Allergen Management for Food Businesses

Food allergies are becoming more common in Canada. It is critical that all Food Handlers working in a food business understand their obligation to know what ingredients are in the food products they handle, make or sell.

Any food may contain an allergen. It is vital that the business ensures procedures and training are put in place, and food service staff understand their obligations to declare known allergens in food when a customer asks.

The effect of an allergen on a person who suffers with allergies can lead to serious health consequences, including death.

Food businesses in Canada are accountable for knowing the presence of allergens in foods they sell. Ignorance is not an excuse, nor a defence. This rule applies whether the sold food is packaged or unpackaged.

People with food allergies react differently. Some people have a reaction that presents as a rash or hives; others may suffer from swelling or dizziness, which can affect their breathing. Anaphylactic reactions can occur almost instantly in persons who suffer with allergies, and in severe cases, can result in death if not treated quickly. Regardless of sensitivity, there is no safe level of exposure for individuals with an allergy. 

SOME KEY POINTS TO REMEMBER ABOUT FOOD ALLERGENS:

• Always treat an allergy request seriously.
• Any food may contain an allergen. Once a customer informs of an allergy, the business is legally responsible for preparing food that does not contain the allergen, or for notifying the customer that they cannot guarantee that the food does not contain the allergen.
• There are 12 common allergens. These account for the majority of food allergies and are legally required to be declared on labels.
• Allergens are an important food safety risk. Heavy penalties, including prosecution and a criminal conviction, may apply to businesses complicit in customers experiencing allergic reactions from their food.

TO AVOID AN INCIDENT, ALWAYS DO THE FOLLOWING:

• Review recipes, ingredients and food components (such as pre-made sauces) to check if they contain allergens.
• Read the label on all ingredients used in food preparation. If a pre-made food item or ingredient does not have a label, it should not be used unless you have documentation listing all ingredients.
• Be allergy-aware during food preparation. Allergens may be introduced through cross-contamination between allergenic and non-allergenic ingredients. For example, peanut oils used to fry food that does not contain peanuts can introduce traces of peanut into the food. Cross-contamination during preparation most often occurs through:
  • food-to-food contact (touching or dripping)
  • hand-to-food contact (unhygienic handling by Food Handlers)
  • equipment-to-food contact (sharing of utensils)
• Be aware of your business’s responsibilities about communicating allergen information. You will need to notify your customer:
  • if the product contains an allergen (by labelling the food product or telling them when they ask)
  • if you can’t guarantee an allergen-free meal

LEARNING FROM REAL-LIFE EXAMPLES

Managing allergens in a food business can be challenging, but living with a severe food allergy is both difficult and frightening. Below are some true cases that demonstrate the serious consequences of allergic reactions to food, as well as how widespread this condition is across different demographics. Pay special attention to how easily small amounts of allergens can cause fatal reactions, even when medical responses are immediate. 

SHAHIDA SHAHID

Shahida Shahid was an 18-year-old university student. Shahida, who had food allergies including dairy, ate a chicken burger at a restaurant unaware that the burger was marinated in buttermilk. Shahida discussed the menu and alerted the server to her allergies before ordering her meal. After eating the burger, Shahida collapsed and was immediately administered her epinephrine auto-injector. A few days later Shahida was removed from life support and died. You can read Shahida’s full story here. 

ELIJAH SILVERA

Elijah Silvera was a 3-year-old attending a preschool. Elijah’s severe reaction was set off after he was given a grilled cheese sandwich by an employee at the school. Elijah’s death occurred despite the preschool having documentation of Elijah’s severe allergies to dairy and other foods. You can read Elijah’s full story here. 

AMANDA THOMPSON

Amanda Thompson was a 50-year.old mother of two. Amanda collapsed and died after eating a bowl of sorbet in a hotel. Amanda had made it known to the holiday agent — as well as to the hotel — that she needed specially prepared food as she had severe allergies to dairy products. You can read Amanda’s full story here.

You need to be aware of, and understand, the differences between allergies and food intolerances, as they develop and present differently from one another.

ALLERGIES

A food allergy is a physical response to a protein that the body ‘thinks’ is harmful. There is no cure for a food allergy and the only way to prevent an allergic reaction is to avoid eating food that contains the protein.

The body can react in many ways to an allergen, such as: developing hives, swelling, pain, vomiting, difficulty breathing, dizziness and collapse. The symptoms can be fatal. There is no safe limit for exposure to an allergen.

FOOD INTOLERANCES

Food intolerance is the body’s inability to digest or process some foods (e.g. gluten in bread).

Gluten, lactose, yeast, food additives and sulphites are all products which may cause intolerances in some people. While the symptoms can be unpleasant, and in some cases severe, they are generally not life-threatening. Food Handlers should apply the same principles when responding to intolerances and allergies. 

