3 Steps to an Allergy Aware Canteen

Transcription

1 3 Steps to an Allergy Aware Canteen Did you know Food allergy is different to food intolerance? There is often confusion about food allergy and food intolerance as the signs and symptoms of food intolerance can be similar to those of mild or moderate food allergy. However, food intolerance is different to food allergy. Food intolerance does not involve the immune system and does not result in life threatening reactions. Why is it important to consider food allergy when preparing food? Eating out and purchasing take away food is very much a way of life today. Often a student s first introduction to independent food purchasing is at the school canteen. When a student starts school, purchasing from the canteen should be a fun and exciting new experience, even for the student with food allergy. Students with food allergy and their parents are often anxious about eating food prepared away from home. It is important that staff in school canteens paid and voluntary understand the importance of safe food preparation for individuals with food allergy. The only way to prevent an allergic reaction is to avoid the food. Even very small amounts of a food allergen can cause a severe allergic reaction. There are a number of things school canteens can do to make food selection from the school canteen a safer, positive experience for students with food allergy. Step 1: Communication It is important for parents/students to inform the school and the canteen when ordering if their child has a food allergy. Canteen staff cannot provide an appropriate food service if they are not informed. Canteen staff should know which students in the school have food allergies. Parents/students can be reminded through school newsletters to note the student s allergy on the lunch order as one of the many risk minimisation strategies that can be implemented in the school. Encourage parents of children with allergies to visit your canteen to check which food products may be appropriate for their child. Keep information about the student/s with food allergy in a prominent place so all staff/parent helpers are aware of it. Examples include having on the wall: a copy of student s emergency care plan (ASCIA Action Plan), or a list of names of the students with food allergies, or a laminated picture of the students with their names but remember to get parent consent first. Talk to school staff and parents about the management of food allergies. Advise the parents of students with food allergies when new products are to be introduced into the canteen. Step 2: Identify the risks review how the food is prepared and served Identifying lunch orders from students with food allergy how do you know that the student has a food allergy? 1

2 Canteen menu To minimise the risk in the canteen, peanut and nut products and products containing nut pieces are best not stocked e.g. in primary schools and the lower years. It is best that peanut/nut spreads are removed from the canteen to avoid mistakes being made. If there is a child with egg allergy, the school may decide no egg sandwiches are to be sold in the school canteen. It is unreasonable to remove all baked foods that contain egg as an ingredient. Food selection are you checking the food labels or product information? Food labels must always be checked EVERY time new stock arrives to determine whether the food is appropriate for students with food allergy. If a food product arrives unpackaged and unlabelled, you must obtain a current list of ingredients from the supplier. Food storage is there a risk of cross contamination when you store your ingredients either in the storeroom, fridge or freezer? Food preparation is there a risk of cross contamination of allergens when you prepare the food? Food service is there a risk of cross contamination when you serve the food? Think about packaging are you able to package the food to prevent cross contamination with other foods? Think about cross contamination when serving unpackaged foods (e.g. at recess and lunch aftersales). Step 3: Make the required changes Training The canteen manager (and other paid canteen staff) should attend anaphylaxis training offered to school staff. Volunteers can be invited to the training or directed to free online training from the ASCIA website ( This will help increase their awareness. Ensure all canteen staff (including volunteers) are educated about cross contamination risks during storage, preparation and serving of foods. Identifying lunch orders: The canteen may choose to have different coloured lunch order bags (where used) for students with food allergy (e.g. white paper bags for students with allergy and brown paper bags for all other students or vice versa). Requesting that parents/students write the student s food allergy on the lunch bag Canteen menu Include the needs of students with food allergy when planning your stock purchases or foods for special days. Food selection Read all labels regularly and before selling any food or drink to students who have food allergy. If a food product has an ingredient that the student is allergic to, the food is not suitable for that student. For products with no labels (e.g. baked goods), suppliers of these goods are required to give you an accurate and complete list of ingredients contained in their product/s, in writing. If the information received is not satisfactory, consider changing suppliers to one that can support your needs and answer your questions. 2

