Food allergy knowledge, attitudes and practices of foodservice workers at restaurants in Lebanon: Findings from a national cross-sectional study

Abstract

Introduction: Dining out at restaurants could be challenging for people with food allergies who ought to depend on food service workers or restaurant staff to prepare allergen-free food. Objective: The present paper aims to explore knowledge, attitudes and practices related to food allergy among food service workers and managers at Lebanese restaurants. Methods: A nationally representative survey was conducted among restaurants’ food service workers and managers in Lebanon. Through face-to-face interviews, food service workers and managers filled in a multicomponent questionnaire containing two sections: (1) sociodemographic characteristics and work experience, and (2) knowledge, attitudes and practices related to food allergy. An additional section related to the restaurant characteristics was completed by managers only. Results: A total of 137 restaurants' food service workers and managers completed the surveys. Results indicated that all foodservice workers and managers had positive attitudes towards serving “special customers”; however, many (72%) had limited knowledge and malpractices related to food allergies. Restaurants' managers with adequate knowledge of menu ingredients and those who received food allergy training had significantly higher knowledge scores as compared to their counterparts (β = 1.339, p = 0.016 and β = 3.062, p = 0.007 respectively). Both very low and low food service experience resulted in lower staff knowledge scores (very low: β = −2.160, p < 0.01, low: β = −1.664, p = 0.003) and lower practice scores (very low: β = −1.492, p < 0.01, low: β = −0.730, p = 0.038). However, previous food allergy training yielded higher staff knowledge scores (β = 1.736, p = 0.003). Lower educational level (low: β = −2.12, p < 0.001, moderate: β = −0.680,p = 0.033, high: β = −0.712,p = 0.017) correlated with lower staff practice scores. However, previous food allergy training yielded higher staff and manager practice scores (β = 2.472,p < 0.01 and β = 3.075,p = 0.003 respectively). Managers’ practice scores were also correlated to allergen-free menu (β = 1.479, p = 0.015). Conclusions: The results of this study show that improved legislation, training of restaurant staff, and food allergy knowledge are highly recommended to prevent severe allergic reactions upgrade patient safety. It is recommended that the Lebanese Ministry of Health enact regulations requesting restaurants to implement effective food allergies’ management plans. © 2021 Elsevier Ltd