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Prevention and Management of Food Allergic
Reactions in Foodservice Operations
Module 6
Module Content
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Food allergy management plans in foodservice
establishments
Challenges and issues specific to foodservice operations
Strategies to reduce/eliminate food allergy risks
Best practices
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foodservice establishments
Table 6.1. Recommended Food Allergen Control and Management Plan.
General
1) Establish/maintain a group of advisory board members who can provide advice
to the foodservice operators.
2) Determine common types of food allergens used in specific foodservice
operations.
3) Develop an allergen control plan through food production and service systems
as a part of the food safety program.
Segregation of allergenic food or ingredients during storage, handling, and
processing
1) Store allergenic ingredients or products separately to prevent cross-contact
with other food items.
2) Have a separate kitchen area for the production of allergen-free foods.
3) Develop standard operation procedures (SOP) for the production of allergenfree foods.
Supplier control programs for ingredients and labels
1) Require food suppliers to notify changes of food ingredients.
2) Locate detailed ingredient information from commonly used manufacturers and
a person(s) to contact when questions arise.
3) Review food ingredient lists regularly and update SOP for the production of
allergen-free foods.
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foodservice establishments
Table 6.1. Recommended Food Allergen Control and Management Plan.
Prevention of cross-contact during processing
1) Set aside dedicated processing equipment, tools, containers, utensils, and work
areas to prevent allergen cross-contacts.
2) Clearly mark allergen-free tools, containers, and utensils (e.g., color-code
them), and store them away from other equipment and utensils used for general
production and service.
3) Minimize the reuse of processing and/or cooking media (water or oil).
4) Restrict personnel working on processing lines containing allergenic
ingredients from working on allergen-free production lines.
Training
1) Provide general training on allergen awareness and control for all employees in
your foodservice establishment.
2) Train staff how to check the ingredients of menu items to see if they contain
allergens.
a. Have a list of the ingredients of each menu item.
b. If ingredients cannot be changed in menu items or are unavailable, staff
should inform the guest that they cannot provide safe food for them.
3) Provide training to all new staff on food allergies before they interact with
customers to create better awareness and understanding.
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foodservice establishments
Serving consumers with food allergies
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Know who will answer guests’
questions about food
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allergies.
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Advise customers with
allergies not to eat certain
foods.
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Establish steps to avoid crosscontact.
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Have at least one person available during hours of
operation who can handle questions and special requests.
If a guest says that he or she has an allergy, direct the
designated person to handle the order.
Fried foods should be avoided, as the cooking oil may be
used for many foods unless there is a designated fryer.
Desserts should be avoided, as many desserts incorporate
the main food allergens, such as nuts. Fresh fruit may be a
good alternative.
Sauces should be avoided, as these may include
unexpected ingredients.
Buffet and cafeteria services should be avoided, as there is
a high possibility of cross-contact due to dishes being close
together and guests serving themselves.
Have scheduled times throughout the day for a staff
member to check the kitchen and preparation areas for
proper cleanliness and organization.
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foodservice establishments
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The emergency plan should include the following (FARE,
2010):
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Call 911 immediately for emergency medical attention.
Locate management; have a list of individuals to call if the
immediate supervisor cannot be reached.
Keep the individual from standing up.
Comfort the guest and keep others calm. Do not leave the scene
until the emergency medical crew arrives.
If an epinephrine auto-injector (e.g., an Epipen®) is available,
make sure it is stored in a designated area so that it can be easily
found.
Teach employees how to administer epinephrine auto-injector, if
applicable.
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Challenges and issues specific
to foodservice operations
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Staff members rely on customers to inform them about
specific accommodations due to food allergies
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Untrained or inadequately trained staff members are not
reliable for informing customers about food ingredients
(Kronenberg, 2012)
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Food labeling for major allergens is not a requirement for
restaurants (Taylor & Baumert, 2010)
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Recipes can be modified to use unintuitive or creative
ingredients, such as peanuts in pizza sauce (Taylor &
Baumert, 2010)
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Space and equipment available for food preparation is
limited (Taylor & Baumert, 2010)
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Challenges and issues specific
to foodservice operations
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Many other avenues for cross-contact exist:
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Fish, shellfish, and gluten can become airborne during cooking
processes (FARE, 2010)
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Shared cooking surfaces and cooking oils in fryers (Taylor &
Baumert, 2010)
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The sharing of cooking and serving utensils can be habitual in
some operations (Taylor & Baumert, 2010)
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Serving methods, such as the use of the same tray to serve both
allergen-containing items and allergen-free items, salad bar
cross-contact that occurs due to customer actions, and plates
overlapping when the server carries dishes to the table, can result
in cross-contact (Taylor & Baumert, 2010)
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Strategies to reduce/eliminate
food allergy risks
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Implement cross-contact prevention.
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Set up the kitchen with food allergens kept away from commonly
used items.
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Thoroughly clean and sanitize work areas before preparing
allergen-free orders.
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Wash hands and change gloves before handling allergen-free
orders.
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Use separate grills and cutting surfaces for allergen-free orders.
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Strategies to reduce/eliminate
food allergy risks
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Ensure ingredient disclosure.
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Follow recipes strictly. Do not allow other ingredients to be added
to the food.