3 Products with may contain statements are plentiful but it is unnecessary to remove all such products from the school. Products with may contain statements should not be served to students with the food allergy. For example, may contain traces of nuts labelled products should not be given to students with peanut or tree nut allergies. Food preparation Food for allergic individuals should be prepared by staff who are allergy informed and aware of cross contamination risk. Prepare food for individuals with food allergy first. Be aware that a food that is fine for one individual with food allergy, can be life threatening for another, so extreme care needs to be taken when preparing each lunch order. For example, when making lunch for a student with milk allergy and lunch for a student with egg allergy, you need to consider cross contamination issues for both and ensure the cutting board and utensils have been cleaned in between. Preparation of sandwiches and rolls in canteen kitchens must be reviewed and areas where cross contamination could occur need to be identified. The canteen could consider having colour coded nut free or milk free cutting boards for example, or place a sheet of baking paper on top of a clean cutting board when preparing food for a student with food allergy. Food service Always have the manager or other food allergy informed person serve the students with allergies. A canteen staff member educated about food allergy must ALWAYS check the ingredient lists of foods purchased for individuals with allergies, prior to serving. What about canteens that are totally self-service (no orders)? Most students with food allergy should be able to select an item from a self-service canteen if a wide variety of foods are offered (e.g. sandwiches/rolls, rice dishes, non-dairy items etc) and prepared appropriately for food allergic individuals (i.e. no cross contamination with allergens). However, you may need to allow students with food allergy to place an order if there are no items on your menu that cater for them. They may order an item that is already available, but you can prepare it first to minimise the risk of cross contamination. Depending on what food allergy the student has, you may need to provide a slightly modified version of an existing item. When it comes to providing food for an individual with food allergy, it is always best to talk to the parents and students. Cross contamination Cross contamination occurs when one food is contacted or contaminated with another and may involve only trace amounts. Cross contamination can occur during the storage, preparation, display and serving of the food. Examples of this include: Using a knife that has been used to cut an egg sandwich to then cut a cheese sandwich for a student with egg allergy. Using the cutting board previously used for grating cheese when making a chicken sandwich for a student with milk allergy. Warming the chicken nuggets for a student allergic to fish on the same tray that was used for fish fingers. It is a good idea to think about cross contamination of food allergens the same way you think about bacteria cross contamination. It only takes a very small, non-visible amount of food allergen (or bacteria) to cause big problems. 3

4 Frequently Asked Questions How common are allergies? Food allergies are real and increasing among Australian children. Research shows that 1 in 10 children less than 5 years old have food allergies. Up to 2% of the population will have food allergies for life. Most schools now have several children who have been diagnosed with a potentially life threatening food allergy. What is anaphylaxis? Anaphylaxis is the most severe form of allergic reaction. It can be rapid in onset and progress quickly to a lifethreatening emergency. It requires the prompt administration of adrenaline by means of an adrenaline autoinjector (EpiPen or Anapen ). Students who have a prescribed adrenaline autoinjector should also have an ASCIA Action Plan for Anaphylaxis, which provides guidance on when and how to use the adrenaline autoinjector and further manage an emergency. What are the most common food allergens? There are 9 foods that are responsible for 90% of food induced allergic reactions in Australia. These include: egg, milk, peanut, tree nuts (e.g. cashew, walnut, pistachio, hazelnut), fish, shellfish (e.g. prawn, lobster), sesame, soy and wheat. Whilst these foods cause most food allergic reactions, any food has the potential to cause an allergic reaction. Are allergies life-long? Peanut, tree nut and sesame allergy which are often diagnosed in childhood are also usually lifelong allergies. Children often grow out of milk, egg, soy and wheat allergy but sometimes this does not happen until well into their school years. Fish and shellfish allergy is more common in adults and is usually life-long. Can we create a nut free zone? It is unrealistic to think a school can be free of any allergen. Even in allergen free schools, someone on the school campus has the allergen in their lunch box either intentionally or unintentionally. It is critical that a number of strategies are implemented to reduce risk to a child with severe allergy. There is no one rule for all schools or for all children at risk of anaphylaxis. Dependent on the age of the child and allergens involved, strategies will differ. If you choose to label your school or school canteen, allergy aware is a more appropriate term. This reflects that you are aware of all allergens, not just nuts and have a range of strategies in place to prevent food allergic reactions. What information relating to allergens must be on a food label? The food labelling laws (Food Standards Code) require the following major allergens to appear on the label if they have been used as an ingredient or as part of the processing of a product: Peanut and peanut products Tree nuts and tree nut products other than coconut Crustacea (shellfish) and their products Egg and egg products Fish and fish products Milk and milk products Sesame seeds and sesame seed products Soybeans and soybean products Cereals containing gluten and their product 4

