Chris Pearce's Blog, page 33

Food allergy, intolerance, toxicity and aversion

Food allergies and food intolerances relate to the adverse reactions that occur in some people after consumption of certain foods. Allergies and intolerances are often mistaken for each other. Basically, a food allergy is where the immune system is upset after a particular food, whereas a food intolerance is where the digestive system is affected rather than the immune system. Compared with food intolerance, food allergy is less common but reaction is usually quicker and more severe. Other bad reactions to food are food toxicity and food aversion.

Food allergies

A food allergy occurs when tissue reacts abnormally to an antigen within the food, which can be a protein, something bound to it, or a food additive. The result is cell damage and histamine release, triggered by the antibody IgE. But the immune system is an amazing thing. Enzymes can change the constitution of food in the intestine, reducing the effect of the allergen. An antibody called IgA further reduces the allergen’s penetration. However, reaction can occasionally be severe and even life-threatening. An allergy can be caused by a very small amount of a food and can happen quite quickly. The protein or additive causing the reaction is actually harmless and has no adverse effect in most people.

Allergy rates are increasing worldwide. Babies and children are more prone to food allergies due to their naturally weaker immune systems. An estimated 6-8 percent of children currently suffer from food allergies compared with 2-4 percent of adults. Young children will often outgrow their allergies. However, allergies to foods such as nuts and fish are likely to remain.

Sometimes allergies run in families and can be hereditary. If a family member has an allergy, a child is 20-40 percent more likely to have an allergy. This increases to 50-80 percent if more than one member has an allergy. Breastfeeding helps strengthen a baby’s immune system and reduces the risk of allergies. Exposure to cigarettes, dust, mold, fur, and solid foods too early in an infant’s life all increase the risk.

Food intolerances

Food intolerance, on the other hand, can be the result of several things. A non-allergic histamine can be released after eating certain foods, such as shellfish or strawberries. The symptoms are often similar to a food allergy, with victims suffering headache, vomiting, facial swelling, urticaria around the body, and diarrhea. On many occasions, all that is required is anti-histamine tablets.

Then there are metabolic defects that can cause food intolerance. For example, people lacking the lactase enzyme will have trouble digesting milk or ice cream. Those intolerant to gluten in wheat can suffer celiac disease from eating bread. Another type of intolerance is where large quantities of certain food substances act like a drug in the body. An example is caffeine, which can cause palpitations and migraines. Various food additives such as colorings and flavorings can result in an intolerance in certain people. For example, sulfur dioxide affects about 40 percent of children with asthma.

Main foods causing allergies and intolerances

Main foods causing allergies include nuts, eggs, milk, sesame, fish and other seafood, grains such as wheat, and soy. Others are fruit, berries, potatoes, tomatoes, and cucumber.

Food allergy symptoms usually come on quicker than those of intolerance and can include an itchiness, burning or swelling of the mouth, tongue or lips, as well as a runny nose, rashes, urticaria, difficulty breathing, nausea, vomiting, cramps, diarrhea, and anaphylaxis where the airway can be blocked within minutes and the person can die of suffocation.

The causes of food intolerance are largely meat and dairy products, including milk, cheese, chocolate, eggs, fish, pork and chicken, but also food additives, flavor enhancers, strawberries, citrus fruit, tomatoes, and wine. Vegetarians tend to suffer less from food intolerance as they don’t eat dairy or meat.

Symptoms of food intolerance vary from person to person but some of the more common ones are headache, sweating, tremor, rapid breathing, nausea, vomiting, diarrhea, burning sensation, urticaria, face and chest tightness, and asthma. Longer term symptoms can include migraine, fatigue, anxiety and depression. Thus some symptoms are common to food allergies and food intolerances, sometimes making diagnosis more difficult.

Food toxicity

Neither food allergy nor food intolerance should be confused with food toxicity, where food is spoiled or becomes contaminated and the person suffers food poisoning from eating it. If you’re the only person to eat something and suffer, it’s hard to know if it’s food toxicity or another type of adverse reaction to food. However, if the whole family is sick or if a number of people at a party or restaurant are sick, then it’s probably food toxicity.

Food aversion

A fourth bad reaction to food is called food aversion, and is where a person convinces themselves that a particular food disagrees with them but tests find nothing. It is quite common.

There are several steps to take to avoid any of the four adverse reaction types to food. Determine what is causing the reaction by keeping a diary of food consumption and symptoms. Avoid the suspected foods one at a time. If you find the culprit, avoid it altogether. Check food labels to make sure it’s not in the products you buy. If you can’t isolate the problem, have skin prick and blood tests. Your doctor and dietician should be able to provide further advice.

My own experience with allergy tests

Further to my article, ‘Allergic reaction: swollen lips’  (https://chrispearce52.wordpress.com/2015/07/18/allergic-reaction-swollen-lips/), I went to a pathology clinic and got a skin prick test done. My forearms were cleaned with alcohol before they were marked with rows of dots using a special dye, so the spot where each allergen was to be applied wasn’t lost. Each allergen was applied with a new lancet next to a dot. The instrument hardly broke the skin’s surface.

