Food Safety & Food Allergies

Food Safety & Food Allergies



good afternoon welcome to the all you serve webinar we're going to give another minute and then we'll get started with our webinar today and waiting for people to come on I'm giving them another minute thank you for being so proper the other you three o'clock will give another minute and then we will start the program so welcome to the audience or educational theory and we will get started to the moment we will start our webinar just in a few moments while we're waiting if you have any questions during the presentation please type them in and we will get this towards to them towards the end of the presentation also some housekeeping tips on the webinar recording and the PowerPoint slide show and the certification of participation which is for the CEU credits will be available to download on Monday June 24th at all users comm once again welcome to the all you serve webinar thank you for joining us this afternoon I do want to tell everybody some housekeeping tips the webinar recording the PowerPoint slideshow and the certification of participation which is for your continuing education credit will be available to download on Monday June 24th at all users com it may be before but it will be definitely by that day so please go to that site and download your certificate of participation for your CEU credit and to review the audio there's also will be a survey when you finish the webinar please answer that that helps us get better on our performing and also gives us more information and it will give you more information to Jordan so let's get started my name is Marsha diamond and I am the facilitator for this afternoon and I work with all you serve our new business development so let me start by saying our food allergy is important to you they certainly should be one out of every ten adults has a food allergy so decided to put together this program and okay but so today what will happen is you will learn from us let's just speaker which I'll tell you a little bit about get a few Roman what objectives are you will be able to easily identify the top 8 food allergens in the United States you will be able to use your best practices when handling food allergy requests you will recognize current labeling laws and exemptions with food allergens you will understand how the Americans with Disabilities Act of 1990 section 5 404 Rehabilitation Act of 1973 and food allergies impact on your establishment she will walk away with a lot of takeaways today so sit back enjoy and let's get started so let me introduce you to a featured and honored speaker Jordan my son MD you made a mark on the food allergy community which was chosen as the SEM for the National Restaurant Association to develop search safe elegance following the program launch she continued working with companies both nationally and internationally with her own company Shafer dining so that 2018 she does food allergy consulting and education with that company and today join receives a BS in biology and sports medicine and continued her education with the University of Florida specializing in nuclear cardiologists upon being diagnosed which are adult onset of deadly food allergens should analyze the diverse background it became her mission to educate the food service of hospitality industry Jordan nationally-recognized speaker both speaking for and working closely to develop information and training content with Food Protection Association the University State's College of Agriculture the FDA Food Protection Partnership International Food Protection training institute regulatory compliance services the US FDA and numerous food manufacturers and company so I'm very honored to have Jordan lesson Shana today and I'm honored that all ye serve was able to sponsor this and sponsor her speaking so welcome to that thank you very much Marsha you all right let's get this started thank you for everybody for being here first I was listening to some music to get prepared and I heard some lyrics that were so fitting that I must share them before we actually get started they're from imagine dragons believer first things first I'm going to say all the words inside my head I'm fired up and I'm tired of the way things have been I think that is very poignant and very fitting as I said I want to take a moment to thank all you serve and Marsha first launched during today's webinar I also want to thank all of you for joining us for this important webinar concerning food allergies as Marsha stated my name is Jordan Mason and yes there's all the pretty stuff on paper however credentials status age sexual orientation race gender et cetera mean absolutely nothing to food allergies this presentation will of course be professional and educational informative however it's coming from a woman that had her entire future planned when a breast cancer diagnosis preceding anaphylactic food allergies arrived on our doorstep and literally blew up my world I am fortunate enough to be allergic to all seasonings and spices yes you heard me correctly all seasonings and spices now try dating a Latin with that I dare you once I realized my world would never be the same I chose to do something about it for myself and the millions of others with food allergies as I work to develop best practices for few dollars in handling create training content speak nationally and advocate for legislation I was also working towards my dream Lake Tahoe this is a nerd moment this is a NASA satellite image of Lake Tahoe taken on March 9th 2019 we may have had an awesome winter when I had the opportunity to sell my company focus on my own health and wellness and live my dream I did that living in Lake Tahoe has allowed me time in the woods to sink which I'm a sinker and reflect what is my