Updated:

November 1, 2019

What You Should Know About Cross-Contact and How to Avoid It

Living with severe food allergies can feel like navigating a constant challenge, where the possibility of unintended exposure to allergens looms with every step, impacting both well-being and quality of life. Remaining vigilant is essential to minimize the continual risk of encountering allergens. Our blog on cross-contact delves into the significance of this concern for individuals and families managing food allergies. We will answer the question, "What is cross-contact?" and  offer practical insights, share valuable tips, and emphasize the importance of preventive measures to effectively mitigate the risks associated with cross-contact.

How does cross-contact occur?

Cross-contact poses a significant risk during food preparation and storage, manifesting in various ways that may go unnoticed. This can occur through direct contact between two foods. There's also in-direct cross contact, which can present challenges in detection as the cross-contact can be invisible to the naked eye. Even small traces of allergens hold the potential to elicit severe reactions. Whether it's two foods inadvertently mingling during the cooking process or shared surfaces and utensils facilitating the transfer of allergenic proteins, the threat of cross-contact remains omnipresent. This underscores the importance of meticulous attention to detail, implementing strategies such as using separate utensils and surfaces, prioritizing allergy-safe food preparation, and maintaining rigorous cleaning practices to eliminate microscopic traces that could compromise the safety of individuals with food allergies.

What is direct cross-contact?

Direct cross-contact in the context of food allergies refers to the unintended transfer of allergenic proteins from one food item to another during the production, preparation, or serving processes. This can occur when allergen-containing foods come into direct contact with allergen-free items, leading to the contamination of the allergen-free items. For individuals with food allergies, even trace amounts of allergens can trigger an immune response, potentially leading to severe allergic reactions. It is crucial for food manufacturers, chefs, and food service establishments to implement strict protocols and practices to prevent direct cross-contact, such as using separate utensils, cleaning surfaces thoroughly, and clearly labeling allergenic ingredients. 

What is indirect cross-contact?

Indirect cross-contact in the realm of food allergies occurs when allergenic proteins are transferred to allergen-free foods through shared equipment, utensils, or surfaces during the food production or preparation process. Unlike direct contact, where allergens come into direct contact with allergen-free items, indirect cross-contact involves the transfer of allergens without direct physical contact between the two. This can happen when equipment or surfaces are inadequately cleaned or not properly sanitized, allowing residual allergenic proteins to persist.

For individuals with food allergies, even minute traces of allergens resulting from indirect cross-contact can elicit severe allergic reactions. Thus, stringent measures must be in place, including thorough cleaning practices, equipment segregation, and comprehensive staff training, to minimize the risk of indirect cross-contact. These precautions are crucial to providing a safe dining environment for individuals with food allergies, ensuring their protection against inadvertent exposure to allergens that could compromise their health. Here are three examples of how indirect cross-contact can occur:

Food/Object Contact

Indirect cross-contact can arise when utensils are shared across different food types, presenting a potential risk. Consider a scenario where a chef utilizes the same knife for slicing both gluten-containing and gluten-free bread. If the knife isn't thoroughly cleaned between uses, crumbs from the gluten-containing bread might adhere to it and subsequently transfer to the gluten-free bread during slicing.

Moreover, shared cooking surfaces can contribute to allergen cross-contact challenges. Picture a restaurant employing the same flat-top grill for cooking eggs, pancakes, and bacon. The proteins from common allergens like egg, wheat, or milk may effortlessly move between these food items. Even if bacon doesn't naturally contain egg, milk, or wheat proteins, it could pick them up from the shared cooking surface.

Food/Skin/Saliva Contact

Indirect cross-contact takes another form when considering food/skin/saliva interactions, especially concerning those with severe, highly sensitive food allergies. Individuals or animals consuming allergen-containing foods may inadvertently transfer allergens to others through their saliva. For instance, a dog enjoying a treat with milk proteins might pass those proteins to a person's face through licking. Similarly, a mother consuming peanuts before kissing her baby could leave traces of peanut proteins on the child's cheek. Vigilance in managing these various forms of indirect cross-contact is crucial for safeguarding those with food allergies from potential health risks.

