Food allergy and gastrointestinal diseaseImpact of school peanut-free policies on epinephrine administration
Section snippets
Determination of epinephrine administration in schools
After administering epinephrine, all Massachusetts school nurses must complete and submit a standardized data collection form (see Fig E1 in this article's Online Repository at www.jacionline.org)10 to the Massachusetts Department of Public Health (MDPH). Reporting of epinephrine administration in all Massachusetts schools became mandatory in November 2003 under 105 CMR 210, the Regulations Governing the Administration of Prescription Medications in Public and Private Schools. Nurses completing
School epinephrine administration
The number of students enrolled in Massachusetts public schools per academic year (AY) was publicly available: 968,661 students in 1,875 schools during AY 2006-2007; 962,806 students in 1,870 schools during AY 2007-2008; 958,910 students in 1,846 schools during AY 2008-2009; 975,053 students in 1,831 schools during AY 2009-2010; and 955,563 students in 1,824 schools during AY 2010-2011.
The number of times epinephrine was administered each year for all causes was 138 during AY 2006-2007, 117
Discussion
Our study is the first examining epinephrine administration rates for peanut and tree nut reactions in schools over time, and rates are increasing. Although Banerjee et al9 demonstrated that peanut-free classrooms were associated with decreased lunch peanut content, no studies have examined clinical outcomes of schools' peanut-free policies. This is a crucial public policy question that must be addressed, especially as rates of food allergy and anaphylaxis to peanuts and tree nuts in schools
References (26)
- et al.
Food allergy
J Allergy Clin Immunol
(2010) - et al.
IgE-mediated food allergy in children
Lancet
(2013) - et al.
Disparity in the availability of injectable epinephrine in a large, diverse US school district
J Allergy Clin Immunol Pract
(2014) - et al.
The US Peanut and Tree Nut Allergy Registry: characteristics of reactions in schools and day care
J Pediatr
(2001) - et al.
Identification of peanuts and tree nuts: are allergists smarter than their patients?
Ann Allergy Asthma Immunol
(2013) - et al.
The ability of adults and children to visually identify peanuts and tree nuts
Ann Allergy Asthma Immunol
(2012) - et al.
Peanut and tree nut allergic reactions in restaurants and other food establishments
J Allergy Clin Immunol
(2001) - et al.
Food allergy: a practice parameter update–2014
J Allergy Clin Immunol
(2014) - et al.
Anaphylaxis—a practice parameter update 2015
Ann Allergy Asthma Immunol
(2015) - et al.
Bullying among pediatric patients with food allergy
Ann Allergy Asthma Immunol
(2010)
Out-of-hand nut consumption is associated with improved nutrient intake and health risk markers in US children and adults: National Health and Nutrition Examination Survey 1999-2004
Nutr Res
American Academy of Pediatrics Section on Allergy and Immunology. Management of food allergy in the school setting
Pediatrics
The prevalence, severity, and distribution of childhood food allergy in the United States
Pediatrics
Cited by (55)
Anaphylaxis: A 2023 practice parameter update
2024, Annals of Allergy, Asthma and ImmunologyFood Allergy
2023, Primary Care - Clinics in Office PracticeSocial disparities in early childhood prevention and management of food allergy
2023, Journal of Allergy and Clinical ImmunologyCreating a kinder world for children with food allergies: Lessons from the coronavirus disease 2019 pandemic
2022, Annals of Allergy, Asthma and ImmunologyFood Allergies in Inner-City Schools: Addressing Disparities and Improving Management
2022, Annals of Allergy, Asthma and ImmunologyRecognition and Management of Food Allergy and Anaphylaxis in the School and Community Setting
2022, Immunology and Allergy Clinics of North America
This research is supported by the National Institutes of Health (NIH grant nos. R01 AI 073964, U01 AI 110397, and K24 AI 106822; PI, W.P.; grant no. K23 AI 104780; PI, W.J.S.) and an NIH Pediatric Research Loan Repayment Program grant (grant no. L40 AI 113590; PI, L.M.B.). Funding was provided by The Allergy and Asthma Awareness Initiative, Inc. This work was conducted with support from Harvard Catalyst | The Harvard Clinical and Translational Science Center (National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health Award no. UL1 TR001102) and financial contributions from Harvard University and its affiliated academic health care centers. The content is solely the responsibility of the authors and does not necessarily represent the official views of Harvard Catalyst, Harvard University and its affiliated academic health care centers, or the NIH.
Disclosure of potential conflict of interest: M. F. Huffaker has been employed by Brigham and Women's Hospital and Stanford University and has received a travel grant from Teva. M. Hauptman has received grants from the Agency for Toxic Substances Disease Registry (ATSDR of the Centers for Disease Control and Prevention) (grant no. FAIN U61TS000237), the Environmental Protection Agency (grant no. DW-75-92301301), and the National Institute for Environmental Health Sciences (grant no. P30-ES000002). M. C. Young is employed by South Shore Allergy and Asthma Specialists, PC and has received royalties from Quarto Publishing. The rest of the authors declare that they have no relevant conflicts of interest.