While the 12 most common food allergens cause around 90 percent of allergic reactions, all foods can be allergenic depending on individual sensitivity.

In partnership with Canadian allergy associations and the medical community, Health Canada and the Canadian Food Inspection Agency (CFIA) have identified 12 key substances most frequently associated with food allergies and allergic-type reactions. They are:

1. Gluten
2. Eggs
3. Milk
4. Mustard
5. Peanuts
6. Shellfish
7. Fish
8. Sesame seeds
9. Soy
10. Sulphites
11. Tree nuts
12. Wheat and triticale

This section includes more details of the 12 priority allergens identified by Health Canada. Each allergen is frequently used as an ingredient in other foods. It is important to review ingredients of all pre-packaged foods when checking for allergens and look for any trace of allergen or declaration of cross-contamination.

Knowing your products and effectively communicating product information is key to ensuring the safety of your customers with food allergies.

1. Gluten

Gluten is the common term for a group of related proteins known as prolamins and glutenins found in wheat, rye and barley. Gluten is harmful to patients with gluten-related disorders (a term used to describe all conditions related to gluten) which includes celiac disease, wheat allergy, non-celiac gluten sensitivity, dermatitis herpetiformis (celiac disease of the skin) and gluten ataxia. Some common foods that are not thought to have gluten but often do are cold cuts, french fries, sausages, veggie burgers, marinades, gravy and ketchup.

According to Health Canada, for foods to be labelled as gluten-free they must contain less than 20 parts per million (ppm) of gluten. This standard will protect the health of most people who suffer from celiac disease.

This level is recognized internationally in the Codex Alimentarius Standard for Foods for Special Dietary Use for Persons Intolerant to Gluten (Codex Standard 118-1979), which states that the gluten content of foods labelled gluten-free shall not exceed 20ppm of gluten. 

2. Eggs

Eggs are another common allergy-triggering food, particularly for children. Both the egg white and the yolk can cause an allergic reaction, so Food Handlers should not serve either if a customer notifies of an egg allergy.

Eggs are also a common ingredient in many recipes including baked goods, meringues, custards and other desserts, pasta and some types of noodles, dressings such as mayonnaise and aioli, and binding agents in processed foods (including some processed meats).

3. Milk

Milk allergies should not be confused with lactose intolerance. Milk allergies are caused by an immune system reaction to proteins in milk products, whereas lactose intolerance results from the body lacking the digestive enzyme, lactase. Those with a cow’s milk allergy may also have allergies to other animal milks like goat or sheep.

It is important that you check with the customer what alternatives they can consume, as many non-dairy milks are made from other allergens like soy or almonds (tree nut). Food Handlers should be mindful of cheese, cream, powdered milks, yogurts, whey protein as well as fresh milk. 

4. Mustard

Apart from jars of mustard, there are other foods derived from the mustard plant. These include mustard leaves, seeds and flowers, sprouted mustard seeds and mustard oil, as well as foods that contain them. All are likely to cause reactions in people with a mustard allergy.

Food Handlers should check all food and products that contain mustard or mustard seed and any product whose label carries a warning that the product might have mustard in it, such as “may contain mustard.” Some common foods that contain mustard are: barbecue sauce, fish sauce and fish paste, ketchup, pickles, salad dressings, sausage, seasonings, flavouring agents and emulsifiers. 

5. Peanuts

Despite being the “poster child” of nut allergies, peanuts are actually classified as legumes and not nuts. They contain many proteins that may trigger an allergic reaction and are common ingredients in many cuisines and pre.made products, such as satay sauces. Food Handlers should be aware that foods containing other nuts may also have traces of peanut due to cross-contamination during the manufacturing process. Common peanut ingredients in commercial kitchens include: peanut oil, peanut butter, and raw or roasted whole nuts.

Individuals with a peanut allergy may also react to lupin, another legume comprised of similar proteins. This is known as cross-reactivity, and occurs because the immune system sees them as the same. Lupin is increasingly used as a gluten-free alternative to wheat and other grain flours, and can be found in breads, biscuits and other baked goods, sauces, pasta and processed meat products like burgers and sausages. It may also be used as a substitute for soy products. 

6. Shellfish

Shellfish refers to aquatic shelled animals, especially those that are edible, such as molluscs (e.g. oysters or cockles) or crustaceans (e.g. crab or shrimp).

Common shellfish allergens include: crab, lobster, shrimp, prawns, scampi, crayfish, snails, clams, oysters, mussels, squid and octopus.

Shellfish are common ingredients in Asian soups, sauces and stocks and as flavourings. Food Handlers should ask for clarification if a customer is allergic to all, or some types of shellfish.

