My sister-in-law Lynn is one of the most allergic people I have ever met. She has multiple severe allergies, the worst of which is a nut allergy so bad that the mere touch of a peanut on her skin will raise a welt. Like a lot of other people with this level of allergies, she carries an Epi-Pen everywhere in case she goes into anaphylactic shock, and has to pay scrupulous attention to any and all prepared foods. My niece and nephews have been raised with a heightened awareness about always asking what is in the food they are given and automatically shun anything with nuts or ingredients that their mother is allergic to, even though they themselves have not displayed even minor allergies.
Lynn was a rarity when we were growing up in my hometown in Maine. You might occasionally know a kid who couldn’t have a pet due to someone in the house having an allergy to pet dander, or a kid who couldn’t take penicillin when they were sick, but food allergies were not common and that level of severe multiple allergies was truly an anomaly. But over the last two decades food allergies, and nut allergies in particular, have nearly doubled among the general population. Statistics in the U.K. show a 75% increase in the number of children diagnosed with nut allergies from 1985 to 2005, and a 2003 survey for the NIH reported 3 million self-reported cases of nut allergies in the U.S.
One inescapable consequence has been the success of media fear-mongering among the general public about the risk of developing food allergies and the subsequent adoption of a variety of “nut-free” policies and strategies for public school departments nationwide, who have been forced to deal with the situation. Not surprisingly, the thoughtfulness and appropriateness of these policies has been all over the map, resulting in inconsistent guidelines and expectations and frequently frustrating parents of non-allergic and allergic children alike. We noticed this inconsistency ourselves within the public schools in our community; when Charlotte started kindergarten, that school had an iron-clad “no nuts in the building, period” policy. As it happened, though, Charlotte’s kindergarten cohort did not have any nut-allergic kids. There were, however, several children with other food allergies BUT the school did not have any written policy to cover exposure to anythng except nuts, leaving those kids at risk to exposure to food products that were unsafe for them. The following year, she moved to a new school for first grade, and that school DID have kids with nut allergies in the older grades (it is a 1-3 Elementary school) but ALLOWED nuts and segregated the allergic kids from the rest of the population at snack/lunch. They also have a “no home-baked treats for class parties” policy and a list of approved snacks (nut-free) that can be given out. Again, however, no provision is made at the policy level for food allergies beyond nuts.
This piece at the science magazine website LiveScience.com argues that the tendency of school departments to put into place often-draconian “no nut” policies is a huge over-reaction to the problem, driven by the public’s media-fueled frenzy. It also points to comments made by Harvard Medical School’s Nicholas Christakis in a recent article in a British medical journal (link goes to a PDF) about the over-zealousness of banishing nuts. For example:
The issue is not whether nut allergies exist or whether they can occasionally be serious. Nor is the issue whether reasonable accommodation should be made for the few children who have documented serious allergies. The issue is what accounts for the extreme responses to nut allergies and what to do about the responses and the allergies themselves.
The responses bear many of the hallmarks of mass psychogenic illness (MPI), previously and quaintly known as “epidemic hysteria.” MPI
is a social network phenomenon involving otherwise healthy people in a cascade of anxiety. Outbreaks typically occur in small towns and in schools, factories, and other institutions, and they are most often prompted by fears of contamination. It does indeed provoke anxiety to imagine a hidden, deadly danger in so innocent a thing as having a snack in kindergarten.
The LiveScience article AND Christakis both argue that no-nut policies may even make the likelihood of developing severe allergies worse, since research indicates that the increase in allergic reactions of all sorts is related to our relatively sanitized environments and resultant lack of desensitization to common allergens. I’m not holding my breath for our school system to wake up to this — the need for CYA policymaking is well-entrenched here (as it is in many municipalities) — but if more voices from the established scientific community can join in on this, maybe the policy pendulum will swing back to common sense.
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