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Knowing about allergies is a matter of life or death for many people in the UK. According to Allergy UK, the United Kingdom is among the countries with the highest prevalence rates of allergies in the world and more than 20% of the population has an allergic disorder. In the last two decades, the country has seen an alarming rise in hospital admissions due to anaphylaxis – an astonishing 615%. As such, workplaces need to be mindful of food allergies. In this guide, we’ll tell you everything you need to know about food allergies in the workplace.
What are food allergies?
A food allergy is an immune response to certain proteins. When someone who has a food allergy comes into contact with or ingests an allergenic food, their immune system perceives the proteins as harmful invaders. As such, they react defensively. Depending on the severity of the allergy, the immune response can lead to a range of symptoms.
There are two main classifications of food allergies: IgE-mediated food allergies and non-IgE-mediated allergies.
IgE-mediated food allergies
This is the most common type of food allergy. It involves the production of Immunoglobulin (IgE) antibodies in response to specific food proteins. When the allergenic food is ingested, the immune system releases histamine along with other chemicals. This leads to allergic symptoms. IgE-mediated food allergies can range from mild to severe. The most severe reaction is anaphylaxis, which is potentially life-threatening. This is because it causes difficulty breathing due to constricted airways.
Non-IgE-mediated food allergies
With non-IgE-mediated allergies, a different part of the immune system is involved and there are no IgE antibodies produced. These allergies often cause delayed reactions that manifest as skin conditions like eczema or gastrointestinal symptoms.
Common food allergens
The majority of food allergy cases (90%) come from eight different foods. These are:
- Peanuts: Peanuts are actually not nuts at all, but legumes. Peanut allergies are often severe and result in anaphylaxis. In sensitive individuals, even trace amounts of peanut in the air can cause a reaction.
- Tree nuts: There are various types of nuts that fall into this category. These include almonds, walnuts, cashews, pistachios and hazelnuts. People who are allergic to one type of tree nut might also experience symptoms to others.
- Cow’s Milk: Cow’s milk is a common allergen, especially in children. It often causes non-IgE reactions. With cow’s milk allergies, it is often the proteins casein and whey that cause the reaction. Many people who are allergic to cow’s milk often have symptoms with soy milk too due to the similar proteins.
- Eggs: Egg allergies are also common in children. It is usually the proteins in the egg whites that cause the allergic reaction.
- Fish: People can be allergic to one type of fish or several. Common fish allergens include cod, tuna and salmon.
- Shellfish: This allergy is caused by crustaceans like shrimp, crab and lobster as well as molluscs like clams, mussels and oysters. Shellfish allergy is one of the most common to begin in adulthood rather than childhood.
- Wheat: Wheat allergy is an allergy to proteins like gluten. However, this is different from coeliac disease, which is an autoimmune condition.
- Soy: This allergy is often more common in children and is caused by proteins in soy-based products.
Besides the “Big Eight” allergens, it’s possible to be allergic to other things. Other fairly common allergies are celery, mustard, sulphites, lupin and sesame.
Food allergy symptoms
Food allergy symptoms vary in presentation and severity depending on the person and the allergen. Symptoms can appear within minutes or after a period of time.
Common symptoms include:
- Skin reactions: Hives are common. Eczema can be triggered or worsened by allergens.
- Gastrointestinal symptoms: This could include nausea, vomiting, pain, cramps and diarrhoea.
- Respiratory symptoms: This includes a runny nose, nasal congestion, sneezing, coughing, wheezing and shortness of breath.
- Swelling: This includes the lips, face, tongue and throat and is called angioedema. This symptom is a big concern because it can restrict and obstruct the airways and cause breathing difficulties.
- Cardiovascular symptoms: In severe cases, an allergic reaction can lead to low blood pressure (hypotension), which can cause fainting and dizziness.
- Oral symptoms: Aside from swelling, a person might experience tingling or itching sensations on the lips, tongue or mouth.
- Anaphylaxis: This is a severe and life-threatening condition that involves multiple systems. It requires immediate medical attention and the administration of an EpiPen containing epinephrine (adrenaline).
How can food allergies be managed in the workplace?
For those with allergies, it is imperative that there is a plan in place in the workplace. This is essential to create a safe environment for allergy sufferers.
Firstly, anyone with an allergy (especially those who have previously suffered from anaphylaxis) should inform their employer as well as their co-workers and supervisors. This awareness means that colleagues can be considerate when they bring food into the workplace. It also means that they will be careful of shared kitchens, too.
Those with allergies are likely used to managing it very well but other people won’t be, so it’s important to communicate requirements and seek adaptations if they’re needed.
It’s also a good idea to report any incidents. If you come into contact with an allergen at the workplace, you need to report it promptly. This is especially important for those with severe reactions.
Finally, those with medications like epinephrine auto-injectors must carry them with them at all times. It’s also a good idea to have one in a safe or locker at work where it can be accessed by key people should a severe reaction happen.
What should employers do about food allergies in the workplace?
