Food Allergy Training Research Articles

The influence of empathy on food allergy training effectiveness: An experimental study with foodservice employees in the U.S.

This study aimed to examine the effects of empathy intervention on food allergy training through a between-subjects factorial experiment. A total of 388 foodservice employees participated, with half randomly assigned to the control group and half to the intervention group. Participants in the intervention group were shown a video describing a food allergy death to elicit empathic responses. Results showed that the intervention video elicited higher empathic responses toward food allergy victims among foodservice employees than those in the control group. Empathic responses positively related to post-training food allergy knowledge acquisition and practices. Emotional attachment and attitude towards food allergy training mediated the relationships between empathic responses and post-training knowledge acquisition and post-training practices. Meanwhile, prosocial motivations moderated the indirect effects of empathy intervention on post-training food allergy knowledge acquisition and food allegory practices through empathic response and emotional attachment/attitude towards the training. Theoretical and practical implications are discussed.

Food Allergy Knowledge and Attitudes of Owners and Managers of Independently Owned Restaurants in Metro Orlando, Florida

Owners and managers (n = 102) of independently owned restaurants in Metro Orlando, FL, completed a web-based questionnaire that assessed food allergy knowledge and attitudes. Participants were confident in their knowledge of food allergens (4.28 ± 0.63). The attitude item with the lowest mean score was “not all restaurants needed to comply with food allergy policies” (2.70 ± 1.26), suggesting participants believed compliance with food allergy policies was critical in all restaurants. Eighty (78.4%) participants correctly answered all 10 knowledge questions. The mean knowledge score was 7.7 of 10 possible points. Florida requires foodservice workers to be knowledgeable about food allergies but does not mandate food allergy training or certification. It is in the best interest of foodservice establishments to train workers on food allergies to safeguard customer health.

A systematic review of the knowledge and training of food service workers on food allergies

<abstract><sec> <title>Background</title> <p>Food allergies are adverse reactions to a specific food antigen which is mediated by immunological mechanisms and are fast rising to become a significant public health concern. Around 1% of the world's adult population suffers from food allergies. The prevalence of food allergies which can be life-threatening is commonly estimated to affect 3–5% of the adult population in North America.</p> </sec><sec> <title>Objectives</title> <p>The purpose of this study is to review published food allergy knowledge and training amongst food service workers and identify the policies in place concerning food allergies globally.</p> </sec><sec> <title>Methodology</title> <p>Documented food service workers' knowledge and training about food allergies published between September 2006 and February 2021 were comprehensively reviewed. A widespread literature search was carried out using subject headings, search terms, and keywords. Results were examined in groups to explore patterns through research.</p> </sec><sec> <title>Results</title> <p>A total of 18 relevant studies that analyzed the food allergies knowledge and training of food service workers were reviewed. Eight studies (44%) were performed in the USA, followed by two studies (11%) in the UK, and one study each (5%) for New Zealand, Turkey, Malaysia, France, Western Romania, Germany, Brazil, and Canada. In the studies, respondents were asked a series of questions to assess their level of knowledge and the types of training relating to food allergies they received.</p> </sec><sec> <title>Conclusions</title> <p>This study identified the gaps in policy, as well as knowledge and training among food service workers, to manage food allergies safely, thus emphasizing the importance and need for food allergy training.</p> </sec></abstract>

