The management of the allergic child at school: EAACI/GA²LEN Task Force on the allergic child at school

Abstract

The management of the allergic child at school: EAACI/GA 2 LEN Task Force on the allergic child at school. Allergy 2010; 65: 681-689. AimThe aim of this Task Force document is to describe an ideal model of care centred on the allergic children at school (Box 1), which is appropriate for use by all stakeholders. Despite a substantial body of literature on allergy management, the evidence available on how to best care for such children at school is inadequate. Furthermore, legislation, education, facilities and health care practices vary between countries. We have presented the information in such a way that individuals will be able to adopt the advice within the context of their local or national facilities to improve care for all children with allergy at school. Where local facilities are not able to support such an approach, this document may be used as a reference to inform national policy. How to use the recommendationsOur key recommendations are presented as 'action points' for schools. Some of these are generic and apply to all allergic children at school (Box 2), and others are presented as disease-specific action points. To facilitate the implementation of these recommendations, specific responsibilities for each stakeholder have been identified (Box 3). A comprehensive protective package for children with allergy at school can therefore be provided within this framework. These recommendations are based upon the available evidence and expert opinion.Allergy at school manifests in multiple ways: eczema, bronchial asthma (hereafter asthma), rhinitis and/or conjunctivitis, food allergy and less commonly venom allergy and AbstractAllergy affects at least one-quarter of European schoolchildren, it reduces quality of life and may impair school performance; there is a risk of severe reactions and, in rare cases, death. Allergy is a multi-system disorder, and children often have several co-existing diseases, i.e. allergic rhinitis, asthma, eczema and food allergy. Severe food allergy reactions may occur for the first time at school, and overall 20% of food allergy reactions occur in schools. Up to two-thirds of schools have at least one child at risk of anaphylaxis but many are poorly prepared. A cooperative partnership between doctors, community and school nurses, school staff, parents and the child is necessary to ensure allergic children are protected. Schools and doctors should adopt a comprehensive approach to allergy training, ensuring that all staff can prevent, recognize and initiate treatment of allergic reactions. urticaria. Children may present with various symptoms such as wheezing and dyspnoea related to asthma, which may be triggered by allergen contact, airway infection or physical exercise. Children with allergic rhinitis (or rhinoconjunctivitis) might have a runny nose, sneeze frequently, mouthbreath persistently and have itchy eyes in spring and/or summer, or they may have all-year-round symptoms. Indoor pollutants can be particularly harmful for students already affected by allergies or asthma...

Among Children with Food Allergy, Do Sociodemographic Factors and Healthcare Use Differ by Severity?

“…It would be expected that children with moderate/severe food allergy would be more likely than those with mild food allergy to use an IEP, since those children are more likely to require specific strategies to avoid exposure to allergens and to maximize availability of needed treatment. It is estimated that 20 %of food allergy anaphylactic reactions and approximately one-quarter of first-time reactions to food among allergic children occur at school [13,14]. However, in this analysis only 20 %of children with moderate/severe food allergy reported using an IEP, and many school districts report low compliance rates with the American College of Allergy, Asthma, and Immunology recommendations of having an emergency management plan (EMP) in place for food allergic students [13,15].…”

“…It is estimated that 20 %of food allergy anaphylactic reactions and approximately one-quarter of first-time reactions to food among allergic children occur at school [13,14]. However, in this analysis only 20 %of children with moderate/severe food allergy reported using an IEP, and many school districts report low compliance rates with the American College of Allergy, Asthma, and Immunology recommendations of having an emergency management plan (EMP) in place for food allergic students [13,15]. Although we found no differences in the relationship between IEP use and food allergy severity by demographic groups, future research to investigate characteristics that may account for variation in IEP or EMP use between school districts may be useful.…”

Anaphylaxis treatment: current barriers to adrenaline auto-injector use

“…The EAACI/GA 2 LEN expert workforce on allergy in schools has called (57) for 'a cooperative partnership between doctors, community and school nurses, school staff, parents and the child' to ensure protection of allergic schoolchildren. They recommend that teachers are trained to recognize signs of anaphylaxis and to use an AAI, which should be made available in all schools.…”

EAACI Food Allergy and Anaphylaxis Guidelines: managing patients with food allergy in the community

“…Furthermore, we hope that it will help children with FA, their families, schools, and their specialist and nonspecialist healthcare providers (Table 1). This guideline has been prepared by EAACI's Taskforce on Community and builds on the previous EAACI Position Paper on Management of the Allergic Child at School (2). Details on the production of these guidelines, the approaches used, and the involvement of experts and stakeholders are summarized in the Data S1 and Table S1.…”