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I’m often asked whether a consumer device that tests for unwanted ingredients in foods will give those with food allergies a false sense of security when dining out. My response is usually the same: do waitstaff give the food allergic a false sense of security when assuring customers their food is safe?

From personal experience as a waitress, and as someone with food allergies, I can assure you, it happens.

Roughly a decade ago, I waitressed at a restaurant in Midtown Manhattan. It was a fast-paced work environment that demanded recall of dozens of orders and seating positions at any given time. The restaurant was located a few blocks north of Madison Square Garden, so we’d routinely get flooded with hungry patrons before and after performances. During my tenure waiting tables, I grew accustomed to the frequency with which waitstaff made mistakes—and it’s often. A few times a week I would mix up orders, fail to put in special requests, and was once lambasted for accidentally serving a woman regular coke instead of diet. I never made that mistake again.

But there’s a difference between mixing up soft drink orders and forgetting to inform the kitchen of a food allergy. Despite their best efforts and intentions, waitstaff don’t always get it right—even when it comes to food allergies. Many waiters don’t know that pesto usually contains pine nuts, that marzipan is almond paste, or that peanuts and nutmeg are not tree nuts. According to a recent CDC report, restaurants were found responsible for nearly half of all food allergy fatalities over a thirteen-year period. That same report found that less than half of all restaurant managers, and only one third of servers, receive any formal training on food allergies. Legislation is also lagging. Today, only six states (Illinois, Massachusetts, Maryland, Michigan, Rhode Island, and Virginia) and two cities (NYC and St. Paul, MN) have passed laws to increase food allergy safety and awareness in restaurants. We’ve clearly got a long way to go.

I’ve also had my fair share of personal experiences with misinformed waitstaff. This past year alone, waitresses at two different restaurants assured me that my dish was allergen-free when, in fact, it was not. One of the more memorable incidents occurred when I was ten. Our family went to a fancy restaurant near our home for my mom’s 40th birthday. I typically wasn’t allowed desserts at restaurants, but my parents decided to make an exception. We informed the waitress of my food allergies, who then confirmed with the chef that the dessert was safe. After sheepishly taking a small bite, the waitress came barreling out of the kitchen towards the table: there was marzipan in the icing (they hadn’t checked with the pastry chef until after it was delivered to our table). Fortunately, I spit the cake out and the reaction did not rise to the level of anaphylaxis.

Dining out has and will always present challenges for the food allergic, and living in a bubble isn’t a realistic option: I don’t know one adult with food allergies that doesn’t dine out at restaurants or eat foods prepared by others. Right now, the food allergy community relies on the word of the kitchen and waitstaff—the first and only line of defense to prevent a reaction; then there’s epinephrine if things go wrong. Little progress has been made in the way of management tools for preventing allergic reactions in past decades, but fortunately, that’s starting to change. We’re finally seeing a surge of start-up activity in the food allergy space, with different products and apps designed to help the food allergic population better manage their allergies. After all, dining out shouldn’t feel like a game of Russian roulette!

Consumer devices that test foods for unwanted ingredients are intended as a supplement, not a substitute, to the standard precautionary measures those with food allergies would otherwise take when dining out or eating foods prepared by others. For example, I’m still going to tell the waitstaff I have food allergies; I’m still going to take a small bite before diving into my dish; I’m still going to avoid Thai restaurants, desserts, and pesto; and I’ll continue to have my epinephrine on hand. But an additional layer of assurance would be a vast improvement on the status quo.

Having been on both sides of the table, I know this much is true: waitstaff make mistakes, and it only takes one to trigger anaphylaxis. We food allergic folks need all the tools and reassurances we can get.

- Abi and the Allergy Amulet Team

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