What is the risk of cross-contact?

Cross-contact poses a significant risk for individuals with food allergies, as it involves the unintentional transfer of allergens from one surface or food item to another. This can occur at any stage of food preparation, processing, or handling, leading to the contamination of supposedly allergen-free foods. Even trace amounts of allergens can trigger severe allergic reactions, such as anaphylaxis, in sensitive individuals. 

Shared equipment, utensils, cutting boards, and surfaces can become sources of cross-contact, especially in restaurants, food processing facilities, and kitchens where multiple ingredients are handled. Additionally, inadequate cleaning practices and lack of awareness about specific allergens may contribute to the heightened risk of cross-contact. Vigilance, education, and clear communication between food preparers and individuals with allergies are crucial in minimizing the potential dangers associated with cross-contact and ensuring the safety of those with food allergies.

How to prevent cross-contact with food allergies

Ensuring your health and safety, as well as that of your child, hinges on effectively avoiding cross-contact. Knowing how to prevent cross-contact means being proactive and posing the right questions to mitigate  your riskst, whether you're at home or dining out.

Prepare Foods Safely:

  • Use separate utensils, dishes, and surfaces when making and serving different types of foods.
  • If separation isn't feasible, ensure thorough washing of utensils and surfaces with soap and water when preparing allergy-safe foods.
  • When cooking diverse foods, prioritize preparing allergy-safe options first.
  • Cover allergen-free foods and store them separately.
  • After handling allergens, wash hands thoroughly with soap and water before touching anything else.
  • Clean surfaces and utensils diligently with soap and water after meal preparation.
  • Discourage sharing of foods, drinks, cups, plates, or utensils, emphasizing this to children.
  • At home, label foods as “safe” or “not safe” for allergies.
  • Don't hesitate to request handwashing, whether dealing with guests or hosts.

Plan Ahead:

  • Communicate your food allergy needs to hosts, servers, or managers, preferably calling ahead.
  • Emphasize the importance of preventing cross-contact.
  • Check restaurant menus online beforehand for safe meal choices.
  • If uncertain about cross-contact, err on the side of caution and avoid consuming the questionable food.

Ask the Right Questions:

  • Inquire about a separate space for preparing special-diet foods.
  • Confirm the use of separate cutting boards and utensils for allergy-safe meals.
  • Verify whether the restaurant employs a shared grill or fryer for both regular and allergen-free foods.
  • Ask if servers will be involved in preparing any part of your meal, as they may not be aware of allergy-safe spaces or utensils.
  • Understand how the allergy-safe meal will be designated and delivered, ensuring a separate delivery to prevent cross-contact.
  • Inquire about sanitizing the table to reduce the presence of allergen proteins.

Cross-contact vs. cross-contamination

The question of cross-contact vs. cross-contamination comes up frequently. While cross-contact and cross-contamination are often used interchangeably, they carry distinct meanings. Cross-contact specifically involves different foods coming into contact, either directly or indirectly, resulting in the transfer of allergen proteins from one food to an allergen-free counterpart. To mitigate the risks of cross-contact, it is essential to avoid consuming the food that has been in contact with the allergen, and thorough washing of anything exposed to the allergen is recommended. 

On the other hand, cross-contamination occurs when contaminants such as bacteria, viruses, or molds make food unsafe for consumption, affecting individuals with or without food allergies. Unlike cross-contact, cross-contamination may lead to food-borne illnesses, commonly known as food poisoning, rather than allergic reactions. While symptoms may overlap, cooking the contaminated food can reduce or eliminate the risk of illness, though this is not always the case. Recognizing these differences is crucial for implementing appropriate preventive measures in both scenarios.

Frequently asked questions about cross-contact 

What should you do to avoid cross-contact when preparing food for someone with a food allergy?

Avoiding cross-contact during food preparation is paramount for the safety of individuals with food allergies. Implementing careful steps in your food preparation can significantly reduce the risk of allergen transfer. Firstly, use separate utensils, cutting boards, and surfaces for foods with allergens and those without. If complete separation is impractical, ensure thorough cleaning with soap and water between uses. When cooking, prioritize the preparation of allergen-free options first to minimize the chances of cross-contact. Cover allergen-free foods and store them separately from allergen-containing items. 