Using a single needle, I was tested for 89 substances, which meant 89 needle pricks in close succession, probably quicker than one per second. Each allergen was then applied to the surface of the skin at the point of each skin prick. On a scale of 0-5, with 0 being a negative reaction and 5 being a severe positive reaction, I rated 0 for about 75 substances and 1 for the rest, with a 1 usually indicating an inconclusive result or no allergy. My allergies continued, so for me, the skin test wasn’t accurate. The accuracy of skin tests varies from person to person.

Another way to test for allergies is hair sample analysis, although it is not generally supported by the medical fraternity as an accurate way to find food and other allergies. However, I decided to try it as, for me, the skin prick test hadn’t worked.

I sent a sample of hair in a plastic bag in the mail to a naturopath who offered this service and who lived about 60 miles to the north. The results came back a week later. He had tested for over 250 food and other items and found that I was allergic to the following:

– soy sauce

– Gravox

– Vegemite (a food paste made from yeast extract)

– Promite (a vegetable and yeast extract)

– cabbage

– peas

– hazel nuts

– oat bran

– So-Good (a soy milk product)

– Diet Coke

– green tea

– baby shampoo

– kerosene

– gold.

I found the results to be reasonably accurate. By the time I did the hair test, my allergies had improved considerably but I was still getting a bit of discomfort like a kind of heartburn from time to time. I eliminated the foods I had been eating that came up positive in the test and the discomfort disappeared.

This was about 15 years ago and I have had no real problems since. More recently, I have tried Vegemite occasionally and also peas and have had no reactions. Interestingly, I have gold caps on several back teeth and these seem fine. Also, I have worn a gold wedding ring for over 30 years and have never had any problems, so perhaps the gold finding (for me) wasn’t accurate.

Skin tests for allergies and their accuracy

Skin testing for allergies is one of several ways the medical profession can diagnose what allergens a patient is suffering from. Skin tests include the skin prick test, intradermal test and patch test. Other ways to test for allergies include blood tests, elimination testing, provocation testing and hair analysis.

An allergy skin test is carried out in a medical clinic by trained personnel, usually a doctor or nurse. For the basic skin prick or scratch test, the test site is cleaned with alcohol before it is marked with rows of dots with a special dye, so the spot where each allergen is applied isn’t lost. Each allergen is applied with a new lancet next to a dot. The instrument hardly breaks the skin’s surface. The preferred site is the inner forearm for adults and the upper back for children.

Many dozen substances can be tested at once, although the number will be lower if the patient has been able to narrow down the possible causes of their allergy. After 15 to 30 minutes, the nurse inspects the site for allergic reactions. A positive reaction to a substance will show up as a red mark for a mild reaction through to a larger hive or wheal for a more severe reaction.

The nurse then tests the skin for two more substances: histamine and glycerin or saline, to see if the skin is reacting to the allergens properly. Histamine causes a reaction in nearly everyone’s skin and is used as the positive control. Glycerin or saline reacts in almost no one, so it is used as the negative control. The use of these substances helps provide an indication of the accuracy of the test.

Sometimes a skin prick test is inconclusive and an intradermal test in conducted where allergens are injected into the arm. This is common if a person is thought to be allergic to penicillin or an insect bite.

A third type of test is the skin patch test where allergens are put on a pad and taped to the skin for 1 to 3 days. This test might be used to find the cause of contact dermatitis, such as latex, medication, preservative or hair dye.

Skin tests are more accurate for pollen, dust and insect bites than for food and medication. Food allergies are usually quite complex and skin test diagnosis is therefore less accurate. The only medication that can be satisfactorily skin tested is penicillin.

Further, the accuracy of tests varies from person to person. Some people test positive for a substance, yet they have outgrown the allergy or have never had a reaction to the substance before. Other people can test negative to a substance, yet they are sure they have an allergy to it. Further, test results can differ over time but the person doesn’t think their allergy is any different.

As it is not possible to be immunized for allergies, some people feel the tests are not worthwhile and simply avoid the things that cause them problems. That’s alright for those who have been able to determine the cause of their allergy. For other people, the results of a skin test are at least indicative of the problem and this is better than guessing. Some people see the results as a message – they see their skin swell up quite quickly due to a minute amount of the allergen and realize what a large amount might do, and are more careful to avoid the allergen.

There are a number of things a patient can do to increase the accuracy of a skin test for allergies. The first one is to discuss the allergy in detail with their doctor. This may include the patient’s medical history, lifestyle, diet, suspected allergies, other illnesses, symptoms, what they’ve done to treat the allergies, family history of allergies, and whether they’ve kept a food and allergy diary. If the allergen has been isolated, avoidance may be the answer and a skin test might not be necessary.