THE LEARN EARLY PROJECT: LEARNING EDUCATORS ANAPHYLAXIS RESPONSE NEEDS

<h3>Introduction</h3> With the Incidence of food allergies on the rise, and more studies demonstrating the disproportionate impact on Black and Hispanic children, it is crucial that allergists investigate and begin to address these disparities. A significant gap in this area is the role that daycares and preschools may play in helping to prevent anaphylaxis and death. <h3>Method</h3> The LEARN Early Project partnered with 17 Head-Start centers to investigate barriers they face in managing food allergies. Individual needs assessments were performed as well as food allergy knowledge tests. The results of these were then discussed in focus groups to identify potential areas for improvement as well as solutions. <h3>Results</h3> Significant variability exists in the structure of each Head Start center which presents implementation dilemmas. Additionally, there is no standardization of epinephrine training or food allergy training. In general, educators tended to over-estimate their food allergy knowledge as well as their capability of managing food allergy emergencies in comparison to that of center directors. Finally, despite some legislation appearing to support policies surrounding food allergy, such as stock epinephrine, early childcare centers are sometimes considered exceptions to these policies. <h3>Conclusion</h3> Identifying barriers that early learning centers face in providing for children with food allergies is critical in ensuring equitable, and safe care. These barriers are likely distinct for each center, but general themes were identified. It is likely that these needs will continue to evolve, and it is important to continue to reassess these needs to ensure we are implementing appropriate solutions.

Elementary School Teachers' Perceptions of COVID-19-Related Restrictions on Food Allergy Management.

(1) Background: Approximately 7% of Canadian children live with a food allergy (FA). Pre-COVID-19, ~20% of anaphylactic reactions occurred in schools. Yet, teachers reported poor FA-related knowledge, and experiences during the COVID-19 pandemic are not well-studied. Additionally, teachers’ management approaches vary widely. We aimed to describe elementary school teachers’ perceptions about FA management during the COVID-19 pandemic; (2) Methods: Using a semi-structured interview guide, English-speaking elementary school teachers in Winnipeg, Canada were interviewed virtually. Interviews were audio-recorded and transcribed verbatim. Data were analysed thematically; (3) Results: Most teachers were female and taught in public schools. Two themes were identified. Theme 1, COVID-19 restrictions made mealtimes more manageable, capturing the positive impacts of pandemic restrictions such as seating arrangements and enhanced cleaning. Limited lunchtime supervision prompted some teachers to assume this role. Theme 2, Food allergy management was indirectly adapted to fit changing COVID-19 restrictions, describing how changing restrictions influenced FA-related practices. FA training was offered virtually with less nursing support. Class cohorts and remote learning decreased teachers’ perceived risk and FA-related management responsibility; (4) Conclusions: COVID-19-related practices were perceived as positively influencing in-school FA management, although unintended consequences, such as increased supervisory roles for teachers and reduced nursing support, were described.

Food Allergy Education and Management in Schools: A Scoping Review on Current Practices and Gaps.

Currently, no synthesis of in-school policies, practices and teachers and school staff’s food allergy-related knowledge exists. We aimed to conduct a scoping review on in-school food allergy management, and perceived gaps or barriers in these systems. We conducted a PRISMA-ScR-guided search for eligible English or French language articles from North America, Europe, or Australia published in OVID-MedLine, Scopus, and PsycINFO databases. Two reviewers screened 2010 articles’ titles/abstracts, with 77 full-text screened. Reviewers differed by language. Results were reported descriptively and thematically. We included 12 studies. Among teachers and school staff, food allergy experiences, training, and knowledge varied widely. Food allergy experience was reported in 10/12 studies (83.4%); 20.0–88.0% had received previous training (4/10 studies; 40.0%) and 43.0–72.2% never had training (2/10 studies; 20.0%). In-school policies including epinephrine auto-injector (EAI) and emergency anaphylaxis plans (EAP) were described in 5/12 studies (41.7%). Educational interventions (8/12 studies; 66.7%) increased participants’ knowledge, attitudes, beliefs, and confidence to manage food allergy and anaphylaxis vs. baseline. Teachers and school staff have more food allergy-related experiences than training and knowledge to manage emergencies. Mandatory, standardized training including EAI use and evaluation, and the provision of available EAI and EAPs may increase school staff emergency preparedness.

