By Allergen Bureau

Is it safe for nuts to return to school lunchboxes?

A series of conditional recommendations for managing food allergy in childcare centres and schools has been made by a group of scientists following systematic literature reviews of the anticipated health effects of selected interventions. Lifting blanket bans on food allergens like nuts in schools and childcare centres is among them.

According to the group, who published their findings in an Open Access paper the Journal of Allergy and Clinical Immunology, past research indicates there is no benefit to banning certain foods from the school environment, with a more targeted approach for at-risk children recommended.

Based on costs, feasibility, acceptability, and effects on health equity of selected interventions, the group recommend the following for childcare centres and schools:

  • Implement allergy training and action plans;
  • Use adrenaline to treat suspected anaphylaxis;
  • Stock unassigned adrenaline autoinjectors, instead of requiring students to supply their own personal autoinjectors to be stored on site for designated at-school use;
  • Do not implement site-wide food prohibitions (eg, ‘nut-free’ schools) or allergen-restricted zones (eg, ‘milk-free’ tables), except in certain special circumstances such as where ‘safe zones’ may be needed for children at high risk of accidental exposure.

The recommendations are referred to as ‘conditional’ due to the low quality of available evidence, with more research needed to determine with greater certainty which interventions are likely to be the most beneficial.

Reference: Waserman et al. 2021. Journal of Allergy and Clinical Immunology. DOI. 10.1016/j.jaci.2021.01.034