The doctor will also need to know the patient’s medication details. Some medications suppress allergies while others are likely to bring an allergy on, making skin testing less accurate. Antihistamines, antidepressants and heartburn medications can affect skin tests for allergies.

The accuracy and other aspects of allergy skin tests should be compared with alternative tests. Skin tests are regarded as safe, cheap, easy and usually reliable. The main alternative is blood tests, which search the blood for antibodies. An antibody has to be present for an allergic reaction to take place. Blood tests are less sensitive than skin tests and for this reason may be more suitable for some people. These tests are more likely to pick up food allergies than skin tests.

Elimination testing is another common test. Here, suspected foods are cut from the diet for a few weeks and then reintroduced one by one. Provocation testing is where allergens are introduced under controlled circumstances and should be supervised by a doctor. There is also hair testing, although this is not generally supported by the medical fraternity.

The accuracy of skin tests for allergies can depend on a number of factors, the most important being the type of substances a person is thought to be allergic to. Skin tests are more accurate in detecting airborne and insect allergies but less accurate for food and medication allergies. Further, the accuracy of skin tests varies from person to person.

Dealing with shellfish allergy

People with shellfish allergies can get relief from antihistamine tablets such as loratadine (Claratin) or diphenhydramine (Benadryl). Lotions such as Calamine or Caladryl ease the itchiness associated with hives. Another way is to put ice on the hives as this shrinks the blood vessels and reduces swelling. Milk of magnesia may help reduce symptoms, as can peppermint tea. For severe symptoms, it might be possible to receive an epinephrine injection from your doctor. It’s always best to see a doctor while the symptoms are present.

Skin and blood tests can be conducted for shellfish allergy. With skin prick tests, you can be tested for allergies to each type of shellfish. A blood test can measure antibodies in the blood to see how the immune system responds to shellfish protein. It’s also a good idea to wear an alert bracelet.

People with allergies to shellfish have to be careful to avoid a range of situations and prepared foods. The best way for sufferers to avoid shellfish allergies is of course to avoid shellfish altogether, but this can be difficult. If you eat at restaurants, you need to be aware of the possibilities for cross-contamination. A chef may use the same pans and utensils for cooking shellfish and other food such as fries or chicken, or these foods might be cooked in the same oil. Cross-contamination can occur in factories too, where equipment used for one product is then used for another. Beware of foods that may contain shellfish, such as bouillabaisse, fish stock, flavourings, cuttlefish ink, surimi, etouffee, gumbo, cioppino, jambalaya, chili, and various sauces and dressings.

Some people can become quite ill after consuming no more than a trace of shellfish. Or they can be affected by the steam from the cooking process, as the allergy-causing proteins can be airborne. This applies equally in restaurants and at home. If someone in the household is allergic to shellfish, it is best to move them well away from the kitchen when another family member is cooking shellfish. Further, symptoms can occur merely from handling or touching shellfish.

It might be a good idea to avoid coral calcium supplements as these have the same protein as shellfish. Omega-3 may contain shellfish, although fish is more usual, such as cod liver. Also avoid food containing gelatin.

Glucosamine is a food supplement for arthritic patients that is often put forward as a problem for people with shellfish allergies. But this is rarely the case as it is made of crustacean shells as distinct from the flesh, which is the location of the problem proteins. Vegetarian glucosamine is available in any case. Glucosamine actually occurs naturally in the body and helps repair healthy cartilage.

Some sources say there is an allergy connection between IV dye and shellfish. This is a myth. The only connection is that both contain iodine. Reaction from IV dye isn’t really an allergic reaction as the dye causes histamine release without assistance from allergic antibodies.

Labeling laws were changed in the United States in 2006 with the Food and Drug Administration’s Food Allergy Labeling and Consumer Protection Act, which specifically relates to crustacean shellfish among other foods that typically cause allergies. Labeling laws now require labels to be in plain, simple English that a seven-year-old can read. The term “may contain traces” has been banned. Instead, products that include shellfish have to state this on the label as “contains …” either separately in bold or after other ingredients. Shellfish isn’t usually a hidden ingredient in food products at any rate. Food labeled as Kosher will have no shellfish, in line with the Kosher diet.

Shellfish allergy and its symptoms can be quite alarming. Symptoms range from unpleasant hives and swelling to life-threatening whole-of-body reactions. Avoiding seafood altogether is the best option. Care should be taken when eating at restaurants. Check the ingredients on food labels. Your doctor will be able to offer appropriate treatment, including tests and medication.

Symptoms of shellfish allergy

Shellfish allergy is one of the most common types of allergies. An estimated two per cent of the population of the United States suffers from allergies to shellfish, second only to peanuts. Unlike many allergies, you can’t outgrow shellfish allergy. It usually occurs first in adulthood, although many children suffer from it too. The allergy is most common in women and boys and is likely to run in families.

