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Schools and day care centers should implement allergy training and action plans and have unassigned epinephrine autoinjectors for use, but site-wide food prohibitions are not suggested for allergy management, according to practice guidelines published in the May 1 issue of the Journal of Allergy and Clinical Immunology.
Susan Waserman, M.D., from McMaster University in Hamilton, Ontario, Canada, and colleagues conducted a systematic literature review and developed recommendations for food allergy management in child care centers and schools. The recommendations have been endorsed by the U.S. Allergy and Asthma Network; American Academy of Allergy, Asthma & Immunology; American College of Allergy, Asthma & Immunology; Canadian Society of Allergy and Clinical Immunology; and the World Allergy Organization.
The authors suggest that child care centers and schools implement allergy training and action plans, including training teachers in prevention, recognition, and treatment of food allergy; requiring parents of students with food allergy to provide allergy action plans; and having site-wide protocols for management of suspected allergic reactions. Epinephrine use is suggested to treat suspected anaphylaxis. Instead of requiring students to supply their own personal autoinjectors, it is suggested that schools and child care centers stock unassigned epinephrine autoinjectors, which can be stored on site for designated use at school. Implementation of site-wide food prohibitions or allergen-restricted zones are not suggested, except in special circumstances. Due to the low quality of evidence available, the recommendations are labeled conditional.
"It's not possible to totally remove the risk of allergic reactions," Waserman said in a statement. "However, interventions based on evidence may help community members manage the risk and support allergic students."
Several authors disclosed financial ties to the pharmaceutical industry.