Mislabeling is the most common reason for product recalls of pre-packed goods so adding an “ask the staff” label could increase the risk of such incidents.

Geoff Ogle, FSS’s chief executive, said the public consultation is an important opportunity for people to provide opinions and suggestions.

“It’s a matter that affects thousands of people at risk of allergic reactions daily, who have to be particularly careful when eating outside of the home. Everyone with a food allergy should have the information they need to stay safe, and I encourage everyone to give their views,” he said.

“After the consultation, all responses will be shared and considered by FSS’s board alongside the other agencies involved. We will then provide independent advice to Scottish ministers to consider the next steps.”

Incidents of suspected food allergy reactions are not automatically communicated to the relevant local authority nor to the FSA. The agency and local authorities in Yorkshire have looked at a pilot program to improve notification of incidents between businesses, local authorities, and the NHS. Reported near misses would trigger a priority inspection of the food firm through the local authority to ensure non-compliance is identified and resolved.

Carla Jones, CEO of Allergy U.K., said whilst the organization believes those living with allergies must be vigilant, the broader food industry must do more for the allergic community.

“In the U.K., about 10 people die every year from food-induced anaphylaxis, there are also about 1,500 asthma deaths, some of which might be triggered by food allergies. For those at greatest risk, the tiniest trace of a food allergen can trigger severe symptoms and, in some cases, cause fatal or near-fatal symptoms. We encourage all those living with allergies to engage with this consultation to ensure their views on this important issue are heard.”

Leaders of The Anaphylaxis Campaign said people with food allergies must be able to make informed decisions and to assess risk and self-manage their conditions.

“We hope all food business that sell food pre-packed for direct sale engage with this consultation to ensure that feasibility across all business sizes is taken into consideration. We also hope food allergic individuals actively take part in this consultation and share their views on how they want this incredibly important information shared with them,” according to a statement from the charity, which supports those at risk of severe allergies.