Allergy

Ken - man in red with food allergy Ashley - Ken's friend Lisa - waiting staff Menu - food labels Cutlery - cross contact caution Restaurant sign - training First Aid Kit - Emergency rescue

Listen to OU's Podcast Series on Safer Dining

Notes about Food Allergies

Click on each character or object to learn what to do:

Dining Out Safely:

Ken - man in red with food allergy Ashley - Ken's friend Lisa - waiting staff Menu - food labels Cutlery - cross contact caution Restaurant sign - training First Aid Kit - Emergency rescue

Listen to OU's Podcast Series on Safer Dining

Notes about Food Allergies

Click on each character or object to learn what to do:

Dining Out Safely:

USE THESE TERMS TO BE CLEAR

AVOID THESE PHRASES "I'm a bit allergic" "I don't like..." "It's probably fine"

"I have a SEVERE allergy to..." "This could KILL me" "I need to know ALL ingredients" "Can I check how the food is prepared and cooked please; is there ANY chance of my food coming into contact with items I am allergic to?"

Your safety is the priority!

To make sure you are communicating your needs accurately:

• Tell staff immediately about your allergy
• Show your allergy card
• Ask to speak to the manager
• Ask about preparation areas and cleaning
• Request clean utensils/prep area
• Check ingredients in ALL components of your meal including toppings, stock and flavourings that may not be listed on the menu

• Do not rely on a “vegan” logo if you are allergic to

milk, crustacean, mollusc or eggs

• Avoid rush hours when possible
• If unsure about any item, don't eat it
• Remember: better to seem overly cautious than risk a reaction

• Check cooking methods, including use of oils and grills

Ken - man in red with food allergy Ashley - Ken's friend Lisa - waiting staff Menu - food labels Cutlery - cross contact caution Restaurant sign - training First Aid Kit - Emergency rescue

What to do at the restaurant if you are allergic to any food source

You can help advocate for your friends and stand up against food allergy bullying by:

Food allergy is a serious medical condition where even very small amounts can cause severe reactions

AVOID THESE PHRASES "A little bit won't hurt you" "Can't you just pick it out?" "But you look fine!" "Are you sure it's that serious?" "Don’t make a fuss" "Just try it" "You are just being picky" "You are being so dramatic!" "You weren't allergic before" "Take antihistamines and eat it anyway" "This is so inconvenient"

• Speaking up when others make light of allergies
• Correcting misconceptions about allergies
• Supporting friends when they need to ask about ingredients
• Backing them up when making special requests at restaurants
• Choosing suitable places that cater for their needs

• Understand that food allergy is a serious problem, it can be life threatening!
• Taking allergies seriously shows respect for your friend’s health and safety
• Let your friend order first and give them time to inform the staff about their allergy
• Avoid sharing drinks and utensils
• Be mindful of ingredients in shared dishes and only share your food if you know it does not contain what they are allergic to

Ken - man in red with food allergy Ashley - Ken's friend Lisa - waiting staff Menu - food labels Cutlery - cross contact caution Restaurant sign - training First Aid Kit - Emergency rescue

What to do if you are dining with someone who has a food allergy

Stop, Ask, Find out, and Ensure that all food and drinks are SAFE before serving them

Common places allergens hide:

Be alert. Be aware – Hidden ingredients kill

□ Sauces□ Marinades □ Seasonings □ Coatings □ Glazes □ Garnishes □ Cooking oils □ Surfaces

You should ask all customers if they have any allergies; if they do, you need to ensure you know what's in the food you are serving as lives depend on it. It is not just about what is in the food, but also how it is prepared – if you are not sure, ask your colleagues. It is everyone's responsibility and clear communication between yourself, the customer, and the kitchen is vital.

