Be Aware. Show You Care. Using Food Allergy Week (May 13-19) to help improve safety at your school
When Allergy & Anaphylaxis Australia talk to the ever increasing number of parents of children with food allergies, they openly communicate that starting kinder, starting school and then certainly starting high school are major milestones often shadowed by fear and anxiety. As parents ‘let go’ and entrust the care of children at risk of anaphylaxis to others, parents have an underlying unrest because they know they can never remove all risk of exposure to known allergens. This unrest is what spurs Allergy & Anaphylaxis Australia to reduce the risk in whatever manageable ways they can.
Although there is a need to acknowledge that the risk of a fatal allergic reaction is rare, Allergy & Anaphylaxis Australia know (from recent fatalities in Australia and around the world) that teenagers and young people are a high risk group. Whilst we can take a deep breath and remind ourselves of just how rare fatalities are, the reality is that fatal reactions do happen and we all need to ‘get’ this. Alongside this thought, we need to remember that many people manage the risk of anaphylaxis in school and outside of school very well, every day. It does not mean they never have a severe reaction, but when it does happen (and it will!) they and those caring for them are well prepared to recognise what is happening and administer their adrenaline autoinjector (EpiPen ®) according to their ASCIA Action Plan for Anaphylaxis.
While Allergy & Anaphylaxis Australia increases awareness of food allergy all year round, they also join with many others to focus on awareness raising during Food Allergy Week each year. Consider what your school can do to assist Allergy & Anaphylaxis Australia with food allergy management in your community. Visit Food Allergy Aware for ideas on what you can do to bring your school community together to help increase food allergy safety.
How does a school manage the risk of anaphylaxis?
Management is not simply about asking parents not to send in a particular food. This strategy is often used amongst several other strategies in primary school settings but generally not in high school settings where students are much more independent and hopefully much more allergy aware and self-caring. Whilst it may be possible for a class teacher caring for a primary school aged child with peanut allergy to request that food with peanut not be brought to school, it would be unrealistic to think the class is peanut free or that peanut has effectively been banned. Reducing the amount of an allergen in the classroom should only ever be considered amongst many other strategies to reduce risk.
Management of food allergy in school settings includes:
- awareness raising
- forward planning
- appropriate staff anaphylaxis training which includes regular practice with adrenaline autoinjector training devices( at least twice yearly aside from formal training session)
- communication with parent and student community
- ongoing communication with all school staff
- implementation of age appropriate strategies to reduce the risk of exposure to known allergens
- always having the student’s adrenaline autoinjector and ASCIA Action Plan for Anaphylaxis easily accessible.
School staff have a duty of care to do what they can to help keep students safe. Whether a student is 7 or 17 years old, their teacher and their school are responsible for implementing strategies to reduce the risk of an allergic reaction. The development of a health care plan (health management plan) that includes information on a student’s medically diagnosed allergy and ideas on risk minimisation strategies as discussed with the parent is crucial. The health care plan includes the ASCIA Action Plan for Anaphylaxis but is not limited to it. School staff must check that the adrenaline autoinjector is always easily accessible. If a student is responsible for carrying their medication, staff and parents should check that this is happening.
All school staff must know which students have food allergy and are at risk of food anaphylaxis. The duty of care does not sit solely with the class teacher, a specific subject teacher or the school nurse. Duty of care must be shared so that responsibility is shared and workload is more manageable. Just as students need support in managing their condition, all staff need support in everyday management, recognition of an allergic reaction and emergency situations.
When is the risk of anaphylaxis an even greater risk?
When we review how or when severe allergic reactions have occurred in a school, it is often when there is something out of the ordinary happening at the school. Anecdotally, when severe allergic reactions occur, they often occur when there is disruption to the usual school routine. It may be a sports carnival, an excursion, a school camp, a school fun day, a cooking activity or a rewards day. Staff and parents of students at risk need to consider added risks when ‘other’ or ‘new’ activities are planned. Forward planning and communication helps everyone mange the increase in risk.
It is not reasonable for a teacher who has no knowledge of students at risk of anaphylaxis to be on yard duty nor is it reasonable for a student to travel by bus to a sport session with a teacher who does not know they have a student at risk of anaphylaxis in their care. Nor is it reasonable to have a student at risk of anaphylaxis in the sole care of a staff member who has not been trained in how to prevent, recognise and respond to an allergic reaction including anaphylaxis.
A word on food used in classroom activities
The increase in food allergy is of concern to all in the school setting. Importantly children who once outgrew milk and egg allergy before starting school are now attending school with these food allergies. Whilst a school can avoid using peanut and tree nuts in food activities, you often cannot avoid milk and egg, without some serious substitution. Sadly, there was a time about twenty years ago when teachers and even parents said, “Kids with food allergies should go to the library during the food activity and older students should avoid doing food technology”. Thankfully this has changed. We should all do our best to include students with a food allergy.
Students with a food allergy need to learn how to cook like any other student. With forward planning, parental involvement and some sensible strategies in place, the student with a food allergy should be able to join in a food activity or a food technology class. Some things will need to be done differently but with communication and collaboration, a student with a food allergy can be included.
Food technology teachers can help educate students about food allergy as part of their strategy to manage the risk. Once the basics of food allergy are presented, the teacher can, with the parent and the student, work on safety strategies to help reduce the risk of an accidental allergic reaction. This could include the student with milk or egg allergy working with another student at a bench that is a no go zone for others using say egg or milk. If the allergen is peanut or tree nuts, serious consideration should be given to not using these ingredients and finding alternatives. The teacher can encourage students to cook the same recipe containing peanuts/tree nuts at home.
The student at risk of anaphylaxis
Children need to be educated at an age appropriate level. Some that do not live with a life threatening allergy are reluctant to make allowances because ‘children need to live in a real world”. This is very true but we don’t put a child on a busy road and ask them to cross it because they need to live in the real world. We do lots to prepare them for the time when we think they can cross the road on their own with safety. This is how we need to approach management of food allergy. As children step their way through primary school and then approach their teen years they need to be building on the skills, knowledge and understanding they have to navigate through life with a serious food allergy that could lead to an anaphylaxis. Children and their carers need to understand that small amounts of a food allergen can trigger life threatening allergic reactions.
We need to empower individuals at risk from an early age. We want them to learn to care for themselves and this includes disclosing their allergy to their teachers and peers, telling those serving them food that they have an allergy once they learn a little about adults they can trust, taking 20-30 seconds to read a food label, carrying their adrenaline autoinjector and ASCIA Action Plan for Anaphylaxis (emergency plan). That said, teens still need to manage their food allergy with adult guidance, support and supervision.
By the time children reach high school, they need to be managing aspects of their care with the understanding that they have school staff that are aware of and willing to support their healthcare needs.
What should schools do now?
Food allergy is manageable if people are educated. Food Allergy Week is a time to review our processes, do some further awareness raising and bring all in the school community together to increase safety. Food allergy is a community concern; it is a concern we can manage if we are aware, if we do our best to avoid the allergen and if we are always prepared to act promptly to administer life saving medication in an emergency.
About the Author
Maria Said, CEO of Allergy & Anaphylaxis Australia, writes on behalf of Allergy & Anaphylaxis Australia, the trusted charity for allergy support. We listen, guide and educate Australians living with allergic disease. We advocate on their behalf to ensure their voice is heard.
For more information on managing food allergy, visit www.allergyfacts.org.au or call 1300 728 000. Allergy & Anaphylaxis Australia has many helpful resources to assist parents, children and school staff.