point with all of this why am i discussing the importance of food allergies with you today instead of playing the woods or crawling on my rocks the question in itself is your answer however we'll discuss my food allergy should be important to you in addition we'll discuss the Big Eight or top 8 food allergens all bombard you with very nerdy and statistical numbers because hey I love math and I can't see you so don't worry we will also cover the extremely exciting information concerning food labeling laws and understanding how the ad a and a 504 plan affect your establishment Marsh is going to take a quick poll before we move on do you either personally have or know somebody that has a food allergy please select which one and we're going to see out of the group that we have here today just how many people have or know someone that has a food allergy so Marshalls going to collect that information and then I'm going to keep moving forward okay we have about 95% have even though he personally or know somebody 95% had a pal group all right so 95% so everybody I hope you heard that 95% of this group either has a food allergy or know somebody that has a food allergy I'm gonna try to move on maybe Russia possibly moving on we made it onto this pole for the next okay area so I want everyone to grasp the vast impact a food allergy diagnosis has on an individual partner or spouse parents and family friends co-workers and more remember we just said ninety-five percent of this group has a food allergy or know someone has a food allergy let's review a few statistics to put them in perspective the latest information which we'll discuss in greater length in future slides was performed by Fair Health at the conclusion of 2016 previous Pacific's used were from the end of 2014 according to the 2016 statistics approximately 32 million Americans have at least one food allergy that's 10 percent of the entire population or 1 in 10 if I use their numeric data with 32 million Americans having at least one food allergy of the 10% population which is the pie graph you see on the left-hand upper side we use the current census information available for today 329 million Americans with a current trajectory we'd have roughly 80 million Americans with at least one food allergy that would be 25% of the population before I move on you may be thinking 25% isn't that much after all it's the smaller number let me just say this and keep in mind this is coming from someone with deadly food allergies the 25% includes myself we are the ones who ultimately make the decision we may be going to dinner with our family or friends meeting a business client for a drink going with the family on vacation or deciding to get our first tattoos all of these decisions must also include the person with the food allergy since their needs must be accommodated the experience is had by the other guests to 75 percent or the 90 percent are influenced by their later decisions even when the food allergic individual isn't around is they're impressed with the service knowledge willingness to accommodate and the excellent customer service they tell their friends and so forth so now this 25 percent has grown because someone has a food allergy and it affects everyone in their life as well you why is learning about food allergies even necessary first there is no cure for food allergies you may have heard about different drug testing and pharmaceuticals that are out there that are still in the FDA process these are to reduce and minimize reaction they are not for a cure every three minutes a food allergic reaction send someone to the emergency department a food allergy is the most common cause of anaphylaxis in the United States for emergency room visits over 50% of all food allergic reactions occur outside the home okay so we're going to have another quick poll here okay here we go coming out do you believe that you can name the top 8 food allergens in the US right now if we were to do a pop quiz so whenever it's come in 8120 78 to 2030 we're getting people who are voting confident people some pretty confident people out there or did I fit in people 77 to 23 all right so about 77% of you believe that you can name all eight of the food allergens let's see if you are correct you 90% of all three allergens in the US are caused by eight foods I'm lucky enough to be in the remaining 10% because who really wants to be in the majority the top eight are eggs let's see if those seventy-seven percent of you are correct eggs fish milk peanuts shellfish the u.s. recognizes crustacean shellfish only such as crab lobster and shrimp the reason I discussed this is because this does not include molluscan shellfish or Mullis such as mussels clams oysters and scallops there is a very distinct difference between the two soybeans you Treena and finally wheat so how did you 77% do we won't do another poll we'll just see how you all think you did although the US only recognizes the top eight it's important to understand that other countries recognize additional food allergens many visitors to the US are often unaware and expect us to be prepared here as well Canada recognizes 11 the US 8 plus mustard sesame seeds and sulfite the UK recognizes 14 the 11 we've mentioned with Canada in the US Plus celery the molluscan shellfish which we had mentioned the US only recognizes crustacean shellfish plus Lupin Lupin is a flower it's highly cross-reactive peanuts peanuts and should be treated as such so speaking of cross-reactive and peanuts how much can really do harm I love this image here because although the amount may vary for each individual studies have shown that only one milligram of peanuts or one six hundredths is enough to induce an anaphylactic reaction when you look at this amount in comparison they're the size of a