What is the priority in public schools regarding food allergy management...creating a safe environment vs allowing a potentially life threatening environment to continue to exist?

I have lived in two states with my family and one of our family members is a child with life threatening food allergies.  Managing our child's food allergies is a process that continues every day of the week.  Out of our fear and determination to keep our child healthy, safe, happy, and included we have taken much action with other parents of like kinds to ensure that schools, restaurants, and other facilities are safer.

Of the two states that we have lived, Maryland and Colorado, both of these states have legislation that pertains to the management of food allergies.  In each of these states legislators passed bills that could use more definition of what food allergy management really requires in the public school rather than focus only on the handling, storage, and administration of medication.  The state of Maryland has taken the step to create anaphylaxis guidelines through their Departments of Education and Health and Mental Hygiene.  These guidelines include communication and prevention to avoid illness or fatality in all school related settings (classroom, lunchroom, bus transportation, and field trips).   The state of Colorado falls short here.  I have learned from listening to other families that the issues that some legislators, administrators, and board members fail to realize are that safe storage and administration of medication is a crises solution. A necessary requirement but only one aspect of food allergy management.   Prevention is the means to avoiding costly and potentially fatal consequences.  Some of the school administrators even fail to realize this is a health issue.  Still, in both states and probably 48 others, parents are fighting to convince school administrators, principals, and teachers to keep their children safe.

Is failing to provide children with food allergies a safe school environment ignoring U.S. federal laws?  Children with food allergies can receive special services under Section 504 of the Rehabilitation Act of 1973, the Americans with Disabilities Act Amendments Act of 2008 (ADAAA), and the Individuals with Disabilities Education Act (IDEA).  ADAAA is an update from the American's with Disabilities Act.   If a student has one major life limitation, including eating, then that student is considered to have a disability.  Under the jurisdiction of section 504 of the Rehabilitation Act of 1973 if a public school cannot accommodate a child with food allergies the parents may request a '504'  meeting to develop a plan of action to support the safety and well being of the child at school.   The 504 Student Accommodation Plan will describe the services and accommodations needed to allow a fair and equal education to the student. . The overall plan is supposed to state what is the least restrictive environment and any special services needed.  It should also detail where, when, and how often the services should be performed.  If the 504 plan requirements are not met then the parent can lodge a complain with the office of civil rights.   There are more than two dozen children with food allergies in my son's school.  Would it save money and prevent allergic reactions to have a 504 plan and teachers supervising all of the children in the school with food allergies or cost less overall to educate the entire school staff to provide a safe environment? 

While still perched on my soap box my point is that this subject will be discussed and argued until every decision maker at every U.S. public school district understands that change is necessary.  It is necessary to keep students with food allergies healthy and able to feel comfort not fear while trying to get an education. The choice some district officials make is siding with the families who want the convenience of packing a peanut butter and jelly sandwich without much thought on how to solve the problem to make it fair and safe for everyone.  Small, easily adaptable changes and proper food allergy education are all that are required to create a healthy atmosphere for these children, who total over 3 million nationwide under the age of 18 according to the Center for Disease Control (CDC).  Why create an atmosphere where millions of families have to make their school comply through the 504 plan when easily adaptable changes can be made.  Is it because these children are not a majority or are expendable? Let us hope not. 

Lawmakers and school officials are happy to make the effort to create a 'greener' environment and now, with the help of the first lady, Michelle Obama, they have finally opened their eyes to providing and serving healthier school lunches.  In schools across the nation there is no tolerance (or so they say but that is another subject to discuss) for any child carrying weapons and taking drugs.   Why in the world are these people not open minded about preventing a life threatening food allergy reaction?  It is not for lack of materials and educators available to make this change work for each and every school across the nation.

