Food Allergies: It Only Takes One Bite

Originally published September 2013

By Jan Hanson

Food allergy is a growing health concern in North America and for good reason. Too many kids are having allergic reactions and going into anaphylactic shock, a life-threatening event, while at school.

Often this is a result of a lack of education and preparation. Tragically, fatalities also occur. Understanding the impact food allergies have on affected children is the first step in recognizing the need for better management. Consider the following:

• Six million children in the North America have a food allergy, or 1 in 13 children.
• The nine major food allergens in Canada are: peanuts, tree nuts, eggs, milk, wheat, soy, seafood (fish, crustaceans, shellfish), sesame, and mustard.
• Peanuts and tree nuts account for 90% of fatalities, but any food to which a person is allergic can cause a life-threatening reaction.
• Trace amounts of a food allergen can cause a reaction.
• Annually, 77,000 children in the U.S. are treated in hospital emergency rooms for food-allergic reactions.
• 16-18% of children experience a reaction while at school.
• 79% of reactions at school occur in the classroom.
• 25% of food-allergic reactions at school are experienced by students previously undiagnosed as having a food allergy.
• Having both food allergies and asthma put children are at a higher risk for fatal anaphylaxis.

An Act to Protect Anaphylactic Pupils

In October of 2004 a high school student with a peanut and milk allergy ate French fries she thought were safe; they weren’t and contained cheese residue from the tongs used to serve them. She suffered an anaphylactic reaction and died. This incident was the catalyst for the passing of Bill 3, Sabrina’s Law, in 2005 in Ontario. The first legislation of its kind in the world, Sabrina’s Law ensures all school boards have policies or procedures in place to address anaphylaxis in schools, which includes providing instruction to staff and guidance on the administration of medication.

A school is a high-risk environment for children with allergies because the opportunity for food allergen exposure is increased. Food is an integral part of the school day: snack, lunch, holiday/birthday celebrations, pizza parties, and ice cream socials, for example. Food is also used in the curriculum in all grades: art, science, cooking, and cultural enrichment projects. The possibility for allergen exposure through ingestion, skin contact, cross-contamination, and inhalation exists with all of these activities.

Allergic reactions at school can be prevented. Advance planning and vigilance are critical. Allergen avoidance, education, and response protocols must be implemented. To do so, educators and school personnel should:

• Have a nurse on staff at school.
• Provide education on food allergies and anaphylaxis for staff and the school community.
• Provide EpiPen administration training for all staff (where state regulations allow).
• Keep EpiPens and related medicines accessible.
• Work with the parents to develop a healthcare plan to treat an allergic reaction, and one to prevent allergen exposure for all school-sponsored activities in which the child will participate, and in all areas of the school environment.
• Understand laws that protect children with food allergies.

Students with food allergies are entitled to a safe school experience. Education, preparation, and a thoughtful, coordinated approach—along with a strong partnership between parents and school personnel—will achieve this result.

Jan Hanson, M.A., has over twenty years experience in the area of food allergy management, is founder of the consulting company Educating for Food Allergies, LLC, and is the author of Food Allergies: A Recipe for Success at School.