Research Shows Fast Food Restaurant Workers Lagging in Food Allergy Information

New research indicates that restaurant workers are willing to accommodate patrons with severe food allergies, but are dangerously ill informed about the number of precautions needed to guard against reactions such as anaphylaxis.

A team from the University of Pennsylvania visited all 233 quick service restaurants in the Center City neighborhood of Philadelphia and asked restaurant workers to answer a tablet-based survey that assessed their knowledge of, attitudes about and practices concerning food allergies. Employees from 187 of the restaurants (80%) participated.

The overwhelming majority of restaurant workers (89%) said they’d willingly expend considerable extra effort to serve a safe meal to patrons with serious food allergies, but none of the workers who participated in the study could name all of the steps necessary to maximize food safety.

Among the steps that workers often failed to consider were changing gloves and cleaning utensils and work surfaces. Many did not even think to check ingredient lists on various meals to ensure the absence of specified allergens.

Asked what to do in the event of an emergency, 79% of the workers said they would call 911, but only 20% knew that the proper treatment in the case of anaphylaxis is an injection of epinephrine.

“Each year there are 90,000 emergency department visits for food-induced anaphylaxis. Food service establishments are an important target for prevention, given that Americans consume half of their food dollars away from home,” wrote the study authors, who will present their findings at the annual meeting of the American Public Health Association.

“In this study, food service workers were highly engaged, expressing a desire to learn more about safe food allergy management… Food service workers are important allies in reducing food allergy morbidity and mortality. Improved restaurant training and protocols are crucial in this era of escalating food allergy prevalence.”

Several other studies have found that most restaurant workers are ill prepared to make food for customers with allergies and that workers often hold mistaken notions of safe food handling procedures.

A study published in 2011 by Clinical and Experimental Allergy, for example, asked workers at 162 restaurants to participate in a telephone survey. Responders included 7 owners, 48 managers, 20 waiters and 15 chefs. Although only a third had ever had food allergy training, 81% said they were “very” or “somewhat” confident they could provide a safe meal to a customer with food allergies.

However, nearly all of the respondents had some dangerous misconceptions. Among the most common were the belief that water could dilute an allergen and ameliorate an allergic reaction (38%), that consuming a small amount of an allergen was safe (23%), that removing an allergen from a finished meal would make the food safe to eat (21%) and that cooking an allergen thoroughly would render it safe for consumption (16%).

The authors of that study reached a similar conclusion as their counterparts at the University of Pennsylvania.

“Despite a high confidence level, there are obvious gaps in restaurant staff's knowledge of allergy. Food-allergic patients need to be aware of this and adapt their behaviour accordingly,” they wrote.

“Our data challenge the impact of current food allergy training practice for restaurant staff, and support the need for more rigorous and accessible training.”