7. Fish

When speaking about fish allergies, fish refers to finned fish. Salmon, tuna and halibut are the most common kinds of fish that people are allergic to. Chopped fish products (such as canned tuna) have a high risk of being contaminated with many other types of fish during processing. Some other unexpected sources of fish are barbecue sauce, bouillabaisse, Caesar salad, Caesar dressing and Worcestershire sauce. 

8. Sesame Seeds

Sesame seeds are known to be a very strong allergen, so it is critical to check ingredients for sesame products. Sesame is a common ingredient in a range of cuisines, from Asian dishes made with sesame oil, to Turkish and Lebanese foods such as tahini and hummus.

Sesame seeds are used in many types of baked goods such as crackers, biscuits and pretzels. They are found in salads as either seeds or oil in dressings, and in spice mixes, marinades and herb rubs. They are also a common ingredient in many vegetarian foods. 

9. Soy

Soy comes from soybeans, a type of legume, and goes by many names — such as bean curd, tamari, tempeh, and tofu — which means Food Handlers should be checking for alternative names on labels.

Aside from obvious soy products like soy milk and soybean paste, soy is a common product in processed foods, particularly as a meat or dairy substitute in vegetarian dishes. Soy is also known to be used as a substitute for gluten or “allergen-free” breads. It can be found in vegetable stocks, gums, soup mixes, and as flour or flavouring in cereals and baked goods.

10. Sulphites

Sulphites are substances that naturally occur in some foods and in the human body. They are also food additives that are used as preservatives to maintain food colour, prolong shelf-life, prevent the growth of microorganisms and maintain the potency of certain medications. Sulphites are also used to bleach food starches, such as potato, and in the production of some food packaging materials, such as cellophane.

Sulphites that can be added to foods in Canada are potassium bisulphite, potassium metabisulphite, sodium bisulphite, sodium dithionite, sodium metabisulphite, sodium sulphite, sulphur dioxide and sulphurous acid.

11. Tree Nuts

Tree nuts are separate to peanuts and include almonds, brazil nuts, cashews, chestnuts, hazelnuts, hickory nuts, macadamia nuts, pecans, pine nuts, pistachios, walnuts and others. Many people with a tree nut allergy will be allergic to more than one type of tree nut. It is important for Food Handlers to check products for any tree nut ingredient, not just individually declared allergies. Tree nut products include flours, meals (such as cornmeal), some non-dairy milks and bakery products. They can also be used as flavourings for foods like ice cream and chocolate. 

12. Wheat and Triticale

Wheat and triticale allergies should not be confused with gluten intolerance or celiac disease. A wheat allergy is an immune sensitivity to wheat proteins, and symptoms present just like any other allergic reaction, up to and including anaphylaxis.

Common products containing wheat are bread, biscuits, cakes and other baked goods, pasta and cereals. Wheat is also used as a thickening agent in sauces, soft candies like licorice, jelly beans, hard candies, vegetable gums, hydrolyzed vegetable protein, beer and ales, and processed meat products like hot dogs.

Triticale is a hybrid cereal produced by crossing wheat and rye and grown as a fodder crop. Although not typically available commercially, people with wheat allergies should avoid triticale as well.

There are many processes that you and your food service staff should know and follow to minimize risk when preparing, displaying or selling foods that contain known allergens. Below we have selected the top three processes that can help avoid setting off a food allergy sufferer’s reaction. They are:

1. knowledge of products and their ingredients
2. communicating ingredients with customers
3. management of food preparation

KNOWLEDGE OF PRODUCTS AND THEIR INGREDIENTS

It is vital that you and your staff know the products that you make and sell, as well as their ingredients. Check product labels of all foods and ingredients used in the business for allergens, including allergens listed by alternative names. Food Handlers should:

• Check ingredients in pre-packaged foods, especially products manufactured off-site (e.g. commercial mayonnaise).
• Only use labelled ingredients and products. For example, if a bag of dried porcini mushroom and herb risotto mix does not list all the contents, then the product should not be used.
• Take care when adding any ingredients to products in-house. For example, exercise caution when adding peanut butter to a curry, or sesame oil to a salad dressing.
• Avoid the dangers of not using reliable suppliers, and check with them for allergens when products are reformulated or changed.

Not all employees need to check food labels — but all staff should know what goes into the foods that your business prepares and serves. 

COMMUNICATING INGREDIENTS WITH CUSTOMERS

When asked if an item contains any known allergens, Food Handlers must respond accurately and honestly. It is vital that Food Handlers know what to do if they are unsure when asked about allergen content. All food businesses should follow these principles so that staff can answer allergen questions confidently:

• Employees and customers should have access to ingredient information (written documents wherever possible).
• Employees should feel comfortable asking management and other staff members about the products they offer.
• Management should instruct staff members to tell customers if they cannot guarantee an allergen-or intolerance-free meal.
• When a customer orders an allergen-free meal, wait staff must inform all kitchen and service staff that an allergen-free meal is being prepared.
• Employees should discuss with the customer how staff can best manage their allergy, as they may be able to advise preparation techniques.

