What if your customer has allergy for a certain ingredients How can you avoid accident or allergic reaction on the customers?

How Can I Prevent Allergic Reactions?

When preparing a meal, cutting chicken on the same cutting board that you used to chop up shrimp doesn’t seem like a big deal. But to someone with a shellfish allergy, that act alone could be life threatening. One simple mistake could easily give a customer an allergic reaction. Attention to detail is important in preventing such reactions.

One thing that is commonly overlooked is cross-contact. This causes a transfer of allergens to a food that would typically be safe for consumption, but now poses a risk to the allergic person. Cutting boards, knives, pots, pans, and so much more can cause cross-contact with other foods, spreading the allergens.

Prevention of cross-contact can be simple. Let’s begin by discussing how an allergen can trigger a reaction, the most common food allergens to be aware of, and finally three methods used to avoid causing these reactions in your customers.

What Causes an Allergic Reaction

An allergy happens when your body decides that a substance (an allergen) should not be allowed in your body. When that allergen is introduced into your body, your immune system releases antibodies.

These antibodies are proteins which act as messengers to your cells that let them know that the substance must be stopped. The cells release histamine, causing the blood vessels to expand, triggering an allergic reaction. Antibodies only target one type of allergen. This is why people can have allergies to one thing but not another.

Allergic reactions range in severity, but always come with the risk of death. Symptoms may include diarrhea, vomiting, indigestion, hives, rash, tingling lips, difficulty swallowing, and difficulty breathing. Always take customers who claim to have food allergies seriously. You do not want your restaurant to be responsible for someone having an allergic reaction.

Common Food Allergens

There are 8 major food allergens that manufacturers are required to label on products. In owning a restaurant, allergen labeling is not required, but it’s important to recognize these allergens to ensure a safe experience for your consumers. Although many allergies exist, the eight major allergens are:

• Peanuts
• Eggs
• Dairy
• Wheat
• Shellfish
• Fish
• Soy
• Tree nuts

It is important for both servers and chefs to be respectful and sensitive when dealing with people who have food allergies. Do not assume that they simply do not like the ingredient or are being picky eaters.

Some diseases and sensitivities to food can also require that a food be prepared the same way as an allergy free meal. One example of this would be someone with Celiac disease ordering a gluten free meal. Someone with this disease could be impacted if even a little bit of wheat or grain product is in their food. Prepare their food with the same care you would an allergen free meal.

3 Methods for Preventing Allergic Reactions

When preparing food with any of the eight major allergens, implementing these three methods can drastically decrease the incident of reactions.

1. Always check the ingredients to be sure it is free of the allergen in question. Be willing to check labels of ingredients. If you are unsure of whether a particular item contains any amount of an allergen, be honest and tell the customer you do not know if that food item will risk their safety.
2. When possible, use dedicated fryers, cutting boards, utensils, etc. to prevent the allergen from being introduced to other foods. Using common fryers, cutting boards, and serving utensils could cause cross-contact of the allergen with foods that would be normally be harmless. Use care when handling any of the common allergens, taking note of what has touched the surface.
3. Immediately after handling foods containing an allergen, change gloves and wash your hands to prevent cross-contact with other foods.

Navigating life with allergies can be difficult and challenging. Keep your costumers safe and healthy by following safe food practices.

For more on food allergen safety, visit our food allergen safety training page.

Symptoms of food intolerance

Symptoms of food intolerance can include:

• nervousness
• tremor
• sweating
• palpitations
• rapid breathing
• headache, migraine
• diarrhoea
• burning sensations on the skin
• tightness across the face and chest
• breathing problems – asthma-like symptoms
• allergy-like reactions.

Symptoms of food allergy

The symptoms of mild to moderate food allergy include:

• swelling of lips, face, eyes
• hives or welts
• tingling mouth
• abdominal pain, vomiting – these are signs of anaphylaxis for insect allergy.

Signs of anaphylaxis (severe allergic reaction):

• difficult or noisy breathing
• swelling of tongue
• swelling or tightness in throat
• wheeze or persistent cough
• difficulty talking or hoarse voice
• persistent dizziness or collapse
• pale and floppy (young children).

Action plans for anaphylaxis are available at ASCIA Action, First Aid, Management, Travel and Treatment Plans and Guides .

Body parts affected by food allergy

Various sites on the body can be affected by an allergic reaction to food, including:

• swelling of the face, lips, eyes
• swelling of the tongue
• swelling or tightness in the throat
• stomach pains, vomiting – these are signs of anaphylaxis for insect allergy
• skin – rashes, such as hives (urticaria) or atopic dermatitis
• lungs – wheeze, cough, asthma (more common in children than adults).

Severe allergic reactions to foods can be life-threatening

Anaphylaxis is a severe allergic reaction that needs urgent medical attention. Foods (such as peanuts, tree nuts, seafood, wheat, milk and eggs), insect bites and stings and some medicines are the most common allergens that cause anaphylaxis.