Symptoms of shellfish allergies can show up in minutes or they may take hours. The most common symptoms are hives (or urticaria) and swelling (angioedema). Hives are raised red weals that can appear anywhere on the body, but usually around the stomach, back, thighs, backside, limbs, and face. Those on the torso can be the size of dinner plates. Hives can be quite itchy. Angioedema is where blood cells produce fluid that builds up in the tissues under the skin and results in swelling. Common sites are the lips, tongue and throat, but also the hands and elsewhere.

Other symptoms of shellfish allergy can include tingling in or around the mouth or throat, chest tightness, nasal congestion, wheezing, breathing difficulties, light-headedness, dizziness, fainting, nausea, vomiting, stomach cramps, and diarrhea. Symptoms usually occur each time shellfish is eaten.

Potentially the worst symptom is an acute, whole-of-body allergic reaction. This is called anaphylaxis. The worst type is anaphylactic shock where a quick release of histamines and other mediators means fluid leaks into the skin. The blood vessels dilate, causing swelling, including to the throat. This constricts the airways. Blood pressure falls, and pulse can speed up or be faint. Any of the symptoms above can also be present. Disorientation can occur as the body goes into shock. Loss of consciousness and death are a risk, although luckily this is fairly rare.

Any of the shellfish can cause these symptoms. The two main types of shellfish are crustaceans and mollusks. Crustaceans include shrimps, prawns, crabs, crayfish, lobster, sea urchins, scampi, and langoustines. Mollusks include oysters, mussels, clams, squid (calamari), octopus, cuttlefish, scallops, abalone, cockles, whelks, periwinkles, conch, quahogs, limpets, and escargot (snails). A third type is echinoderms, such as sea urchins.

The two main groups of shellfish are biologically dissimilar and, while some people are allergic to one group and not the other, there is high cross-reaction between the two groups. If a person is allergic to a certain shellfish, they are 75 per cent likely to be allergic to others. Shrimps are worst as an allergenic, although there are cases where a person is allergic to some types of shrimps but not others. There is also a cross-reaction between shellfish and certain insects. No cross-reaction exists between shellfish and fish, although people can be allergic to both food types.

Shellfish allergies are caused by the proteins in the flesh. The main allergy-causing protein in shellfish is tropomyosin. The immune system produces antibodies against the allergen, causing the release of histamines and other chemicals. Tropomyosin is also found in some supplements, as well as in dust mites and cockroaches. Allergies can also be caused by the gelatin in the skin and bones of shellfish. Getting sick from shellfish might not be allergy but food poisoning from toxins or bacteria in the shellfish. Symptoms are similar, although the immune system isn’t involved with food poisoning.

Allergic reaction: Swollen lips

Lips can swell for many reasons, one of which is allergic reaction. Swollen lips from allergies usually start with a tingling in the lips, followed by the sensation of feeling the lips steadily swell over the next few hours. The swelling may remain at its worst for several hours before gradually easing, disappearing altogether after perhaps 12-24 hours.

A range of allergens can cause swollen lips, including from food, insect stings and bites, medications, contact with certain products, dust, pollen, infectious diseases, bacteria, pollution and contaminants.

A food allergy is the most common type of allergy and is where the immune system is upset after a particular food. Various foods can cause the lips to swell in people susceptible to allergies, although the most common is probably shellfish.


An insect sting by a bee, wasp, hornet or ant, or by a biting insect such as a mosquito, bug or tic, to the lips or nearby areas can set up an allergic reaction and cause swollen lips.


Almost any medication can bring on an allergic reaction, although antibiotics, penicillin and aspirin are noted for producing allergies. This usually involves skin rashes or hives but can also result in swollen lips, tongue and face.


Allergic reactions such as swollen lips can occur by coming into contact with other allergens. This can include not only things like dust, pollen, animal fur, and grass, but also blowing up a balloon, touching your face with a rubber glove, contact with other latex products, and after a visit to the dentist or the hairdresser.


Lip swelling can result from contact with mattresses or pillows if they are made of a material that causes local irritation. People who sleep on their sides or front are more at risk.

Any allergic reaction, including lip swelling, can be hereditary too.

Swollen lips are the most common symptom of a condition called angioedema, which is usually the result of an allergy. “Angio” means blood vessels and “edema” is swelling. The blood vessels leak fluid, which causes a local build up in the tissues under the skin resulting in swelling. The condition can also cause swelling in the hands and elsewhere. Urticaria may develop too.

The best way to cope with swollen lips is to take antihistamines and try to isolate the cause. If you suspect the problem is food, record what you eat and any reactions in a diary. Determine the suspect foods and avoid them one at a time until you isolate the culprit. Look at food labels in the supermarket to make sure you’re not buying products containing your allergy. Skin prick and blood tests are always options, as is seeing your doctor or dietitian.

Personal story

A long time ago, I suffered periodic lip swelling for many years. My first episode was about a month after my wife and I soaked our feet in water with cayenne pepper. It was supposed to get rid of colds. It did that alright. I didn’t have a proper cold for perhaps a decade. Instead, my lips would swell up to several times their normal size. It probably didn’t help that I left my feet in the solution for 20-30 minutes; it was only supposed to be for a few minutes. My wife couldn’t leave her feet in it at all as she felt that it was burning her feet.

