This guide was developed to help foodservice operators and Food Handlers better understand allergens, safely manage allergy requests during service and protect customers and food businesses from allergy-triggered incidents.
With food allergies on the rise in Canada and the serious health risks they can cause — including death — it is vital that food businesses understand their obligation to protect customers from exposure to known allergens.
In This Resource
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:
TO AVOID AN INCIDENT, ALWAYS DO THE FOLLOWING:
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:
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.
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.
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).
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.
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.
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.
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.
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.
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.
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.
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.
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.
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:
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:
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:
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.
