14.05.2019 09:30

Study: What do restaurant staff know about food allergies?

Nuts in the salad

Von: Editorial staff

14 May 2019 – People with food allergies have to avoid the foods that trigger their allergic reaction. When visiting a restaurant, however, it’s not so easy to find out whether foods that cause allergies are used there, particularly as even the tiniest amounts are enough to cause an allergic reaction. The obvious thing to do would be for the restaurant guest to ask, and this is often recommended. But according to a recently published study by the Institute of Occupational, Social and Environmental Medicine at Heinrich Heine University Düsseldorf, this is not a reliable solution.

The current research carried out in Düsseldorf confirms similar findings from studies in other countries. In the EU, Regulation (EU) No. 1169/2011 on the provision of food information to consumers sets out the legal position for restaurants. Even in the case of unpackaged food, they must provide information on which products contain ingredients that could potentially trigger allergies. In a study involving 300 staff members of restaurants in Düsseldorf, PD Dr. Adrian Loerbroks from the Institute of Occupational, Social and Environmental Medicine at Heinrich Heine University Düsseldorf together with the Department of Otorhinolaryngology and Head and Neck Surgery at University Hospital Düsseldorf and the University of Singapore uncovered significant gaps in staff knowledge. These relate to typical foods that trigger allergies, the health consequences of an allergic reaction and effective preventive and emergency measures.

A lack of access to information cannot be the key reason for the lack of knowledge. Good material on food allergies for the catering industry is provided by the German Hotel and Restaurant Association and the Association of German Chambers of Industry and Commerce, among others. Dr. Adrian Loerbroks, who headed up the study, considers it especially problematic that guests who say that they have a food allergy are not always believed. He says this can have a direct impact on how guests are treated and can increase the risk for people with food allergies. The fact that the guests themselves sometimes do not make a sufficient distinction between allergies, intolerances and lifestyle decisions may also play a role here. Nevertheless, food allergies can trigger potentially life-threatening reactions. “Reports of food allergies always need to be taken seriously”, warns the researcher.

Roughly one third of the restaurant staff interviewed do not feel solely responsible for an allergic reaction suffered. Nevertheless, they generally agreed strongly that kitchen or service staff should be knowledgeable about food allergies. But there is still a problem with implementation. The results of the knowledge test tell a different story:

Those responsible for the study interviewed staff at all kinds of restaurants in Düsseldorf using standardised questionnaires and face-to-face interviews, for example to rule out language problems. The restaurants were selected at random in each district. The study found that 30% of those interviewed could not name any three of the main allergens – which include eggs, peanuts, cow’s milk, hazelnuts and walnuts, seafood and fish, soy and wheat. There was also no evidence of an association of better knowledge with previous training by the restaurant business. “We therefore have to assume that the training is ineffective”, says Loerbroks. One third of those surveyed also believed that customers having an allergic reaction should drink water as an emergency measure. “This is a misconception that can have dramatic consequences if it results in a delay in treating an allergy-related emergency with medication”, explains the head of the study. 

A lack of information about food in restaurants and shops is a problem not only for people with a food allergy (10% of all Europeans). People with diagnosed food intolerances, e.g. to lactose or alcohol, are also affected. The large group made up of insulin-dependent diabetes patients is also dependent on correct information, e.g. concerning the weight of bread products and the use of starchy ingredients in meals. “There are really lots of people who absolutely need to be informed about food for health reasons because these foods can have direct and serious effects on their health. It would be desirable to follow the existing positive approaches and increase the specialist knowledge of staff who work with food on a daily basis in the interest of their customers’ health”, appeals Loerbroks.

Original publication: Loerbroks A, Tolksdorf SJ, Wagenmann M, Smith H (2019) Food allergy knowledge, attitudes and their determinants among restaurant staff: A cross-sectional study. PLoS ONE 14(4): e0214625. https://doi.org/10.1371/journal.pone.0214625


PD Dr. Adrian Loerbroks

Institute of Occupational, Social and Environmental Medicine

Faculty of Medicine at Heinrich Heine University Düsseldorf

Tel.: +49 211 / 81-08032, adrian.loerbroks@uni-duesseldorf.de

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