Anaphylaxis Awareness Week
In just the space of a few weeks, there have been several reports of deaths following food-related anaphylaxis, a life-threatening allergic reaction that can kill within minutes.
Three stories were reported, including the death of a woman at a Disney resort due to elevated levels of dairy and nut in her system, the death of 13-year-old Hannah Jacobs, who died from just sipping a drink that contained dairy, and 18-year-old Lily King, who died following a meal abroad. All three had declared their allergies to the servers when ordering.
These are real people, much-loved daughters, wives, and friends, who passed away after doing what billions of us do daily without a thought: eating and drinking. This is the stark reality of what severe allergies can do.
This Anaphylaxis Awareness Week, we’re keen to use our position as one of the leading staffing agencies in the hospitality industry to shed light on the impact of food allergies and the importance of understanding and education for those who work in the food and beverage sector. We want to empower those who work in the industry to confidently and safely serve guests with severe food allergies.
As part of our Impact Strategy, our vision is “to shape the world of flexible work into a better place for all” and part of this is to protect those who have allergies, both within our team and the customers that they serve across the UK. With clear communication from the customer and informed, attentive action from trained waiting staff, the risk of a severe allergic reaction could be significantly reduced.
Pictured: Hannah Jacobs. Photo Credit: Family Release
About Food Allergies
Allergies are considered to be the most common chronic disease in Europe, and they’re on the rise; in fact, by 2025, it is believed that half of the entire population of the European Union will be affected by chronic allergic diseases. Here in the UK, around 2.4 million adults have food allergies.
Did you know that you can complete the FSA Food Allergy Training for free via the Food Standards Agency website? Click here for further details.
According to the NHS, the most common food allergies are to:
- Cow’s milk
- Eggs
- Peanuts, soybeans, peas and chickpeas
- Tree nuts, such as walnuts, almonds, hazelnuts, pecans, cashews, pistachios and Brazil nuts
- Shellfish, such as prawns, crab and lobster
- Wheat
Food allergies vary greatly in severity from person to person, some people just get one symptom, others get several. Symptoms can include sneezing, itching, diarrhoea, vomiting and tummy pain. The more severe reaction is called anaphylaxis (pronounced ana-fill-axis) and the latest reports show that in 2022, there were just over 5,000 admissions to NHS hospitals with food-related anaphylaxis – that’s a 154% increase in twenty years.
What is Anaphylaxis?
Anaphylaxis is a life-threatening allergic reaction and characterised by one or more of the following symptoms, often referred to as the ABCs of anaphylaxis:
Airways: Swollen tongue, difficulty swallowing, throat tightness and/or a change in voice (hoarse/croaky)
Breathing: Difficulty breathing, tight chest, noisy breathing, persistent cough and/or wheeze
Circulation: Feeling dizzy or faint, collapse, loss of consciousness and/or pale or floppy (in babies or small children)
Although anaphylaxis can be caused by anything that someone is allergic to (there are cases of unknown triggers, known as idiopathic anaphylaxis) it’s most commonly caused by food, medicine or insect stings. It causes the immune system to release a flood of chemicals that can cause the body to go into shock, blood pressure drops and airways narrow.
How to Treat Anaphylaxis
1. In the first instance, they should use their Adrenaline Auto-Injector device as soon as possible. Most people who experience anaphylaxis are aware that they have a life-threatening allergy and should carry two Adrenaline Auto-Injector devices (AAIs). There are three types of AAIs available in the UK. They should have received training from their doctor on how to use it.
However, you can see on below a how-to-guide on injecting someone correctly using an EpiPen (image credit: Sheffield Teaching Hospitals NHS Foundation Trust)
Alternatively, click here to watch a video demonstration.
2. Call 999 and alert the operator that the person is suffering from anaphylaxis (pronounced ana-fill-axis) and stay with the person until help arrives.
3. Lie the person flat on the floor with their legs raised. This may be difficult if they are struggling to breathe, in this case, sit them down with their legs raised. Ensure that the person does not stand up.
4. If, after five minutes, there is no improvement and they are carrying a second Adrenaline Auto-Injector, then that should be used. Ideally in the other leg.
The Case of Natasha Ednan-Laperouse
In our assessment sessions at Arc, we cover the story of Natasha Ednan-Laperouse. At just 15 years old, she died from cardiac arrest after suffering a severe allergic reaction on a flight to France. Natasha had eaten a baguette from Pret a Manager that was made with sesame seeds, invisible to the naked eye, and not declared on the list of ingredients. Despite using two of her Adrenaline Auto-Injector devices, Natasha passed away later that day.
Natasha had, for many years, lived with asthma and severe allergies, including an allergy to sesame. Despite labelling laws that were passed two years prior to her death, which meant that pre-packaged food must clearly label the 14 allergens in bold (more on this later), her baguette was made on the premises, and at the time, this meant that they did not legally have to declare the allergy information.
