All about Allergens for Hospitals

  • Australia has one of the highest incidences of food allergy in the developed world with around one in 10 infants [1], one in 20 children (aged 10-14 years) [2] and one in 50 adults affected [3].
  • The most recent data shows that food-induced anaphylaxis doubled between 1999 and 2012 [4].
  • Fatalities from food-induced anaphylaxis increase by around 10% each year between 1999 and 2012 [4].
  • Hospitals have a legal requirement and duty of care to provide safe and suitable food for patients including those with food allergies.

Today, a free, potentially life-saving online food allergy training course for hospital staff working in kitchens and on wards has been launched by the National Allergy Strategy, a partnership between the Australasian Society of Clinical Immunology and Allergy (ASCIA) and Allergy & Anaphylaxis Australia (A&AA). This project has been funded by the Australian Government Department of Health. “All about Allergens for Hospitals” is the first nationally standardised training for food allergen management for food service in Australian hospitals.

“The National Allergy Strategy is proud to launch this free training that increases food safety and has the potential to save lives,” says Ms Maria Said, CEO of Allergy & Anaphylaxis Australia and Co-chair of the National Allergy Strategy. “People understandably assume that their food allergies are going to be managed well in a hospital environment because they see hospitals as a safe place. Currently, many hospitals do not have adequate practices in place and this is concerning.”

“Until the death of 13-year-old Louis Tate in 2015, only a few hospitals in the whole of Australia had a food allergy policy. Tragically, Louis’ death was preventable and we know that even since losing him there have been other incidents in hospitals that have been near misses. This new training aims to improve the understanding of both food preparation staff and hospital ward staff about the seriousness of food allergy, and to improve food safety, prevent allergic reactions and ultimately save lives,” continued Ms Said.

Louis Tate had a severe anaphylaxis after he ate a spoonful of the breakfast he was served. This was despite the fact that his mother had communicated Louis’ food allergies multiple times. His family want hospitals to have robust policies and processes in place for providing appropriate foods to patients with food allergy.

The “All about Allergens for Hospitals” training is aimed at all staff involved in the food service chain in a hospital. This includes kitchen managers, kitchen staff, ward managers, dietitians, nurses and other ward staff. They all play an important role in keeping patients with food allergy safe when they are in hospital. The training provides practical information and there are free downloadable templates and resources available from the Food Allergy Training website.

Read more: National Allergy Strategy launches first free national food allergy online training for hospital...

30 July 2019

  • Food allergy rates in Australia are rising, with around one in 20 children (aged 10-14 years) [i] and 2-4 per cent of adults [ii] affected
  • Food-induced anaphylaxis has doubled in the last 10 years, and fatalities from food-induced anaphylaxis increase by 7 per cent [iii] each year

A free, potentially life-saving online food allergy training program for cooks and chefs, funded by the Australian Government Department of Health, has today been launched by the National Allergy Strategy, a partnership between the Australasian Society of Clinical Immunology and Allergy (ASCIA) and Allergy & Anaphylaxis Australia (A&AA).

Developed in conjunction with chefs and cooks with experience in commercial kitchens, “All About Allergens: The next step for cooks and chefs” focuses on food preparation, handling and storage, and highlights the importance of effective communication between the kitchen and other staff and consumers with food allergy.

“Food allergy rates are continuing to rise in Australia, and we know that the majority of fatalities from food-induced anaphylaxis occur when people are eating out,” says Associate Professor Richard Loh, co-chair of the National Allergy Strategy and past President of ASCIA.  “So that is our area of focus with the All About Allergens online training program. We had great uptake of the first stage of the free All About Allergens program for people in the food service industry, so we’ve developed this next stage specifically for cooks and chefs to maximise their understanding of food allergies and hopefully reduce the number of food-induced allergic reactions we see.”

The first All About Allergens online food allergy training program has seen almost 11,000 food service industry workers from all over Australia enrol in the course since its launch in July 2017. This next stage of the training program provides information specific to cooks and chefs and aims to educate them on the safest way to handle, prepare, cook and store food to prevent food-related allergic reactions.

There are two versions of the new training program; one for general food services such as restaurants and cafes, and one for camp food services, such as school camps or sports camps. Free to access for all users and delivered in a convenient online format that can be completed at the user’s convenience, All About Allergens: The next step for cooks and chefs has been developed for anyone providing a food service.

