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Food-allergic reactions in schools and preschools
A Nowak-Wegrzyn1, M K Conover-Walker, R A Wood
1Division of Allergy & Immunology, Department of Pediatrics, Mount Sinai Medical Center, Campus Box 1198, One Gustave L. Levy Place, New York, NY 10029-6574, USA. anna_nowak-wegrzyn@mssm.edu
Insights
Food-allergic children frequently experience reactions in school, with 18% reporting incidents in the past two years. Many reactions involve multiple organ systems, highlighting the need for improved prevention and treatment strategies in educational settings.
Area of Science:
- Pediatric Allergy
- School Health
- Public Health
Background:
- Food allergies affect a significant portion of school-aged children, potentially impacting up to 6% of this population.
- Understanding the prevalence and characteristics of food-allergic reactions in schools is crucial for student safety.
Purpose of the Study:
- To characterize food-allergic reactions experienced by children aged 3-19 in school and preschool settings.
- To identify existing prevention and treatment mechanisms for food allergies in educational environments.
Main Methods:
- A telephone survey was conducted with parents of food-allergic children regarding reactions in school.
- Schools were contacted to survey personnel responsible for treating allergic reactions.
Main Results:
- 18% of children experienced at least one food-allergic reaction at school in the past two years.
- Milk and peanut were the most common allergens, and 59% of reactions were skin-limited, while 36% involved multiple organ systems.
- Only 15% of reactions were treated with epinephrine; 14% lacked physician's orders, and 16% had no available medications. 39% of schools reported at least one reaction, and 67% made accommodations.
Conclusions:
- Food-allergic reactions are common in schools, with a notable percentage involving severe symptoms or multiple organ systems.
- There is a critical need to enhance the recognition, prevention, and appropriate treatment of food allergies within school settings.
- Improving emergency preparedness and ensuring access to necessary medications and physician's orders are vital for managing allergic reactions in schools.
Background:
Food allergies may affect up to 6% of school-aged children.
Objectives:
To conduct a telephone survey to characterize food-allergic reactions in children (defined as those aged 3-19 years in this study) with known food allergies in schools and preschools and to determine mechanisms that are in place to prevent and treat those reactions.
Design:
The parents of food-allergic children were contacted by telephone and asked about their child's history of food-allergic reactions in school. The schools the children attended were contacted, and the person responsible for the treatment of allergic reactions completed a telephone survey.
Results:
Of 132 children in the study, 58% reported food-allergic reactions in the past 2 years. Eighteen percent experienced 1 or more reactions in school. The offending food was identified in 34 of 41 reactions, milk being the causative food in 11 (32%); peanut in 10 (29%); egg in 6 (18%); tree nuts in 2 (6%); and soy, wheat, celery, mango, or garlic in 1 (3%) each. In 24 reactions (59%), symptoms were limited to the skin; wheezing occurred in 13 (32%), vomiting and/or diarrhea in 4 (10%), and hypotension in 1 (2%). Also, 15 (36%) of the 41 reactions involved 2 or more organ systems, and 6 (15%) were treated with epinephrine. Fourteen percent of the children did not have a physician's orders for treatment, and 16% did not have any medications available. Of the 80 participating schools, 31 (39%) reported at least 1 food-allergic reaction within the past 2 years and 54 (67%) made at least 1 accommodation for children with a food allergy, such as peanut-free tables, a peanut ban from the classroom, or alternative meals.
Conclusions:
It is common for food-allergic children to experience allergic reactions in schools and preschools, with 18% of children having had at least 1 school reaction within the past 2 years. Thirty-six percent of the reactions involved 2 or more organ systems, and 32% involved wheezing. Every effort should be made to prevent, recognize, and appropriately treat food-allergic reactions in schools.
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