Food-allergy management from the perspective of restaurant and food establishment personnel

Background: Restaurant and food establishment dining poses dangers for food-allergic consumers. Objective: To identify, from the restaurant's perspective, factors that affect providing allergen-safe meals. Methods: A structured questionnaire was administered to a convenience sample of restaurant personnel. Results: Participants included 100 individuals (42 managers, 32 servers, 24 chefs, and 2 others) in 100 establishments (48 restaurants [17 continental, 19 Asian, and 12 Italian], 18 fast food, and 34 take-out [8 bakery, 13 ice cream, 9 Asian, and 4 pizza]). Food-allergy training was reported by 42% (76% apprenticing and 24% set program). On a 5-point Likert scale, a rating of "very" or "somewhat" comfortable was selected by 72% for providing a safe meal, 70% for "guaranteeing" a safe meal, and 47% for managing a food-allergy emergency. Regarding knowledge questions, 24% indicated that consuming a small amount of allergen would be safe, 35% believed that fryer heat would destroy allergens, 54% considered a buffet safe if kept "clean," and 25% thought that removing an allergen from a finished meal (eg, taking off nuts) was safe. More than 80% recognized peanut, milk, and seafood as major allergens (61% recognized egg). In practice, 58% indicated having a plan in place in the event of a reaction, and 62% had a plan to provide safe meals. An interest in further training was expressed by 61% of participants. Conclusions: The restaurant personnel surveyed expressed a relatively high comfort level in providing safe meals to allergic consumers, but there are deficits in their knowledge base, indicating the need for more training and consumer caution.