Martin Latter, Group Director of Kitchens for AEG Ogden, who has managed some of Australia’s largest commercial kitchens and has even cooked for royalty, welcomed the new training program, saying, “It can be very difficult to manage all of the different dietary requests that come through a large kitchen, and often customers don’t have any concept of the type of pressure cooks and chefs are under and make requests at the last minute.

“Over my many years of working in large kitchens I’ve often seen little things happen that can put people with food allergies at serious risk, like not using the same utensils across different foods, or wearing gloves for hygiene purposes but not understanding the cross-contamination risk.”

“This training program will go a long way towards minimising the risk of food allergen cross-contamination by spelling out, in simple terms, the best way to reduce risk and help to keep our customers safe. It also provides some great resources and templates that can be used in commercial kitchens to help reduce the risk.”

Maria Said, CEO of A&AA, says “Hospital admissions for food-induced allergic reactions have increased fivefold over the past 20 yearsii, and fatalities from food-induced anaphylaxis are increasing by about 7 per centiii every year. While we know that food allergen management in kitchens needs to improve, we’re certainly not wanting to point the finger at cooks and chefs. What we do want to do is encourage a sense of shared responsibility when it comes to preventing episodes of anaphylaxis and food-related allergic reactions. Customers with allergies are primarily responsible for their health needs and need to advise food service staff about their allergies, preferably in advance, and kitchen staff need to take their food allergy seriously and understand how to manage those requests.”

Jaclyn Jauhianan, a 24-year-old university student who is allergic to honey and at risk of anaphylaxis to tree nuts, is pleased to see more being done to educate those working in food service about food allergies, saying “I dream about the day when I can eat out with my family and friends without having to be on high alert about my allergies even after I disclose them. When I can trust that the kitchen staff have taken my dietary requirements seriously and haven’t just brushed me off as being ‘fussy’. I know it is my responsibility to clearly communicate, but there definitely needs to be more awareness and education about managing food allergies in the food services industry.”

“It really needs to come from both sides,” continues Ms Said. “We urge customers with food allergies to contact the establishment about their food allergy requirements in advance when making the booking, and then to double check with staff when they arrive that their food allergy requirements have been understood and can be managed. We encourage all cooks and chefs to complete the new All About Allergens training course to ensure they understand their role in preventing food-related allergic reactions, including preventable deaths.”

Common causes of food-related allergic reactions in commercial settings

  • Wait staff not communicating the customer’s food allergy to cooks and chefs
  • Food service staff presuming a menu choice is fine without checking ingredients
  • A chef or cook not checking ingredients in a garnish
  • Using utensils across multiple food types, including knives, tongs, spoons, etc
  • Not checking the ingredients label on pre-prepared products, e.g. mayonnaise, tomato sauce
  • Suppliers changing ingredients without informing the kitchen staff
  • Mistakes in communications: e.g. delivering special dietary requests to the wrong customer
  • Customers not informing kitchen staff about their allergy
  • Customers not clarifying whether their request is due to an allergy, an intolerance or that they simply dislike something i.e asking, “Does this have egg in it?”

pdfNAS All About Allergens for cooks and chefs media release 30 July 2019235.81 KB

For further information go to www.foodallergytraining.org.au

Read more: National Allergy Strategy launches first free national food allergy e-training program designed...

24 June 2019 

  • World first national health campaign advises parents to introduce common allergy causing foods to babies before they turn one, to reduce food allergies
  • Includes a new online resource Nip Allergies in the Bub that provides parents with a ‘one-stop-shop’ for the latest evidenced-based information
  • In large published studies, researchers found that introducing smooth peanut butter/paste to babies between 4-11 months of age, reduced the rate of allergy by about 80 per cent
  • Optimising eczema management is also important, as babies with eczema may develop food allergies after exposure to foods through their skin

Nip Allergies in the BubAs part of the National Allergy Strategy, Australia’s leading allergy organisations have today launched the Nip Allergies in the Bub Food Allergy Prevention Project - a world first national health campaign to educate parents on how to prevent food allergies, funded by the Australian Government Department of Health. It includes the Nip Allergies in the Bub website, that outlines the most up-to-date recommendations for introducing common food allergens to babies.

