Edge Express: Food Allergens as a Safety Hazard

This Food Protection Connection CE article appeared in the April 2026 issue of Nutrition & Foodservice Edge Express. To view a PDF of this article, click HERE.

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Food Allergens as a Safety Hazard

By: Jessy Sadler, SNS

FOOD ALLERGIES are becoming more common and continue to rise every year. They are more than dietary preferences or sensitivities; in some cases, they pose a serious threat to safety, especially within healthcare settings.

For vulnerable individuals with weakened immune systems, trace amounts of an allergen can trigger severe reactions, including life-threatening anaphylaxis. Because of this, preventing these outcomes requires more than basic food safety knowledge. Allergy awareness must be integrated into the overall operational system which also includes admission, menu planning, service, and staff training. Agencies and organizations such as The Joint Commission, the Centers for Medicare & Medicaid Services (CMS), and the U.S. Food and Drug Administration (FDA) continue to stress the importance of safe food handling and risk-reduction practices as essential components for patient safety.

FOOD ALLERGY VERSUS FOOD INTOLERANCE

Not all discomfort that comes after eating particular foods is due to an allergy. According to the American College of Allergy Asthma and Immunology (ACAAI), a food allergy occurs when the immune system mistakenly identifies a food protein as a harmful threat. This response causes the body to release chemicals that can trigger symptoms ranging from mild reactions, like itching or hives, to more severe complications.

On the other hand, a food intolerance does not involve the immune system. Instead, it results from the body having difficulty digesting or processing certain foods which then causes gastrointestinal discomfort or other nonimmune reactions. Common intolerances include lactose, caffeine, and gluten. Lactose intolerance is associated with dairy products, caffeine reactions can occur with foods or beverages containing stimulants, and gluten intolerance may be triggered by wheat, barley, and rye.

For foodservice professionals, understanding the differences between the two is important as allergic reactions require stricter prevention measures, with the ability to respond immediately and appropriately. 

THE “BIG 9” FOOD ALLERGENS

The Centers for Disease Control and Prevention (CDC) estimates roughly 31 million Americans, including more than 5 million children, are affected by food allergies. In the United States, nine major allergens are responsible for most allergic reactions: milk, eggs, fish, shellfish, tree nuts, peanuts, wheat, soybeans, and sesame. Congress signed the Food Allergy Safety, Treatment, Education, and Research (FASTER) Act into law in April 2021, declaring sesame as the ninth major food allergen effective January 1, 2023. This law requires all manufacturers to clearly list any intentional use of the Big 9 on food labels by listing allergens in parentheses after an ingredient, writing the allergen in bold text or having a “contains” statement, which comes after the entire list.

Allergen risks vary not only by age, but also by country and geographic location. The list of major allergens in the U.S. differs from the lists in other parts of the world. For example, the European Union identifies 14 major allergens on their list, including additional foods such as mustard, celery, and mollusks.

FOOD ALLERGY HAZARD AS A FOOD SAFETY ISSUE

In food safety, hazards are categorized as either biological, chemical, or physical. In this context, food allergens are considered chemical hazards because they consist of naturally occurring proteins that are capable of triggering harmful immune responses. Unlike biological hazards, such as bacteria, allergens cannot be reduced or eliminated through cooking or temperature control.

The main danger associated with allergens is cross-contact, which happens when an allergen is unintentionally transferred from one food or surface to another. Cross-contact can happen at any stage of foodservice operations — from purchasing and receiving to preparation, service, and cleaning.

Choosing suppliers who have strong allergen control policies, inspecting deliveries carefully, and properly labeling all ingredients can significantly reduce these risks. For example, using allergy-friendly condiments and training staff to recognize allergen labeling helps prevent accidental exposure during hectic kitchen operations. When products are delivered, the person receiving the shipment should be aware of the common allergens and be on the lookout for any areas where contact has occurred. Cooking and serving food pose the highest risk of causing an allergic reaction. When preparing special-order foods along with other orders, it is best to prepare the special orders first to minimize the risk of cross-contact.

PREVENTING CROSS-CONTACT

Preventing cross-contact is one of the most critical components of allergen food safety. Routine practices such as sharing cutting boards, utensils, mixers, or slicers without proper cleaning, storing allergen-free foods below allergen-containing items, or failing to change gloves and wash hands between tasks can all increase risk of cross-contact. Because allergens are invisible, equipment and surfaces that appear clean may still pose a hazard.

Most operations do not have a double or a separate set of big equipment, like fryers and grills, to use for special orders. However, kitchens can still reduce risk with alternatives such as using fresh allergen-free oil and placing foil barriers on grill surfaces. Clean smallware should always be used, and if possible, a separate set of dishes, pans, and utensils should be designated for special orders. Clear identification methods, such as color-coded dishware or labeling systems, can help ensure safe handling from preparation through service. For example, some facilities use purple-colored small wares such as cutting boards, sheet pans, utensils, and storage containers to clearly identify items reserved exclusively for allergen-free meal preparation.

