A survey of restaurant and food establishment personnel reveals that for food-allergic consumers, dining out may be a greater risk than they realize. The first-of-its-kind study was published this month in Annals of Allergy, Asthma & Immunology, the scientific journal of the American College of Allergy, Asthma and Immunology (ACAAI). Ryan Ahuja and Scott H. Sicherer, M.D., of The Elliot and Roslyn Jaffe Food Allergy Institute, Mount Sinai School of Medicine, New York, N.Y., found that food-allergy training was reportedly conducted in only 42 percent of personnel at 100 restaurants and food establishments. While approximately 90 percent of managers, servers and chefs reported varying degrees of "comfort" with providing a safe meal, numerous misconceptions were disclosed. For example, restaurant personnel reported that consuming a small amount of allergen is safe (24 percent); fryer heat destroys allergens (35 percent); and, removal of an allergen from a finished meal was safe (25 percent). Food allergy registries indicate that reactions in restaurants accounted for up to 25 percent of accidental exposures in persons with peanut and tree nut allergies, and 15 of 32 percent of fatal reactions to foods began from food obtained in a restaurant or food establishment. Dr. Sicherer emphasizes that the discrepancy between high comfort in preparation of a safe meal and deficits in knowledge about food allergy found in this study carries important lessons for restaurants and consumers. "Food preparers should familiarize themselves with issues relevant to food allergy, including cross-contact of allergens with safe foods," he said. "The food-allergic diner must clearly disclose their allergies, ensure there is a clear line of communication with the people making the food, and remind the staff about problems with cross contact." He also recommends carrying emergency medications, avoiding dishes or restaurant situations that are likely to be problematic (such as buffets and sauces) and suggests allergic diners have a written "Chef Card" listing their allergies which can be handed to the restaurant staff for starting a conversation to better ensure a safe meal. The American College of Allergy, Asthma and Immunology (ACAAI) is a professional medical organization headquartered in Arlington Heights, Ill., that promotes excellence in the practice of the subspecialty of allergy and immunology. The College, comprising more than 5,000 allergists-immunologists and related health care professionals, fosters a culture of collaboration and congeniality in which its members work together and with others toward the common goals of patient care, education, advocacy and research. Citation: R Ahuja and SH Sicherer. Food-allergy management from the perspective of restaurant and food establishment personnel. Ann Allergy Asthma Immunol 2007;98:344-348. Annals of Allergy, Asthma & Immunology is online at