Several years ago, a school bus full of elementary students in Massachusetts was evacuated. A potentially deadly item was found on the floor. Was it a gun? A bomb? A blood-contaminated hypodermic needle?
Over-the-top responses to peanuts aren't uncommon. People are under the impression that the mere whiff of a peanut is enough to send some kids to the emergency room. But, that's simply not true. The molecules in peanuts that are responsible for aroma are not the same as the ones that trigger allergies. Also, an allergic reaction only occurs if peanuts are eaten or inhaled; touching a peanut briefly will not trigger an allergic reaction, unless the child then rubs his or her eyes or mouth.
High-profile stories (such as the one about a woman with an extreme peanut allergy who died after kissing her boyfriend) lead the public to think that this sort of thing occurs regularly. But it does not.
A commonly cited statistic is that 150 to 200 Americans die from peanut allergies annually. However, that figure appears to be a back-of-the-envelope estimate with little evidence to support it. Journalism professor Meredith Broussard reported that merely 11 Americans died from all food allergies combined in 2005. Even if the larger estimate is true, it's still five times fewer than the number of people who die falling out of bed1, and it's roughly equivalent to the number who die from autoerotic asphyxiation.
Still, many will argue that going to extreme lengths to protect children who suffer from severe allergies is worth the hassle. Even if kids are unlikely to die, protecting them from anaphylaxis is worthwhile. Fair enough. That reasoning is precisely why some schools have implemented various types of restrictions or bans on peanuts. Do they work? No.
A new article published in the Journal of Allergy and Clinical Immunology surveyed schools in Massachusetts. They compared the rates of epinephrine administration (a proxy for anaphylaxis) from 2006-2011 between schools with various peanut restrictions and schools without them. Obviously, one would expect that schools with restrictive policies wouldn't need to use EpiPens2 very often. But that's not what they found. (See figure.)
As shown, restrictive peanut policies don't reduce anaphylaxis. Furthermore, schools that were truly "peanut-free" (i.e., the school did not serve peanuts and banned students from bringing them) had the exact same rate of epinephrine administration as schools without those policies. The only policy that worked, the authors found, was for lunchrooms to establish peanut-free tables.
The temptation of society to ban things "for the public good" is incredibly strong. It would be nice, however, if less hysteria and more data factored into policymaking.
(1) According to the CDC, 922 Americans fell out of bed and died in 2015. To confirm that number, click here. After clicking "I Agree," select the year 2015 and ICD-10 code W06 (fall involving bed).
(2) EpiPens aren't the only epinephrine auto-injectors on the market. CVS is selling Adrenaclick to many patients for $10.
Source: Lisa M. Bartnikas, Michelle F. