Back to School: Peanut Allergies and Peanut-free Zones

     The Department of Transportation’s (DOT) ruling last year concerning a peanut-free buffer/zone in airplanes has resulted in hundreds of media articles in past several months. Additionally, school staffs increasingly are being asked to ban peanuts and peanut-containing products from their schools.

     The original DOT ruling stated that a family’s request to have a “peanut-free zone” during a flight would have to be honored by all commercial airlines. This zone included three seats in front and three seats in back of the row in which a the allergic patient was sitting. Soon after, because of public, peanut lobbyist, and congressional outcry, Congress blocked the DOT ruling and it was withdrawn. Currently, most airlines are working with peanut-allergic patients on an individual basis.

 

Advocates address peanut bans in schools

   

     In some schools, superintendents, principals and school nurses have been asked to ban all peanuts and peanut-containing products from the school grounds. Some vocal food allergy advocates believe that a ban on peanuts will protect their child while in school. However, the Food Allergy Network, a lay organization for individuals and families with food allergy concerns, and others have voiced the opinion that a ban would lead to a false sense of security for the child and the school, and would not help the child learn the intricacies of dealing with a potential life-threatening allergic reaction.

     An estimated 6% – or up to two million children – have food allergies. A child who experiences an allergic reaction to peanuts generally has this sensitivity for life. An additional important fact about peanut allergic children is that they are capable of having a serious, life-threatening reaction called anaphylaxis at any time, even if they previously experienced milder symptoms. It is apparent from recent studies that children with either peanut or tree nut allergies should be treated as if the next reaction could be fatal. Over 50% of peanut or tree nut allergic patients have accidentally ingested peanuts at some time and have experienced some type of reaction. These reactions most often occurred in the school setting.

 

Academy position statement provides guidelines

 

     A recent AAAAI position statement, Anaphylaxis in Schools and Other Childcare Settings, was published to address issues such as proper identification of offending foods, avoidance strategies for specific allergens, and treatment strategies related to accidental food ingestion.

     The statement notes that school nurses should work in partnership with allergic children’s parents to develop strategies for avoiding reaction while allowing them to participate fully in all activities. It is stressed in this document that treatment protocols for use in the school setting should be physician prescribed.

 

Staffs are required to take appropriate measures

 

     The Americans with Disabilities Act and Section 504 of the Rehabilitation Act requires schools to provide sufficient school nurses to ensure appropriate care. All staff members involved with the child’s care should be instructed about the potentially severe nature and proper treatment of food allergy reactions and problems. It is possible to reduce a child’s exposure to an allergenic food within the school setting. Specific school measures which should be established include:

  • Informing all appropriately involved staff of the technical and scientific names for common allergenic foods
  • Implementing “no food or eating-utensil trading” rule
  • Washing surfaces clean of contaminating foods
  • Substituting any food used in lesson plans with another non-allergenic food, depending on the allergies of the students
  • Ensuring that injectable epinephrine is available in unlocked areas and that staff is trained in its use
  • Familiarizing all individuals who are entrusted with the care of children with basic first-aid and resuscitative techniques. This training should include additional formal training on how to use epinephrine devices to treat anaphylactic reactions.

 

     A school-wide food allergy awareness program for staff should also be developed to ensure that everyone will know what to do if an accidental allergic reaction occurs. Parents are advised to never sign a waiver absolving the school of responsibility of the failure to provide and administer epinephrine or other emergency medical assistance.

 

Resources available

 

     For more information, those concerned about food allergy may contact The Food Allergy Network (FAN) in Fairfax, VA, which can provide The School Food Allergy Program, the Protect and Life (PAL) Program, and other educational materials. For more information, visit FAN’s Web site at www.foodallergy.org or call 1-800-929-4040.

     For a copy of the AAAAI’s position statement or the Tips to Remember brochure on food allergy, visit www.aaaai.org.

 

 

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“Anaphylaxis in Schools and Other Childcare Settings”, The Journal of Allergy and Clinical Immunology, Vol. 102, #2, August 1998, p. 173-176.


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