Information about known allergens in food can also be provided by listing them clearly in an obvious place such as a menu, chalkboard or information package. If the information is not provided up front, let your customers know where they can get it, either in writing or verbally.

LEARNING ACTIVITY #1

Think about how you would respond to the following queries from customers about different allergens. Discuss the below scenarios with a colleague. 

SCENARIO 1

A customer asks you if the stir-fried beef on your lunch menu contains peanuts or traces of nuts. If you are not sure, what would you say to her? 

SCENARIO 2

A customer at your hotel explains that he is allergic to cow’s milk and wants to know if you have an alternative to prepare the custard you serve. What would you say to him if you also have light soy milk and almond milk as an option to prepare the custard? 

MANAGEMENT OF FOOD PREPARATION

When a customer alerts you to a food allergy, you must take steps to minimize the risk of cross-contamination. Everyone who handles food needs to be informed and remain updated about the products they prepare or sell, and the ingredients contained in those products. To assist staff, known allergens must be identified and communicated. You and your staff should take the following actions:

• Always document and verbally alert kitchen and wait staff when a customer has ordered an allergen-free meal.
• Only use ingredients listed in recipes and do not replace one ingredient with another. For example, do not use sesame seeds instead of poppy seeds. A customer may have chosen the meal and not disclosed an allergy.
• Remember and understand that allergen proteins are not destroyed by cooking or cooling processes.
• Try to keep a designated allergen-free meal preparation area set aside, and regularly clean and sanitize preparation areas to remove residues. Even tiny amounts of an allergen can cause allergic reactions.
• Always use clean and sanitized utensils when storing, preparing or serving an allergen-free meal.
• When preparing an allergen-free meal, make it fresh and prepare it first. Depending on the type of dish ordered, check with the customer what a suitable alternative might be. For example, you can lay foil on a grill when cooking a steak to avoid contamination with fish cooked earlier, or use olive oil instead of butter on pasta.
• Avoid cross-contamination by not reusing any equipment for different ingredients. For example, do not reuse a cutting board that was used for preparing chopped peanuts to prepare vegetables for a salad. All utensils must be thoroughly cleaned and sanitized between uses/products. 

LEARNING ACTIVITY #2

Think about how you would minimize the risks associated with the following practices and discuss your response with a colleague. 

SCENARIO 1

A Food Handler uses the same wok over and over again. One of the oils used when cooking with the wok is peanut oil. Between preparing dishes, the Food Handler wipes the wok with a paper towel before reuse.

SCENARIO 2

A coffee shop displays desserts in a tiered glass case to tempt customers. One of the desserts, chocolate mud cake, which may contain traces of tree nuts, is displayed on the same tier as a lemon meringue pie. 

SCENARIO 3

The chef has updated his curry recipes with a Thai curry paste from a new supplier that imports spices directly from Thailand. The jar of curry paste does not have ingredients listed on the label.

Ongoing staff training in allergen management is a necessary part of any food business. All Food Handlers need to understand the severity of allergic reactions to foods by some people, and how to deal with any situation that may arise.

All staff should be trained on how to inform customers about known allergens in food and how to deal with situations when they don’t know or are unsure about the food items they sell. When training employees in allergen management, you need to ensure they are:

• aware of the food items and processes involved in preparing products
• aware of foods that contain allergenic products
• careful to avoid cross-contamination by changing gloves and preparing foods hygienically
• comfortable reading ingredients or seeking clarification
• informed of who to ask when information is requested by a customer
• not serving or selling products to customers if there is any known risk
• communicating to all appropriate staff involved when informed that a customer has an allergy
• trained to call 911 immediately if a customer has an allergic reaction

The following guidelines will assist all food handling staff in the front and back of the house to manage food allergens. For front of house food handling, ensure that staff:

• know their obligation to declare allergens and other substances in food if a customer asks
• have access to up-to-date information

For back of house food handling, ensure that staff:

• only accept correctly labelled foods from suppliers
• avoid cross-contamination (in the context of allergen control)
• store food safely in clearly labelled containers
• keep surfaces, utensils and hands clean

Both back and front of house Food Handlers need to know how to access information about the food products they are selling. Staff should be made aware that recipes and ingredients must be reviewed to understand whether they contain allergens.

While food allergens can cause reactions in some people, informed and well-trained food handling staff will be able to minimize the risks involved when preparing, displaying and selling food products to customers.

Knowledge is empowering and in the case of allergen awareness, it can be lifesaving. Don’t gamble the lives of others by taking risks. 

• Health Canada
• Canadian Food Inspection Agency
• Food Allergy Canada
• HealthLink BC
• Be Prepared, Be Allergy Aware. NSW Food Authority
• Anaphylaxis Campaign
• Savona Foodservice