The Leap Study in Great Britain found relation between eczema in infants and food allergy

According to the 'Leap study' in London, ( http://www.leapstudy.co.uk/index.html) the presence of eczema in infants 4 to 11 months was related to food allergy. In the study the researchers tested the presence of immunoglobulin E (IgE) antibodies in 640 infants and found that 31% were allergic to milk, 14 to 23% to nuts including peanut, and 16% to other foods. Findings have been recently reported on; http://www.emaxhealth.com/1506/50/35894/children-eczema-often-have-food-allergies.html

Leap, 'Learning Early About Peanut Allergy', was founded by British allergy specialists, who are trying to discover and determine the 'best strategy to prevent peanut allergy in children', (as written on the Leap study website; http://www.leapstudy.co.uk/index.html).  The results of the study on eczema and food allergy is a major step in finding out how to prevent and control food allergies.   These doctors are conducting two different approaches to eliminating and/or controlling a food allergy reaction; 1. avoidance of the peanut proteins and 2. whether measurable portion control and controlled frequency of peanut protein ingestion will minimize the peanut reaction to a lesser degree or absence thereof.  Recent findings on the connection between eczema and food allergy adds to the knowledge base needed to find a 'cure'. 

There are other studies involving food allergies and desensitization in the United States. Beginning in October, 2009 and now going into phase two Dr. Robert Wood, Study Chair and Chief of Pediatric Allergy and Immunology of Johns Hopkins Children's Center, is studying the efficacy of a peanut vaccine. This research is sponsored by the National Institute of Allergy and Infectious Diseases.  Go to; http://clinicaltrials.gov/ct2/show/record/NCT00850668 for detailed information about this clinical trial.

At Duke University, the Duke Food Allergy Initiative (DFAI), was created to study desensitization and treatments in children and adults who have food allergies.  A study involving infants, milk allergy, and formula is slated for the future.  Currently the DFAI is studying, according to their website;

1. 'Desensitization study of egg allergic patients
2. Desensitization study of peanut allergic patients
3. Immunotherapy for patients with peanut anaphylaxis'

To learn more go to their website; http://www.dukechildrens.org/services/duke_food_allergy_initiative

Duke University has already found success while performing a clinical trial in collaboration with Johns Hopkins Childrens Center.  This study was conducted with 19 individuals allergic to milk.  Of the 19 children, ages 6 to 17, twelve were able to tolerate increasingly higher doses of milk protein.  Those who were given a placebo were not able to tolerate a higher dose of the milk protein.

Celiac Disease study on quality of life found that children attending gluten free camps improved their well being from the PEDIATRICS.aapublications.org website

Published online February 15, 2010
PEDIATRICS Vol. 125 No. 3 March 2010, pp.e525e529(doi:10.1542/peds.2009-1862)

Impact of Gluten-free Camp on Quality of Life of Children and Adolescents with Celiac Disease

Tasce R. Simon Bongiovanni, BSc, Ann L. Clark, BS, Elizabeth A. Garnett, BA, Janet M. Wojcicki, PhD, MPH, Melvin B. Heyman, MD, MPH
Department of Pediatrics, University of California San Francisco, San Francisco, California
OBJECTIVE A gluten-free camp allows children with celiac disease (CD) to enjoy a camp experience without concern and preoccupation with foods they eat or the stigma of their underlying disease. The objective of this study was to evaluate the impact of gluten-free camp on quality-of-life indicators for children and adolescents with CD. METHODS Children aged 7 to 17 years with CD were administered a 14-question survey at the beginning and the end of a 7-day gluten-free camp. Surveys used a Likert scale to examine general well-being, emotional outlook, and self-perception for the week before each survey. Differences between the time points were compared. Data were analyzed by paired t test.
RESULTS Of the 104 campers who attended camp, 77 (21 male) completed the survey at both time points. Most (70%) had been on a gluten-free diet (GFD) for <4 years. All seemed to benefit from camp, no longer feeling different from other kids or feeling frustrated with a restricted diet. A more beneficial impact was found for campers who were on a GFD for <4 years. Overall, campers reported an improvement in 11 of 14 questions, statistically significant (P < .05) for 8 of those 11 questions. Improvement was observed in each of the 3 categories of questions: well-being, self-perception, and emotional outlook.
CONCLUSIONS Children who had CD and attended a week-long gluten-free camp demonstrated improvement in well-being, self-perception, and emotional outlook. The positive effects of camp were more apparent among campers who had been on a GFD for <4 years compared with those who had been on a GFD for 4 years, suggesting an adaptation to CD with time. A gluten-free camp that provides an environment of unrestricted foods can at least temporarily alleviate stress and anxiety around food and social interactions. Durability of these observations on return to daily life requires additional study.