The first time I had swollen lips was the night after eating a warm, mildly spicy seafood dish at a work lunch one day. I put it down to the seafood, but in hindsight, the underlying cause was probably the cayenne pepper a few weeks earlier, and the seafood dish may have been the catalyst. I soon had more episodes. Before long, hardly a week went past when my lips didn’t swell. It was usually combined with urticaria, which could be quite itchy and could appear anywhere on my body, as well as on the backside and thighs, like I was burning from the inside.

My lips weren’t the only thing to swell. I also suffered swelling to the tongue, nose, eyes, lower arms, hands, fingers, thighs, and legs, but never to the throat, so I’m lucky in that regard. It made me feel lethargic and I sometimes had to take a day off work with it, but never more than one day at a time as the symptoms completely disappeared within a day. We were busy and often ate Chinese takeaway for tea. I had a liking for honey prawns and they often comprised my tea 3-4 times a week. This wouldn’t have helped my allergy, so I stopped eating them but my lips kept swelling up.

I went to several specialist doctors but none seemed to have the answer. They put me on courses of antibiotics, cortisone and antihistamines. These suppressed the symptoms but didn’t eliminate them. I had blood tests, which didn’t show any problem. I also had skin prick tests for allergies and this didn’t find anything either. I was skin tested for 89 substances. On a scale of 0-5, with 0 being no reaction and 5 being a severe reaction, I rated 0 for about 75 substances and 1 for the rest.

I was getting swollen lips from pepper, dust, oil on sultanas, and petroleum products. My wife used to wear petroleum jelly on her lips if they were a bit dry. One night, I kissed her goodnight and immediately felt a tingling and hardening of the lips. Over the next few hours, I lay awake as my lips grew larger and larger. On other occasions, they started swelling in the early morning after I had lain on my side for several hours. This would have been an allergic reaction to the mattress or pillow. The swelling would start on the side of the lips that was resting on the bed. Gradually, the swelling became even across the lips. I also suffered neuralgia around the gums, and could be in a lot of pain. But I never had neuralgia and swollen lips together; it was one or the other.

Just as children often outgrow their allergies, I seemed to outgrow mine. Over the years, the severity of my lip swelling lessened and episodes became further apart. Improvement in diet probably helped too, although most of this came after my worst allergy years were behind me. My diet was never too dreadful anyway. These days, the lip swelling has gone, as has the neuralgia and the urticaria, and I’ve hardly had an episode of any of these things for perhaps 15-20 years. I might have passed the allergy on to my nephew though. He has had slight to moderately swollen lips after eating a large number of fresh prawns.

What I had was probably angioedema, with urticaria.

Top 10 proofreading tips

Proofreading is the final check of a document before it is sent out or published. Traditionally, it refers to the process of checking material that has been typeset ready for printing, where a proofreader verifies that everything in the original document has come across correctly into the typeset version. These days, most documents are not typeset, and proofreading no longer usually involves checking one version against another. Nevertheless, the principles and the importance of proofreading remain.

The principles apply to all types of documents, whether articles for a writing site, promotional material, workplace reports, publications of all types, and of course job applications. Given the tight labor market these days, it is more important than ever to make sure your job application is well written, clearly laid out and totally free of any spelling mistakes, poor grammar and typographical errors.

Make time between writing and proofreading

Leave as much time as possible between writing a document and proofreading or editing it if the author is also the proofreader/editor. This allows you to come back to the document with a fresh pair of eyes, and chances are you will pick up errors that you hadn’t noticed while writing, rewriting and editing. Try to put a document aside until at least the next day before proofreading. This isn’t always possible, in which case you could come back to the document after a meal or short break.

Find quiet place free of distractions

When proofreading a document, you need as few distractions as possible. Try and find a quiet place where you are unlikely to be disturbed. That might mean shutting yourself in the back room or waiting until the kids have gone to bed. For some people, it might mean heading to the local library. In the workplace, it might be possible to find an empty office or a small meeting room that isn’t currently being used.

Get someone else to proofread

In some situations, it might be a good idea to get someone else to proofread your work. Any writer can get too close to their work and a different set of eyes might pick up things the author has missed. Even expert writers will often use a proofreader. In the workplace, see if there’s a colleague who might have time to check through your report before it’s submitted to management.

Proofread on paper

Proofreading is easier on printed copy rather than on a computer screen. Research has shown that people read faster on paper, although this is now less of an issue with high resolution computer monitors. Printed copy still has the advantage of allowing you to move back and forth through a document more easily, looking for inconsistency in such things as page layout, paragraphing, margins, indenting, headings, font type and size, and so on. Corrections and comments can then be transferred to the electronic document (where an editable file type has been used, such as a word processed document), making it easier for the author to accept or reject suggested edits.

