1. Module 11: Allergens, Toxins and Chemical Contamination

2. Case Study

4. 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

5. 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

6. 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

7. 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

8. 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

9. Food Allergens

10. 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.

11. 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.

12. 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.

13. 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.

14. Food Allergies
This is an accurate depiction of what some people experience during anaphylaxis

15. 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.” (
Can tell Sabrina’s story here

16. 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

17. 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

18. 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

19. 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

20. 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.

21. 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

22. Toxins and Chemical Contamination

23. 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.

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

25. 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

26. 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

27. 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

28. 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

29. 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?

30. 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

31. 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

32. 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)

33. 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)

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

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

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