After handling allergens, wash hands rigorously with soap and water before touching anything else. Regularly clean surfaces and utensils with attention to detail, reducing the likelihood of microscopic traces causing cross-contact. Discourage the sharing of foods, drinks, or utensils, and label stored foods as "safe" or "not safe" for allergies. Maintaining a proactive approach and adhering to these measures can significantly enhance the safety of food preparation for those with food allergies.

How to select food for someone with a food allergy

For individuals with food allergies, navigating dietary choices involves a keen awareness of allergens and suitable substitutions. Those with allergies can typically enjoy a wide range of foods, focusing on fresh fruits and vegetables, lean proteins like poultry or fish, and whole grains. Opting for alternative sources of dairy, such as plant-based milks or cheeses, can be an effective swap for those allergic to dairy products. 

Additionally, exploring gluten-free grains like quinoa or rice provides alternatives for those with wheat allergies. Nut allergies can often be accommodated with seeds like sunflower or pumpkin seeds. Being mindful of ingredient lists, choosing whole, unprocessed foods, and experimenting with allergen-free recipes can open up a diverse and delicious array of options, allowing individuals with food allergies to maintain a well-balanced and satisfying diet. Always consult with a healthcare professional for personalized guidance based on specific allergies.

What is one of the top causes of cross-contact?

One of the primary causes of cross-contact stems from the shared use of utensils, surfaces, or equipment during food preparation. When cooking various foods in the same space or with the same tools, allergenic proteins from one item can inadvertently transfer to another, even if the foods themselves don't come into direct contact. This common practice, while seemingly convenient, poses a substantial risk for individuals with food allergies. Cross-contact can occur when utensils or surfaces are not adequately cleaned between uses, allowing microscopic traces of allergens to persist and contaminate allergen-free foods. To mitigate this risk, it is crucial to adopt practices, like using separate utensils, prioritizing allergy-safe food preparation, and thoroughly cleaning surfaces to prevent the inadvertent transfer of allergens.

How Aspire Allergy & Sinus Can Help Mitigate Cross-Contact

If you or a loved one is seeking effective strategies to manage food allergies and reduce the fear of cross-contact, consider exploring the comprehensive services we offer at Aspire Allergy & Sinus. Our experienced team specializes in personalized treatment plans, including OIT or food allergy drops, to enhance tolerance and improve the quality of life for individuals with food allergies. 

Oral Immunotherapy (OIT) is a promising solution in preventing cross-contact scares for individuals with food allergies. OIT involves gradually introducing small, controlled amounts of allergens to the individual, allowing their immune system to build tolerance over time. This heightened tolerance can provide a crucial buffer against potential reactions caused by accidental cross-contact. 

Food allergy drops can also be a treatment option. These drops typically contain small, controlled amounts of allergenic proteins, allowing the immune system to gradually build tolerance. As individuals consistently take these drops under medical supervision, their sensitivity to specific allergens decreases, reducing the risk of severe reactions caused by accidental cross-contact.

By prioritizing prevention and understanding the nuanced dynamics of cross-contact, we aim to empower those affected by food allergies to forge a path toward a safer, more confident existence. Our commitment to providing insights, practical advice, and a supportive community underscores our dedication to helping individuals and families navigate this challenging terrain with resilience and assurance. Schedule an appointment for expert guidance and tailored solutions to navigate the complexities of food allergies with confidence and peace of mind!

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About The Author:

Stacy Silvers, MD

Dr. Silvers is a board certified allergist specializing in environmental and food allergy diagnosis, treatment and prevention. Dr. Silvers oversees our allergy program and protocols, and also leads the food allergy and oral immunotherapy (OIT) program at Aspire Allergy & Sinus. Dr. Silvers is considered an expert in the field of food allergy diagnosis and treatment. In 2019, Dr. Silvers was named Best Allergist in the Statesman's Best of the Best Contest.