Food allergy knowledge, attitudes, and practices of food handlers working in the five-star hotel kitchens in Turkey

The purpose of this study is to determine the food allergy knowledge, attitudes and practices of food handlers working in five-star hotel kitchens in Turkey and to explore the association between the obtained scores and handlers’ demographic and working characteristics. A cross-sectional survey involving 450 food handlers in the state of Istanbul, Ankara and Antalya, in Turkey, was conducted using a paper-based questionnaire. The total knowledge score of the participants was 11.89 ±2.22 (max 17), attitude score 60.63 ±10.34 (max 75) and practice score 55.60 ±8.01 (max 65). In the comparison based on demographic characteristics; the knowledge (12.10 ±2.15) and practice (56.33 ±5.91) scores of the food handlers who received food allergy training in the hotel they work were found to be significantly higher than those who did not receive food allergy training (p&lt;0.05). Food allergy knowledge of food handlers was evaluated as "average", attitude as "positive", and practice as "low risk practice". The results obtained are expected to contribute to the development of food allergy policies, procedures, and the planning of the necessary trainings for reducing the risks of food allergies and preventing fatal allergic reactions.

Food allergen labeling of commonly used ingredients in Chinese restaurants in the United States

This study aimed to create a food allergy reference resource to identify food allergens in commonly used Chinese restaurant packaged foods to create an initial reference database. Ninety-nine commonly used packaged foods in Chinese restaurants were identified, and their ingredient labels collected for analysis for major allergens, adherence to Food Allergen Labeling and Consumer Protection Act labeling regulations, and use of voluntary allergen advisories. Analyzed data was used in the creation of a food allergen reference resource of packaged Chinese restaurant ingredients to extend the knowledge of allergens commonly found in Chinese restaurants. Wheat (71.7%) and soy (53.5%) were the commonly found allergens on ingredient labels. The manner in which allergens were listed varied among ingredient labels. Food allergen labeling legislation that provides standard guidelines on allergen labeling for easy identification of food allergens and providing food allergy training to foodservice workers about reading ingredient labels could help restaurants, especially Chinese restaurants to better serve customers with food allergies. • Food allergies remain a challenge for consumers when dining out. • Ethnic restaurants are a concern because of a various ingredients that are used. • Allergens in commonly used ingredients in Chinese restaurants was compiled.

P119 THE IMPACT OF FOOD ALLERGY EDUCATION IN THE RESTAURANT INDUSTRY

Food allergy affects approximately 10% of the US population and attributes to over half of Emergency Department anaphylaxis cases. Vague restaurant menus and lack of food allergy training among restaurant employees are among safety and psychosocial concerns for patients with food allergies. Multiple studies report suboptimal food allergy knowledge among restaurants staff and unsuccessful educational interventions. We developed an educational handout on food allergy to determine if this intervention would improve restaurant employees’ food allergy knowledge.

The Impact of Food Allergy Training on a Teacher’s Self-Efficacy when Managing Food Allergic Students

Food allergy training for teachers remains an important, but commonly overlooked, aspect of education as millions of children have been diagnosed with food allergies. Therefore, it is pertinent teachers receive food allergy training that is most beneficial in growing a teacher's understanding for teachers to be best suited in correctly helping food allergic students. Four food allergy training methods: hands-on in-person (actual handling of epinephrine), non-hands in-person, group video, and individual video, and their effects on the self-efficacy of participants is the focus of this study. Teachers were contacted from within the city of Chicago, both public and private, and from a mixture of food allergy training methods and were administered an online survey which asked questions pertaining to their food allergy knowledge, perception, and self-efficacy. Participants were given statements to which they would respond on a five-point Likert scale, scored using a chi-square test. Ultimately, the hypothesis that teachers who engaged in hands-on in-person would showcase higher levels of self-efficacy, due to higher levels of engagement, was not supported. While several statements proved significant after data analysis, there was not enough significance to prove a meaningful relationship between the self-efficacy and training method.

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.