dime it's quite evident just how easily someone may not see this on a plate of food in addition I've included this study that showed that peanuts remain in the saliva for up to three hours after ingestion the same studies suggest the three hour rule include a peanut free meal brushing your teeth chewing gums become 87 percent nonreactive that still leaves a 13% chance that someone will react they also talked about sharing utensils straw or even kissing a person within three hours after ingesting a peanut can be fatal to the person with a food allergy that's why dating with food allergies is so much fun we talked about the harm we talked about how much can cause a reaction but what is a reaction the most severe reaction is an anaphylactic shock it's an acute reaction to a food allergy working in any food service industry you should be familiar with these common symptoms so you can quickly identify when someone starts to experience anaphylactic shock I want to take a moment and be very real and I want to let you all know about two different times that I personally went into anaphylactic shock I want to talk about these because I want to find out what impacts do you believe watching me go through in anaphylactic reaction in a restaurant or in a hospital cafeteria had on those around me do you feel as if those patrons would return to those businesses do you think they told their friends and those friends told their friends about what had they what they had witnessed how do you think I feel every time I put my life and trust in someone else's hand when I go out to dinner or when I want to pick up a package of ground meat at a grocery store and wonder if they've cleaned the counter properly after packaging a preseason grab and go protein item the trauma and fear expose to my friends that were with me on the days that I've gone in anaphylactic shock now we'll never eat with me again so for example I went out to eat one night evening had a meal meal came out first bite an induced anaphylactic reaction within 60 seconds we needed to find my EpiPen we injected the EpiPen I was living in Jacksonville working at a trauma center we realized it was going to take them too long for the ambulance to get there and my friend needed to drive me to the hospital instead everyone in the restaurant is watching the waiters are watching the managers are not watching people I'm starting to lose consciousness we only have two epi pens and SEM will only give you about ten minutes of airway we have to inject the first one we now have to inject the sec that one right before we leave to start to drive me to the trauma center this is severely traumatic for anyone that's watching the second time that I want to talk about is eating in my own cafeteria at the hospital that I worked in and we check the ingredients we found out later that the ingredients had been changed and they were never updated so I went back to my break room and went into anaphylactic shock immediately had to have my co-workers rush me down to my own trauma Bay go into a full code went into an intubation and spent seven days in ICU this has a major impact on everyone around me and everyone around the person that has to deal and go into anaphylactic shock it's not just about the person that has a food allergy we talked about epinephrine the epinephrine auto-injectors market in the u.s. is expected to exceed more than 2.5 billion dollars by 2020 for the picture up top is what most people think about and granted I have absolutely no problems taking other people with a needle yet I'm not a fan of having stuff myself I will wait for the last second stick myself with an EpiPen which is why I can relate to wealth of this image if there is an ink in a needle for a new tattoo then I don't want it near me epinephrine is the only medication that can help save the life of someone going into anaphylactic shock it's also pure adrenaline and as I said previously it allows approximately 10 to 15 minutes of airflow so we can breathe one important note did you know that not all ambulances are required to carry epinephrine this is an important reason to always notify a 9-1-1 operator if someone is having an allergic reaction this ensures an ambulance arrived with epinephrine you over the next few slides we were going to review a study that was commissioned by fair the food allergy research and education and then performed by Fair Health different fair a national independent nonprofit organization that collects and analyzes data on healthcare cost to analyze claims with anaphylaxis and history of food allergy diagnosis the reason these next few slides and statistics are so important is because over the past few decades research continually focused on geography specifically urban versus rural then they started to look at gender age the foods we ingested and the cost that were associated with food allergies and anaphylaxis so when we came out with a new statistical data that was studied between 2009 and 2015 there was some very interesting statistics and data that were found keep in mind this comes from the claims that were coming in through insurance claim overall since 2009 2016 the insurance claims rose by three hundred and seventy seven percent lab services associated with the anaphylaxis increased by eight hundred and seventy one percent charges for the lab services increased by five thousand three hundred and ninety percent as you look at the screen and you see the two maps from 2009 to 2015 interestingly the top five the highest percentage of anaphylaxis claims for State for 2009 and 2016 changed except for one Connecticut it continued to be ranked as number five the number one state with the highest percentage of claims in 2016 with Delaware Massachusetts in New York were ranked number one and number two in 2009 