When an allergen emergency arises during meal service, what’s the first thing to do?
This question is increasingly on operators’ minds. The percent of children under 18 with a food allergy rose 18 percent from 1997 to 2007 according to a 2014 survey by the Center of Excellence for Food Safety Research in Child Nutrition Programs at Kansas State University, underscoring the need for operators to have an allergy management plan in place. However, the same report notes, just 38 percent of K-12 operators have attended allergy training in the past year.
“Allergies are on the rise at a fairly frightening rate,” said Beth Winthrop, wellness director for Sodexo education-campus. “The effect on foodservice directors is they are getting more allergic customers and they need to have a plan.”
The only known prevention is food avoidance, said Kevin Sauer, associate professor of dietetics at KSU, who co-authored the report with doctoral candidate Emily Patten. Most food allergy training includes not only information on the major eight allergens, but procedures for keeping allergens separate from other foods while in storage and during preparation, and what to do in an allergen emergency. Directors work with campus and school dieticians to develop individualized menus for students with multiple allergies, while some operations create allergen-free menus that are accessible to all students.
“We won’t declare ourselves peanut free, but we do not menu items that have peanuts, nor do we have shellfish on our menus,” says Josh Mathiasmeier, director of nutritional services for Kansas City, Kansas Public Schools, who counts 300-400 students with known allergy issues among a total population of 24,000. He works closely with district nutritionists to create allergen-free menus for affected diners.
Sodexo, which services more than 850 colleges and universities, created specific hot stations called Simple Servings in its residence halls. The program’s entire menu is made without the top eight allergens; for example, a typical meal features grilled chicken, steamed brown rice and steamed broccoli, says Beth Winthrop, wellness director for Sodexo Education-Campus.
Items containing allergens are stored separately from other foodstuffs at all Sodexo-run kitchens to avoid cross contamination. Kitchen workers are trained to read ingredients and separate utensils and equipment used to prepare non-allergen foods, she says.
At the University of Albany in New York, those cooking for Simple Servings as well as all foodservice managers are certified in food allergy awareness, says Donna Duffy, campus dietician.
Employees are trained to recognize the signs of an allergic reaction and what to do next, she says. If someone is turning red, has difficulty breathing or grabbing their throat, employees should alert a manager and call the campus emergency response team, which is equipped with EpiPens—auto-injectable epinephrine devices used to treat anaphylactic reactions to allergies.
Some districts, such as Detroit Public Schools, require schools to have epinephrine devices on hand to administer in the event of a severe reaction. In Kansas City school employees are not taught to administer epinephrine, but Mathiasmeier is considering adding the training.
“In all emergency situations, the first call is 911,” he says. “If the situation includes a student with a special diet, the second call is to the nurses and principal.”
The big eight
According to the FDA, the following eight foods are responsible for 90 percent of food-related allergic reactions in the United States:
- Milk
- Eggs
- Fish
- Crustaceans/shellfish
- Tree nuts
- Peanuts
- Wheat
- Soybeans