Food Allergy Knowledge, Attitude and Practices of Restaurant Employees in İstanbul, Turkey

With the significant increase in fatal cases of allergic reactions, the issue of food allergy has attracted the attention of authorities, particularly food allergy competence and practices among food handlers. The purpose of this study is to determine food allergy knowledge, attitude, and practices among restaurant employees in Istanbul, Turkey. This observational cross-sectional study was conducted among 490 restaurant employees included restaurant managers, cooks and service workers. The questionnaire used in this study was developed by researchers based on previous studies. The mean knowledge score for participants was 41.74±20.27, the attitude score was 69.42±2.42 and the practice score was 75.26±13.1. According to these results, the level of food allergy knowledge and attitude of the restaurant employees were ‘moderate’ and the practice level was evaluated as ‘low risk practice’. It was found that only 22.9% of the participants attended food allergy training and only 26.9% stated that they could provide appropriate service in order to prevent food allergy. The knowledge (47.45±20.77) and practice (82.02±10.06) scores of the participants receiving food allergy training were statistically higher than those not receiving food allergy training (39.99±19.80 and 73.25±13.23, respectively; p

‘Food allergy? Ask before you eat’: Current food allergy training and future training needs in food services

The incidence of allergic reactions to food occurring in eating out situations is becoming increasingly prevalent amongst susceptible consumers. Previous studies repeatedly identified food allergy knowledge gaps among foodservice staff. This highlights the importance of food safety and food allergy training in foodservices to minimise risk of food allergic reactions. This study aims to determine the current food allergy training practices, challenges and future food allergy training needs of foodservices in England. A postal survey was conducted among 500 foodservice operators in North West England. The questionnaire is divided into 5 sections: (i) demographics; (ii) current food allergy training practices; (iii) importance of food allergy training topics; (iv) challenges faced by restaurants when training foodservice staff; and (v) future food allergy training. Out of the 30 restaurants, only one restaurant did not carry out food allergy training. More than 70% of the restaurants frequently trained newly hired staff and whenever changes or updates occurred in the food hygiene regulations (60%). Most of the training were on-the-job training and took between 1 and 2 h to complete. Identification of food allergens in menu, prevention of cross contact and communication were identified as the most important topics in food allergy training. High staff turnover and lack of time contributed to the difficulty in training foodservice staff. There was considerable interest in the types of future food allergy training and most preferred on-site training by authorised staff or training at local councils. Further work is needed in the evaluation of future food allergy training needs to develop effective training materials and delivery methods to ensure the safety of food allergic individuals.

Camp Leadership Perspectives on Food Allergy–Related Anaphylaxis Events and Training for Camp Staff: A National Survey of Summer Camps

Training of camp staff to recognize and treat anaphylaxis is recommended because food allergies are prevalent among summer campers. The frequency of food allergy anaphylaxis events and the extent of anaphylaxis training for camp staff are unknown. To estimate the frequency of food-allergic reactions in camps across the United States and to assess the state of food allergy anaphylaxis training for camp staff. We partnered with CampDoc.com to send a 20-question survey in February 2016 to camp leadership representing 528 camps. Questions addressed demographic characteristics, food allergy policies, training, medication availability, anaphylaxis events, and confidence in staff to recognize and treat anaphylaxis. A total of 559 responses were received, representing 258 camps. The majority surveyed (n= 529 [94.6%]) reported food-allergic children attending their camps. Only 47.6% (n= 266) respondents reported requiring individualized emergency action plans as required for camper attendance. Anaphylaxis treated with epinephrine was reported by 24% (n= 134) of leadership within the previous 2 years at their camp. These respondents were more likely to have a training session for staff (odds ratio, 2.46; 95% CI, 1.4-4.3). A total of 63.3% (n= 354) reported training session presence. However, 15.6% (n= 87) of leadership were unsatisfied with training materials and one-third were not confident in staff to manage anaphylaxis. Appropriate policies to manage food anaphylaxis events and anaphylaxis management training were missing in a substantial proportion of camps. Camp-tailored food allergy training is needed given the number of camps reporting food allergy reactions requiring epinephrine.