Employers should provide training sessions on food allergies and the importance of avoiding cross-contamination. The training should also incorporate education on dealing with allergies and how to respond in an emergency situation.
If severe allergies are present among staff, then employees should be encouraged to clearly label any food with allergen information. It is also a good idea to provide a separate eating area or a clearly-defined allergy-friendly zone to prevent cross-contamination. This includes the provision of separate utensils, where needed.
Where there are meals provided at events or in a cafeteria, it’s important to have a plan to be inclusive. There should be allergen-free food options provided by staff who are trained in food allergen management.
What should employees do about food allergies in the workplace?
Employees play an important role in creating a safe, inclusive and protected workplace for their colleagues with food allergies.
Here are some key ways they can support their co-workers:
- Be informed about food allergies and anaphylaxis: Education about food allergies and misconceptions is crucial. This can prevent accidental exposure to allergens.
- Respect allergen-free zones: If an area has been designated as allergen-free, employees should ensure they respect the space and avoid bringing in foods with common allergens into that area.
- Label foods: If bringing foods into the workplace, it’s important to label them with any allergens so that people can make informed choices.
- Avoid sharing utensils: If there are designated allergen-free utensils, it’s important that this is respected to avoid cross-contamination.
- Wash hands: This should be done before using shared spaces or equipment and especially if you’ve been preparing or consuming allergens.
- Be respectful and supportive: Show compassion and be mindful of the needs of colleagues with allergies. Making jokes or trivialising the condition is not appropriate.
- Learn and follow emergency procedures: If a colleague has severe allergies and anaphylaxis, be sure to learn what to do in an emergency and seek training on the administration of EpiPens.
What adjustments can be made in the workplace for food allergies?
Workplaces can make several adjustments when it comes to creating a safer environment for allergen sufferers. This includes creating allergen-free areas and providing separate equipment and utensils. For example, those who have a gluten allergy could be provided with their own cutting board, knife and even toaster.
In shared kitchens, it’s also important to label foods with allergens too or have allergen-free refrigerators and cupboards.
Where work events are organised and catering is provided, whether in-house or away, it is important to ensure there are allergen-free options. This helps to create an inclusive work community where everyone is free to enjoy food.
Workplaces should also have protocols in place for those with allergies. This includes emergency procedures, the storage of EpiPens and ways to report such incidents.
In terms of practicalities, workplaces should look at air quality in the workspace, especially for those triggered by airborne allergens.
To make things easier for those with allergies, employers could also consider offering flexible work arrangements and allowing employees to work remotely. They can also allow them sufficient time for breaks to prepare and consume meals without being rushed.
Finally, employers can really help matters by fostering a supportive workplace culture that promotes empathy and understanding among all colleagues. With a strong and collaborative workforce, those with allergies will feel much more confident when going about their job.
Are there any laws to protect allergy sufferers at work?
The Health and Safety at Work Act of 1974 obliges employers to protect the health and safety of employees. If the allergy also constitutes a disability, then it could be considered a protected characteristic.
Should workplaces ban nuts?
Nut bans can be difficult to enforce at work, and if one were in place, it could lead nut allergy sufferers to have a false sense of security. It’s also impossible to ban every possible allergen so it’s generally not done.
Should workplaces allow employees to eat at their desks?
This is common and is difficult to ban. However, if an employer knows an employee has a severe food allergy, then it would be advised to provide a designated eating space. It is also not a good idea for an allergy sufferer to ‘hot desk’.
Do hand sanitisers remove allergens?
No. Handwashing is a much safer way of removing allergens from your hands.
Who should administer an EpiPen when it’s needed?
Anyone is allowed to administer an EpiPen. This is under the Human Medicines Regulations 2012 under Regulation 238. However, it’s good to have a plan in place as to who has access to EpiPens. Employees who might need to administer one should also be provided with training on how to do so.
How quickly do EpiPens work for food allergies?
You should see some improvements very quickly. If there have been no signs of improvement within a few minutes, another EpiPen can be administered five minutes after the first one.
Should food allergy sufferers inform their colleagues of their allergies?
It is an individual choice to disclose an allergy. However, it is recommended that a few close colleagues be made aware. This is so that they can help if there is a reaction.
When is a good time to inform an employer about an allergy?
Unless your new role means coming into contact with something you’re allergic to (e.g. a nut allergy sufferer working in a chocolate factory), then you don’t need to tell your employer at interview. It is recommended that you tell them as soon as possible, however, so that they can make reasonable adjustments and assure your safety.
What should you do if you think your colleague is having an allergic reaction?
Depending on the severity of the reaction, you will need to do different things. For mild reactions, it might be a case of waiting for it to pass. For more serious reactions and anaphylaxis, you need to act fast to call an ambulance and administer an EpiPen injection of adrenaline.
Managing allergies in the workplace is everyone’s responsibility. The allergy sufferer should ensure that enough people know about the allergy, especially if it could lead to anaphylaxis. When employers know about allergies, they should ensure they remain vigilant and put plans into place to support their employees. This includes educating, training, providing safe spaces, ensuring safe practices, and making reasonable adjustments.