they both passed food allergy laws for food handlers in 2009 they were no longer on the list in 2016 personally I don't think their numbers went down just by coincidence so as I stated earlier we were talking about geography one of the biggest trends that was followed over the past 20 years was the geography between urban and rural by doing so they created what became known as the hygiene hypothesis in basic terms is where by having a greater exposure to microbes allergens and foods the children that grew up on or around farms and the rural areas had less food allergies however the newest data it gave us quite a surprise when they analyzed the years of 2000 to 2016 the urban allergy diagnosis increased by 70% while the rural allergy increased by a hundred and ten percent it blew the hygiene hypothesis right out of the water they also looked at the reaction by su type and here you see the large purple area is the anaphylactic reaction by other other is 33% why is the other important this includes wheat soy and people like myself unfortunately those of you in the healthcare field will feel my pain there's currently are not any icd-9 or icd-10 codes that correspond with elite allergen a soy allergen or multiple other food types on the same note tracking statistical data for anaphylactic deaths is extremely difficult as most times the death are noted from final causation such as cardiac arrest respiratory arrest or brain death not anaphylaxis it's also important the reason we discussed the other and not having these codes because we're not getting proper documentation which allows us for proper research tracking funding labeling and drug approval if we look at the rest of the pie chart we've seen a surprise the second number highest number is peanuts followed by tree nuts and then we have the similar smaller percentages of eggs crustaceans milk we'll talk about this one in a moment fish fruits and veggies and then food additives so I said I would speak about milk a little bit further and there's a reason for this although the milk products were only responsible for 5% of all allergy claims the diagnosis for 2000 2016 it had the highest average claim cost and services per patient the reason we discussed milk is one for one reason is milk is the most difficult to remove to clean and sanitize from any surface the other point I want to make is milk is the food allergy Dairy is a category so if we think about it eggs and milk both allergies they're both in the dairy section when you go to a grocery store however they are separate ingredients and they are separate allergens you so again looking still at the food types the statistic stood out to me to relate to the percentage of the claim peanuts and rose by 445 percent tree nuts rose by 603 percent while other again not having proper documentation only rose by 71 percent when we looked at the age and gender an interesting variation was found although ages 0 to 18 had the highest percentage of 66% and 19 plus had 34% the largest group when it was broken down with 0 to 3 of 27 percent while the smallest group a 4% was over 60 when it came to gender an interesting flip-flop occurred the blue line represents the male and the green line represents the females from the ages 0 to 18 males had the highest claim percentage for 19 plus females had the highest claim percentage when we look at everything and we talk about all of these numbers and the gender and the age and what they were eating and when it occurred we also looked at the cost because that's really where it kind of boils down to they took into account two services two services is quite low if you have a reaction you're going to have a hospital visit with a follow-up visit which testing and then another follow-up visit but they took into account two visits they took each allergen and what I did is I took an average across the board in 2013 they estimated the cost to be 4.3 billion dollars in 2016 using their numbers of 32 million food allergic people a five hundred and three dollars per patient it would cost 16 point 1 billion dollars in just three years the estimated cost is risen twelve billion dollars or four hundred percent these are statistics for 2016 keep in mind we are halfway through 2019 so just imagine what that number is now and also who's really paying for this do they have insurance is there going to the taxpayer is it going to the hospital's who's paying for that 16 point 1 billion dollars for just two services you I want to talk about mitigating your risk we've talked about the numbers we've seen what they can do we want to talk about how we can mitigate risk so all these numbers are great so if it's dangerous we take necessary precaution just like exercising it's easier said than done let's discuss what laws have been put in place to protect the food allergic individual and what impacts these have on a foodservice venue will then review resources to mitigate your risk as a business owner or as an employee if there is a food allergy incident at a facility can you be sued I don't need a pole for this one because I have a feeling all of you are shaking your head yes huh you bet so however there are plenty of ways to reduce your liability beginning with training I'm going to review a few cases and I want to say first that I apologize in advance for using companies that may have representatives that are on this call today however I feel is important for everyone to understand that it doesn't matter how big or small your company if proper training and protocols are not in place you're in jeopardy the first one I'm going to talk about is a grocery chain there was a suit filed that was just recently dropped by a judge against a Florida grocery store or a grocery chain the case is still active however against the employee for