Module 11: Allergens, Toxins and Chemical Contamination

Case Study http://www.101cookbooks.com/archives/chocolate-puddle-cookies-recipe.html

http://www.usatoday.com/story/money/business/2015/03/24/family-sues-publix-wrongful-death/70381282/

What Happened June 2014, Clarksville, TN 11-year-old Landon Wood was visiting relatives in Tennessee when they decided to take a trip to Publix Landon wanted a wrapped chocolate cookie for his treat Landon’s mother asked if the cookie contained tree nuts and then purchased it when she was told it was nut free At home, Landon’s mom tasted the cookie to double check and everything seemed fine

What Happened Three bites into his cookie, Landon said his mouth was burning Landon’s mom gave him Benadryl and an epinephrine shot Despite the medications, Landon went unconscious En route to the hospital, Landon’s throat swelled and doctors were not able to resuscitate him

What They Found The chocolate cookie contained walnuts There were no allergen warning labels on the cookie package or display Store associate did not know the ingredients in the cookie Family filed a lawsuit against Publix in order to raise awareness

What possible explanations can you think of for how this happened? Discussion What possible explanations can you think of for how this happened? Allergens were not properly labeled, employee didn’t know ingredients, or possibly, someone added walnut to a recipe that wasn’t supposed to have it

Learning Objectives Identify the most common food allergens Explain how cross-contact may be prevented and controlled Describe the correct procedure for wait staff to follow if a guest inquires about a menu item List sources and control of foodborne toxins

Food Allergens

Can you name any of the Big 8? Common Food Allergens FDA Food Code 2013 requires that PIC of a food establishment must be able to demonstrate knowledge of major food allergens (Big 8) and include food allergy awareness in the training of others. Can you name any of the Big 8? 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.

Common Food Allergens 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. Allergens can come on anytime during someone’s life The Food and Drug Administration requires that foods be labeled conspicuously 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. http://busybeekate.com/wp-content/uploads/2014/05/top8.jpg

Reactions to Food 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, causing uncomfortable symptoms such as vomiting, abdominal pain and diarrhea. Examples: Wheat gluten intolerance (Celiac disease) Lactose intolerance (Can’t digest lactose, a sugar in milk) Food and Drug Allergies are diseases of the immune system. Intolerances and sensitivities are reactions of your digestive system not immune system.

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. Reactions can vary person to person; sometimes reactions to various allergens also differ for one person.

Food Allergies This is an accurate depiction of what some people experience during anaphylaxis https://www.youtube.com/embed/HX4yBmuazqM?ecver=1 http://go.ncsu.edu/opr27z

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 Can tell Sabrina’s story here

Prevent Cross-Contact Cross-contact is similar to cross-contamination, but cooking and sanitizing don’t eliminate the risk. Storage – separate allergens Handling – clean utensils and surfaces after contact with allergens Cooking surfaces – heat doesn’t eliminate allergens. Clean or use designated areas Food contact surfaces – clean between allergen and non-allergen foods Handwashing – both preparation and service Buffet service – label service utensils and communicate with customers

Storing Allergens Store allergen ingredients away from non-allergen ingredients whenever possible Ingredients from food processors are required to have labels declaring potential allergens. Consider labeling your containers in storage with appropriate allergen information

Know What’s in Your Ingredients! Example: Caesar dressing & Worcestershire sauce often contain fish It is best practice to pay attention to supplier recall alerts so that you can stay privy to any changes in ingredients or undeclared allergens http://foodpoisoningbulletin.com/2014/fairway-condiment-grilling-sauce-recalled-for-undeclared-fish/

Handling, Preparing and Serving Allergens Be sure to wash hands when switching from allergen to non-allergen foods Use separate preparation and cooking surfaces, or clean and sanitize in between foods Use separate utensils in service and on buffet lines Label as necessary to prevent confusion

Communicating with Customers and Staff Menu notes of potential allergens Consumer Advisories may be used Allergen friendly menus Train service staff to be receptive to customer questions Encourage servers to communicate with cooks Encourage cooks to communicate with each other E.g., "Don't cook fish on this section of the grill…” Staff receptive to customer questions: Best practice would be to have servers ask the chef. Bacon bits are a big issue in small restaurants cutting costs of bacon, as bacon bits are made of soy. Salads made with mayo also often have sour cream in them and staff needs to be informed. READ LABELS and have chefs/cooks write down the items used and stick with a set recipe.

