Keeping food‐allergic children safe in our schools—Time for urgent action

Food allergy knowledge, attitude and management among preschool personnel in Malaysia

BACKGROUND

Children are vulnerable, and they may experience their first serious food allergy reaction at school, where they spend much of their time. The present study aims to determine the level of food allergy knowledge, attitude and management (KAM) among preschool personnel in Klang Valley, Malaysia.

METHODS

A cross-sectional study was conducted with 292 personnel working in Klang Valley preschools. The participants completed an online questionnaire asking about sociodemographic information and food allergy KAM. Mann-Whitney U and chi-squared tests were used to compare the KAM level between public and private preschool personnel and examine the association of KAM of food allergy with various sociodemographic factors, respectively.

RESULTS

Some 86.3% of the participants demonstrated a low level of food allergy knowledge, 64.7% showed a negative food allergy attitude and 57.9% indicated fair food allergy management. The total mean score for food allergy knowledge was higher (p < 0.01) among the private preschool personnel compared to the public group, although there was no significant difference in attitude (p = 0.244) or practice (p = 0.171). Age group (p < 0.01) and monthly income (p < 0.05) were significantly associated with the level of attitude, whereas no sociodemographic factor was associated with knowledge and management of food allergy.

CONCLUSIONS

Most preschool personnel in Klang Valley have a low level of food allergy knowledge, negative attitudes and a fair level of ability to manage food allergy reactions. The findings of the present study may guide future studies to improve the food allergy KAM of preschool personnel and provide a safer environment for children with food allergies.

A Qualitative Investigation of Parent and Child Perceptions of School Food Allergy Policies in the United States

BACKGROUND

Many schools implement well-intentioned food allergy policies; however, may not ease parents'/children's worry and concern. The purpose of this study was to (1) explore children's and parents' perceptions their school's food allergy policy and (2) compare these perceptions to the documented school policy.

METHODS

Children ages 8 to 18 with a food allergy and their parents (N = 18 pairs) across the US completed one-on-one semi-structured, audio-recorded phone interviews. School food allergy policies were collected from school websites. Content analysis was applied to the transcriptions by two investigators to identify themes among parents and children.

RESULTS

Parents and children described policies may impact the child's social and/or emotional well-being. Many opportunities for improvement were provided by parents and children. There is a wide variation in food allergy policies across the schools in this study, and overall, parents and children thought that policy enforcement needs to be improved.

CONCLUSIONS

With so much variation in food allergy policies in schools coupled with inconsistent enforcement, parents and children may feel unsafe or unsupported by the school. Schools should adopt a team- or whole-school approach to develop and enforce policies that help protect children with food allergies.

Developments in the field of allergy in 2020 through the eyes of Clinical and Experimental Allergy

While 2020 will be remembered for the global coronavirus pandemic, there were also important advances in the field of allergy. In this review article, we summarize key findings reported in Clinical and Experimental Allergy during 2020. We hope this provides readers with an accessible snapshot of the work published in our journal during this time.

School allergy training promotes internal policy review and enhances staff's preparedness in managing pupils with food allergy

Background

Recently non‐statutory allergy management guidance for schools has been produced in the United Kingdom; however, there has been limited progress in implementing this. The aim of this study was to evaluate the effect of face‐to‐face training on self‐reported school staff preparedness in managing the severely allergic child and whether it would stimulate schools' allergy policy review.

Methods

A preparedness survey was conducted prior and 2 months post‐intervention to assess the effect of training on self‐reported preparedness and perceived confidence to manage children with food allergies.

Results

A sample of 18 primary schools that consented to participate were selected. Of the trained schools, 89% of the head teachers felt confident in dealing with an allergy emergency compared to 39% prior training (p = 0.016). Post‐intervention all but one had arranged/were considering introducing allergy awareness sessions to help pupils manage their allergies (45% pre‐training vs. post‐training 93%, p = 0.003). Preventative measures for accidental exposure to food allergens (i.e., no food sharing policy) were adopted by all (pre‐training 61% vs. post‐training 100%, p = 0.03).

Conclusion

A face‐to‐face school allergy training programme enhances self‐reported staff preparedness and promotes internal allergy policy review in managing the needs of these children, hence addressing the current gap between recommendations and practice in schools.

A survey of school's preparedness for managing anaphylaxis in pupils with food allergy

Allergic diseases are on the increase and can affect the child's well-being. The aim of this survey was to assess regional schools' preparedness in dealing with anaphylaxis following the publication of national and international guidelines for schools in 2014. The survey was developed in 2015 and distributed to schools in Cumbria, North West England, UK between 2015 and 2016. Only 47% of the respondents (95% CI, 39-57%) felt confident to manage anaphylaxis. Schools without allergic pupils were significantly less likely to have a standard management protocol in place for emergencies compared to those with allergic pupils (p < 0.001). The majority of the schools indicated that further training was needed (81% (95% CI, 74-88%).Conclusion: At the time of the survey, schools' preparedness in the region, did not meet safety standards recommended by national and international organisations. Although schools have shown eagerness in accessing training in the management of anaphylaxis, tailored training for schools is not yet widely available. There is now an urgent need to design feasible training strategies that create a safe environment for allergic pupils across all UK schools. What is Known: • One quarter of the severe allergic reactions take place for the first time while at school with some of them being fatal. • School staff is ill-prepared in the management of anaphylaxis. Access to formal training is not widely available. What is New: • School staff remains unconfident in managing the severe allergic child. Training in the management of anaphylaxis is scarce, and when available, it does not offer the required depth to cover the holistic needs of allergic pupils. • Schools would welcome generic adrenaline autoinjectors and a national policy with central funding which would describe step by step the necessary measures for the management of anaphylaxis.