Module 10: Allergens

Staying Diligent: Allergens and Cross Contact

http://allergicliving.com/2010/07/02/sabrinas-law-the-girl-and-the-allergy-law/2/

Sabrina knew she was allergic to peanuts and dairy http://allergicliving.com/2010/07/02/sabrinas-law-the-girl-and-the-allergy-law/2/

http://allergicliving.com/2010/07/02/sabrinas-law-the-girl-and-the-allergy-law/2/ Helps to read this all the way through-even if we are taught not to read slides-greater impact here when we get the complete story.

What Went Wrong Sabrina took precautions in choosing her food Cross Contact transferred the allergen onto another food No one involved realized the severity of the situation in time http://allergicliving.com/2010/07/02/sabrinas-law-the-girl-and-the-allergy-law/2/

DISCUSSION Allergic reactions, like our case study, are very scary. They can happen very quickly, have potentially deadly consequences, and can be caused by a simple mistake. Do you know any one with a true food allergy?

Learning Objectives Identify the most common food allergens Explain how “cross-contact” may be prevented or controlled Describe the correct procedure for a member of a wait staff to follow if a guest (with an allergy) desires information about a menu item List reasons for control of allergens

Outline Food Allergens Cross Contact Prevention and Control Communicating with Customers Emergencies Food and Drug Allergies are diseases of the immune system. Intolerances and sensitivities are reasctions of your digestive system not immune system. From aafa.org/allergies 3-8% of children rave reactions to some food. Only 1-2% have true food allergies. Some children grow out of their sensititivty to certain foods by age 4 (egg) HOWEVER allergies to peanuts, tree nuts and shellfish do not go away. Only 1-2% of adults have true food allergies-Life threatening reactions more common in people who also have asthma. Symtoms of severe reaction Wheezing, difficulty breathing , throat tightness, nausea, rapid pulse,flushing,faintness,itching of palms and soles of feet and even passing out. Also check out www.foodallergy.org-Your Food Allergy Field Guide pages 9 and 10 may be useful for restaurant personnel if Epi pen appears before they pass out!

Type of Reactions Food allergy: The body's immune system has an abnormal reaction to proteins in a food These can be life threatening Food intolerance: The body doesn’t digest certain chemicals properly, like: Wheat gluten intolerance (Celiac disease) Lactose intolerance (Can’t digest lactose, a sugar in milk) These can cause vomiting, abdominal pain, diarrhea

Food Allergies Allergic reactions can be mild or very severe Mild reactions can cause itching, eye and throat irritation, hives, and swelling Severe reactions can result in anaphylactic shock Closing of the airway, heart stops beating, cardiac arrest Symptom onset can be almost immediate, or take up to a couple hours. Some people will wear a medical alert bracelet or necklace. Many do not.

Can you name any of the Big 7? Common Food Allergens FDA Food Code requires that PIC of a food establishment must be able to demonstrate knowledge of major food allergens (Big 7) and include food allergy awareness in the training of others. Can you name any of the Big 7? Over 12 million Americans suffer from one or more food allergies. Between 5 and 8% of children and 1 to 2% of adults have some type of allergic reaction to foods. This is drastically up from a decade ago when only 2-3% of people were allergic to foods. Allergen’s can come on anytime within a life span. Children outgrow some. The Food and Drug Administration now requires that foods be labeled if they contain allergens listed in this slide. The only way we can avoid illness or a reaction from consumption of allergens is through labeling and ensuring that the person allergic to the food does not consume the food product. SOYBEANS TREE NUTS FISH & CRUSTACEAN SHELLFISH MILK EGGS WHEAT PEANUTS

How Can Food Service Be A Factor? “Cross-contact occurs when an allergen is inadvertently transferred from a food containing an allergen to a food that does not contain the allergen. Cooking does not reduce or eliminate the chances of a person with a food allergy having a reaction to the food eaten.” (www.foodallergy.org)  http://www.foodallergy.org/tools-and-resources/managing-food-allergies/cross-contact

Risk Factors Ingredients that are allergens Processed products that may contain allergens Cross contact – allergen transferred by hands, surfaces, utensils Labeling repackaged allergen containing foods in storage At risk populations

Best Practices Know your ingredients Prevent cross contact Labeling allergens, relabeling containers Communication with employees Communication with customers Understand allergens and terms for foods such as gluten free and vegan.

Know What’s in Your Ingredients! Ex. Caesar dressing & Worcester sauce often contain fish http://foodpoisoningbulletin.com/2014/fairway-condiment-grilling-sauce-recalled-for-undeclared-fish/

Label To Prevent Confusion Ingredients from food processors should label potential allergens. May consider labeling your containers in storage with appropriate allergen information

Preventing Cross Contact Similar to cross contamination, but cooking doesn’t eliminate the risk. Storage – separate allergens Handling – sanitize utensils and surfaces after contact with allergens. Cooking surfaces – heat doesn’t eliminate allergens. Clean or use designated areas Hand washing – both preparation and service Buffet service – label service utensils and communicate with customers

Communicating with Customers and Staff Menu notes of potential allergens Consumer Advisories may be used Service staff receptive to customer questions Servers communicate with cooks Cooks communicating with each other “Don’t cook fish on this section of the grill…” Staff receptive to customer questions: I always state please ask the chef –but local cooks may not be as knowledgeable. Bacon bits are a big issue in small restaurants cutting costs of bacon. Salads made with mayo also often have sour cream in them and staff need to be informed. READ LABELS and chefs/cooks write down the items used.

Reacting to Emergencies Plan ahead for a quick response Train employees to recognize symptoms Understand what may immediately happen: Epi-Pen injections Other customers’ reactions Know who to contact Plan for who will make that call and what type of information to provide Contact EMS? School Nurse?

What’s Your View? Have you noticed a food business doing a good job managing allergen risks? How so? Red Robin Burger joints have hand delivered menu’s for allergy customers that list best choices for your allergy. The world will not change for you on everything your allergies may require of you so you must be vigilant. Servers and cooks need training. The Celiac Disease Foundation has a training course for chefs.

Case Study How It Happened What They Found Staff knew there was no peanut oil used on the fries Sabrina asked the right questions

Case Study What Went Wrong Prevention Be aware of cross contact Communicate with customers Be prepared for emergencies Tongs transferred cheese onto the fries Sabrina thought it was asthma

Quiz Cross contact is: The transfer of a pathogen from one food to another An allergen is inadvertently transferred from a food containing an allergen to a food that does not contain the allergen Mislabeling a product that contains an allergen Touching food with a bare hands Answer: b)

Quiz Cross contact is: The transfer of a pathogen from one food to another An allergen is inadvertently transferred from a food containing an allergen to a food that does not contain the allergen Mislabeling a product that contains an allergen Touching food with a bare hands Answer: b)

Quiz Which are NOT common food allergens (Big 7)? Milk Egg Lettuce Wheat Peanuts Soybeans Berries Tree nuts Fish & Crustacean Shellfish C and G

Quiz Which are NOT common food allergens (Big 7)? Milk Egg Lettuce Wheat Peanuts Soybeans Berries Tree nuts Fish & Crustacean Shellfish C and G

Review Food Allergens Cross Contact Prevention and Control Emergencies