“We know that parents, understandably, can be extremely apprehensive about introducing common foods associated with allergies to their babies, but doing so to avoid development of food allergy can actually prevent a lifetime of added stress around leaving children at day-care or school, eating out, assessing allergic reactions for severity, and constant vigilance,” said Maria Said, Co-Chair of the National Allergy Strategy and CEO of Allergy & Anaphylaxis Australia (A&AA).

“The Nip Allergies in the Bub website provides a one-stop-shop for parents explaining what foods to introduce when, how to introduce them and how to recognise if their baby has an allergic reaction,” explained Ms Said. “While some babies will still develop a food allergy despite early introduction of common food allergens, this number will be greatly reduced.”

 “Australia has the highest rate of allergies in the world, with around 20 per cent of the population affected, and the prevalence of food allergies continues to rise” explained Dr Preeti Joshi, consultant specialist in Paediatric Allergy and Immunology. 

“In the past, the advice has been to delay the introduction of common food allergens, such as peanuts, cow’s milk, eggs, wheat, soy, shellfish and fish, particularly in babies with a family history of allergies or other risk factors. However, the most recent evidence tells us that we actually need to be introducing these foods before the age of one to prevent allergies from developing. One study found that introducing peanuts between 4-11 months of age can reduce peanut allergy in high risk babies by about 80 per cent.”

Read more: World-first national health campaign to help parents prevent food allergies

10 April 2019

Sign NAS petition here The one in five Australianswho live with chronic and potentially life-threatening allergic diseases will have access to vital resources thanks to today’s announcement that the Australian Greens are pledging $20 million funding to the National Allergy Strategy. 

The National Allergy Strategy exists to improve the health and quality of life of Australians with allergic diseases and minimise the burden of allergic diseases on individuals, their carers, healthcare services and the community.

“We welcome this funding pledge from the Australian Greens, in response to our call for action. This funding is needed to ensure that the National Allergy Strategy can implement a wide range of initiatives to improve allergy management at every level, including prevention, diagnosis, ongoing management and emergency care”, said A/Prof Richard Loh, Co-chair of the National Allergy Strategy.

“Allergic disease once developed, for the most part can be managed, but not cured. This funding will allow the National Allergy Strategy to undertake major projects to help change cultural attitudes towards food allergies of health professionals, food service providers, regulators and the broader community”, commented Maria Said, Co-chair of the National Allergy Strategy and CEO of Allergy & Anaphylaxis Australia.

The National Allergy Strategy has made good progress over the past few years engaging with the food service sector and teens and young adults. These projects continue to have a positive impact increasing awareness and safety for all. The National Allergy Strategy has demonstrated its ability to engage with key stakeholders to achieve positive outcomes and meet contractual agreements.

“This funding will allow the expansion of existing projects and implementation of new projects focussed on ensuring people with allergic conditions receive timely access to best-practice and evidence-based advice and therapy, together with effectively coordinated healthcare and support, as close as possible to where they live”, said A/Prof Richard Loh.

We also need to address drug allergy and implement strategies to ensure that people who are allergic to a medicine are never given those medicines”, said Leader of the Australian Greens Dr Richard Di Natale. “We also need to ensure that people who are no longer allergic to a medicine are given appropriate medicines, which will support antimicrobial stewardship strategies”, he added.

“This announcement will make a difference to the lives of all Australians living with allergic conditions and we are grateful for the support of Senator Richard Di Natale and the Australian Greens”, commented Maria Said.

pdfNAS Media Release Greens Support275.35 KB

pdfAustralian Greens National Allergy Strategy80.66 KB

Read more: The Australian Greens support major funding for the National Allergy Strategy

NAS advocacy5 April 2019

  • Australia has among the highest allergy rates in the world[i]
  • Life threatening food allergy rates have doubled in ten years[ii]
  • Allergy deaths have increased by 42% over six yearsii
  • Australia has a shortage of allergy specialists and health professionals with allergy expertise, particularly in rural or remote areas
  • Children are being sent home from health facilities inadequately treated after severe allergic reactions (anaphylaxis)
  • In one state alone there have been close to 1000 cases of anaphylaxis since November 2018[iii]

pdfCrisis in the Care of Allergic Patients in Australia154.34 KB

“We are talking about young people dying and going into emergency departments, in most cases due to anaphylaxis that could have been avoided,” claims Associate Professor Richard Loh, a leading children’s allergy specialist.  “And the irony is that allergy specialists, GPs, families and consumers who live with allergy have developed a comprehensive solution. It just needs the political will and commitment from all parties, and at all levels of the health care system, to provide leadership to implement the strategy. We must also have adequate funding or else we will progress slowly or not at all and Australians will continue to be at risk.”

