Measures to Prevent Food Allergy Incidents for Eating and Drinking Establishments
- Let’s take measures to prevent food allergy incidents - (for eating and drinking establishments)

Labeling of foods that cause food allergies (Food Labeling Act)

The Food Labeling Act specifies 28 food items that may cause allergic reactions for some people.

Among these items, eight items (shrimp, crab, walnuts, wheat, soba, eggs, milk, and peanuts) to which a significant number of people have severe allergic reaction and symptoms, are referred to as "specific ingredients". When foods containing any of these ingredients are used in processed foods that have been prepackaged in containers, they must be labeled with a warning (the grace period has been set for walnuts up to March 31, 2025).

It is also recommended that processed foods containing any part of 20 items (almonds, abalone, squid, oranges, cashew nuts, kiwi fruit, beef, sesame, salmon, mackerel, soybeans, chicken, bananas, pork, macadamia nuts, peaches, yams, apples, gelatin) be labeled as such whenever possible.

On the other hand, there is no obligation or recommendation for labeling food products that are sold over the counter or by volume in stores or served at eating and drinking establishments. However, to prevent harm to health, it is necessary to provide more information to customers with food allergies.

Symptoms of food allergy

The symptoms of food allergies are very diverse and vary from person to person. The same person may have different symptoms depending on the amount of food they eat. The most common symptom is skin abnormality.
Symptoms progress very rapidly in minutes, so a rapid response is required when symptoms appear. The serious systemic symptoms are called “anaphylaxis”. This appears rapidly and may cause death.

Skin symptoms	Urticaria, itching, and redness
Respiratory symptoms	Throat feels cramped, throat swelling, hoarseness, coughing, stridor and feeling of dyspnea
Mucus membrane symptoms	Eyes: Bloodshot eyes, itching, swollen eyelids Nose: Sneezing, runny nose, nasal congestion Mouth: Any of these coupled with tongue discomfort, swelling of the tongue, itchiness of the throat
Digestive system symptoms	Abdominal pain, diarrhea, nausea
Systemic symptoms	Tiredness, listlessness, loss of consciousness

Response to symptoms of food allergy

If a customer experiences symptoms that appear to be caused by food allergy, first determine if the symptom is acute or serious. Do not hesitate to call an ambulance if the symptom is serious or changes suddenly.

If the customer has an EpiPen® (adrenaline for self injection), consider using it.

If the symptoms are of the minor variety, provide a place to rest and prepare for the sudden change in symptoms. In preparation for such circumstances, the person responsible for taking charge should be decided and trained in advance.

Refer to the Food Allergy Emergency Response Manual to learn about emergency responses.

The Food Allergy Emergency Response Manual can be downloaded from Tokyo Food Allergy Information navi..

To prevent food allergy accidents

Preparations

1. Determine the rules of your place of business (whether it can be addressed, ingredients that can be handled, contamination control, how to respond, etc.).
2. Ensure that all employees understand food allergies correctly and respond in accordance with rules for the business.
3. Keep an up-to-date and accurate knowledge of what ingredients you use.
4. Design menus, signs, customer treatment, etc., that make it easier for customers to get easy-to-understand information about ingredients that can cause allergic reactions.
5. Decide who will oversee the management of food information, education of employees, responses to accidents, etc.

Hospitality/cooking

1. Accurately communicate your business’s food allergy response rules. Ambiguity and inaccuracy can lead to serious consequences or inability to respond. Be sure to clearly state rules, etc.
2. Get an understanding of food allergies that customers may have.
3. If a customer raises any question, make sure to provide an up-to-date, accurate description of the ingredients you use.
   If the information may not be up-to-date or accurate, answer "I don't know" and leave it up to the person responsible.
4. Be aware of possible contamination of food with ingredients that could cause an allergic reaction in some people. Be sure to let customers know about the potential for contamination by displaying information on the menu or by verbal explanation.
5. Use the allergy communication sheet on the back to ensure accurate communication between the customer and waiter/waitress and between waiter/waitress and cook.

Three suggestions to prevent food allergy accidents

• Provide an up-to-date, accurate description of the ingredients you use.
• Do not give ambiguous answers to questions.
• Be aware of allergen contamination and be sure to inform the customer of the potential contamination

Allergy Communication Sheet

• You can have the customer write down ingredients that he or she is allergic to, and confirm that they are correct.
• You can suggest selections that do not contain those ingredients or selections that you can remove the ingredients in question or communicate by pointing to the text.
• You can copy the sheet and use it together with the menu.
• The text is in Japanese, English, Chinese (simplified and traditional), and Korean, in that order. Pictograms are used to communicate with people who do not understand these languages.

Allergy communication sheet concerning measures to prevent food allergyincidents for eating and drinking establishments