One in every 20 children with a food allergy in Ireland suffers an accidental allergic reaction while in a school or pre-school setting each year, according to the findings of a new study.
Research carried out by staff at Children’s Health Ireland at Crumlin also found that one in every 110 food-allergic children could have an anaphylactic shock in the educational facility they attend each year.
The study examined the experience of 521 children with a confirmed food allergy over a 12-month period. It recorded 24 cases of accidental allergic reactions including five cases of children suffering a potentially life-threatening anaphylactic shock.
Researchers found that reaction to cow’s milk is a risk for young children attending pre-schools, creches and nurseries as it accounted for 50 per cent of reactions in such settings.
The study claimed its results also highlighted the ineffectiveness of “nut bans” in schools as all but one of seven allergic reactions to nuts occurred in schools which prohibited pupils from bringing in food containing nuts on the premises.
It claims to provide the first research into the frequency of accidental allergic reactions within educational facilities in the Republic.
It found that 5 per cent of children with a food allergy in a pre-school setting suffered an accidental allergic reaction. The rate for children with similar allergies in schools was marginally lower at 4.5 per cent.
However, the study, whose findings are published in the Irish Journal of Medical Science, said many of the recorded reactions which it had identified were “likely avoidable.”
It found half of the reactions could be attributed to human error or the failure to follow basic procedures.
Two cases were linked to a birthday party with one each to Pancake Tuesday and a bake sale.
In the majority of cases, the child was responsible for eating the food themselves but teachers, parents and friends had given the food to the affected child in five incidents.
Researchers said schools were the third most common location for children to suffer an accidental allergic reaction after their own home and food establishments.
Primary school-aged children were found to be twice as likely to experience an adverse reaction than secondary school students.
The research found that none of the four children attending primary school who reported having an anaphylactic shock were administered adrenaline by school staff.
Two were given adrenaline by parents on their arrival at the school, while one received it at the emergency department of a hospital.
One of the co-authors of the report, Miranda Crealey, said almost 5 per cent of young children in the Republic have a food allergy.
“It can therefore be estimated that in every classroom or childcare room, there is at least one child with a food allergy,” said Dr Crealey.
The study noted that in addition to planned daily food consumption in schools, there may be many unplanned episodes including birthday parties, bake sales and cultural holiday celebrations, which sees food brought in from outside the school.
It also observed that there is no government policy on the management of food allergies in school or pre-school childcare settings, unlike other countries where it is often covered by legislation.
However, individual schools in Ireland have the discretion to operate a policy on the management of food allergies, with the study finding 61 per cent of participants were in educational facilities with such a policy.
In addition, two-thirds of parents had provided the facility with an allergy action plan for their child.
The study found 98 per cent of children had two adrenaline autoinjectors available to them in school but in 35 per cent of cases, the devices were stored in different locations.
Overall, three-quarters of facilities banned nuts ranging from 37 per cent of secondary schools to 90% of pre-school childcare settings.
Dr Crealey said the findings showed that children in educational facilities with an allergy action plan were at a “significantly lower risk” of an accidental allergic reaction than those without such a plan.
The paediatrician noted the incidence of accidental allergic reactions in Irish schools and pre-schools were equivalent to findings from international studies.
However, she added: “Ireland lags behind in establishing a unifying mechanism for risk reduction.”
Dr Crealey said a collaborative approach was needed between healthcare professionals and education governing bodies to introduce a standard food allergy policy in schools and pre-school facilities.
The study claimed the early promotion of milk tolerance by the use of “milk ladders” was important to reduce the future risk of reactions in milk-allergic infants.
On “nut bans” in schools, Dr Crealey said she believed they discouraged training children about “not sharing food” which was critical to the avoidance of accidental allergic reactions.
She also claimed the large number of reactions highlighted that school and pre-school staff were not prepared for such events.
Dr Crealey said the findings showed there was also a need for education and training in the management of food allergies in schools and pre-schools.
“Timely recognition of the need for adrenaline needs to be taught to all who care for children with a food allergy,” she added.
Although all the participants had received a personalised allergy action plan by CHI, the study found a third of parents had not provided their child’s educational facility with a copy.
Almost 7 in 10 children who participated in the research were male, while the average age of participants was 7.6 years.
Two-thirds of the children had two or more confirmed food allergies.
The most common food allergen was peanuts which affected two-thirds of children examined in the study followed by other nuts, eggs, milk and fish.
A quarter of all children had a past history of experiencing an anaphylactic shock.
