Allergy communication typically breaks down between the front and back of house. Find ways to ensure everyone gets the allergy alert.

Food allergies can be life-threatening. More than one in 10 Americans suffer from food allergies that could be potentially fatal. Serious food allergy incidents are quite common, sending at least 200,000 people to hospital emergency rooms across the U.S. every year.

Serious reactions can occur because of miscommunication or food cross-contamination. Either or both can happen in restaurants (or with food to go) when staff don’t receive sufficient training about food allergies.


Prepare your team to be allergy-aware with the ServSafe Allergens course


Allergy Awareness Month in May is an ideal time to review what restaurants need to know. Here’s a refresher taken from the ServSafe allergy awareness training program.

What foods are responsible for allergies?

Some 160 different foods are potential allergens, but most reactions are caused by milk, eggs, soybeans, wheat, peanuts, fin fish, shellfish and tree nuts. These foods are required by law to be identified on labels of packaged foods; a new law will add a requirement to flag sesame as a ninth major potential allergen. (More on this below.)

What are the symptoms of allergic reactions?

Reactions can include wheezing or shortness of breath; hoarseness, coughing or trouble swallowing; flushed skin, hives, rashes or swelling of various parts of the body; nausea, gastro issues or abdominal pain; and loss of consciousness.

If a customer does have an allergic reaction on site, front-of-house staff should

  • Notify management and coworkers
  • Call 911
  • Remain with the guest
  • Ask if anyone in the party has administered norepinephrine
  • Tell the 911 operator
  • Designate someone to meet first responders at the door
  • Follow up with management according to the restaurant’s policies

How can restaurants prevent cross-contact between potential allergens and other foods?

Cross-contact happens when one food comes into contact with another and their proteins mix. If a customer is allergic to one of these foods, even a microscopic amount can provoke a reaction—at worst, life-threatening anaphylactic shock.

Back-of-house staff should:

  • Wash hands and keep uniforms clean
  • Check ingredient labels
  • Use proper recipes so they can track ingredients
  • Inspect deliveries for any substitute products containing food allergens

To prepare an allergen order, employees should wash hands and change gloves and aprons; use separate equipment; wash, rinse and sanitize all surfaces and equipment before and after preparing the order; mark the prepared allergy order with a special plate, flag or lid covering; and communicate with front-of-house staff about the special order

Front-of-house staff should:

  • Wash hands and wear clean uniforms and aprons
  • Wash, rinse and sanitize all surfaces and utensils before and after use
  • Change cloths, buckets and cleaning solutions after use, or use dedicated spray bottles and single-use towels
  • Communicate with the kitchen and other servers about allergy orders
  • Deliver food allergen orders separately from the rest of the table’s orders

It takes a lot of attention and equipment to follow these policies to the letter, notes Lauren Bridges, who oversees the ServSafe Allergens program for the Association. Realistically, not every eatery has the resources.

What should all restaurants be doing to prevent allergy incidents? Every organization should develop its own allergen awareness policy and train its staff so they are fully aware of what the policy is and what to do when a customer with an allergy shows up, Bridges says. “Any foodservice organization should take a hard look at its staff and equipment to understand exactly what they are able to accommodate,” she says.

What should the server do if a customer says he has an allergy? Servers should “be incredibly careful,” to communicate the situation, Bridges advises. Folks should always follow the operation’s allergen policy and consult with management and the kitchen if they’re uncertain about serving the customer safely.

Where can communication break down? Typically, incidents occur because of miscommunication between the server or front-of-house staff and the kitchen, Bridges says. To prevent that, all employees should be trained on the company’s food allergen awareness policy, which should include things like the ingredients included in all recipes and dishes, the designated point of contact for allergen management, and what the procedure is in the kitchen for preparing food.

What’s the positive payoff of committing to serve guests who have allergies? “Like other Americans, people with allergies love to eat out, and they have their own version of a referral and review site to spread the word on where allergy sufferers can dine safely,” she says. Committing to take the extra steps needed to serve them safely can produce customer loyalty and peace of mind for the 32 million- strong community of folks affected by food allergies.

Big news on sesame

Since 2004, federal law requires labels on packaged foods to call out eight major ingredients that account for most allergic reactions. In response to recent research indicating that sesame is a more common allergen than previously thought, President Biden signed into law the Food Allergy Safety, Treatment, Education & Research (FASTER) Act, which will add sesame as the ninth allergen to be flagged on labels in January 2023. “The FASTER Act is a big deal,” says Bridges. “It will also fund research on food allergies and make it easier in the future to add additional major allergens if needed.” 

Foods prepared in restaurants for immediate consumption aren’t required to be labeled, but operators and chefs should be aware of sesame ingredients in their menu items, from sesame seed-studded burger buns and bagels to Middle Eastern hummus or falafel. Sesame can also be hidden in a variety of items coming in your back door.

While some large food processors voluntarily list sesame as an ingredient, many do not. Sesame components may be identified as tahini (sesame paste), gomasio (sesame salt), sesamol, sesamum, benne or gingelly. But sesame could also be lumped under “natural spices” or “natural flavors”—until 2023. If in doubt, check with the manufacturer.