Don’t rely on spelling and grammar checkers

Spelling checkers are a useful tool but they won’t pick up errors such as incorrect word usage, for example, there, their and they’re, or advice and advise, or to and too, or its and it’s and a host of others. They tend to have limited dictionaries, so a word might be perfectly correct but appears as an error as it’s not in the dictionary. Also, many words have alternative spellings, and different versions might appear in the same document. These differences won’t be picked up by a spelling checker.

Grammar checkers are far from perfect and cannot be relied upon. They will pick up faulty grammar in many cases and suggest changes, although they will usually miss a lot of instances of grammatical errors. They are notorious for pointing out sentence fragments that are actually correctly structured sentences. To use a grammar checker successfully, you need to know your grammar!

Proofread several times

Proofreading should involve several passes over a document, concentrating on particular aspects each time. This might involve checking headings in one pass, paragraphing and alignment in another, then consistency of tables and charts, then grammar and typographical errors, and finally overall readability. Even for a one or two page article, it is best to proofread for errors and readability separately. I nearly always go through online articles twice before posting.

Keep a style sheet

It’s often a good idea to keep a style sheet, especially for documents where the various parts are written by different authors and even where an organization has its own style guide. Style sheet entries can be arranged alphabetically and will ensure consistency throughout the document. It can include spelling of certain words, what to capitalize, punctuating bullet points, formatting of dates, words using a hyphen and those not, and anything else where there is more than one way of doing something.

Pay attention to detail

This is one of the most important aspects of proofreading, and if done properly and thoroughly, it should result in a document free of any errors and inconsistencies. It involves checking for consistency in spelling, hyphenation, shortened forms, capitalization, numbers and dates. Check for things like punctuation, quotes, captions, cross-referencing relating to chapter and section numbers, factual errors, headers and footers relating to the correct chapter, and number of spaces after a period (full stop).

Check everything

Make sure that you check everything. Some people think of proofreading as a quick read through a document before it is finalized, to pick up any spelling mistakes, typographical errors, poor grammar and ambiguities. While these things are important, there are many more things to look out for.

If you are proofreading a large publication, one of the first things to do is to check that the components of a publication are in a logical and conventional order. A title page, imprint page and then a table of contents usually appear at the start, perhaps followed by lists of figures, tables and abbreviations. A summary and an introduction should follow. After the main text, make sure any appendixes are properly labeled.

Check the layout of each page making sure it is consistent, including margins, page breaks, and adequate white space. Tables, figures and other illustrations should be properly placed. All pages should be numbered. Headings should be consistent, and if there are several levels of headings, they should form a proper hierarchy. There should also be consistency with fonts and font size, footnotes, and any headers and footers.

Checking tables and charts

Many documents will have statistical tables and charts. These need special attention when proofreading. In the typesetting process, charts and tables are things that are more likely to go wrong than most other parts of a document. Each part of a chart needs to be checked, including the title, X-axis and Y-axis titles, labels and scale, the legend, the lines and columns themselves, footnotes and source.

With tables, check that titles, column and row headings, headnotes, all numbers, footnotes and sources have been brought across properly. Make sure that table titles (and chart titles) accurately reflect what the data are about. Data should be checked back to the source collection or document. Also, check that numbers in the text agree with those in the tables.

How to use quotation marks properly

Quotation marks, also called quote marks, quotes, speech marks or inverted commas, are used in a number of situations. Their main use is to show the start and end of direct speech and passages by other writers. They are also used for the title of certain works and for various terms.

Direct speech should always be enclosed with quotation marks. For example: “I don’t think we should go in there,” Joan said. Also, “The last time we were here,” he said, “the door was locked fast.” Note that the marks go around only those words that were actually spoken. Commas and periods are usually placed inside the quote marks. No quotes are used for indirect speech, such as: He said that we could go inside after our tickets are confirmed.

Any passage of text by another writer should be enclosed in quotation marks, such as in the following example. According to Adams, the government “did not get serious about secondary education until well into the 1950s”. If the statement is paraphrased rather than quoted directly, then quote marks would not be used. In this case, the writer might say something like: Adams felt that the government didn’t do much towards secondary education before the late 1950s (but still cite the source).

Other uses of quotation marks are to enclose the title of an unpublished work, a chapter of a book, a journal article, a newspaper or magazine article, a lecture, an essay, a poem and a song.

Titles of unpublished works are usually enclosed with quotes. For example: His thesis for his master degree was called “A Sociological Study of Urban Legends”. Similarly, the chapter name of a book has quotation marks. For example: The second chapter, “Crime rates in other countries”, compares crime in the main OECD countries outside North America. Note that italics are used for the titles of published works and names of newspapers and journals rather than quote marks, although quote marks are often used online where italics aren’t possible. A lecture or paper has quotation marks, for example: Brown will deliver a paper, “Are we drowning in phoney statistics?”, at the forthcoming conference. For poems: She read her poem, “Street fighter”, at the poetry festival.