To reduce allergen risk, one needs to eliminate the opportunities for cross-contact and protect individuals with food allergies. While the safest approach is to use dedicated preparation areas and equipment for special orders, this is not always feasible. Dishes and utensils should be washed with hot, soapy water or in a high-temp dishwasher. Some smaller equipment — such as waffle irons, toasters, or slicers — cannot be effectively cleaned to remove allergens and should have separate sets designated for allergen-free preparation. In addition, staff plays a critical role by properly washing hands thoroughly, changing gloves, and using clean aprons before handling any special-order meals. It is important to remember that similar to only cleaning, sanitizing alone does not remove allergens. Surfaces must be thoroughly cleaned first to remove allergen residue before sanitizing can be effective.

STAFF TRAINING AND SAFETY CULTURE

Even well-designed food safety systems rely on trained employees. Effective food allergy management requires staff to understand both the operational procedures and the serious health consequences associated with allergen exposure.

Section 2-103.11 in the 2022 Food Code highlights the responsibility of the person in charge to ensure employees receive appropriate allergen awareness training. In addition, the Protecting Children with Food Allergies Act, signed into law in January 2026, requires annual food allergy training for school foodservice personnel participating in federal child nutrition programs. Job-specific training should focus on identifying major allergens, correctly reading labels, recognizing symptoms of allergic reactions, and preventing cross-contact. Practical scenario-based learning can include reading menus, labeling tray tickets, and practicing case scenarios to help strengthen decision-making skills and prepare staff for real-world situations.

Clear and consistent communication among front-of-house and back-of-house staff and management is as important as training to prevent allergic reactions. Because the priority is prevention rather than reaction, encouraging all team members to routinely ask guests about dietary concerns can help ensure allergy needs are identified early. Front-of-house staff plays an important role in accurately relaying allergy information to the back-of-the-house staff and recognizing potential points of risk exposure, while kitchen staff must prepare meals using practices that minimize the risk of cross-contact.

Encouraging employees to ask simple questions such as, “Do you have any allergies or dietary restrictions I should be aware of?” can make a difference in protecting guest safety. Management also plays a key role in supporting these efforts by providing ongoing training, reinforcing expectations, and establishing standard operating procedures that promote safe food handling and effective allergen risk reduction.

THINKING AHEAD

Managing food allergies is an essential part of the overall food safety management within all foodservice operations, but especially in health care. Because allergens cannot be destroyed through cooking or sanitizing, foodservice programs can significantly reduce the risk of allergen-related reactions by strengthening their operational systems through accurate documentation, ingredient verification, cross-contact prevention, and staff training.

WORKS CITED

2022 Food Code. U.S. Department of Health and Human Services, 2023, p. 47, www.fda.gov/media/164194/download?attachment. Accessed 12 Mar. 2026.

Bottoms-McClain, Lauren, et al. Diagnosed Allergic Conditions in Adults: United States, 2024. National Center for Health Statistics, 8 Jan. 2026, www.cdc.gov/nchs/data/databriefs/db545.pdf. Accessed 10 Mar. 2026.

FASTER Act of 2021. 117th Congress S.578, 23 Apr. 2021, www.congress.gov/bill/117th-congress/senate-bill/578/text. Accessed 10 Mar. 2026.

“Food Allergies.” U.S. Food and Drug Administration, 11 Mar. 2026, www.fda.gov/food/nutrition-food-labeling-andcritical-foods/food-allergies. Accessed 15 Mar. 2026.

Food Allergy: What You Need to Know. American College of Allergy, Asthma & Immunology, 28 June 2023, acaai.org/allergies/allergic-conditions/food/. Accessed 10 Mar. 2026.

Protecting Children with Food Allergies Act. S.121 — 118th Congress, 26 Jan. 2023, www.congress.gov/bill/118th-congress/senate-bill/121. Accessed 15 Mar. 2026.

“Top 14 Food Allergens.” Allergy UK , 2026, www.allergyuk.org/about-allergy/types-of-allergies/food-allergy/top-14/. Accessed 8 Mar. 2026.

About the Author

Jessy Sadler, SNS

Jessy Sadler has worked in school food service for eight years and is currently the Nutrition Director in Urbandale, Iowa. She holds a School Nutrition Specialist (SNS) credential with a Master’s Degree in Nutrition Science from Eastern Michigan University and a B.S. in Nutrition and Dietetics with a minor in Wellness from Bradley University. Sadler is a certified ServSafe Instructor and Proctor, and provides food safety training to many professional groups such as schools, restaurants, and healthcare facilities.