5 If a food product has any of the above substances identified in the ingredients list, the food is not suitable for a person with an allergy to that food. For products with no labels (e.g. baked goods), suppliers of these goods are required to give you a true list of ingredients contained in their product/s in writing so that you have it available if a customer asks about food content. You can then share the information verbally or in writing. If the information received is not satisfactory, consider changing suppliers to one that can support your needs and answer your questions. What about products with may contain statements? May contain statements are voluntary and unregulated and therefore it is often difficult to determine the real risk. If a food product has May contain... for any of the above food allergens, the food should not be given to a student with an allergy to the ingredient. For example, a product with may contain traces of nuts should not be given to a peanut or tree nut allergic child. There are many products carrying these statements, but it is unnecessary to remove all such products from the school. These products pose a risk to the student with food allergy if they eat them, however there is no risk to the allergic student by sitting alongside a student who is eating a product labelled as May contain... The important point is to make sure that no food sharing occurs. Do I need to check the food label every time? Food labels must always be checked EVERY time new stock (new products and those previously ordered) arrives to determine whether the food is appropriate for particular students with food allergy. Ingredients and manufacturing processes of commercially prepared foods often change, so it is important to check the label every time. If a food product arrives unpackaged and unlabelled, you must obtain a list of ingredients from the supplier. Why remove peanut butter? The problem with nut spreads in particular, is that they are sticky, stay on fingers and can be smeared on the student eating it, around their classroom and the play equipment. During food preparation in the canteen, there is a real risk of cross contamination. It is best that peanut butter and nut spreads are removed from the canteen to avoid mistakes being made. One needs to consider that parent volunteers with no training in the service of food, often help in school canteens. What about food for special events? School, canteen staff and parents should work out how best to manage the needs of the students with food allergy on special event days when products available change and risks increase. Advance planning and communication including the parents (and the older student in high school) is recommended. Does cooking the food remove the allergen? No. However, some children with egg and milk allergy are able to tolerate cooked egg or cooked milk. This must be confirmed by the child s allergist. Want more information? Visit the Anaphylaxis Australia website ( to see our range of helpful resources and posters for your school and school canteen or contact Anaphylaxis Australia by (coordinator@allergyfacts.org.au) or phone ( ) for more information. Online anaphylaxis management training is available from the ASCIA website ( This training course is freely available and includes how to prevent, recognise and respond to an allergic reaction including anaphylaxis. Anaphylaxis management guidelines for WA schools as well as many other supporting resources are freely available from the WA Health anaphylaxis website ( 5

6 SCHOOL CANTEEN ASSOCIATION INC Acknowledgements Funded by the Department of Health, this insert was developed by the WA School Canteen Association Inc. in partnership with the Child and Adolescent Health Service. We thank Anaphylaxis Australia and the following individuals for their valuable contribution to this resource developed for use by canteen staff: Leonie Conley, South Halls Head Primary School Vicki Leavy, Football Club Canteen and Meals on Wheels Kitchen Attendant Anna Prosper, Beaumaris Primary School (WASCA President) Dionisia Tsokos, St Andrew s Grammar Ann Watson, Central Midlands Senior High School Helen Wenn, Kelmscott Senior High School 6