“The National Allergy Strategy was developed using the best available evidence and aligned with the experience of consumers,” says Maria Said, CEO of Allergy & Anaphylaxis Australia and a parent of a young adult with severe allergies who has been advocating for people with allergic disease for more than 25 years.  “Families living with a child or young adult with food allergy, live life being fearful. They don’t trust food labels and they don’t trust the health care system to do the right thing, and that’s just food allergy. There are many thousands of people who are unsure whether they have a drug allergy, who can either be wrongly denied medication or be given it unknowingly.”

“The increased allergy rates amongst children and adults have put an enormous burden on the health care system. Many doctors have not had enough support or allergy training,” says Associate Professor Loh. “This means that allergy specialists like me see young people who should be managed by their GP, and could be, if GPs felt more confident. Others who should see an allergy specialist for severe allergies are left to manage themselves leaving them at even greater risk. Many people in rural and regional areas are travelling unacceptable, costly distances for health care at huge costs to both the family and the health system.”

“With relatively small investments we could take a ‘whole of health’ approach from the ground up, because it needs comprehensive action to avoid delays in accurate diagnosis and best practice treatment,” says Maria Said, who is also a registered nurse. “People can either have unnecessary food restrictions or insufficient restrictions because they are poorly diagnosed.”

“On top of that, patients are put at risk because we do not have standards of care for anaphylaxis in Australia - these need to be developed and implemented. When children have a severe allergic reaction, many don’t receive the right emergency care and are often sent home without self-injectable adrenaline. These people need food to sustain their life but without appropriate care and ongoing management it could be food that actually kills them. It is not a lifestyle choice,” continued Ms Said.

“The National Allergy Strategy calls for a top to bottom approach,” says Associate Professor Loh.  “That includes a system such as an anaphylaxis register or notification scheme, which collects better data on things such as unsafe foods which don’t have accurate ingredient labels. It also includes training of health professionals and food service providers so that more people can receive quality care, better training in the food service industry, better access to emerging treatments for food allergies, immunotherapy for insect sting allergy, better diagnosis of drug allergies, and much more.”

“While there is no cure for food allergy, continued funding to help prevent allergies is critical, such as implementing infant feeding guidelines,” continued Associate Professor Loh.

“All political parties have publicly endorsed their commitment to the strategy, but serious funding is required to do what needs to be done. An investment of just $20 million would go a long way to getting some of this off the ground,” says Maria Said.

“That’s less than the cost of some of the cancer medications that have been approved in recent years. We applaud those approvals and hope that political parties also provide funding to prevent the development of allergic diseases and to improve care of those with allergic diseases.  Allergic disease is one of the fastest growing chronic diseases in Australia and must not be the poor cousin. The impact on quality of life is greater than that of diabetes or rheumatoid arthritis,” finished Ms Said.  

Read more: Crisis in the Care of Allergic Patients in Australia

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National Allergy Strategy Rationale

Allergic diseases have become an increasingly important chronic disease and public health issue in Australia and other developed countries over the last two decades, contributing to increased demand for medical services, significant economic cost of care and reduced quality of life of people with allergic diseases and their carers.

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National Allergy Strategy Websites and Courses

All about Allergens
All about Allergens
The next step for cooks and chefs
The next step for cooks and chefs
Authorised Officers Resources
All about Allergens AO
Food allergy prevention
e-training for health professionals
Food allergy prevention e-training for health professionals
Paediatric atopic dermatitis
e-training for health professionals
Paediatric atopic dermatitis e-training for health professionals
Food Allergy Education
for the community
Food Allergy Education
Food Allergy Aware - Hub
Food Allergy Aware - Hub
250K for teens and young adults
250K
Nip Allergies in the Bub

Lead organisations

ascia logo 2018s
Australasian Society of Clinical Immunology and Allergy (ASCIA) is the leading medical organisation for allergy in Australia. 

aaa logo 2018s
Allergy & Anaphylaxis Australia (A&AA) is the leading patient support organisation for allergy in Australia. 

The National Allergy Strategy has received funding from the Australian Government Department of Health for the following projects:
Food allergy prevention | 250K Youth Project | Food service | Drug allergy | Shared Care Model

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