Recently the Journal of Allergy and Clinical Immunology published a great article with common sense, evidence-based advice that all allergists should be discussing with their food allergy patients. This week we will highlight improving safety at restaurants/food establishments.

• High-risk establishments include ice cream parlors, bakeries, and Asian restaurants. Avoid these places or use additional instructions to staff to reduce risk. Have food prepared specifically for the patient, taking into consideration cross-contact and hidden ingredients
• Desserts, sauces are higher risk. Avoid these unless safety can be confirmed.
• Restaurant personnel are often not educated about food allergy. Educate while informing. For example, instead of saying: “I cannot have peanut I am allergic,” consider: “I have a severe peanut allergy and a small amount can make me sick. You cannot chop nuts and my food together, you cannot remove peanuts from my food, a vanilla milkshake could affect me if the same mixer had been used with peanuts earlier, frying/cooking food does not remove peanut protein, and if peanut is a minor or secret ingredient in a food I can get sick.” This additional information addresses cross-contact, hidden ingredients, and common misconceptions
• Poor communication puts you at risk. Identify a proper person to provide information; this may be wait staff, chef, and/or manager. Suggest proper communication among staff so that chain of information about the food is reliable. Gauge responsiveness of food establishment staff and option to leave if not comfortable. Parents should encourage and supervise young children so that they gain confidence and accuracy in alerting restaurant staff

https://www.jaci-inpractice.org/article/S2213-2198(18)30714-1/pdf