For thousands of people, food allergies are a very real danger. One bite of something containing an allergen – or merely coming in contact with an allergen – could be fatal.
There are many tragic stories of allergy sufferers who died after consuming even a trace of allergen, and it’s not enough to say they should have been more careful. In this age of convenience and rush, allergy sufferers face a uniquely grave problem. Even when allergic individuals carefully read food labels, share allergy concerns with friends and with food service workers, carry epinephrine injections, conscientiously avoid all foods known to contain the allergen, and wear medic alert bracelets, there is still the ominous awareness that every bite of food could be their last.
The food manufacturing industry historically has made little effort to provide reliable and consistent information concerning allergens, and it has taken accounts like that of Christina Desforges, a young teenager with a peanut allergy, who died after kissing her boyfriend who had consumed peanut butter hours earlier to really make the industry take note of the issue.
Thankfully, the Food Allergen Labeling and Consumer Protection Act (FALCPA) took effect in 2006. This act requires food labels to have clear statements concerning the presence of the eight major food allergens (see sidebar).
While the food manufacturing industry is rising to meet the challenge of removing the risks for allergy sufferers, our food service industry is only slowly waking up to the need for change. Restaurateurs have an equally important responsibility and should design training programs for staff, provide accurate ingredient information to customers, and overall, support the trend toward making the world safer for those who suffer from food allergies.
Allergy Basics
A food allergy is an exaggerated response by the immune system to a specific food or groups of foods. Some reactions are mild, while others are life threatening. The body reacts to the food as if it is a foreign invader and mobilizes antibodies, which causes inflammation and other adverse reactions.
Some people have just one allergy, while others have several. Some have mild to moderate reactions such as dermatitis or inflammation around the mouth while others may experience anaphylaxis after coming into contact with a mere trace of an allergen. For individuals with mild allergies, allergic reactions can occur 4 to 6 hours after ingestion of a specific food, while other reactions may take more than 6 hours for the development of any adverse reaction or condition. However, the amount that may be eaten before symptoms appear is usually very small and varies with each individual.
In fact, in very sensitive individuals, the amount of an allergen that can trigger a reaction can be less than a milligram, which is evidenced by the fact that many individuals have experienced reactions from mere traces of an allergen. Furthermore, of the eight foods that have been identified to be the cause of the vast majority of reactions, peanuts and tree nuts cause the most severe reactions, and, according to one allergist, “most, if not all peanut allergies are considered potentially anaphylactic.†The only treatment for food allergies is avoidance of the problem food(s). Thankfully, many children outgrow allergies to milk, eggs, wheat and soy, but allergies to peanuts, tree nuts and shellfish tend to be life-long.
Numbers and Statistics
An estimated 11 million Americans suffer from food allergies, which amounts to 2% of the adult population and 6-8% of children in the United States. (To put that figure in perspective, there are 11.6 million employees in the restaurant industry.) Eleven million means that 1 in 25 people in America are suffering from food allergies. While that is a staggering proportion, research provided by the Food and Drug Administration reveals that approximately 90% of food allergies are caused by the big eight. Despite the fact that these eight foods account for the vast majority of food allergies, reactions are widespread and hard to prevent because nuts, milk, eggs, and wheat are so commonly used in food manufacturing and often are labeled in inappropriate or misleading ways. For patrons of restaurants that use any kind of manufactured item in their production, the risk of facing an allergen is present. Likewise, restaurateurs should realize that unless every item on the menu is made completely from scratch with pure ingredients, or unless precise information about store-bought ingredients is known, there is the risk that an allergic patron could have a reaction.
When one considers that approximately half of the American food budget is spent on meals away from home, and the average American eats 198 meals out a year, it is clear that the risk of having someone experience a reaction in your establishment is worth considering.
Even though not all anaphylactic reactions are fatal, they almost always result in emergency room visits. According to the National Institute of Allergies and Infectious Diseases, food allergy is the most frequent single cause of emergency room visits for anaphylaxis and accounts for 34 to 52 percent of such emergency room visits. In addition, anaphylactic shock as a result of food allergies kills, by some estimations, 150 to 200 people every year.
Food allergies appear to be on the rise, particularly in children. The most common allergy in children is the peanut allergy, and more than one million Americans are severely allergic to nuts. What is most alarming to the restaurant industry are those statistics that directly reflect allergic reactions in restaurants. According to a 2001 fatality survey conducted by the Food and Anaphylaxis Network (FAAN), 47 percent of food-allergy deaths occurred in restaurants, and one-third of allergic respondents to the 2004 FAAN survey experienced reactions from food provided by restaurants.
Responsibility and Risk
The fast pace of restaurants necessitates efficient communication and quick responses, but a human life is always worth an extra consideration. Even though the threat of causing someone’s death is enough to make restaurateurs enact new strategies to aid those with food allergies, the threat of litigation certainly gives an added motivation.
It begs the question: what is the responsibility of the food service industry in meeting needs for allergy sufferers? Beyond immediate financial losses, losing in court brings the irreparable loss of reputation. And the loss of reputation will deter non-allergic customers as well as allergic customers because the idea that there was negligence in one area tends to make people think that there is negligence in another. In other words, the overall quality of food safety will be called into question should someone experience a reaction to food served in your restaurant. For this reason, it is important to have strict procedures in place to prevent such an incidence.
Nancy Caldarola, PhD, RD, a consultant with Concept Associates, is active in the GRA and   the   Women’ s   F oodservice   F orum.   With more than 35 years in the industry she has held senior operations, training, and marketing roles in several international chains. She is a past lecturer at UGA, and was recently named Education Director for NACS CAFEÌ at GSU. 678-523-3080
Allison Barfield graduated from the University of GA with a degree in Dietetics. She is currently a graduate student at the Washington University School of Medicine in St. Louis studying Occupational Therapy. A licensed pilot, Allison’s future includes mission work in underdeveloped areas where she can share her knowledge and skills.
