Case Study What Happened June 2014 Clarksville TN 11yearold Landon Wood was visiting relatives in Tennessee when they decided to take a trip to Publix Landon wanted a wrapped chocolate cookie for his treat ID: 908505
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Slide1
Module 11: Allergens, Toxins and Chemical Contamination
Slide2Case Study
Slide3Slide4What Happened
June 2014, Clarksville, TN
11-year-old Landon Wood was visiting relatives in Tennessee when they decided to take a trip to Publix
Landon wanted a wrapped chocolate cookie for his treat
Landon’s mother asked if the cookie contained tree nuts and then purchased it when she was told it was nut free
At home, Landon’s mom tasted the cookie to double check and everything seemed fine
Slide5What Happened
Three bites into his cookie, Landon said his mouth was burning
Landon’s mom gave him Benadryl and an epinephrine shot
Despite the medications, Landon went unconscious
En route to the hospital, Landon’s throat swelled and doctors were not able to resuscitate him
Slide6What They Found
The chocolate cookie contained walnuts
There were no allergen warning labels on the cookie package or display
Store associate did not know the ingredients in the cookie
Family filed a lawsuit against Publix in order to raise awareness
Slide7Discussion
What possible explanations can you think of for how this happened?
Slide8Learning Objectives
Identify the most common food allergens
Explain how cross-contact may be prevented and controlled
Describe the correct procedure for wait staff to follow if a guest inquires about a menu item
List sources and control of foodborne toxins
Slide9Food Allergens
Slide10Common Food Allergens
FDA Food Code 2013
requires that PIC of a food establishment must be able to demonstrate knowledge of major food allergens (Big 8) and include food allergy awareness in the training of others.
Can you name any of the Big 8?
Slide11Common Food Allergens
Slide12Reactions to Food
Food allergy:
The body's immune system has an abnormal reaction to proteins in a food.
These can be life threatening
Food intolerance:
The body doesn’t digest certain chemicals properly, causing uncomfortable symptoms such as vomiting, abdominal pain and diarrhea.
Examples:
Wheat gluten intolerance (Celiac disease)
Lactose intolerance (Can’t digest lactose, a sugar in milk)
Slide13Food Allergies
Allergic reactions can be mild or very severe
Mild reactions can cause itching, eye and throat irritation, hives, and swelling
Severe reactions can result in anaphylactic shock
Closing of the airway, heart stops beating, cardiac arrest
Symptom onset can be almost immediate, or take up to a couple hours.
Slide14Food Allergies
Slide15How Can Food Service Be A Factor?
“Cross-contact occurs when an allergen is inadvertently transferred from a food containing an allergen to a food that does not contain the allergen.
Cooking does not reduce or eliminate
the chances of a person with a food allergy having a reaction to the food eaten.” (www.foodallergy.org)
Slide16Prevent Cross-Contact
Cross-contact is similar to cross-contamination, but cooking and sanitizing don’t eliminate the risk.
Storage
– separate allergens
Handling
– clean
utensils and surfaces after contact with allergens
Cooking surfaces
– heat
doesn’t eliminate allergens. Clean or use designated areas
Food contact surfaces
– clean between allergen and non-allergen foods
Handwashing
– both
preparation and service
Buffet service
– label
service utensils and communicate with customers
Slide17Storing Allergens
Store allergen ingredients away from non-allergen ingredients whenever possible
Ingredients from food processors are required to have labels declaring potential allergens.
Consider labeling your containers in storage with appropriate allergen information
Slide18Know What’s in Your Ingredients!
