Food safety and allergen researcher Ivy Nyantakyiwa Tsibuah on training, cross-contact, and the distance between what a kitchen knows and what it does
Most people never think about what stands between them and a foodborne illness. They order lunch, take a tray, eat, and move on. Behind that ordinary transaction sits a quieter discipline than engineering or medicine and considerably less visible than either: the training of the people who handle food. Every safe meal served in a dining hall, a school cafeteria, or a hospital kitchen depends on a worker remembering a practice, under time pressure, at the end of a shift, when nobody is watching.
What rests on that scale is not small. The Centers for Disease Control and Prevention estimates that foodborne illness causes roughly 48 million illnesses, 128,000 hospitalizations, and 3,000 deaths in the United States each year — about one in six Americans sickened annually. Improper food handling by food service workers remains a leading contributor to retail and food service outbreaks. This puts the question of whether training works squarely at the center of the problem, not at its edge.
Ivy Nyantakyiwa Tsibuah has spent the past several years asking exactly that question and arriving at an uncomfortable answer. A ServSafe-certified food safety manager and AllerTrain-certified allergen specialist, she is completing a Master of Professional Studies in Hospitality Management at The Pennsylvania State University while working in high-volume institutional dining at Penn State Campus Dining. Her path into the field is unusual: she taught for roughly a decade in Ghana, first in basic education and later in secondary food and nutrition, before moving into food service operations. Her undergraduate honors research at the University of Education, Winneba, examined the hygiene and food safety practices of traditional caterers at Market Circle in Takoradi — a workforce that prepares food in volume for markets, events, and institutions, and that sits largely outside formal regulatory oversight.
In 2026, she published a systematic review of forty studies on food safety and allergen training among food handlers, drawn from restaurants, hospitals, schools, and university dining operations across thirteen countries. What she found was consistent enough to be called a pattern.
“Training reliably raises what people know. It does not reliably change what they do,” Tsibuah said. “That gap is the whole problem, and our industry is structured not to see it, because we measure knowledge and call it compliance.”
The figures in the reviewed literature are blunt. In one study of restaurant workers, 97 percent reported washing their hands before handling food; 81 percent were actually observed doing it. Approved hand drying fell from 75 percent reported to 43 percent observed. In another study of 712 restaurant staff, food safety knowledge had no significant direct effect on allergen management practice at all. Attitude did.
Allergen competence, she found, lags further still. In one national sample, only 16 percent of food handlers could identify all of the major allergens named. In another study, 86 percent of the restaurants assessed carried no allergen information on their food lists.
“A passing score measures recall in a quiet room,” she said. “It does not measure what somebody does on a Tuesday lunch rush with a colleague out sick and a queue forming. If we evaluated training by observing practice instead of scoring tests, I think we would find that a good deal of what we currently count as compliance is not protecting anyone.”
The stakes have risen recently for a specific reason. The Food Allergy Safety, Treatment, Education, and Research Act of 2021 designated sesame as the ninth major food allergen in the United States, effective January 2023 — expanding disclosure and cross-contact obligations across the food supply. Advocacy organizations estimate that on the order of 33 million Americans live with food allergies, including roughly 5.6 million children.
Sesame is also, by Tsibuah’s account, the hardest of the nine to train for. It appears in bread formulations, spice blends, sauces, and dressings, often invisibly. And the rule produced an unintended consequence: some manufacturers responded by adding sesame to products deliberately, so they could declare it rather than control it.
“The ingredient landscape shifted underneath kitchens that had no idea it was moving,” she said. “A product that was safe two years ago may not be now. Meanwhile, nobody’s training hours expanded when the allergen list did.”
That constraint is where her current work is focused. Under USDA Professional Standards, established through the Healthy, Hunger-Free Kids Act, school nutrition directors must complete twelve hours of training annually, managers ten, full-time staff six, and part-time staff four. Those hours must already cover procurement, civil rights, food safety, and nutrition. Allergen content competes for time that was fully allocated before sesame was added.
“Asking for more hours is not a serious proposal, because nobody is going to grant them,” Tsibuah said. “The question is how to make the hours that already exist do more work. That means role-specific training, so a serving line associate learns what they actually need rather than sitting through a manager’s curriculum. It means short and frequent instead of annual and long. And it means verifying competence by watching people work rather than by testing them.”
Her perspective is shaped by having watched the same failure in very different settings. In Takoradi the constraint was infrastructure and access to training; in a large American university dining operation it is turnover, scale, and time. The gap between knowing and doing looked much the same in both.
“What I would resist is any story in which knowledge simply flows from wealthy countries to poorer ones,” she said. “The caterers I studied in Ghana were skilled people solving hard problems under real constraint. The same knowledge-practice gap I documented in that market runs through American and European kitchens. What differs is the constraint, not the competence.”
Technology, she suggests, will help with this unevenly. Mobile microlearning fits how the food service workforce actually lives: short modules on a phone, in the worker’s preferred language, delivered close to the moment of use. Digital observation tools let a manager record practice during a routine walkthrough rather than a formal audit. Both are genuine improvements.
Her caution is about what those tools make easy. “Technology is very good at generating documentation, and documentation is already the thing we over-rely on,” she said. “A completion certificate is not a safe practice. If these tools end up being used mainly to prove that training happened, they will make the gap harder to see rather than smaller. The test for any new tool is whether it measures behavior or only measures participation.”
By her own description, it is unglamorous work. Success in food safety is invisible by definition: it looks like nothing happening, over and over, for years.
“A hundred safe services earn nobody’s attention. One failure is a child in an emergency room,” Tsibuah said. “That asymmetry is exactly why the work matters, and it is why I am less interested in whether people learned something than in whether they did it. That second question is harder to answer. It is also the only one that counts.”
Ivy Nyantakyiwa Tsibuah is a ServSafe-certified food safety manager and AllerTrain-certified allergen specialist completing a Master of Professional Studies in Hospitality Management at The Pennsylvania State University, with a minor in African Studies. She holds a Bachelor of Science in Catering and Hospitality Education and a Bachelor of Education from the University of Education, Winneba, Ghana. She works in institutional dining at Penn State Campus Dining, and her published research examines the effectiveness of food safety and allergen training among front-line food handlers.
