Food-Allergic Reactions in Schools and Preschools

Nowak‐Węgrzyn, Anna; Conover-Walker, Mary Kay; Wood, Robert A.

doi:10.1001/archpedi.155.7.790

Cited by 186 publications

(141 citation statements)

References 19 publications

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“…4,5 These procedures include strict "no food-sharing" policies; use of commercially prepared and labeled, individually wrapped food items; education of those providing foods regarding safe and unsafe foods and label-reading; education of cafeteria/food service staff; a ready supply of safe alternative snacks; and policies of no eating on the school bus and having a means of communication on the bus. Avoidance strategies and emergency management must also be communicated to personnel who may not have primary responsibilities for the student, such as coaches, specialty teachers (art, music, etc), substitute teachers, field trip personnel, etc.…”

Section: Best-practice Strategiesmentioning

confidence: 99%

“…3 Results of studies of children with food allergy indicate that 16% to 18% have experienced a reaction in school. 4,5 Allergic reactions or treatment for anaphylaxis also occur in children whose allergy was previously undiagnosed (ϳ25% of cases of anaphylaxis). 5,6 Fatalities were noted to be overrepresented by children with peanut, tree nut, or milk allergy and among teenagers and those with underlying asthma.…”

Section: Introductionmentioning

confidence: 99%

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Management of Food Allergy in the School Setting

Sicherer¹,

Mahr²

2010

Pediatrics

118

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Food allergy is estimated to affect approximately 1 in 25 school-aged children and is the most common trigger of anaphylaxis in this age group. School food-allergy management requires strategies to reduce the risk of ingestion of the allergen as well as procedures to recognize and treat allergic reactions and anaphylaxis. The role of the pediatrician or pediatric health care provider may include diagnosing and documenting a potentially life-threatening food allergy, prescribing self-injectable epinephrine, helping the child learn how to store and use the medication in a responsible manner, educating the parents of their responsibility to implement prevention strategies within and outside the home environment, and working with families, schools, and students in developing written plans to reduce the risk of anaphylaxis and to implement emergency treatment in the event of a reaction. This clinical report highlights the role of the pediatrician and pediatric health care provider in managing students with food allergies.

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Section: Best-practice Strategiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Management of Food Allergy in the School Setting

Sicherer¹,

Mahr²

2010

Pediatrics

118

View full text Add to dashboard Cite

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“…As reported previously, 20,23 there is a hesitancy to administer epinephrine for anaphylaxis. We found 65 reactions where the caretaker failed to administer epinephrine even though they felt it was indicated.…”

Section: Figurementioning

confidence: 58%

Allergic Reactions to Foods in Preschool-Aged Children in a Prospective Observational Food Allergy Study

2012

PEDIATRICS

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WHAT'S KNOWN ON THIS SUBJECT: Infants and children with diagnosed food allergy are at risk for acute, potentially life-threatening symptoms. Limited data are available on the frequency, severity, and circumstances of reactions and caretaker medical response. WHAT THIS STUDY ADDS:This study describes food allergy reaction frequency, circumstances, and response. Pitfalls that may inform improved anticipatory guidance included lack of vigilance, misreading ingredient labels, allergen cross-contact, nonaccidental allergen feeding, and underutilization of epinephrine for severe reactions. abstract OBJECTIVE: To examine circumstances of allergic reactions to foods in a cohort of preschool-aged children. METHODS:We conducted a prospective, 5-site observational study of 512 infants aged 3 to 15 months with documented or likely allergy to milk or egg, and collected data prospectively examining allergic reactions. , with accidental exposures attributed to unintentional ingestion, label-reading errors, and cross-contact. Foods were provided by persons other than parents in 50.6% of reactions. Of 834 reactions to milk, egg, or peanut, 93 (11.2%) were attributed to purposeful exposures to these avoided foods. A higher number of food allergies (P , .0001) and higher foodspecific immunoglobulin E (P , .0001) were associated with reactions. Of the 11.4% of reactions (n = 134) that were severe, 29.9% were treated with epinephrine. Factors resulting in undertreatment included lack of recognition of severity, epinephrine being unavailable, and fears about epinephrine administration. RESULTS:CONCLUSIONS: There was a high frequency of reactions caused by accidental and nonaccidental exposures. Undertreatment of severe reactions with epinephrine was a substantial problem. Areas for improved education include the need for constant vigilance, accurate label reading, avoidance of nonaccidental exposure, prevention of cross-contamination, appropriate epinephrine administration, and education of all caretakers. Pediatrics 2012;130:e25-e32 AUTHORS:

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“…Many schools did not provide their staff with education on how to prevent allergic reactions or respond to life-threatening events (4,15). Written studentspecific emergency plans for staff to follow in the event of an allergic reaction were frequently not available or used, and in some cases, there was no physician's order or supply of epinephrine available in schools (4,(15)(16)(17).…”

Section: Discussionmentioning

confidence: 99%

School Board Policies on Prevention and Management of Anaphylaxis in İstanbul: Where Do We Stand?

et al. 2016

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Background: Allergic diseases with a potential for anaphylaxis pose a critical public health issue in schools. Aims: This study was carried out to identify the current status of prevention and management of anaphylaxis in school children with the main goal of establishing such an action plan. Study Design: Cross-sectional study. Methods: Schools were randomly selected from 11 different regions of Istanbul. A questionnaire was filled out by 2596 teachers/school principals from 232 public schools. Results: A school safety committee was absent in 80% of elementary schools (ES) and 60.8% of preschools (PS). Although some form of health recording system was available in many schools, no such system was available in 24.5% of ESs and 10% of PSs. A specific inquiry for detecting children with food allergies was a routine practice in only 4% of ES and 10% of PS. Approximately 27% of teachers stated that monitoring children in school places was not possible at all times. Eighty four percent stated that no written anaphylaxis treatment protocol was available in their school and only around 2.3% in ES and 3.1% in PS stated that they would perform an epinephrine injection in the event of anaphylaxis. Conclusion: Our survey demonstrated critical gaps in the organization of schools for the management of children at risk of anaphylaxis. Data derived from this study would provide the initiative for legislators to review the current situation of school health policies along with the relevant authorities to establish school anaphylaxis guidelines.

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Food-Allergic Reactions in Schools and Preschools

Cited by 186 publications

References 19 publications

Management of Food Allergy in the School Setting

Management of Food Allergy in the School Setting

Allergic Reactions to Foods in Preschool-Aged Children in a Prospective Observational Food Allergy Study

School Board Policies on Prevention and Management of Anaphylaxis in İstanbul: Where Do We Stand?

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