Preventing Allergic Reactions to Foods: The Development and Evaluation of a Fact Sheet for Food Service Operations

Abstract

P-087 Abstract: Food allergies are a common, serious—and sometimes fatal–problem. Nearly 7 million Americans have food allergies. Among children under the age of 6, 1 in 12 has a food allergy. Fortunately, most have mild allergies and may experience a runny nose, sneezing, itching skin, hives, or digestive upset. But, for those who are severely allergic, exposure to a ‘trigger’ food may cause life-threatening reactions, such as an asthma attack or swelling of the tongue, lips or throat. In fact, severe allergic reactions (known as anaphylaxis) to nuts cause 100 deaths annually. Those with food allergies must avoid allergen-containing food. Eating away from home can make this avoidance difficult, especially if food service personnel do not know how to safely serve customers with food allergies. Little research has addressed baseline food allergy knowledge and practices of food service personnel and few educational materials are available. Therefore, the purpose of this study was to describe the importance food service personnel place on serving allergen-free orders and the information food service personnel need to prevent triggering food allergic reactions in their customers. Trained interviewers conducted key informant interviews with food service managers (N=33) in operations including quick service, fine dining, and school lunch using a guided interview protocol. During the ∼30-minute interview, managers rated the importance of food service personnel knowing how to handle allergen-free orders, described information most important for food service personnel to know about handling allergen-free orders, and described the desired format of related educational materials. Managers rated knowing how to handle allergen-free orders as very important (mean= 4.6±0.8 on 5-point Likert-scale). Qualitative analysis revealed the most important educational messages were: food allergies are a serious health issue; food allergens can be almost any food (including identification of common food allergens and their possible presence as “hidden ingredients”); and steps to ensure allergen-free orders. Managers indicated educational materials should be serious in tone, use photographs, be reproducible, durable, and in at least English and Spanish. Interview findings were used to create a factsheet for food service personnel. Factsheet drafts were evaluated by food service managers and physicians, then refined. The final factsheet complies with the 2005 Model Food Code published by the Food and Drug Administration. In addition, the factsheet has been legislatively mandated to be distributed to all food service operations in the state of New Jersey to help food service personnel avoid triggering food allergic reactions.