Take allergies seriously every time – they can be life-threatening. When a guest mentions an allergy:

• Write down the specific allergy immediately
• Double-check with the kitchen what dishes will be suitable – double-check about ALL ingredients, how the dishes are prepared and cooked
• When checking ingredient lists, if it doesn’t say allergen free, do not assume it is!
• Vegan labels do not mean that these products are safe for those with food allergies
• Alert your manager and the kitchen staff
• Use clean utensils and prep areas to avoid cross-contact

Ken - man in red with food allergy Ashley - Ken's friend Lisa - waiting staff Menu - food labels Cutlery - cross contact caution Restaurant sign - training First Aid Kit - Emergency rescue

What to do if you are serving someone with a food allergy

Prepare your friend:

• Show them where you keep your adrenaline auto-injectors
• Teach them how and when to use them
• Explain your allergy symptoms
• Share your Allergy Emergency Action plan

Preparation is key. Before you go:

• Check and bring allergy medication and TWO adrenaline auto-injectors
• Practise using your injectors
• Wear a medical alert bracelet/necklace
• Carry a medical alert card which clearly states your food allergies and/or other health conditions
• Take a written card listing your allergies (to show kitchen)
• Have your phone charged with emergency contacts readily accessible
• Have portable wipes for cleaning surfaces
• Have your up-to-date Allergy Emergency Action Plan with you
• If you can choose the restaurant ahead of time, check their menus and policies before you go – ring ahead and speak to someone

Ken - man in red with food allergy Ashley - Ken's friend Lisa - waiting staff Menu - food labels Cutlery - cross contact caution Restaurant sign - training First Aid Kit - Emergency rescue

What to take with you when dining out if you are allergic to any food source

(Food Standards Agency 2024)

More than 160 foods are known to cause allergic reactions – by law UK Food businesses must tell customers if any food they provide contains these 14 allergens.

e.g. almonds, hazelnuts, walnuts, brazil nuts, cashews, pecans, pistachios and macadamia nuts

Tree nuts

found in red wine and dried fruit, e.g. raisins, currants etc

Sulphur dioxide and sulphites

Soybeans

Sesame

Peanuts

Mustard

e.g. mussels and oysters

Molluscs

Milk

Lupin

Fish

Eggs

e.g. prawns, crabs, and lobsters

Crustaceans

e.g. wheat, rye, barley, and oats

Cereals containing gluten

Celery

Food businesses need to tell customers if any food they provide contain any of these 14 allergens

Ken - man in red with food allergy Ashley - Ken's friend Lisa - waiting staff Menu - food labels Cutlery - cross contact caution Restaurant sign - training First Aid Kit - Emergency rescue

• Ensure kitchen and serving staff know how to review ALL ingredients used so they can identify any potential hidden allergens
• Update your menus with accurate allergen information so customers can see before they order
• Empower staff to ask about allergens every time
• Welcome allergy customers and their questions
• Expand your customer base by offering allergen free alternatives
• Label all ingredients clearly and accurately on the menus
• Create sperate prep areas

A business that takes allergens seriously not only saves lives, but also increases who it can serve.

Smart Business Steps for Allergen Management:

• Have an effective allergen management protocol
• Train all staff and have an allergen champion on each shift
• Know the signs of anaphylaxis and how to use auto-injectors, like an EpiPen
• Ensure proper food handling techniques are used to avoid cross-contact
• Believe people when they disclose food allergies
• Label all ingredients in your food
• Keep detailed ingredient lists

Ken - man in red with food allergy Ashley - Ken's friend Lisa - waiting staff Menu - food labels Cutlery - cross contact caution Restaurant sign - training First Aid Kit - Emergency rescue

Businesses can be allergen confident

Click to checkUK Legal requirements

Examples to avoid: □ Shared knife: a knife used for peanut butter, then wiped clean, still carries enough to trigger reaction □ Cooking oil: oil used to fry food with gluten is not suitable to cook gluten-free food in □ Cleaning surfaces: surfaces need to be cleaned with fresh, warm soapy water – just wiping something away is not enough

When Orders Come In: □ Mark allergy tickets distinctly (different colour/flag) □ Have chef/manager oversee allergy orders □ Clear and sanitize prep area completely □ Staff must wash hands and wear fresh gloves □ Use clean, unused utensils and equipment

Cross-contact is serious: even trace amounts of an allergen can kill.

Kitchen Setup: □ Designate allergy-safe prep stations □ Use color-coded cutting boards and utensils □ Store allergy-free ingredients separately □ Label all containers clearly □ Keep dedicated allergen-free fryers

Prevent Cross-Contact: □ Never reuse oils/grills exposed to allergens □ Keep ingredients covered during prep □ Clean all surfaces and hands between orders □ Store sauces/condiments in squeeze bottles □ Use separate serving plates/utensils

When an allergen is accidently transferred from one food to another, or from a surface to food, this is known as cross-contact.

