Food allergens: Knowledge and practices of food handlers in restaurants Aline R. Ajala a , Adriano G. Cruz a, * , Jose A.F. Faria a , Eduardo H.M. Walter a , Daniel Granato b , Anderson S. Sant 0 Ana b a University of Campinas, Faculty of Food Engineering, Department of Food Technology, CEP: 13083-862 – Campinas, SP, Brazil b University of São Paulo, Faculty of Pharmaceutical Sciences, Department of Food and Experimental Nutrition, CEP: 05508-900 – São Paulo, SP, Brazil article info Article history: Received 7 December 2009 Received in revised form 27 March 2010 Accepted 6 April 2010 Keywords: Food allergens Food allergies Food handlers Consumer knowledge Restaurants abstract This survey evaluated the knowledge of managers and food handlers, who work in restaurants function- ing in two large supermarket chains in the metropolitan region of the city of São Paulo (Brazil), concern- ing food allergies. Twelve restaurants were evaluated, representing a total of 74 people (12 managers and 62 food handlers). Results have shown that even though the survey showed that food handlers had some knowledge on food allergies, allergic people must stay on the alert, questioning the place where they are going to have their meals in terms of the ingredients used, verifying whether the food is really free of allergens, and always observing the labels of food products. This is needed since there is no real concern by these establishments in preparing safe meals in terms of food allergies. Ó 2010 Elsevier Ltd. All rights reserved. 1. Introduction Food allergies are reactions caused by a food or its ingredients (allergen). The symptoms may be severe and many reactions occur within minutes, although they could take many hours for them to appear (Food Safety Authority of Ireland, 2009). Similarly to food disorders, food allergies are considered a food and public safety problem, once 2% of the world adult population shows food hyper- sensitivity, and nearly 1% suffers from food allergy per se. In gen- eral these figures are higher in the case of children, of which 5– 8% may show some level of food hypersensitivity and from 1% to 2.5% may suffer from food allergy (International Life Sciences Insti- tute – ILSI, 2003). In the United States, 4% of the American popula- tion, i.e. 12 million people, have some sort of food allergy: nearly 6.9 million are allergic to seafood and 3.3 million are allergic to walnuts and peanuts. Unlike the food intolerance that involves digestive enzymes and may result in abdominal pain, gas and swelling, the severe reactions caused by food allergies are respon- sible for around 30,000 cases of medical emergency and 150–200 deaths per year in the United States (Hunter, 2007; Weiss & Muñoz-Furlong, 2008). With the increased concern and focus of public health authorities on the issue of food allergies, concern and focus regarding the knowledge and practices of food handlers is likely to increase. It is known that the hygienic and sanitary knowledge of food handlers is deficient, regardless of the type of establishment where they work (Ansari-Lari, Soodbakhsh, & Lakzadeh, 2010; Jevšnik, Hlebec, & Ras- por, 2008; Jevšnik, Hlebec, & Raspor, 2009; Nunes et al., 2010; Omemu & Aderoju, 2008; Tokuç, Ekuklu, Berberog ˘ lu, Bilge, & Dedel- er, 2009; Veiros, Proença, Santos, Kent-Smith, & Rocha, 2009; Walk- er, Pritchard, & Forsythe, 2003). Thus, it is essential to improve the practices involved in the preparation and handling of food in a search to reduce the occurrence of food allergies. This directly in- volves qualification of the handlers responsible for preparing the meals, but as yet little is known about their knowledge and practices regarding food allergies. Hence, this survey evaluated the knowl- edge of food handlers working in restaurants functioning in two large hypermarket chains in the metropolitan region of the city of São Paulo, State of São Paulo, Brazil, concerning food allergies. 2. Material and methods 2.1. Restaurants Twelve restaurants were evaluated, functioning in two hyper- market chains in São Paulo and representing a total of 74 food han- dlers including managers, cooks, kitchen assistants, and service assistants. Each food and nutrition unit had at least three food han- dlers and at most seven. Only one unit did not have a fixed man- ager, since the number of meals was too small as compared to the others. In this case, a manager from another unit was commis- sioned to oversee the work on a weekly basis. The following ser- vices were provided by these establishments: breakfast, lunch, 0956-7135/$ - see front matter Ó 2010 Elsevier Ltd. All rights reserved. doi:10.1016/j.foodcont.2010.04.002 * Corresponding author. Tel.: +55 19 3521 4908. E-mail addresses: adriano@fea.unicamp.br, food@globo.com (A.G. Cruz). Food Control 21 (2010) 1318–1321 Contents lists available at ScienceDirect Food Control journal homepage: www.elsevier.com/locate/foodcont