If you do that, PHP5 will throw a big error.
No, it is deprecated and finished this this when you use the '&' in the call. Only for arrays, and only for declarations of the parameters of the function.
All objects are pointer, so only simple vars and arrays need that. but only in the parameters declaration.
Even here in our case, I am not sure if it is required in the declaration. It is just a coding style for the coder to remember it is a OUTPUT parameter.
But when $item is an object, you can be sure it will be working even without '&' because it is systematically a pointer.