Avoiding Cross Contact and its Severe Side Effects

Those with food allergies understand that when it comes to reactions, there is danger in many situations outside of simply eating their allergen. For those with a peanut allergy, there’s concern of peanut being hidden in a potluck dish or school birthday treat. There’s worry of peanut being in a restaurant prepared dish. There’s the constant struggle with cross contact.

“Cross contact is ultimately when a safe food touches, say, a surface where an allergen was,” says Emily Melby, RDN, at Allergy Associates of La Crosse. “For instance, a restaurant makes eggs on a flat bottom grill in the morning, and then they may not properly clean that off. In the afternoon, they make hamburgers. That’s where the cross contact occurs.”

Cross contact vs. cross contamination

Cross contact is a fairly recent term. Previously, it was referred to as cross contamination, and there is now a distinction between the two. Emily explains, “Cross contamination is more of the food safety component. That’s when we have raw meat that then touches another food or kitchen work surface and spreads the potential bacteria or virus to that food or surface.”

Cross contamination leads to food borne illnesses, cross contact leads to allergic reactions.

One big difference between the two is the ability to “cook it off.”

• Juice from raw meat gets on your fresh carrots. After thoroughly cooking your carrots, the risk for cross contamination and related illnesses is almost always eliminated.
• A safe zucchini sits on a counter top where peanut protein is present. After cooking, the zucchini, the protein is often still present and can cause allergic reactions. Emily says, “We can’t do anything to remove the protein. Once it’s on there, it’s on there.”

Cross contact is not always obvious. “The protein can be so small that you may not even know it’s there. Depending on how severe the allergy is, a tiny protein can cause a severe allergic reaction,” Emily explains.

Avoiding cross contact at home

Emily provides a variety of tips for avoiding cross contact in the home, and examples of simple mistakes that could cause serious reactions:

• “Utensils and dishes always need to be cleaned with hot soapy water and then run through the dishwasher. When making a peanut butter sandwich, some just wipe the knife off and dip it in the jelly. That jelly will be at risk for cross contact from the peanut butter because that utensil was not completely cleaned.
• Hand sanitizer does not remove allergens. You’ll want to use hot soapy water to remove the allergens.
• Prepare allergy-free foods first. Start with a clean surface, clean utensils, prepare the allergy-free meal, and then prepare the food that may have those allergens. Each family is different, depending if they are totally allergy free or not.
• Get duplicates of things like baking sheets, cutting boards, pots and pans, and colanders. Have separate ones, and maybe have them in different colors, so that you know which is allergy free in your home.
• Store allergy-friendly foods separately from non-allergy friendly foods. Store allergy-free foods and utensils above the regular ones. In the pantry, we’d want allergy-free foods on top so that the proteins don’t accidentally fall on the allergy-free options.
• A study showed that wiping down surfaces with commercial detergent like Clorox and Lysol (spray or wipes) removes allergens well. It showed that dish soap alone did not remove peanut protein from surfaces. I suggest hot soapy water, and then spraying with a sanitizer on top of that.”

Avoiding cross contact at a restaurant

When the cooking is out of your control, it can induce anxiety for many people with food allergies.  There’s no real way to guarantee that cross contact won’t occur, so Emily says it’s important to find restaurants that you really trust. There are many tools that can help you find places where others with food allergies have had safe experiences. From there, Emily has a few tips.

• Call ahead and talk to the manager or the chef directly to let them know of your allergies. Usually they say to call between 2 to 3 p.m. — after their lunch rush and before their dinner hour. If they’re not available, call back or find a different restaurant.
• When you get to the restaurant, you should tell them your name, who you spoke to, and what about. Open communication is most important.
• A lot of restaurants aren’t going to know what cross contact is, they’re only going to know what cross contamination is. If they haven’t had an allergy training program, you want to be a little bit more watchful that they can handle your requirements.
• You can go to a sub shop and get your sub wheat free in a lettuce wrap, but they’re not usually changing gloves between sandwiches. You need to tell them that they need to completely change their gloves, and maybe grab fresh produce.

An added layer of safety

Safely building tolerance to your food allergy can add another layer of safety in the food allergy fight. Treating food allergies with sublingual immunotherapy begins at a much lower dosing level than the amount that triggers reactions. This small amount, placed under the tongue, is enough for the immune system to build allergic tolerance over time, yet is below the level that triggers a serious reaction.

It’s a safe and effective method that protects individuals from reactions due to accidental exposures, and for some, allows them to reintroduce the once problematic foods. Learn more about treating food allergy with allergy drops.

By Taylor Pasell, Allergychoices