neglect this was filed under the failure to comply with those labeling laws this opened up a ginormous loophole that was found within the labeling laws which grants the state to override authority over federal in certain and specific instances we have a quick-service restaurant that was a franchise and although it was franchise the judge has ordered the case to move forward holding both the employee and the corporation the owners of the franchise the corporation accountable and for the jury to determine final damages a manufacturing company did not disclose on a label an allergy warning although the product contained a milk product this lawsuit was filed in March of 2018 the loophole that was uncovered within the grocery lawsuit most certainly does not apply in this matter for those of you that are on here from universities the university in this case violated and failed to provide reasonable modifications to its policies practices and procedures for students with food allergy related disabilities and failed to adequately train staff on appropriate policies for accommodating individuals with food allergies you may have heard where I just said they had students with food allergy related disabilities now two of the cases I talked about food labeling food allergy labeling Consumer Protection Act of 2004 now if anyone on this calls from government you'll find this statement a little funny but this took effect in 2006 so technically two years isn't too bad now this affects all packaged food sold in the US as you're looking at this I want to give you a bit of information this law does not apply to prescription over-the-counter drugs personal care items such as cosmetics mouthwash toothpaste kosher labeling pet food supplements and supplies any made-to-order restaurant food placed in a wrapper or container does not apply to any food products regulated by the US Department of Agriculture such as meat poultry and process egg does not apply to any food product regulated by the alcohol and tobacco tax and trade Bureau such as alcoholic drink spirits beer and soccer products however if you are required to have this label it can be listed in one of three ways if there is an allergen within the ingredient list by using the allergens common name such as milk eggs wheat soy within the ingredient list in parentheses if it's used in the less common name so if they use whey they must use milk right afterwards and parentheses it can also be labeled as in section number two using the word contains followed by the name of the major food allergen you we also discussed some of the lawsuits that were about having a food-related disability so we're going to discuss the American Disabilities Act and a section 504 plan but first being a kid can be difficult 80% of the population has been bullied at some point in their life this is exponentially worse for a child with food allergies a recent study showed 32% of all food allergic youths were bullied most often with the use of the offending food a food allergic individual becomes even more of a target when they have to sit at a table by themselves they're not allowed through the lunch line they're not allowed on field trips they cannot enjoy and celebrate birthdays or any other parties or festivities that may involve food they become a target when we make them one nobody wants to be left out life-threatening severe allergies may qualify as a disability stated above the adaa modified and expanded the definition of disability the amendments increase the number of activities that are considered to be major life activities and changed the law to provide that a person with an episodic condition or a condition that is in remission a C consider disabled if the condition substantially limits a major life activity as a result individuals with severe allergies are not covered under section 504 and the ADA a when the US Department of Education and the office for civil rights review the key factors and determining whether a person is considered an individual with handicaps they included such conditions and diseases as specific learning disabilities diabetes and food allergies once they added food allergies was a major game changer with the US Department of Agriculture in cases with food allergy a generally children with food allergies or intolerances did not have a disability that was according to US partner of Agriculture but amazingly the government had to work together we had to have everyone on board so in a licensed physicians assessment of food allergies would result in a severe life-threatening anaphylactic reaction the children's condition would meet the definition of a disability and the substitutions prescribed by the licensed physicians must be made therefore the US Department of Agriculture u.s. higher education office for civil rights the Rehabilitation Act section 504 an American Disability Act all work together and now food allergies are considered a handicap a disability and must be treated as such now that we have discussed allergens that are impact the mall surrounding them the lawsuits that result in them I want to review how to mitigate all of your risks one of the big thing is to understand that accidents can happen there is a huge difference between an accident and an incident accidents happen however with the right tools awareness and knowledge you can prevent almost any incident from occurring the main difference is making certain you're being proactive rather than reactive this seems like a basic item but one of the most valuable lessons I learned in school and in college was the kiss method it's keep it simple stupid so does the foodservice industry really get it you very little personal story and the reason I chose this photo is it reminds me of my father I grew up in a family including my paternal