School food bans don't prevent allergic reactions and can stigmatize kids: McMaster-led study

Food bans of peanuts and other items in schoolsand child-care centres aren't effective or necessaryin preventing allergic reactions, according to a new literature review led by Hamilton's McMaster University.

The five-year study,published in theJournal of Allergy and Clinical Immunology,led to a list of guidelinesfrom an international panel.

Panel chair Susan Waserman, an allergist and McMaster professor of medicine, said the team couldn't find good evidence to support food bans.

She said such bans have negatively impacted children.

"They feel stigmatized, they can't eat with their friends, it has led to bullying, and that's something that has to be addressed," she said.

Such bans are often difficult to enforce, "and have not really been proven to work in the literature."

More training instead of food ban

She said instead of food bans, schools and child-care centrescan try otherapproaches, liketraining staff to know the signs of a reaction, supervising children, and promoting proper handwashing and cleaning.

"There's lots of good things happening in schools."

Wasermanacknowledged the international team's advice may face resistance, but said it's important to also focus on the other recommendations.

They include:

• Stocking epinephrine autoinjectors (like EpiPen). Thedrug reverses allergic reactions by opening the airways and regulating blood pressure.
• Having parents create a plan for children with food allergies.

National guidelines on allergies in schools also highlight the need for school plans, staff training, and basic practices includingsupervising students, identifying ingredients in foodand handwashing.

Wasermansaidthe proposed recommendationsare conditional, which means the team believes, based on the research, thebenefits outweighthe harms.

She also said the team's review looked at every piece of research on the subject, but the literatureitself isn't of high qualitya sign schools and child-care centresneed to record more information about allergic reactions.

"I stand behind the recommendations recognizingthey may change ... I feel we were extremely responsible."

Food Allergy Canada supports review

Jennifer Gerdts, executive director of Food Allergy Canada,said while the non-profit organization supports food restrictions in some circumstances, the international team's recommendations include somegood ideas such as stockingepinephrine and developingindividual plans for students.

Some researchers, including one person from Food Allergy Canada, decided not to be listed as co-authors of the study.

Waserman saidthat's because the study was especially sensitive to conflicts of interest when voting on recommendations, and some felt that process was "exclusionary."

She noted no one's opinions were excludedin the process.

"I chaired this particular guideline and I wasasked to refrain from voting on certain question as well."

Parent supports review, school board cautionary

Kymberly Calder, from Grimsby, Ont., has a 15-year-old sonwith an allergy to fructose, a simple sugar. She said he's had many allergic reactions, butshe's"on the fence" about whether there should be school food bans.

"If they have an airborne allergy to a certain food, which means as soon as they can smell itthey can go into anaphylactic shock, I do believe they should have a ban," said Calder. "If somebody has a food allergy that's just food ingested,I'm not sure they do."

She supports allthe other recommendations fromthe McMaster-led review, especially stockingepinephrine autoinjectors.

Contacted by CBC News for reaction to the new study, Hamilton's public school board said in a statement, "We appreciate the literature review," but it advises families to avoid bringing foods to school if students could get allergic reactions.

"Our focus supports the education related to managing food allergies ... staff continue to engage in anaphylaxis training on an annual basis,"said Shawn McKillop, a spokesperson for the Hamilton-Wentworth District School Board.

Wasermansaid she hopesthe recommendations will lead to more discussion and high-quality research.