Food Allergen Awareness

A food allergy is an immune system reaction to a protein in a food. For some people, an amount too small to see or taste can cause a reaction that closes the airway within minutes. Anyone who prepares, serves or sells food is part of the safety system for those people, whether the setting is a restaurant, a bakery counter, a school lunch line, a hospital tray line or a childcare snack table.

Most allergic reactions to food served by others come from the same few failures: someone guessed about an ingredient, a recipe changed, a message was lost between the guest and the kitchen, or a shared tool carried an allergen into a safe dish. Each of these can be prevented.

What You Will Be Able to Do

• Name the nine major food allergens recognized in the United States.
• Explain the difference between an allergy, an intolerance and celiac disease.
• Prevent cross-contact during storage, prep and service.
• Take an allergy request correctly and pass it on without losing it.
• Recognize a serious reaction and respond right away.

The Nine Major Food Allergens

United States law names nine major food allergens. The list was eight for many years, and older materials still say "Big 8". Sesame became the ninth on January 1, 2023, under the FASTER Act.

Some details on this list trip people up:

• Shellfish on the federal list means crustaceans, such as shrimp, crab and lobster. Mollusks such as clams, oysters and squid are not on it. People can still be seriously allergic to them, so treat any stated allergy as real.
• Tree nuts are a group, and labels must name the specific nut. In 2025, FDA narrowed its list of tree nuts and removed coconut. A guest who says they are allergic to coconut still gets the same care.
• Peanuts are legumes, not tree nuts. A person can be allergic to one and not the other.
• Highly refined oils made from these foods are excluded from the federal definition. Do not use that to reassure a guest yourself. Tell them what oil you use and let them decide.

More than 160 foods have been identified as causing allergic reactions. If someone tells you about a food that is not on this list, treat it the same way.

Allergy, Intolerance, and Celiac Disease

These are three different conditions. You do not need to work out which one a person has. You need to take each request seriously.

Gluten is a protein in wheat, barley and rye. For a guest with celiac disease, a gluten-free dish fried in shared oil or cut on a floured board is not gluten-free. In the United States, a package may carry a "gluten-free" label only if the food contains less than 20 parts per million of gluten.

Cross-Contact Is Not Cross-Contamination

Cross-contact is when an allergen moves from one food to another, usually in amounts you cannot see. Cross-contamination is when harmful germs move from one place to another. The difference matters because of how you prevent each one.

Cooking kills many germs, but it does not destroy allergens. Sanitizer reduces germs on a surface, but it does not remove allergen proteins. Only physically removing the residue works, which means washing with soap or detergent, scrubbing and rinsing. Then you sanitize.

A knife wiped on a towel still carries peanut butter. A tray of cookies lifted off with the same spatula used for peanut cookies is no longer peanut-free. Removing the shrimp from a salad does not make that salad safe for someone with a shellfish allergy.

How to Prevent Cross-Contact

Follow these steps in order for any allergy order or allergy-safe meal:

1. Wash your hands with soap and water and put on fresh gloves. Hand sanitizer does not remove allergen proteins.
2. Use a clean, separate prep area. If your workplace has dedicated allergy-safe tools, use them.
3. Wash, rinse and sanitize every board, knife, pan and utensil that will touch the food.
4. Read the label of every ingredient, every time. Suppliers change formulas without warning.
5. Use fresh ingredients from unopened or clearly protected containers. A shared bin of shredded cheese may contain crumbs from other foods.
6. Cook in clean equipment. Shared fryer oil, a grill surface and pasta water all transfer allergens.
7. Keep the finished food covered and apart until it reaches the person. Mark it clearly so that it cannot be swapped.

Store allergen ingredients in labeled, sealed containers. Put them on lower shelves so that a spill cannot land on other foods. Self-service areas such as buffets and snack tables are high-risk because shared serving utensils move between dishes.

Taking an Allergy Request

The person who takes the request starts a chain, and every link has to hold.