Example: Caesar dressing & Worcestershire sauce often contain fish
Slide19Handling, Preparing and Serving Allergens
Be sure to wash hands when switching from allergen to non-allergen foods
Use separate preparation and cooking surfaces, or clean and sanitize in between foods
Use separate utensils in service and on buffet lines
Label as necessary to prevent confusion
Slide20Communicating with Customers and Staff
Menu notes of potential allergens
Consumer Advisories may be used
Allergen friendly menus
Train service staff to be receptive to customer questions
Encourage servers to communicate with cooks
Encourage cooks to communicate with each other
E.g., "Don't cook fish on this
section of the grill…”
Slide21Reacting to Emergencies
Train employees to recognize symptoms
Understand what may happen:
Epi
-Pen injections
Other customers’ reactions
Know who to contact
Plan for who will make that call and what type of information to provide
Plan ahead for a quick response
Slide22Toxins and Chemical Contamination
Slide23Chemical Contamination
Cleaning products, sanitizers, polishes, lubricants, pesticides, additives, etc.
Ensure food is from approved suppliers
Proper storage:
Away from food, utensils and equipment
Separate storage area in original containers
Label properly if transferred to another container
Use carefully during operating hours
Consider using conveniently located staging areas
Keep Safety Data Sheets handy
Slide24Naturally Occurring Toxins
Some food can contain toxins that can make people sick
Fish
Shellfish
Mushrooms
Molds
Slide25Fish Toxins
Fish that can produce toxin:
Puffer fish, moray eels, freshwater minnows
Ciguatoxin
Large warm water fish consume smaller fish that feed on algae
Algae may have organism that produces toxin
Histamine
Fish Poisoning
(formerly
S
crombrotoxin
)
Caused by temperature abuse
Microbes in fish grow and produce toxin
Similar symptoms to allergic reaction
Slide26Shellfish Toxins
Amnesic Shellfish Poisoning (ASP)
Confusion, memory loss, disorientation
Diarrheic Shellfish Poisoning (DSP)
Chills, nausea, vomiting, cramps, diarrhea
Neurotoxic Shellfish Poisoning (NSP)
Tingling and numbness lips, tongue, throat, reversal hot/cold sensations
Paralytic Shellfish Poisoning (PSP)
Tingling and numbness
Slide27Mushrooms and Mycotoxins
Mushrooms
Some mushrooms produce toxins dangerous to humans
A mushroom that is safe in one country or region may have a deadly look alike in another
Mycotoxin
Toxin produced by molds on grains, nuts, and dried fruits
Mycotoxins are heat stable
Slide28Other Toxin Sources
Cleaners and sanitizers
Cleaning and sanitizing compounds
Use and store properly
Chemical leaching
Foods stored in non-food grade containers can be subject to chemical and metal leaching.
Use only food-grade containers
Food additives
Chemical additives are sometimes necessary for flavor or preservation.
Use additives carefully, apply for a variance if needed
Slide29Discussion
Have you noticed any good or bad examples of managing allergen risks?
Slide30Case Study
What Happened
Staff member didn’t know walnuts were in cookie, label didn’t declare allergen
What They Found
Landon and his mom asked the right questions
Slide31Case Study
What Went Wrong
Prevention
Landon ate a few bites of the cookie and reacted
Medications were not enough to save him
Label allergens in products for sale, know where to find allergen information for ingredients
Slide32Quiz
Cross-contact is:
The transfer of a pathogen from one food to another
An allergen inadvertently transferred from a food containing an allergen to a food that does not contain the allergen
Mislabeling a product that contains an allergen
Touching food with a bare hands
Slide33Quiz
Cross-contact is:
The transfer of a pathogen from one food to another
An allergen inadvertently transferred from a food containing an allergen to a food that does not contain the allergen
Mislabeling a product that contains an allergen
Touching food with a bare hands
Slide34Quiz
Which are
not
common food allergens (Big 8)?
Milk
Egg
Lettuce
Wheat
Peanuts
Soybeans
Berries
Tree nuts
Fish & Crustacean Shellfish
Slide35Quiz
Which are
not
common food allergens (Big 8)?
Milk
Egg
Lettuce
Wheat
Peanuts
Soybeans
Berries
Tree nuts
Fish & Crustacean Shellfish
Slide36Review
Food allergens and cross-contact
Allergen management
Dealing with emergencies
Toxins and chemical contamination