Risk reduction strategies
Currently, physicians cannot safely determine which patients may have a mild or moderate allergic reaction and which patients may experience a severe or potentially fatal allergic reaction to a food.
A very small amount of a food allergen ‘‘hidden” in a food or a trace amount of allergen transferred to a serving utensil has the potential to cause a severe allergic reaction. With certain foods such as fish, the vapor or steam produced while cooking has been shown to contain allergens which can trigger asthmatic reactions and anaphylaxis.1,2
Avoidance of an allergenic substance is the only way to prevent an allergic reaction.
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.
The following guidelines are recommended to reduce the risk of exposure for people with food allergy.
Pupils at risk
Those at risk must take ownership for their own safety. This involves sticking to basic rules such as:
- Carry an auto-injector at all times.
- Learn how to use an auto-injector and teach others to assist in an emergency.
- Don’t eat if your auto-injector is not handy.
- Wear medical identification such as a MedicAlert® bracelet.
- Wash hands before and after eating.
- Always read food labels and eat only safe foods.
- Avoid high risk foods such as bulk foods and foods known to often contain an allergenic substance (e.g. peanuts/tree nuts in ice cream, baked goods, and ethnic foods)
- Inquire about the preparation of foods outside of the home.
- Never trade or share food, food utensils, or food containers.
- Eat in the same location while at school (for younger children). Always place meals on a napkin or personal placemat.
Parents/guardians
To help reduce the risk for their allergic children, parents/guardians must:
- Help their children learn to protect themselves by following the guidelines for pupils at risk.
- Work closely with foodservice staff to ensure that appropriate food is being served during lunch and snack programs.
- Ensure that food-allergic children only eat food that they have approved if there is any uncertainty.
Note: Parents of all young children (and especially those in high risk families with a history of allergy) should try new foods at home before they are introduced in a child care or other setting.
Community
Awareness and support from others in a community can help create safer environments for those at risk. To reduce the risk of accidental exposure for allergic people:
- Wash hands and mouth after eating.
- Take precautions to minimize the risk of cross-contamination in food preparation.
- Read food labels and ask food allergic individuals about their specific needs.
- Ensure that children do not share food with food-allergic friends or pressure them into accepting a food they do not want.
- Properly clean surfaces and toys, and dispose of food items after meals and snacks.
- Provide adult supervision of young children when they are eating or when there is food around.
- Ensure that ingredients of food brought in for special events, served in school cafeterias, or provided by catering companies are clearly identified.
- Consider modifying or restricting the use of food in class activities, depending on the allergies of the children.
- Consult parents of food-allergic children when food is involved in class activities.
- Have a ‘‘no eating” rule during daily travel on school buses.
- Crespo JF, Pascual C, Dominguez C, Ojeda I, Munoz FM, Estaban MM. Allergic reactions associated with airborne fish particles in IgE-mediated fish hypersensitive patients. Allergy 1995;50(3):257-61.
- Roberts G, Golder N, Lack G. Bronchial challenges with aerosolized food in asthmatic, food-allergic children. Allergy 2002;57:713-7.