Quote marks can also be used for technical terms, for specially coined phrases or words, to show irony, and for things like colloquialisms and nicknames.

Technical terms are often enclosed in quotes, for example: The term “condylar resorption” describes a type of joint disorder. When a word or phrase is used in a specific sense, it often appears in quotation marks, such as: The public sector suffers “cost disease” as productivity stagnates over a long period. In the above two examples, quotes are usually only used at first mention; subsequent mentions do not need them. Alternatively, terms used can be italicised instead of using quote marks. Quotation marks are sometimes used to emphasise irony, as in: The government’s “policy” to reduce congestion was to build more freeways. Colloquialisms might appear in quotation marks, such as: They took him away in the “funny wagon”. A nickname can be enclosed in quotes, for example, Nat “King” Cole.

The use of single (‘ ’) or double (“ ”) quote marks varies geographically. Double marks are the norm in the United States and Canada. Both double and single marks are common in the United Kingdom and Australia. If a publisher or business has a particular preference, this should be used in all documents. Never use a mixture of single and double quotes in a document, or both straight and curly marks.

Sometimes you might want to quote a passage that already includes quotation marks around part of it. For nesting quotes, or quotes within a quote, use single marks if the document uses double marks; use double marks if the document uses single marks. For example: As Dave recalled, “The teacher said, ‘This is what to expect in the exam,’ and there was silence.”

The placement of other punctuation with quotation marks differs between countries. In the United States, any comma or period is usually placed before the closing quote mark (although a semicolon and a colon come after the quote mark). In the United Kingdom and Australia, the usual practice is to put the comma after the closing quote mark. The full stop or period will go after the closing quotation mark if the quote only includes the last part of the sentence and before the closing mark if the quote covers the whole sentence. In fiction writing, the comma and full stop usually come before the closing quotation mark in these two countries.

There are several situations where quote marks aren’t used. A quotation of more than about two lines is often set in a block and indented from the rest of the text, in which case quote marks are not needed. Sometimes in newspapers and magazines, if a quote covers several paragraphs, an opening quote mark will appear at the start of each paragraph but a closing quote mark will only appear at the end of the last paragraph of the quoted material.

Plays and transcripts do not need quotation marks. In these documents, the speakers are identified by name, followed by what they say. For example, John: We have to get out of here. Sandra: (looking around) I think we’re trapped.

In summary, quotation marks are used for direct speech and to show text by another writer. They are also used for the title of certain written works and for particular types of terms, words and phrases. Quotations marks aren’t used for paraphrased speech or statements, block quotes that are indented, or transcripts and plays.

A guide to the possessive forms of nouns

Nouns are one of eight classes of words or parts of speech in the English language. Broadly, a noun is the name of a person, place or thing, or it can be an abstract notion such as “information” or “wish”. When we want to indicate possession or ownership of something, we use an apostrophe, such as in Mary’s house or the book’s cover. The first noun in these cases is the possessive noun.

For singular common nouns, an apostrophe and an “s” is added to the noun to make it a possessive noun. Examples include the carpenter’s toolbox, the cat’s basket, the river’s water quality, the scarf’s colors, the government’s policies, the town’s population and for argument’s sake. If a noun already ends in “s”, an apostrophe s is usually added just the same, such as the boss’s office and the atlas’s index.

Plural nouns simply take an apostrophe at the end of the word without adding an “s”, to make them possessive. Examples include the judges’ comments, the nurses’ uniforms and the governments’ budgets. Where a plural noun doesn’t end in “s”, an apostrophe and an “s” are added to these words to make them possessive, such as children’s toys, people’s preference and mice’s nests.

For personal names, an apostrophe and an “s” are added, as in Frank’s articles, Janet’s husband, Paul’s sister and Fido’s bone. A problem arises where the name ends in “s”. There are no hard and fast rules, and usage varies. Some people prefer James’s car while others like James’ car. Similarly, with a two-syllable name ending in “s”, such as Dickens, we can use either Dickens’ novels or Dickens’s novels. When it comes to Francis’ car versus Francis’s car, the preference might be for the former, as the latter has a lot of “s” sounds together. For this reason, we would probably say or write Francis’ scooter rather than Francis’s scooter (four “s” sounds in a row). Thus possible rules are to always add just an apostrophe, or to only do this when the noun is more than one syllable, or when it has two successive “s” sounds at end, or always add an apostrophe and an “s”.

With the names of institutions and placenames, the move seems to be away from treating these nouns as possessive, although this varies between countries. Businesses that used to use an apostrophe are now less likely to, for example, Harrods (UK), or they might leave off the “s” altogether, such as Myer (Australia). For cases such as the Libraries Board, an apostrophe would now be rare. A term such as writers’ group is perhaps becoming writers group. Here, the plural word is more like an adjective than a possessive noun. Similarly with placenames, fewer apostrophes are used and we tend to prefer Smiths Beach to Smith’s Beach. Some jurisdictions use no or very few apostrophes in placenames, such as the United States and Australia. Others, including the United Kingdom and Canada, have retained an apostrophe in many cases.