1. Listen and repeat it back: "So you have a sesame allergy, is that right?"
2. Never guess. If you are not certain what is in something, say so and find out.
3. Tell the person in charge or the cook directly, and mark the order or meal record the way your workplace requires.
4. Have the cook or manager check the ingredients and confirm what can be done safely.
5. Be honest about limits. If you cannot prevent cross-contact, say so: "We use shared fryers, so I can't promise that item is safe for you."
6. Deliver the food separately and confirm it with the person before they eat it.

If you discover a mistake after a dish is finished, such as a tree nut ingredient in the plate of someone with a nut allergy, do not pick the nuts off. Throw the dish away and make a new one from the start with clean equipment and safe ingredients.

What the Rules Say

The FDA Food Code is a model that states, cities and tribes may adopt, and the version in force where you work may be older than the latest edition. Under recent editions, the person in charge must know the major allergens and the symptoms they can cause and must make sure staff are trained. Recent editions also call for written notice to consumers of major allergens in unpackaged food, such as a menu note or a sign. Your state or local rule decides what applies to you, and some states have their own allergen training or menu laws.

Childcare programs, schools and healthcare facilities usually have extra requirements. These can include a written care plan for each child or patient with an allergy, signed by a parent and a healthcare provider, along with lists of who has which allergy that respect privacy. Follow the plan for each person exactly.

Recognizing a Reaction

Symptoms usually start within minutes to a couple of hours after eating. They can involve more than one part of the body at once.

Young children may not be able to describe what is happening. They may scratch at their tongue or ears, cry, or suddenly go quiet.

Anaphylaxis is a severe reaction that can become fatal within minutes. The signs of anaphylaxis include trouble breathing, swelling of the throat or tongue, or symptoms in two or more body areas at once.

Responding to a Reaction

Warning: Do not wait to see whether a serious reaction gets better, and do not rely on an antihistamine such as diphenhydramine. Epinephrine is the treatment for anaphylaxis.

1. Call 911, or have someone call while you stay with the person. Say "anaphylaxis" and give your exact location.
2. Help the person use their own epinephrine right away if they have it, such as an auto-injector or a nasal spray. Follow the device instructions and any written care plan. Who may give epinephrine to another person depends on your role, your training and your state.
3. Have the person lie down with their legs raised. If they are having trouble breathing, let them sit up. If they are vomiting, roll them onto their side.
4. Do not leave them alone. Do not let them walk around or stand up suddenly, even if they feel better.
5. Tell paramedics what was eaten, what was given and at what time. Symptoms can come back after epinephrine wears off, so the person needs to go to the hospital.
6. Keep the food and its packaging if you can. Report what happened to your manager and complete any incident report your workplace requires.

Reading this guide does not train you to use epinephrine or perform CPR. Those skills need hands-on training.

Common Mistakes

Check Your Understanding

1. A coworker scrapes the walnuts off a brownie for a guest who has a tree nut allergy. Is that dish now safe?

No. Nut proteins remain on the brownie. Discard it and serve something that never touched walnuts.

2. A cutting board was just used for shrimp, and the next order is for someone with a shellfish allergy. What must you do?

Use a separate clean board, or wash, rinse and sanitize this one first. Spraying sanitizer alone will not remove the shellfish protein.

3. A parent says their child cannot have sesame. The bread label doesn't list sesame, but the bakery's seeded rolls are made on the same line. What do you do?

Check the "may contain" statement and ask your supplier or manager. If you cannot confirm the bread is safe, say so and offer a different food.

4. A guest eats a dish and develops hives and a hoarse voice. She says she feels a little better and wants to wait. What should happen?

Call 911 and help her use her epinephrine if she has it. Skin symptoms combined with a change in her voice suggest anaphylaxis, which can get worse quickly.

Key Takeaways

• The nine major allergens are milk, eggs, fish, crustacean shellfish, tree nuts, peanuts, wheat, soybeans and sesame.
• Cooking and sanitizing do not remove allergens. Washing, scrubbing and rinsing do.
• Never guess about an ingredient. Check the label or say you cannot be sure.
• If a dish is made wrong, throw it away and start over with clean equipment.
• Anaphylaxis can be fatal in minutes. Use epinephrine right away and call 911.
• State and local rules vary, so learn what your workplace and your jurisdiction require.