Fall 2007

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Nut Allergies

Keeping Your School Safe

by Robyn Whyte

When I hear people say that in the old days, people didn’t have allergies like they do now, especially not nut and peanut allergies, I say, “Yes, you’re so right. In the old days, people with these allergies died, often before reaching their teens.” In the past, death among children was also attributed to “consumption” and “failure to thrive.” Sometimes these labels were applied to children who were lactose intolerant, but many may well have died of nut and peanut allergies.

Nut allergies are on the rise, with an estimated two percent of the population affected, but statistics are not kept across our country so it is difficult to know exactly how many Canadians have nut allergies. These types of allergies are proportionally more common in young children who often outgrow their allergies, but adults with this allergy can be at your workplace as well. The reason for concern over this particular allergy is that it is not just irritating, but it can be life threatening, literally taking your breath away.

Doctors will tell you that you never mess around with a peanut or nut allergy because of the severity of reactions. In those with anaphylactic reactions, the body falsely identifies this food as an invader and the immune system over-reacts. The reaction could start with a tingling in the throat, leading to swollen lips and drooling or panting. Asthma symptoms could ensue. The most life-threatening physiological reaction is when the epiglottis, the flap between the throat and the esophagus, enlarges, literally blocking air intake.

In the case of anaphylaxis (anaphylactic shock), a person only has minutes to deal with the problem. The most common antidote is a shot of Epinephrine. Originally, this adrenalin medication was carried by paramedics and available at hospitals. But many children and adults who are aware of their allergies now carry fanny packs with this life-saving drug. They may have two or three doses on hand because in the case of a reaction, they may need to be injected every twenty minutes. At the sign of the first reaction, the EpiPen is administered. An ambulance is called. The throat may clear and breathing become easier. The blood pressure rises and at some point, the powerful reaction could start again by shutting the throat. A second EpiPen is administered. This could be followed by one more. At the hospital, the individual is monitored and may be given powerful steroids for up to four days. Follow-up care could also include IV antihistamines or oral antihistamines such as Benadryl.

Peanut allergies in particular are unique because the first reaction may not be as severe as another reaction two or four hours later. Generally at six hours, the reaction is over. Doctors and paramedics do not release people with allergies to peanuts before the four hour mark following a reaction. The concern is always that the reaction will be worse and the person will not fare well after the second or fourth hour of the reaction. So in the case of peanut allergies, it is always recommended to use the EpiPen. Other nuts generally take longer to have an effect.

Nobody wants to go to work and accidentally send someone away in an ambulance, so hopefully, this article will help you become more aware of this life-threatening allergy.

BECOMING A NUT-FREE SCHOOL
Let’s say your school has recently welcomed a new teacher or enrolled a child who has an allergy to nuts or peanuts, and your school needs to become nut free to ensure a safe working/learning environment. What is the process the school should follow?

Step One
Post a sign that clearly tells the outside world that you have a student or staff member with a serious allergy to peanuts (or whatever the allergen is). Put the same sign on every interior door in the building, including rooms that children eat in and the staff room.

Step Two
Talk to the staff member or the parents of the student to find out how severe the allergy is. Ask for examples to clarify what situations will cause problems for the person with the allergy. Questions like, “If my staff members have peanut butter in the morning, what precautions do they have to take?” It may be necessary that they brush their teeth and wash their hands before coming to school after eating peanut butter for breakfast. You cannot afford to have a staff member eating peanut butter in the staffroom or in their portable thinking that this is a safe place and a private choice. Be aware that if the allergy isn’t affected by airborne particles at present, it may well be in the future. Communicate the facts to all staff members, making it clear that a person’s health depends on an allergen free environment.

Step Three
Contact your local health unit. Ask for a health professional to come to your school to speak to your staff and parents about health risks caused by nut allergies and how to avoid them.

Step Four
Based on what is known about the individual’s allergy, develop a school policy to clarify what food products may not be brought into the building because of their potential for causing harm. Clearly communicate this policy to all students and parents, explaining why it is important that everyone abide by the new food rules. Include a reminder about gift items in the “Nut Free School” policy so that parents don’t send boxes of chocolates to their children’s teachers. Be sure that everyone who uses the school building understands the need for an allergen free environment.

Your policy should include how a banned item is disposed of. Be aware that if the allergic reaction can be triggered by airborne particles, just putting an item in the garbage may not be good enough—ventilation systems may carry allergens throughout the school.

Peanut butter in particular has staying power, so ban washed peanut butter jars in the “nut free” policy. Also, empty cereal boxes that contained nuts should be excluded from classrooms.

In a very severe case of an airborne allergic reaction caused by nuts in a classroom, more stringent measures to make it safe may be called for.

Remove the children and all articles of clothing, shoes, backpacks, etc. from the room and issue a “wash in a washing machine” directive. Students should shower and wash their hair before returning to the classroom. No clothing that was exposed should return to the school before it is washed.

Clean the room: wash the floor and all surfaces in the room, including the walls, desks, chairs, any pens and pencils that may have been exposed to nut oil. Because the room may be connected to other rooms through ventilation ducts, it is important that the cleaning be done immediately. Paper can absorb nut oils so if it was in plain view, throw it out. If it was hidden from exposure, it should be fine. The person who does the cleaning should go home afterwards to shower and put clothing, including shoes, in the laundry.

Robyn Whyte would be happy to share her knowledge of nut allergies with principals, educators and parents. Contact her at: stargazerpress@yahoo.ca.