Cross-contact vs. cross-contamination

Eating at restaurants is hard enough when you've got celiac disease, and the terms we use are part of that confusion. Generally speaking, cross-contact refers to when allergens are able to transfer due to contact, and cross-contamination relates to microbial contamination of food.¹ They're two very different problems that require different solutions, and people will frequently refer to gluten cross-contamination, which in our view, likely hurts celiacs because people apply the cross-contamination standard instead of an allergen safety standard.

Applying the cross-contamination standard to gluten cross-contact implies to people that they can kill off gluten with heat. Gluten is not an organism, it's just a protein - heat is not an allergen control, and cooking does not make gluten safe.² Safe fryers are not created by the fryer being full of hot oil, they are created by having a fryer that only gluten-free food ever enters.³ Importantly, in the US, the restaurant industry already uses the term cross-contact as a distinct allergen control protocol.¹ Using the language that the kitchen uses is more likely to get you better results.

Celiac disease is at an interesting crossroads where the issue is solved for us via allergen control protocols, but the disease itself has no allergic or immediately life threatening component to it⁴ (nonwithstanding a celiac crisis, which still isn't anaphylactic nor allergy-driven). It's hard to get restaurants to pay attention to our needs. Explaining to restaurant staff that you need to avoid cross-contact with gluten, making sure the prep spaces/cooking equipment aren't shared, and making sure that none of the ingredients are contaminated (a good one that people don't always consider is pizza toppings at a pizza restaurant - the pizza toppings are almost guaranteed to be contaminated just by somebody reaching in there with flour on their hands)⁵ are all key strategies to avoiding gluten when eating out. I've even used the term "gluten allergy" myself to help drive home that it requires allergen control protocols to be utilized, but I am not necessarily recommending that.

Overall, the language isn't yet universal worldwide - cross-contact is a more common term in the United States at this point in time⁶ - but the language is shifting. How you explain it to your friends and family can be one way, but how you explain it to restaurant staff matters entirely on what they're trained on.

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