Reacting to Emergencies Plan ahead for a quick response Train employees to recognize symptoms Understand what may 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 If someone receives an epinephrine shot they should go to the emergency room for observation and possibly further treatment

Toxins and Chemical Contamination

Chemical Contamination Cleaning products, sanitizers, polishes, lubricants, pesticides, additives, etc. Ensure food is from approved suppliers Proper storage: Away from food, utensils and equipment Separate storage area in original containers Label properly if transferred to another container Use carefully during operating hours Consider using conveniently located staging areas Keep Safety Data Sheets handy Approved suppliers use chemicals according to regulations. Example: pesticides use must be stopped a certain amount of time before harvesting At a dairy processing plant, a consultant put their hand on the wall and notice there were ants crawling up his arm. He told the manager, who called over the pest control specialist. The ants were sprayed. When the guest looked at the container, one side was labeled with the pesticide label, the other side had a label for butter-pecan flavoring. This could go wrong in 2 ways, spraying the wall with a sugar solution or adding a pesticide to the ice cream.

Naturally Occurring Toxins Some food can contain toxins that can make people sick Fish Shellfish Mushrooms Molds

Fish Toxins Fish that can produce toxin: Ciguatoxin Puffer fish, moray eels, freshwater minnows Ciguatoxin Large warm water fish consume smaller fish that feed on algae Algae may have organism that produces toxin Histamine Fish Poisoning (formerly Scrombrotoxin) Caused by temperature abuse Microbes in fish grow and produce toxin Similar symptoms to allergic reaction

Shellfish Toxins Amnesic Shellfish Poisoning (ASP) Confusion, memory loss, disorientation Diarrheic Shellfish Poisoning (DSP) Chills, nausea, vomiting, cramps, diarrhea Neurotoxic Shellfish Poisoning (NSP) Tingling and numbness lips, tongue, throat, reversal hot/cold sensations Paralytic Shellfish Poisoning (PSP) Tingling and numbness

Mushrooms and Mycotoxins Some mushrooms produce toxins dangerous to humans A mushroom that is safe in one country or region may have a deadly look alike in another Mycotoxin Toxin produced by molds on grains, nuts, and dried fruits Mycotoxins are heat stable

Other Toxin Sources Cleaners and sanitizers Chemical leaching Cleaning and sanitizing compounds Use and store properly Chemical leaching Foods stored in non-food grade containers can be subject to chemical and metal leaching. Use only food-grade containers Food additives Chemical additives are sometimes necessary for flavor or preservation. Use additives carefully, apply for a variance if needed

Have you noticed any good or bad examples of managing allergen risks? Discussion Have you noticed any good or bad examples of managing allergen risks?

Case Study What Happened What They Found Landon and his mom asked the right questions Staff member didn’t know walnuts were in cookie, label didn’t declare allergen

Case Study What Went Wrong Prevention Landon ate a few bites of the cookie and reacted Medications were not enough to save him Label allergens in products for sale, know where to find allergen information for ingredients

Quiz Cross-contact is: The transfer of a pathogen from one food to another An allergen 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 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 8)? Milk Egg Lettuce Wheat Peanuts Soybeans Berries Tree nuts Fish & Crustacean Shellfish C and G

Quiz Which are not common food allergens (Big 8)? Milk Egg Lettuce Wheat Peanuts Soybeans Berries Tree nuts Fish & Crustacean Shellfish C and G

Review Food allergens and cross-contact Allergen management Dealing with emergencies Toxins and chemical contamination