Ken - man in red with food allergy Ashley - Ken's friend Lisa - waiting staff Menu - food labels Cutlery - cross contact caution Restaurant sign - training First Aid Kit - Emergency rescue

Preventing cross-contact

Signs & Symptoms of a severe allergic reaction (anaphylaxis) include ONE or more of the following ↓

[ANNA-Fill-AXIS]

Calling 999: (stay with the person and stay on the phone)

• Say clearly: "ANA-FILL-AXIS"

• Tell them you have given the adrenaline and at what time
• Tell them the age of the person, known allergies, and their location

Critical actions:

• Don't wait for visible symptoms
• Use adrenaline auto-injectors if you suspect anaphylaxis
• Call emergency services 999
• Never leave person alone
• Document timing of symptoms

Circulation:

Feeling dizzy or faint, collapse, loss of or reduced consciousness, pale, confused floppy

Breathing:

Difficulty breathing, chest tightness, noisy breathing, persistent cough, wheeze, blue lips

ANAPHYLAXIS fact sheet by Allergy UK

CONTINUE CARE –Next steps and useful links

Airway:

Click to checkSubtle Symptoms and why they could be dangerous

Remember anaphylaxis can also occur without obvious external symptoms

Swollen tongue, difficulty swallowing, throat tightness, change in voice (hoarse voice /croaky)

Recognising the signs and symptoms of anaphylaxis early and giving the adrenaline in the auto-injector quickly is key to saving lives.

Ken - man in red with food allergy Ashley - Ken's friend Lisa - waiting staff Menu - food labels Cutlery - cross contact caution Restaurant sign - training First Aid Kit - Emergency rescue

What to do in case of an emergency

Ken - man in red with food allergy Ashley - Ken's friend Lisa - waiting staff Menu - food labels Cutlery - cross contact caution Restaurant sign - training First Aid Kit - Emergency rescue

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Listen to OU's Podcast Series on Safer Dining

Notes about Food Allergies

Click on each character or object to learn what to do:

Dining Out Safely:

WATCH FOR: □ Shared utensils □ Buffet contamination □ Oil reuse □ Cutting boards □ Work surfaces □ Hands/gloves If you can’t see it - You can't clean it easily - then you can't risk it! If in doubt don’t risk it, better safe than sorry.

Prevent cross-contact and manage hidden allergens in the kitchen

"You can't see it. You can't taste it. But it can kill." "When we say trace amounts, we mean trace amounts." Examples SHARED KNIFE "A knife used for peanut butter, then wiped clean, still carries enough to trigger reaction" KITCHEN SURFACES "A cleaned counter that had the allergen present peanuts can still hold dangerous amounts." CARVERY LUNCH OR HOSTING GUESTS: Don’t use the same spoons to serve non allergen foods cross contact is a killer!

System training as a business

Take food allergies as seriously as a loaded gun - because that's what they are to someone with severe allergies. Train staff. Know the signs of anaphylaxis Understand how to use an EpiPen Learn proper food handling to avoid cross-contact Believe people when they disclose food allergies Never pressure anyone to "try just a little bit" Label all ingredients in your food Keep common allergens separate in shared kitchens Save lives.

WHAT TO take with you when dining out if you are allergic to any food source:

Emergency Checklist: Never go out without your two Adrenaline Auto injectors they will buy you time until the emergency service arrives. (Downlad Anaphylaxis UK fact sheet here) You may not be able to inject yourself with this medication so always make sure you have a named friend who knows what to do. Make sure your phone is charged. Make sure you have your emergency contacts up to date in your phone so your friends can let your family know if something happens. Carry a medical alert card which clearly states your food allergies and/or other health conditions.