Impact of the regulation (EU) 1169/2011: Allergen-related recalls in the rapid alert system for food and feed (RASFF) portal

IntroductionFood allergy is a public health concern and the information on food allergens incidents, including data provided by RASFF (Rapid Alert System for Food and Feed) portal, is crucial for risk management. AimOur aim is to analyse the data in RASFF portal to determine a correlation between the notifications related to food allergens and the entering into force of the Regulation (EU) No 1169/2011. MethodsAll ‘allergen’ hazard notifications recorded in the RASFF were extracted for the period between 31/12/2011 and 31/12/2017 and information on notification type; allergen; product category; country notifying; notification basis and action taken was analysed. ResultsA total of 627 notifications were reported and a significantly higher number of reports were observed in the last three years. Cereals and bakery products were the most reported categories and the main allergens were milk, cereals containing gluten and eggs. Official control on the market and company's own check were the main basis of the notifications and most frequently taken actions were recall from consumers and withdrawal of the product from the market. ConclusionThe increase in notifications in the last three years might be related to EU Regulation (EU) No 1169/2011. RASFF data can be a useful EU tool to improve allergen risk management, and highlights the call for action in food allergy education and training in the food systems and industry.

A systematic review and meta-regression of the knowledge, practices, and training of restaurant and food service personnel toward food allergies and Celiac disease.

BackgroundUp to 3–5% of adults may be affected by food allergies, while approximately 1% are affected by Celiac disease (CD). Food allergy reactions can be severe and potentially fatal, while CD can result in various symptoms. Restaurant and food service establishment staff have an important role in helping to prevent food allergy and CD risks among affected customers.ObjectivesA systematic review was undertaken to identify, characterize, and synthesize published research on the prevalence of food allergy and CD knowledge, practices, and training among restaurant and food service personnel. The population of interest included any personnel in these settings who prepare, handle, or serve food. Outcomes included the prevalence of food allergy and CD knowledge, practices, and training.MethodsThe review was conducted using standardized methods, including: a comprehensive search strategy; relevance screening of abstracts; characterization of relevant articles; data extraction; and risk of bias assessment. Outcomes were stratified into comparable subgroups and descriptively analyzed to examine prevalence trends across studies. Meta-regression was conducted on selected outcomes to identify possible sources of variability in prevalence estimates across studies.ResultsThirty-eight relevant studies were identified; most were conducted in the United States (50%) and focused on food allergies (90%). Significant variability was identified across studies for most outcomes. Participants generally had a higher knowledge, self-efficacy, and use of practices related to preparing and serving allergen-free meals compared to food allergy emergency response. Participants’ reported use of various risk prevention and response practices was generally low. Most participants across studies had not received prior food allergy training (median prevalence of 65% across 12 studies).ImplicationsKey knowledge and practice gaps were identified that could be targeted by future training programs. Research gaps were also identified, including a need for more experimental studies to evaluate food allergy and CD training interventions.

Food allergy knowledge, attitudes, and resources of restaurant employees

PurposeRestaurants are unique and challenging environments for accommodating food allergies. The purpose of this paper is to evaluate food allergy knowledge, attitudes and resources among restaurant employees, and identify differences based on restaurant mode of operation.Design/methodology/approachA total of 209 food-service workers were surveyed in full-service restaurants across Southern Ontario, Canada. A paper-based questionnaire was used to evaluate participants’ food allergy knowledge, attitudes toward handling food allergy requests and emergencies, and the availability of food allergen resources at the restaurant.FindingsMost participants were knowledgeable about food allergies, and valued being able to provide safe meals. However, there was a general lack of access to important food allergy risk management resources and training. Food allergy attitudes were significantly different between restaurant modes of operation. Also, food allergy training and resources were positively correlated with employee attitudes toward food allergies.Practical implicationsThe results of this study show that engaging employees in food allergy training can contribute to greater levels in employee awareness and confidence in protecting health and safety of restaurant patrons with food allergies. Restaurants that demonstrate a strong preparedness toward handling food allergy requests can deliver a better customer experience and increase customer loyalty.Originality/valueThe findings of this study underscore the need for the restaurant industry, policy makers and food safety educators to work together to develop training programs and relevant resources to support and facilitate food allergy risk management in restaurants.

