College students with food allergies aren't avoiding
the foods they know they shouldn't eat. Students
of all ages are not treated with potentially life-saving
epinephrine as often as they should be. And instructors,
roommates and friends often are not aware of what
to do if a food-allergic student has a reaction.
These are some of the findings of recent studies
at the University of Michigan Health System. The
research suggests that many college students with
food allergies aren't taking the threat of a reaction
seriously enough, or are regularly in environments
where they could not be properly treated during an
emergency. In addition, grade-school students are
often in school environments where there is no food
allergy policy, and where instructors are not trained
how to treat an emergency food allergy reaction.
In four related studies about food allergies, the
researchers found a common theme: "Food-allergic
individuals need to increase the awareness of their
food allergy among the people around them," says
lead researcher Matt Greenhawt, M.D., MBA, who conducted
the research while he was a fellow in the Division
of Allergy and Immunology at the U-M Health System
and now is an associate at the Allergy & Asthma
Center, LLC in the Atlanta metro area.
"This would include not only telling them that
they are food allergic but also showing them how
to treat them and how to recognize signs of an ongoing
reaction," Greenhawt notes.
The most common food allergens are peanuts, tree
nuts, milk, eggs, fish, shellfish, soy and wheat.
Food allergies can lead to death; a life-threatening
reaction caused by allergies is called anaphylaxis.
Food allergy occurs in 6 to 8 percent of children
4 years old or under, and in 3.7 percent of adults,
according to the National Institute of Allergy and
Infectious Diseases.
Among college students, researchers found that only
50 percent of the students who identified themselves
as having an allergy to a food said they always avoided
the food.
About two-thirds could verify that somebody close
to them on campus was aware that they were food-allergic.
About 60 percent could verify that either a roommate,
house mate or suite mate was aware of his or her
food allergy.
The findings that cause the most concern, says Marc
S. McMorris, M.D., is that only 43 percent who identified
themselves as food-allergic could verify that they
had in their possession an emergency medication to
treat a reaction, and only about 20 percent had self-injectable
epinephrine the recommended treatment available to
treat a reaction.
"These students are taking unnecessary risks," says
McMorris, medical director of Food Allergy Service
at the U-M Health System. "There are serious
issues that need to be addressed in terms of educating
these young adults that it is of utmost importance
to not only maintain emergency medication but to
have it with you at all times."
At schools and child-care facilities, researchers
found that 43 percent of food-allergic children have
had at least one reaction at school, and nearly two-thirds
of these occurred in children in kindergarten or
younger. The finding suggests that that these individuals
might be at more risk than older children, McMorris
says.
Only one in five of the schools these children attended
had a peanut or tree nut free policy. Less than half
of these facilities had staff that were trained to
recognize an ongoing allergic reaction or were trained
to treat a reaction, though the rate was much higher
among schools with full-time nurses on staff.
Like on college campuses, the use of self-injectable
epinephrine to treat a reaction was irregular. While
nearly three-quarters of the food-allergic children
had epinephrine available, less than one-third received
the treatment. Among the group that received it,
one-third received it at a delay of 15 minutes or
greater, which also poses a risk to the children
because treatment should occur immediately.
"Until all students who display symptoms of
a severe reaction are receiving epinephrine, I would
say that there's a significant gap that needs to
be closed," Greenhawt says.
For more information, visit these Web sites:
UMHS Food Allergy Service http://www.med.umich.edu/foodallergy
The American Academy of Allergy, Asthma & Immunology,
food allergies and reactions
NIH Quick Facts http://www3.niaid.nih.gov/topics/foodAllergy/understanding/quickFacts.htm
Tips to remember http://www3.niaid.nih.gov/topics/foodAllergy/understanding/quickFacts.htm
Citations
Self-Reported Allergic Reactions to Peanuts and
Tree Nuts Occurring in Schools and Child Care Facilities,
Journal of Allergy and Clinical Immunology, Volume
121, Issue 2, Supplement 1, February 2008
Self-Reported Allergic Reactions to Peanuts and
Tree Nuts Occurring on Commercial Aircraft, Journal
of Allergy and Clinical Immunology, Volume 121, Issue
2, Supplement 1, February 2008
Self-Reported Allergic Reactions to Peanuts and
Tree Nuts Occurring in Restaurants and Food Service
Establishments, Journal of Allergy and Clinical Immunology,
Volume 121, Issue 2, Supplement 1, February 2008
University of Michigan Health System
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