WHAT TO DO if you are dining with someone who has a food allergy:

Understand this is a serious problem!!! AVOID THESE PHRASES: "Just a little bit won't hurt" "Can't you just pick it out?" "But you look fine!" "Are you sure it's that serious?" “Don’t make a fuss” Stand up against food allergy bullying

Key legal requirements for allergen management in restaurants according to official food safety agencies: UK Food Standards Agency Requirements:

□ Must provide accurate allergen information for all foods □ Staff must be trained in handling allergen requests □ Must identify and list 14 major allergens when used as ingredients □ Must prevent cross-contamination □ Must document allergen controls

What to do after you've notified the 999: 1. Monitor breathing and consciousness 2. Give second adrenaline auto-injector dose after 5-15 minutes if: □ Symptoms worsen/return □ No improvement □ Breathing still difficult □ Instructed by 999 3. Begin CPR if: □ The person is unresponsive □ Instructed by 999

To make sure you are communicating your needs accurately, USE THESE TERMS TO BE CLEAR "I have a SEVERE allergy to..." "This could KILL me" "I need to know ALL ingredients" "Can I check how the food is prepared and cooked please; is there ANY chance of my food coming into contact with items I am allergic to?" Your safety is the priority! AVOID THESE PHRASES: "I'm a bit allergic" "I don't like..." "It's probably fine"

What to do at the restaurant if you are allergic to any food source

• Tell staff immediately about your allergy
• Show allergy card
• Ask to speak to manager
• Ask about preparation areas and cleaning
• Request clean utensils/prep area
• Check ingredients in ALL components of your meal including toppings, stock and flavourings that may not be listed on the menu
• Do not rely on a “vegan” logo if you are allergic to milk, crustacean, mollusc and or egg.
• Avoid rush hours when possible
• If unsure about any item, don't eat it
• Remember: Better to seem overly cautious than risk a reaction
• Check cooking methods, including use of oils and grills

14 food allergens that EU legislation requires businesses to clearly state the presence of on food labels:

• Celery
• Cereals containing gluten, such as wheat, rye, barley, and oats
• Crustaceans, such as prawns, crabs, and lobsters
• Eggs
• Fish
• Lupin mainly used as a flour- is a legume related to peanut and soybean, found in baked goods, pasta especially in free from and vegan products.
• Milk
• Molluscs, such as mussels and oysters
• Mustard
• Peanuts
• Sesame
• Soybeans
• Sulphur dioxide and sulphites found in red wine and dried fruit such as raisins, currants etc

WHAT TO DO in cases of emergency:

Time is critical! Give adrenaline first – Then call 999 – Stay with person - Tell them you have given the adrenaline and at what time - Be ready to give 2nd dose SECOND DOSE: Give after 5 minutes if: No improvement Symptoms return Instructed by 999 Do not delay or hesitate to use it. Call 999 – CALL 999: Say clearly: - "A-NA-FI-LAX-IS" - Location - Age of person - Known allergies. - Tell them it is urgent. Sign post to Resuscitation Council UK Guidelines 2012 Anaphylaxis pdf attached. Covers process to follow including position of the person which is key. Assess Airway, Breathing, Circulation. Begin CPR

COMMON PLACES ALLERGENS HIDE: □ Sauces □ Marinades □ Seasonings □ Coatings □ Glazes □ Garnishes

WHAT TO DO if you are serving someone with a food allergy:

"Know what's in your food. Lives depend on it." Knowing that:Checking alone isn't enough Hidden ingredients kill Systems must improve Staff knowledge saves lives Everyone's responsibility ALWAYS communicate with the customer and the kitchen team Stop, Ask, Find out, Ensure it

Subtle Symptoms: □ Feeling of impending doom □ Sudden fatigue □ Confusion/anxiety □ Weak pulse □ Light-headedness □ Stomach cramps

This can be dangerous because: □ Signs often go unrecognised □ Treatment may be delayed □ Can progress rapidly □ May be mistaken for panic □ Could appear hours after exposure

References:

• Ballmer-Weber BK. Allergic reactions to food proteins. Int J Vitam Nutr Res 2011;81:173-80.
• Warren CM, Jiang J, Gupta RS. Epidemiology and burden of food allergy. Curr Allergy Asthma Rep 2020;20:6.
• Sudharson S, Kalic T, Hafner C, Breiteneder H. Newly defined allergens in the WHO/IUIS Allergen Nomenclature Database during 01/2019-03/2021 [published online ahead of print July 26, 2021]. Allergy. https://doi.org/10. 1111/all.15021.