and maternal grandparents of restaurant wars and hoteliers Hospitality is it's in my DNA however my father a trained chef refused to ever cook for me once I developed my food allergies I was too much of a pain in the butt he just absolutely wouldn't do it I always reflected on his attitude and thoughts with my approach as I or any other trainer consultant you have to understand both sides in order to the relationship to work so the reason that comes to mind is because then we started taking a look at the surveys that we're done and wondering if they get it and just like my father not wanting to cook for me how does the food service new industry feel about food allergies and do they understand it so when we did a survey we looked at a couple different numbers 10% run aware that a food allergy can be fatal 20% staff burn off certain patron with food allergies 20% thought removing an allergen from a finished dish from a meal was safe that number is actually better in 2015 a survey showed that 40% felt that if you just removed the allergen from a dish it made the meal safe 30% could only name three food allergens we have 77% but we don't know how many of you are right forty percent believe that the allergies weren't real in addition about a third think that if you drink water you can lessen the severity of an ongoing reaction additionally a quarter of food establishment personnel are under the false impression that we can safely consume a small amount of the food that were allergic to remember the picture of the dime and the small amount while amount will still cause an anaphylactic reaction in order to implement your best practices and prevent accidents training must be at the core of your establishment without it any of us practice or protocol you develop will be lost remember that you rely on your staff computer patients and patrons safe joga not a said it best put your people at the center of your decisions you cross-contamination is often used in food service establishments and most of you discussed this on a regular basis when we talk about foodborne illnesses however when we talk about allergies we talk about cross contact this is when one food comes in contact with another food and the proteins mix remember the images of peanut particles next to the dime again a small trace amount is most likely invisible this is what makes it so dangerous and it's the highest risk for a food allergic individual when we dine out make sure that your staff is aware of hot spots for cross contact is most likely to occur have separate workspaces equipment if possible sanitation and protocols in place for allergen requests ingredient resources are an excellent and quick reference guide for staff when checking recipes or ingredient list for a customer I used to make sure on all of our ingredient resources will be included and also known as or commonly found in some of the commonly found in products could surprise you especially when it comes to peanuts did you know that all pet food almost all pet food contains peanuts also the most perfect time for you to introduce maybe a labeling company or to work with your POS system to ensure cross-check of ingredients and labels are correct if these companies are not aware of labeling laws or what type of entries are most commonly used or even forced written within your POS they won't be any help it's always important to ensure the company has a background knowledge and proper perspective or they have the inside connect with an amazing food allergy consultant someone like me let's give you some more information about some tools and resources we've talked about cross contact let's talk about ingredient resources labeling companies POS systems but we also have your tools and your resources from experience when a customer sees you utilizing purple equipment or purple tags they recognize that and they automatically feel safer in your establishment we love to share that information on social media so other food allergy patrons are aware of this and making kung Petrin eyes your business's there are multiple options available for allergen free utensils and accessories as you can see here we have cutting boards mixing bowls a spatula everything you can think of there are also several other companies that make Universal purple halogen equipment and we can also have other color-coding equipment if you prefer something else within your establishment but you know that the purple color is the universal color that food allergen patrons recognize most often a quickly we also have designated room service delivery carts they're not just for the healthcare industry having a safe and efficient mode to transport the allergen free meal is essential the continuity of care you must have a flow from your communication from your kitchen to your patron or even to a patient think of the multiple food service venues we have Senior Living facilities long-term care cafeterias rehabilitation centers preschools universities dining halls and so many more that these carts are utilized in addition having a separate action station or cooking station or even a prep station is ideal we know that these aren't things that everyone can facilitate into their areas but it is something for somebody to even if you wanted to tag it or have an area that it is separate for having an allergy meal that can be prepared I'm going to discuss labels one more time because it is so important work with a labeling company to develop custom labels for your company I chose this picture before a specific reason and I'll tell you that there are absolutely no laws requiring a company to alert anyone about a recipe change that does not mean that you are not responsible to have this updated information develop an ingredient book you do not have to list all your proprietary