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Engaging food service workers in the prevention of food-allergy related adverse events


Sunday, November 1, 2015

Roxanne Dupuis, MSPH, Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA
Amy Graves, BA, Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA
Zachary Meisel, MD, University of Pennsylvania, Philadelphia, PA
Emily Strupp, BA, University of Pennsylvania, Philadelphia, PA
Sarah Kounaves, MSc, University of Pennsylvania, Philadelphia, PA
Jane Seymour, MPH, Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA
Rosemary Frasso, PhD, MSc, CPH, Center for Public Health Initiatives, University of Pennsylvania School of Medicine, Philadelphia, PA
David Grande, MD, University of Pennsylvania, Philadelphia, PA
Carolyn Cannuscio, ScD, Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA
Introduction: Fifteen million Americans suffer from potentially life-threatening food allergies and must strictly avoid allergenic foods. Behavioral errors are common. Each year there are 90,000 emergency department visits for food-induced anaphylaxis.  Food service establishments are an important target for prevention, given that Americans consume half of their food dollars away from home.

Methods: We conducted an audit of all eligible (n=233) quick-service restaurants in Center City District, Philadelphia, between October 2013 and September 2014. Research assistants approached restaurant staff to participate in a tablet-based survey assessing their food allergy knowledge, attitudes, and practices.

Results: Eighty percent (n=187) of eligible restaurants participated. While 89% of respondents stated they were willing to go the extra mile to protect a patron with food allergies, no respondent was able to name all steps necessary for optimum prevention of food allergy adverse events, such as checking ingredient labels, cleaning utensils and work surfaces, and changing gloves. Moreover, 79% of respondents mentioned they would call 911 in case of an anaphylaxis emergency, but only 20% mentioned the need for prompt epinephrine administration--the cornerstone of emergency response.

Discussion: In this study, food service workers were highly engaged, expressing a desire to learn more about safe food allergy management. Despite their high motivation to help food allergic patrons, respondents knew little about how to prevent or respond to adverse events. Food service workers are important allies in reducing food allergy morbidity and mortality. Improved restaurant training and protocols are crucial in this era of escalating food allergy prevalence.

Learning Areas:

Assessment of individual and community needs for health education

Learning Objectives:
Describe the burden of food allergies in the United States. Explain the importance of restaurants as a site for prevention of food-allergic adverse events. Identify gaps in food service workers’ knowledge of safe food allergy management.

Keyword(s): Prevention

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As a member of the research team, I collected and analyzed data on multiple food allergy research projects, which focused on safe management practices among food service workers and young adults with food allergies. Other projects included interviews with children and families with food allergies to understand the challenges they face outside the home (e.g., school, social settings). These provided me with a strong understanding of the public health burden of food allergies.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.