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Keep the most current ingredient listings for all food items so that
they are readily available for viewing.
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Train staff on menu ingredients and how to read labels to
determine the presence or absence of allergens.
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Verify ingredients periodically for pre-made and convenience
products.
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Make common allergen information available to staff.
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Strategies to reduce/eliminate
food allergy risks
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Foster communication
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Communicate with your customers about their food allergies.
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Encourage your customers to carry a Chef Card (FARE, 2013)
and give it to the chef, who will prepare allergen-free foods.
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A Chef Card outlines the foods that your customer needs to
avoid due to their food allergies. See an example of a Chef
Card at http://www.foodallergy.org/document.doc?id=219.
Introduce the ingredients of the dish and how it is prepared
to customers with food allergies
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Strategies to reduce/eliminate
food allergy risks
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Foster communication
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Communicate effectively (The Culinary Institute of America, 2008)
 When a guest requests an allergen-free meal, all employees who
may be involved in preparation of the guest’s food and service to
the guest need to be alerted immediately. When communicating
with the guest, the staff should do the following:
 Be honest
 Look the guest in the eye
 Say “I understand” to communicate attentive listening
 Repeat the important points back to the customer to clearly
demonstrate understanding
 Ask, “Is there anything else we can do?”
 Offer to have the guest meet the manager
 Communicate the allergy information to other staff members
in plain language that everyone can understand
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Strategies to reduce/eliminate
food allergy risks
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Establish standard operating procedures for allergen-free
meal preparation.
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When the chef is notified about an allergen-free meal request,
he or she should visit the customer’s table to make sure the
specific needs are clearly communicated.
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If the chef is unable to provide an allergen-free meal or is
unsure of his or her ability to do so, the customer should be
informed and provided other options.
Implement a comprehensive food allergy risk plan
(Kronenberg, 2012).
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A well-established plan reduces liability challenges in case of
an emergency and may increase the customer base.
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Strategies to reduce/eliminate
food allergy risks
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Train employees to manage the risks.
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Some states require food allergy safety training for employees.
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The Massachusetts Department of Public Health enacted the Food Allergy
Awareness Act (FARE 2014). Restaurants are required to do the following:
 Display a FARE food allergy awareness poster in an area visible to staff
 Include the following notice on menus and menu boards: “Before
placing your order, please inform your server if a person in your party
has a food allergy”
 Have a manager who has undergone training through a certified
vendor of the Massachusetts Department of Health (FARE, 2014)
Rhode Island has enacted a law similar to that of Massachusetts (FARE,
2014).
The city councils of New York, New York and St. Paul, Minnesota have
already approved a proposal requiring restaurants to present food allergy
awareness posters (FARE, 2014).
New Jersey provides posters that remind staff that allergen-free requests
should be taken seriously, to check product labels, and to avoid crosscontacts (Kronenberg, 2012).
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Strategies to reduce/eliminate
food allergy risks
 Train
employees to manage the risks.
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Staff should be aware of the possible modes of cross-contact
specific to their operation’s environment (The Culinary Institute of
America, 2008).
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A plan and specific practices should be developed for handling
food for a customer with a food allergy (The Culinary Institute of
America, 2008).
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At all business hours, an employee who understands food
allergies well should be scheduled (Wachs et al., 2012).
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Strategies to reduce/eliminate
food allergy risks
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Management strategies for potential food allergy reactions.
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Follow the Four Rs when dealing with a customer with food
allergies (FARE, 2013):
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Refer the food allergy concern to the manager, chef, or person
in charge
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Review the food allergy with the guest and check ingredients
on labels
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Remember to check the preparation procedure for potential
cross-contact
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Respond to the guest and discuss your findings with him or her
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System for Handling Food Allergies
(The Culinary Institute of America, 2008)
1. Customer says
“I’m allergic to a
food.”
2. Service staff
notifies manager.
3. Manager talks
with diner about his
or her special needs.
4. Manager
consults with chef.
5. Chef checks
ingredients.
6. Chef
communicates the
need for added
precautions to
kitchen staff.
7. Kitchen staff or
chef prepares meal.
8. Manager, server,
or chef carries the
plate separately to
the table.
9. Server confirms
that the dish has been
specifically prepared
to accommodate the
diner’s food allergies.
10. Server checks
with the diner
immediately to make
sure the meal is
satisfactory.
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Best practices
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Programs that are appreciated by individuals with food allergies
and their families.
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In schools:
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Provide peanut-free schools or tables, or implement nonfood-sharing policies
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Provide training to food handlers regarding food labels and
provide training to principals, nurses, and teachers on
epinephrine administration
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Communicate with parents of children with food allergies
about special accommodations and possible concerns
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Best practices
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In restaurants:
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Provide online menu and ingredient information
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Communicate with consumers about their food allergies and
which food items to avoid
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Provide specific allergen-free dishes
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Provide food allergy training to both front- and back-of-house
employees
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Summary
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Restaurants and other foodservice establishments are
recommended to establish a “Food Allergen Control and
Management Plan”, and an “emergency plan” to serve
consumers with food allergies.
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Prevention strategies and plans in place by restaurateurs
should focus on:
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Identification of hidden food allergens
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Cross-contact prevention
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Effect communication
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Employee food allergy training and risk management plans