information but if a customer or client is asking about specific foods you should be able to tell them whether the food product contains their allergens be prepared for the time when adjustments are made quickly during your prep the usual recipe may be altered if this information is not passed along to the rest of your staff changes are not made accordingly or to a label or to the ingredient list you are still responsible you must work with your vendors and manufacturers to keep this ingredient list updated this picture was chosen because they have the little sickness to this new recipe and it's very rare that you will see this on any kind of product when you're in a grocery store most times when we go grocery shopping it's like grocery shopping for the first time every time you must always check the label because it's not required to let us know that something has changed or an ingredients have changed so today we discuss the big 8 food allergens which now 100% of you will be able to identify as a fish milk peanuts crustacean shellfish soy tree nuts and wheat you understand that it's important to work with an experienced food allergy consultant not a one-size-fits-all plus this makes the consultant responsible for all of this knowledge in research not you developing and implementing a food allergy protocol is essential food allergy labeling and Consumer Protection Act of 2004 is essential to your company regardless of your in health care if you're in university if you're a manufacturer all of your products are going to have some sort of label the disability laws are not restricted to K through 12 make certain you understand how they affect your exact industry in your market lawsuits are very real not all publicity is good publicity food allergy training is an effective and marketable tool to keep your patients and patrons savor the food allergy community is not only vocal they are extremely loyal finally you reach out to your vendors such as all you serve for food allergy designated equipment and tools and finally any yeah question questions I got two questions already one is well Eddie can be required as input service to have in there like they have the EKG equipment remember the term for worldly EpiPens be required by law or is it up to the discretion of the food service venue so that is a really good question so as far as depending on who's asking a question currently the EpiPen roles are dictated per state if you depending on what state I'll be happy to answer that question separately for that individual so if you are in a state that has passed the EpiPen law and it's required in a food service area sits in a restaurant or it may be required in a park or a sports arena some states have passed the laws but have excluded restaurants some states have passed laws so it's included at all public venues so it's really it is up to the legislation specifically for that state that has been passed there's not a national law that has been passed it another question is there funding for food service because of the disability ask if your funding to make people being able to people to be able to offer the other ingredients or for the other foods etc equipment as I said that is their funding coming from who for the government or what or just for food service equipment food service maybe staff for that area training for because there is a disability because there's a law okay because of the laws of the 88 so there is another great question there is not and that's another that is one reason that I've crawled myself out of the woods and I'm coming back into this field because I do feel that it is very necessary that we have this information out there and we start having the funding and legislation is passed that we have funding but currently an answer that question there currently is not funding out there specifically because there have been laws passed for 88 and disability however a 504 plan that has been taken place and there is a ad a law that they are recognizing in their adhering to for schools and universities that is definitely something that you can work with your state legislators I have seen that done in Florida and in Georgia they can work for that and I'll be happy to discuss that with them as well separately but that is something you need and again that comes right back to having this research and meeting proper documentation so that we can get funding and proper research out there so that funding is available for people that want to put these in place what is the difference between food allergies and food intolerance color it is what is the difference between food allergies and food intolerances a food allergy is an immunologic response and a food allergy can precipitate at any time into an anaphylactic reaction you may start out by having hives or a small reaction and every time that you ingest that item it could potentially get into a more severe reaction a food intolerance is more of a more of a more of a gastric what's the best way to describe this put me on the spot I've been out of this for two years it's it's not an immunologic so you're gonna have like four lafay you have your lactose intolerance you're not going to develop an allergy from that intolerance but it's going to give you gastrointestinal problems you're going to have other problems from that but is something you definitely need to watch but the main difference is the food allergy is going to react to your mass cells and your histamine and it's an immunologic reaction another question is with eggs and milk does it make a difference if they are cooked into a product which take the milk does it make a difference if they are cooked into a product good question so on a survey we I did with the National Restaurant Association one of the questions that was asked