Nuts- They're banned in lots of schools. Should they be banned at work?

Posted by on 21 December, 2011

You might have heard about this Sunrise segment (if not watch it HERE)

It's not the ridiculous workplace bureaucracy that's going off in WA that had people going ferral via email and twitter it was my reference to the fact that there's no evidence to support a 'nut free zone' in schools.

First let me say that yes I am actually a doctor and I actually do see patients. Lots of my patients have severe allergies and many have had anaphylaxis. Their parents are doing an amazingĀ  job to kep their children safe and happy. As a parent, I too place my children's health and safety first.

The theory about a nut free zone in schools is sound on the surface; little children have poor hygiene so are unlikely to wash hands after touching their own sandwiches and they make a mess, meaning food goes everywhere. Plus they tend to share food. In that environment little children with food allergies could so easily become sick, even very sick if they're accidentally exposed to a food to which they react.

The trouble is there's no evidence having a nut free zone actually helps kids. By evidence I mean a study.. a published study in a medical journal. There is some evidence that focusing on peanut or all nut exposure has some other negative effects. It is ineffective unless policed strictly and our overworked teachers don't have time to do strict lunch box inspections each day. In fact one study recently found that in 20 percent of schools with a nut free policy there was a child who experienced an allergic attack on school grounds despite the policy. While we don't have hard data, the thought is that the rate isn't much higher than in schools without a nut-free policy.

The next issue is possible complacency. The best management of anaphylaxis is avoidance of the trigger for sure. But it is ESSENTIAL that teachers and carers know how to recognize a serious allergic attack and use adrenaline (Epi-pen) as soon as possible to thwart the attack. Having a nut free zone could potentially give some staff a false sense of security about whether they will need to know how to use an Epi-pen or even whether what they're seeing is indeed anaphylaxis.

In addition, it's not just nuts that kids are allergic to. Eggs, seafood, fish (including salmon and tuna), and soy allergies are all common. one of my little patients is allergic to beef and garlic, another to peach and mango. Nut free zones don't protect those children.

Studies have shown that food allergens don't make it to the air in concentrations large enough to cause an allergic reaction. Other studies have shown that simple cleaning products remove peanut allergens from hard surfaces and that either hand sanitizers or soap and water remove allergens from hands. But even if your child does touch a substance to which he is allergic, unless he sticks his fingers in his mouth, chances are he will develop a rash that will go away on its own. Potentially fatal anaphylaxis tends to occur with EATING the food to which you're allergic only.

So these days most experts suggest we focus on the allergic child. They have to know about eating their own food ONLY, about good hand washing and making sure they are near a responsible adult when eating just in case. And teachers have to supervise meal times to ensure there is no food sharing and avoid giving foods at school either as a reward or as a cooking demonstration etc. Hand hygiene makes sense all round- before and after eating.

For the people that emailed me worried that their children could die if another child so much as opened a peanut butter sandwich in the same room as their allergic little one, please, please see your doctor. Somehow somewhere the communication has gone awry and I'm concerned you might be worrying far more than you have to.

For all, a merry Christmas. For the people who write personally rude and insulting letters, I wish you a greater level of peace, tranquility and happiness in the year ahead.