Page 17 - Anaphylaxis in Schools & Other Settings, 3rd Edition Revised

Avoidance Strategies
Avoidance is the cornerstone of preventing an allergic reaction. Much can be done to reduce the risk
of anaphylaxis when avoidance strategies are implemented. General recommendations for food and insect stings are provided below. Additional strategies for avoiding specific food allergens are covered in Appendix G.
Food Allergens
For people with food allergies, the key to remaining safe is avoidance of the food allergen. It must be stressed that very small amounts of certain foods can cause severe reactions when eaten. This may happen if a person at risk touches an allergenic substance and then subsequently touches the mouth. Even a very small amount ‘hidden’ in a food or transferred to a serving utensil has the potential to cause a severe allergic reaction. Direct ingestion of an allergy-causing food poses the greatest risk for people with food allergies. In some cases, the vapor or steam produced while cooking certain foods, such as fish, has been shown to contain allergens which can trigger asthmatic reactions and even anaphylaxis.18,19
While it is difficult to completely eliminate all allergenic ingredients due to hidden or accidentally introduced sources, it is possible and extremely important to reduce the risk of exposure to them. Effective ingredient label reading, special precautions for food preparation, proper hand washing and cleaning go a long way toward reducing the risk of an accidental exposure.
The following guidelines are recommended to reduce the risk of exposure for people with food allergy:
1. Adult supervision of young children who are eating is strongly recommended.
2. Individuals with food allergy should not trade or share food, food utensils, or food containers.
They should also place meals on a napkin or personal placemat. Where possible, young children with food allergies should eat in a designated area while at school to help minimize the risk of cross- contamination.
3. School administrators, parents and foodservice staff should work closely together to ensure that food being served during lunch and snack programs is appropriate according to their policies around food.
If there is any uncertainty, food-allergic children should only eat food which parents have approved.
Note: Parents of food-allergic children are often concerned that the odour or smell of a particular food such as peanut butter will cause a life-threatening or anaphylactic reaction. It is the protein in a food which causes an allergic reaction and inhalation of airborne peanut protein can cause reactions, though usually not anaphylaxis.
The odour alone has not been shown to cause an anaphylactic reaction as the smell does not contain the protein. (See Appendix G for more information.)
Anaphylaxis in Schools & Other Settings
© 2005-2016 Canadian Society of Allergy and Clinical Immunology
13
Consensus Statement