Food Allergy Practices Research Articles

Dining out safely with food allergies: A comparative perspective from restaurant managers and servers in Malaysia

Food can motivate visiting a destination or coming together with family and friends, but food allergy concerns and reactions increasingly spoil the tourism and leisure experience. Incidents of food allergies in restaurants, and questions on how to handle food allergy communication and practices require attention from the hospitality industry. Based on a survey conducted at restaurants, we applied a five-level framework to examine and compare the multifaceted perspectives of restaurant managers and front-line employees regarding their understanding and practices on food allergies. Findings showed that managers' and servers' food allergy knowledge in Malaysia was low when compared with similar studies conducted in a 'Western' context. In addition, the results also indicated significant differences between food allergy practices and perceived training needs between the two tested groups. In general, managers were more aware of the practices and perceived training needs regarding food allergies than servers. Majority of servers did not receive training in food allergies. Accordingly, all relevant stakeholders must cooperate in developing appropriate educational tools to improve food allergy knowledge.

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P112 An Investigation of Parent and Child Perceptions of Food Allergy Practices, Protocols, and Policies in Schools

<h3>Background</h3> Many schools implement well-meaning policies to protect children with food allergies; however, these policies oftentimes do not ease parents' worry and concern, or leave children feeling isolated. <h3>Objective</h3> Explore children's and parents' perceptions of how supportive and safe their school is about food allergies. <h3>Study Design, Setting, Participants</h3> Children ages 8 to 18 with a food allergy and their parents (n = 18 pairs) across the U.S. who met the inclusion criteria completed one-on-one semi-structured phone interviews. <h3>Outcome Measure/Analysis</h3> Interviews were audio-recorded and transcribed. Content analysis was applied to the transcriptions by 2 investigators, independently, to identify themes among parents and children. Investigators met to discuss themes and reach consensus. <h3>Results</h3> Overall, both parents and children felt generally safe with their school's policies with some exceptions, although parents seemed to be more concerned vs their children, especially younger children. Exceptions included cross-contamination, outside food, especially home-baked items, being brought into classrooms, and the knowledge and awareness of their child's food allergies among others within the school community. Striking a balance between safety and inclusion was important to parents in normalizing life for their children. For example, a policy of a nut-table in which children who bring a lunch containing nut products may be more inclusive vs a nut-free table (where only those with food allergies sit). This would allow more freedom for those with food allergies to choose where they sit, and may make them feel more included. <h3>Conclusions</h3> While schools across the U.S. have a variety of policies in place to protect children with food allergies, the social and emotional effects of these policies, in conjunction with safety, are important considerations. Policies that may need to be considered include increased food allergy training and education for teachers and staff, nut-free campuses, and banning outside food without a food label.

ATOPY PATCH TESTING IN PEDIATRIC PATIENTS WITH PROTON PUMP NON-RESPONSIVE EOSINOPHILIC ESOPHAGITIS

Introduction The role of atopy patch testing (APT) in Eosinophilic Esophagitis (EoE) remains controversial with no clear guidance for utility in the Food Allergy Practice Parameters. This exploratory study examines the use of APT in pediatric patients with EoE. Methods A retrospective chart review from 08/2017 to 06/2018 was conducted at a large academic Allergy/Immunology Division. Pediatric patients with a diagnosis of EoE who underwent APT in conjunction with skin prick testing to guide food elimination were identified. Results of APT and response to dietary elimination were evaluated using descriptive statistics. Results 45 patients, ages 2 to 18 years, were identified with initial screening. 5 patients had APT prior to second biopsy showing PPI responsiveness and were excluded. Three patients were lost to follow-up. 1 patient was diagnosed with an eating disorder and did not undergo food elimination. 5 additional patients have follow-up endoscopy pending. A total of 31 patients were included in final assessment: 23 males and 8 females, average age 9 years. Of the 31 patients, 1 had improvement on biopsy that could be uniquely attributed to APT. The remaining 30 patients (97%) had APT that was not useful in identification of triggering foods. Conclusions In our sample of pediatric EoE patients, APT was not useful in identifying foods for removal. Given the productivity loss for both patients and parents as well as the increased financial costs of patch tests and three additional visits, guidelines on EoE management should be adapted to more strongly discourage APT for identification of triggering foods.

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Restaurant Food Allergy Practices - Six Selected Sites, United States, 2014.

Food allergies affect an estimated 15 million persons in the United States (1), and are responsible for approximately 30,000 emergency department visits and 150-200 deaths each year (2). Nearly half of reported fatal food allergy reactions over a 13-year period were caused by food from a restaurant or other food service establishment (3). To ascertain the prevalence of food allergy training, training topics, and practices related to food allergies, CDC's Environmental Health Specialists Network (EHS-Net), a collaborative forum of federal agencies and state and local health departments with six sites, interviewed personnel at 278 restaurants. Fewer than half of the 277 restaurant managers (44.4%), 211 food workers (40.8%), and 156 servers (33.3%) interviewed reported receiving food allergy training. Among those who reported receiving training, topics commonly included the major food allergens and what to do if a customer has a food allergy. Although most restaurants had ingredient lists for at least some menu items, few had separate equipment or areas designated for the preparation of allergen-free food. Restaurants can reduce the risk for allergic reactions among patrons by providing food allergy training for personnel and ingredient lists for all menu items and by dedicating equipment and areas specifically for preparing allergen-free food.

Food allergy knowledge, attitudes, practices, and training of foodservice workers at a university foodservice operation in the Midwestern United States

The increasing incidence of food allergies is a major concern for all foodservice operators. The purpose of this study was to examine food allergy knowledge, attitudes, practices, and training among employees working in a university foodservice operation. Results from a paper-based questionnaire showed statistically significant differences in employee knowledge, attitudes, practices, training received, and perceived training needs between student and non-student employees. While training specific to food allergies was not provided, employees considered food allergy training to be important for handling food safely in their workplace. Attitudes toward food allergies had a significant influence on food allergy practices. Results from this study can be used by university foodservice operations to develop food allergy policies and procedures by taking into account the needs of their employees to protect food allergy sufferers in university foodservice operations and promote well-being.

The Attitudes of Child Nutrition Professionals about Food Allergies and Current Food Allergy Practices: A Focus Group Study

The Attitudes of Child Nutrition Professionals about Food Allergies and Current Food Allergy Practices: A Focus Group Study