Within minutes of exposure to the allergen, the person can have potentially life-threatening symptoms, which may include:

• difficult or noisy breathing
• swelling of tongue
• swelling or tightness in throat
• wheeze or persistent cough
• difficulty talking or hoarse voice
• persistent dizziness or collapse
• pale and floppy (young children).

Several factors can influence the severity of anaphylaxis, including exercise, heat, alcohol, the amount of food eaten, and how food is prepared and consumed.

Emergency treatment for severe allergic reactions (anaphylaxis)

To prevent severe injury or death, a person with anaphylaxis requires an injection of adrenaline (epinephrine) into the outer mid-thigh. They should not be allowed to stand or walk. Further doses may be given if there is no response after 5 minutes. Give adrenaline first, then asthma reliever puffer, if required.

People who are considered by their doctor to be at risk of anaphylaxis are prescribed an adrenaline injector (such as an EpiPen® or Anapen®), which contains a single fixed dose of adrenaline. These patients should also have an ASCIA Anaphylaxis Action Plan .

Adrenaline injectors are designed to be used by non-medical people, and are available directly from a pharmacy.

Causes of food allergy

Peanuts, tree nuts, eggs, cow’s milk, wheat, sesame, fish, shellfish and soy cause the majority of food allergic reactions. Peanut allergy is one of the most common allergies in older children as only approximately one in 4 children will outgrow peanut allergy.

Causes of food intolerance

The foods that tend to cause intolerance reactions in sensitive people include:

Finding the allergen

When symptoms appear within a few minutes of eating the particular food, it makes pinpointing the allergen an easy task. However, if the cause is unknown, diagnostic tests may be needed, such as:

• keeping a food and symptoms diary to check for patterns
• under the supervision of a clinical immunology/allergy specialist or dietitian, removing all suspect foods for 2 weeks, then reintroducing them one at a time to test for reactions (except in cases of anaphylaxis)
• skin prick tests using food extracts or IgG blood tests.

ASCIA strongly recommends only having evidence-based allergy tests.

Treating food allergy or intolerance

The easiest way to treat a food allergy or intolerance is to eliminate the offending food/s from the diet. Sometimes, the body can tolerate the food if it is avoided for a time, then reintroduced in small doses, particularly for food intolerances.

Before you eliminate or reintroduce foods, seek advice from a clinical immunology/allergy specialist or dietitian .

Preventing food allergy in children

Allergy prevention in children is an active area of research. Findings to date indicate that:

• Prenatal – there is no conclusive evidence that avoiding allergens in pregnancy will help prevent allergies in your child.
• Postnatal – exclusive breastfeeding during the first 4 to 6 months appears to protect against the development of allergies in early childhood.
• Introducing solid foods (including those considered to be allergenic) around 6 months (but not before 4 months) is recommended, preferably while continuing to breastfeed.
• Breastfeeding – avoidance of a food (including foods considered to be highly allergenic) by a woman while breastfeeding is not recommended.
• Soymilk formula – studies have shown that using soymilk formula does not prevent the development of allergies in children.
• Partially hydrolysed cow’s milk-based formula (commonly referred to as HA formula) is not recommended to prevent the development of food allergy.

Severe food allergy in children

Allergic reactions, including anaphylaxis, are common, although deaths from anaphylaxis are rare. All schools and childcare services across Australia are required to have an anaphylaxis management policy in place. Teachers in every state are trained to recognise and react to an allergic reaction by completing ASCIA Anaphylaxis e-training. They should also practise using an adrenaline injector training device.

Banning particular foods in schools and early childcare is not recommended as it can create a sense of complacency and is difficult to monitor and enforce. A better approach is to educate staff, students and the community about the risks associated with anaphylaxis and put strategies in place to minimise exposure to known allergens. The Allergy Aware website has many resources available.

Food allergen avoidance

You should only avoid foods to which you have a diagnosed allergy. Learn the terms used to describe these foods on food labels, for example:

• milk protein – milk, non-fat milk solids, cheese, yoghurt, caseinates, whey, lactose
• lactose – milk, lactose
• egg – eggs, egg albumen, egg yolk, egg lecithin
• gluten – wheat, barley, rye, triticale, wheat bran, malt, oats, cornflour, oat bran
• soy – soybeans, hydrolysed vegetable protein, soy protein isolate, soy lecithin
• salicylates – strawberries, tomatoes.

The National Allergy Strategy has developed a resource hub to assist with best practice procedures for food allergen management.

Food laws and labels

Since December 2002, the Australia New Zealand Food Standards Code requires food labels to declare certain foods and certain substances in foods, including:

• cereals that contain gluten and gluten products
• shellfish and their products
• eggs and egg products
• fish and fish products
• milk and milk products
• tree nuts, sesame seeds and their products
• peanuts
• soybeans and their products
• added sulphites in concentrations of 10 mg/kg or more
• royal jelly (presented as food or present in food), bee pollen and propolis.

These foods must be declared if they are:

• used as an ingredient
• part of a compound ingredient
• a food additive or part of a food additive
• a processing aid or part of a processing aid.

Where to get help

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