Hyphenated words take an apostrophe at the end of the word, such as mother-in-law’s birthday and editor-in-chief’s duties. Compound titles also do this, for example, the Opposition Leader’s speech and the School of Medicine’s student intake.

Where several people are involved in the possession of something, use of apostrophes depends on whether the ownership is joint or separate. If it’s joint, only the second-mentioned party would take an apostrophe, such as John and Betty’s house or Bill and Ben’s books. However, if ownership is separate, both or all parties would have an apostrophe, for example, Bill’s and Ben’s books. Note that if any party is referred to by a pronoun, the possessive case in used for both or all. For example, we would say Bill’s and his books, regardless of whether Bill and Ben own the book jointly or separately. Also note that where ambiguity could result, the possessive would be used for both parties. Consider the following. Jack and Jill’s children were reported missing. This could mean that Jack was missing, along with Jill’s children, perhaps from another marriage. Here it might be better to refer to Jack’s and Jill’s children.

For double possessives, both people take an apostrophe. Examples include Peter’s friend’s car, her boyfriend’s father’s job, St Paul’s Cathedral’s history and Sue’s partner’s family. An alternative to, say, Janet’s husband would be the husband of Janet’s (not Janet). The latter is often called a double possessive, although it is not usually the preferred option. A double possessive in this format shouldn’t be used for inanimate objects. Here we would say, for example, a friend of the gallery but not a friend of the gallery’s.

A common error is to put an apostrophe in a plural noun where no possession is present, for example, fresh apple’s here, used car’s, and there were two clock’s on the mantelpiece. Also, where there is no actual ownership, an apostrophe isn’t usually used, such as visitors book, girls school and proofreaders marks, although usage can vary between countries.

In summary, the general rule for indicating possession is to add an apostrophe and an “s” at the end of the word. For plural nouns ending in “s”, just an apostrophe is added after the “s”. Where a personal name ends in “s”, sometimes an apostrophe and an “s” is added and sometimes just an apostrophe. The use of apostrophes where several people are involved depends on the circumstances.

How to spot a run-on sentence

A run-on or fused sentence is a sentence consisting of two independent clauses that are not properly joined by appropriate punctuation, or a conjunction (such as “and”, “but”, “or”, “so”, “yet”, “because”). An independent clause can be identified as having a subject and a predicate and stands by itself as a complete sentence. The subject can be something like “John” or “he” or “his father”. The predicate is the rest of the clause and includes a verb.

A typical example of a run-on sentence is where a pronoun connects the second clause back to the first. An example is: “John studied every day he wanted to pass his exams.” This sentence has two independent clauses, the first being “John studied every day” and the second being “he wanted to pass his exams”. Each one stands by itself but they are fused together. The sentence is actually two separate sentences. To make it into one correctly constructed sentence, it needs a conjunction. In this case, a conjunction such as “as” or “because” could be inserted between the two clauses. The sentence becomes: “John studied every day as he wanted to pass his exams.” Alternatively, two separate sentences could be formed: “John studied every day. He wanted to pass his exams.”

A commonly seen run-on or fused sentence is where one of the independent clauses recommends some sort of action. For example: “The exams are coming up, you should now be studying hard.” Note in this example that a comma has been used. It is something that is often seen in run-on sentences. This particular type of run-on sentence is called a “comma splice”. Thus if two independent clauses are linked by a comma, they still form a run-on sentence.

Another easily spotted run-on sentence is where the clauses are linked by a word such as “however” or “nevertheless”.  For example: “The exams were only two weeks away, however John hadn’t started studying yet.” Again, there are two independent clauses here and no conjunction. The punctuation is also incorrect. To make this sentence correct, replace the comma after “away” with a semicolon, and a comma after “however”. Alternatively, “however” could be replaced by “and” and no punctuation would be required. Or, the sentence could start with “Although”, and delete “however”.

A run-on sentence can be any length. For example, “John ran she followed” is a run-on sentence. Here’s a longer example: “Community service is where offenders work on some organized project for the benefit of the public it is an alternative to jail for certain types of law-breakers.” This sentence could be broken into two or have a conjunction added. A better alternative might be to change the sentence around a bit and introduce a dependent clause. Thus the sentence could be rewritten as: “Community service, which is an alternative to jail for certain types of law-breakers, is where offenders work on some organized project for the benefit of the public.” The middle part of the sentence (between the commas) is a dependent clause; the rest is an independent clause.

In summary, to spot a run-sentence, ask yourself whether the sentence has two independent clauses (that is, where each clause is actually a sentence). If it doesn’t, then it won’t be a run-on sentence. Where it does, look to see if there is a conjunction between the clauses. If there is, it’s not a run-on sentence. If there isn’t, consider any punctuation between the clauses. A semicolon, colon or dash should mean it’s not a run-on sentence. On the other hand, if there’s a comma or no punctuation, it’s a run-on sentence.