Following her death, Natasha’s parents tirelessly campaigned for change and created Natasha’s Law, which was passed in October 2021, requiring all food that is produced and packed for sale in the same premises to provide a complete ingredient list. This means that any food business selling Prepacked for Direct Sale (PPDS) foods will be required to identify all ingredients on the product label, with an emphasis on the 14 allergens.
The Natasha Allergy Research Foundation continues to be a leading voice for all those who experience severe allergic reactions and is currently campaigning for the appointment of an Allergy Tsar within the government.
The 14 Major Allergens
By law, food businesses need to inform their customers if they provide food that contains any of the 14 allergens listed below. It’s important to note that people can have allergies to any ingredient; however, it’s only by law that the items listed below are emphasised.
The After Effects of Anaphylaxis
For those who experience anaphylaxis, the battle doesn’t end once the reaction subsides; it’s a traumatic experience that can have a profound effect on the mental and emotional wellbeing of those who have experienced it. In fact, a study has shown that anaphylaxis has a significant impact on mental health and quality of life.
Our Senior Marketing & Communications Manager, Ashleigh Coleman, has a severe allergy to dairy and has experienced three episodes of anaphylaxis since December. Speaking of her experience, she said:
“Personally, I find the aftereffects of anaphylaxis more difficult to deal with than the reaction itself, even though the immediate danger has subsided. When you’re having a reaction, there is a clear path you need to take: inject your EpiPen and get to a hospital. When you’re discharged, you’re left to navigate through the after effects alone: the anxiety, feeling down, and the fear it will happen again.”
Our Top Tips on Serving Customers With Allergies
Eating or drinking is a great part of many cultures across the globe, uniting friends and families, whether at the dining table or in a bar or restaurant. With the right education and communication, we can make eating out safer for those who have food allergies. Here are our top tips on serving customers with allergies…
Always Ask if The Customer Has Allergies and Their Severity Level
When serving customers, always start by asking if they have any allergies. This goes for serving food or drink; even some cocktails can, for example, contain milk, and most beers contain gluten.
The severity level of allergic reactions can vary from person to person; some people react to the allergen being directly present in the food or drink, meaning that it has been made with the allergen in the ingredients; others with more sensitive allergies can react to the food or drink simply being made in the environment where the allergen is present; this means that it may not be an ingredient, but the food or drink contains traces of the allergen.
By asking about the severity of the allergy, you can be transparent with the customer about the kitchen’s practices and preparation methods, allowing the customer to make a decision about whether they feel it is safe to eat or drink there.
Never Assume
As a food or drink server, you have a direct influence over the safety of those with allergies. If you are unsure about an allergy, don’t be afraid to ask the customer for more information. Although in your role, you should have a good grasp of allergies, there is no harm in admitting that you’re not sure and need to confirm some extra information with the customer or the kitchen.
A small oversight could have life-threatening consequences; it’s always better to be safe than sorry. By asking questions, you’re equipping yourself with all the necessary information you need to safely serve the customer. What takes you an extra few minutes to check could save a life.
Check with The Allergen Matrix
Many restaurants and coffee shops now have an allergen matrix, which shows whether the dish contains any of the 14 major allergens. See an example below from www.food.gov.uk.
You can show this to customers if they declare that they have one of the fourteen major allergens; however, as we have stated before, people can have allergies to any ingredient, so it’s always important to check with the Chef, or refer to the ingredient label.
Speak to the Chef and Refer Back to the Customer
If the customer requests a dish, always check with the Chef whether it contains the allergen, even if it’s a regular customer ordering their regular dish. Occasionally ingredients change, and although documents should be updated, it’s always best to double check.
Once you have spoken to the Chef, it’s always good practice to confirm with the customer; it shows that you’re attentive to their allergies and that they are taken seriously.
Be Open and Honest With the Customer
Honesty is always the best policy when it comes to protecting people with allergies. If you have been told that the dish does not contain the allergen within the ingredients but that the chefs use the same pots and pans to cook it in, then share that with the customer. If you use the same steamer for both dairy and dairy-free coffees, let the customer know. If they are armed with the right information, they can make an informed decision of whether they are able to eat or drink there.
How We Protect Those With Allergies at Arc
Now more than ever, we are committed to protecting those with allergies, from our thousands of team members to the guests that they serve at events across the UK.
Pictured: Directors Paul Marcinkowski and Michael Gavin with Head of People, Sarah Harrison
To best protect our team members, all new starters must complete a medical questionnaire, which requires them to declare any allergies they have, amongst any other medical conditions that we need to be aware of. This information is then attached to their record and stored in our secure database.
We work closely with our clients to ensure full compliance with their established processes for notifying them of our team members’ allergies. By aligning with their individual procedures, we can ensure that we are protecting our team members at every shift, understanding the potential exposure to allergens, ensuring precautions are taken to minimise risk, and assessing whether we need to make any reasonable adjustments.
By prioritising allergen awareness from the outset, we can ensure that we protect our clients and their customers, covering allergens within our initial assessment session.
Resources
Anaphylaxis – NHS (www.nhs.uk)
Anaphylaxis UK | Supporting people with serious allergies | Anaphylaxis UK