Food Allergy Training for Schools and Restaurants (The Food Allergy Community Program): Protocol to Evaluate the Effectiveness of a Web-Based Program

BackgroundFood allergy is a growing public health concern. The literature suggests that a significant number of reactions occur in community services, such as schools and restaurants. Therefore, suitable training and education for education and catering professionals using viable and practical tools is needed.ObjectiveThe objective of this study is to evaluate the effectiveness of a Web-based food allergy training program for professionals working in schools and restaurants, designed to improve knowledge and good practices in the community.MethodsFree learning programs which contain educational animated videos about food allergy were developed for professionals working at schools and restaurants. The learning programs comprise of nine 5-minute videos, developed in video animation format using GoAnimate, with a total course length of 45-60 minutes. The courses for professionals at both schools and restaurants include contents about food allergy epidemiology, clinical manifestations, diagnosis and treatment, dietary avoidance, emergencies, labelling, and accidental exposure prevention. Additionally, specific topics for work practices at schools and restaurants were provided. Food allergy knowledge survey tools were developed to access the knowledge and management skills about food allergy of school and restaurant staff, at baseline and at the end of the food allergy program. The courses will be provided on the e-learning platform of the University of Porto and professionals from catering and education sectors will be invited to participate.ResultsData collection will take place between September 2017 and October 2017, corresponding to a 2-month intervention. Final results will be disseminated in scientific journals and presented at national and international conferences.ConclusionsThe Food Allergy Community Program intervention may improve school and restaurant professionals’ commitment and skills to deal with food allergy in the community. Furthermore, this e-intervention program will provide an innovative contribution to understanding the impact of electronic health technologies on the learning process and the development of strategies for community interventions.Registered Report IdentifierRR1-10.2196/9770

‘No nuts please’: Food allergen management in takeaways

There is an increasing number of food allergic reactions occurring in food services including takeaways. This study investigated the food allergy knowledge, attitude and practices of staff in takeaways. Although more than half of the takeaways' staff (n = 28) demonstrated good food allergy knowledge, there still exists some misunderstanding among the respondents. There were confusion about lactose intolerance and milk allergy, a third of the takeaways' staff were uncertain that hands could transfer allergens. Almost half of the respondents were not aware of the danger of offering water to dilute a food allergen to stop the reaction Experienced staff and managers/owners reported more positive attitude and higher frequency of good food allergen management practices. Respondents also strongly agreed that customers should inform staff if they have food allergies. However, takeaways’ staff would enquire customers if they need allergen information when taking orders over the telephone. Clear communication between front service staff, customers and kitchen crew are important and should be established and meals verified with cooks to ensure safe meals are prepared. Managers or owners should also strongly encourage their staff to participate in food allergy training. Food Standards Agency has set up a free food allergy online training that would be a valuable addition to food businesses.

Multicenter survey of restaurant staff’s knowledge of food allergy in eastern France

There are 14 allergens with mandatory labeling of manufactured food. A recent European regulation on the provision of food information to consumers has made it compulsory for restaurants to have a written document informing consumers on allergens contained in the dishes they serve. To investigate restaurant staff’s knowledge about food allergies. A standardized telephone questionnaire was administered to one member of staff at 100 restaurants in Metz and Strasbourg, France. The survey was conducted from November 2016 to March 2017. Responders included 56 owners, 4 managers, 28 waiters and 12 chefs. Seventy-four percent reported food hygiene training; 14% reported specific food allergy training. Seventy-nine percent knew about the European regulation. In all, 32% reported to be very confident in in providing a safe meal to a food-allergic customer, 30% somewhat confident, 34% confident and 4% not confident. Answers to true-false questions indicated some frequent misunderstandings: 25% believed an individual experiencing a reaction should drink water to dilute the allergen; 22% thought consuming a small amount of an allergen is safe; 39% reported allergen removal from a finished meal would render it safe; 32% agreed cooking food prevents it causing allergy and 8% were unaware allergy could cause death. Despite the new regulation, currently eating out in restaurants does not put consumers with food allergies in the position of making safe food choices. Our findings also suggest the necessity for continuing to provide both food allergy and mandatory training and/or to incorporate such training into generic courses on food hygiene. Although the knowledge of the respondents was overall good in our study, certain gaps in this knowledge could be dangerous for consumers with allergies. We believe that the greater the number of trained staff in restaurants, the lower the risk of providing unsafe meals to clients.