May 26, 2024

CDC Study Looks at Restaurant Food Allergy Practices

As part of the Morbidity and Mortality Weekly Report for the week of April 21, 2017, the Centers for Disease Control and Prevention (CDC) has published a study about food allergy practices in restaurants across the country. Food allergies affect about 15,000,000 people in this country and cause about 30,000 emergency department visits and 150 to 200 deaths every year. Almost half of the fatal food allergy reactions over a 13 year period were caused by food from a restaurant or other food service establishment.

Restaurant Chef

The report found that fewer than half of members of the restaurant staffs surveyed in 278 restaurants had received training on food allergies. And although most restaurants list ingredients or recipes for some menu items, few have separate equipment or areas that are designed for the preparation of allergen-free food.

CDC’s Environmental Health Specialists Network (EHS-Net) conducted the interviews. Within each of the six EHS-Net sites (in California, Minnesota, New York, New York City, Rhode Island, and Tennessee), data collectors chose a geographic area and surveyed restaurants by telephone to determine study eligibility. About 50 restaurants were assessed in each of the sites.

Then, on-site interviews were conducted with a worker who had authority of the kitchen, a worker who primarily cooked or prepared food, and a worker who primarily took orders or served food to customers. Two hundred seventy-eight of the 1,307 restaurants contacted agreed to participate.

Among 211 food workers, 86, or 40.8%, reported receiving food allergy training while working at their restaurants. This training covers how to prevent cross-contact, what to do if a customer has a food allergy, and learning about the major food allergens. Among 156 servers, 52, or 33.3%, reported receiving food allergy training. And among managers, 55.2% reported that their restaurants had ingredient lists or recipes for all or most menu items, 18.4% reported ingredients lists for some menu items, and 25.3% said they had no lists on their menus.

Only 19.1% of the restaurants had a dedicated set of utensils or equipment for making allergen-free food. Few managers reported that their restaurant had a special place in the kitchen for preparing allergen free food.

The report states, “The findings in this report suggest that there is considerable opportunity for restaurants to improve their practices to prevent allergic reactions among their patrons with food allergies. The 2013 Food and Drug Administration Food Code (5), which provides the basis for state and local codes that regulate retail food service, recommends that the person-in-charge (i.e., the manager) be knowledgeable about food allergies. Managers are also responsible for ensuring that employees are properly trained in food safety, including food allergy awareness.”

While all of the data is concerning, dedicated equipment for preparing allergen-free food can reduce the risk for cross-contact, although these recommendations might be difficult for restaurants to implement, given resource and space limitations. The report states that restaurants should ensure that all staff members are knowledgeable about food allergies, and should think about investing in and using dedicated equipment to reduce the risk for cross-contact.

Citation: Radke TJ, Brown LG, Faw B, et al. Restaurant Food Allergy Practices — Six Selected Sites, United States, 2014. MMWR Morb Mortal Wkly Rep 2017;66:404–407. DOI:

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