is if you cook the product does it make a difference does it take the allergen away milk is still milk egg is still egg a peanut is still peanuts so although you have cooked the protein it has not changed the protein enough to change the allergen variation within that protein ok other questions how would you recommend designating tools and equipment when dealing with the populations that they have various different food allergy if purple is allergy and just me a second reading the question how would you recommend designating pools and equipment when dealing with a population that they have very different food allergy the best way to and something with purple purple equals allergy so that's what they said okay so when purple equals allergy people see purple equipment they recognize that within the food allergy community so if you have people that have multiple allergies that are coming in let's say someone you have five people that come in they have five different allergies and you want to utilize your purple equipment it's kind of where I'm going with this question you need to have proper sanitation protocol in place so after every allergen meal is created then you would go in you would sanitize clean all of your equipment and all of your tools and you would restart from the very beginning just as if it's a new meal that you're prepping but you're going to reuse those products so you need to have proper sanitation protocol in place which is why it's important to work with proper sanitation company that understands proper allergen control with that okay we have time for two more questions one is do you have any theory why there are so many people experiencing food allergies to get to 20 to 30 years ago she says I may have missed your answers but could you reiterate it do you have any theories why there are so many I think you did say at the beginning why so we I discussed that a little bit with the slides when I was talking about all the fun math statistical data with I guess have my nerdy moment with math and you know if I could give you that answer that's the multi-billion billion dollar answer but they were going through and they were really looking at geography but no the ultimate answer is that no I can't give you the exact answer on why we have so many allergens today but the reason I discussed all of those slides is we've been seeing a different trend and we can see how things have been changing where twenty years ago their focus was people that live in the farm in the rural areas they're not having as many allergies because they're exposed versus people that are living in the city and more urban they have all the allergens where I can also discuss a leak study that was done he was about five years ago it came out where they talked about having the peanuts and they were introducing peanuts to children and those that were being introduced to the peanuts and I'm not at all let me make this very clear I'm not stating this as telling you to give children peanuts and to do this on your own this was done under direct study with a sedition and they were looking see if they introduced the allergen early on and that actually diminished how many reduce the number of patients that had the allergen later on in life so it really kind of flip-flop should answer that I've been reading Studies on that because I've grandson and so to answer that the doctor the pediatrician and the dietitians are to introduce anything that is an allergen to meet you too early or in small doses if there's a reaction because they feel the body builds up and so they are they have worked that way the pediatric community and the side dishes that are working with them have pushed that forward and so I don't know how long they've been doing it but I do know from the research a reading is that it has lessened it has increased the tolerance and so it has what's in the allergy so maybe and I yeah capture or reduce allergens in children and then obviously adolescents yes version one final question and then the other one hold the answers giordano send you an answer but so many products have soybean oil and I read that proven oil is so refined that it was not to sit in an allergen by itself is that still the case I'm sorry I didn't I didn't load up so many products have soybean oil and it was at serving oil so to refine that it was not considered an allergen by itself does that still the case if it'll be an oil is completely refined so when you talk about refined okay so refined oil this is very specific when you talk about refined oil there's literature that does state that if the soybean oil is refined to a certain specific amount that it will clear the allergen however I will say on a personal on a on a personal note you definitely need to read that research and that is a case-by-case if you want to use that and and have that as something that you're going to stand behind from a person that has an allergy that's also on them this said and I would say that needs to be their decision if they want to have that product if you're going to serve that product they still need to know it's a refined product but it is a 14 product well we have a lot more questions Joanne we'll get you back the answer to those questions but we run at a time today so then thank you so very much for informing us and educating and we educating us and really giving us clarity on the legislation out the other studies and what you do thank you everybody for joining us but the fully served educational webinar please answer our survey it helps us get better and it will think of other ideas for topics and thank you for joining us have a lovely afternoon thank you and I look forward to speaking everyone has questions being in contact thank you so much

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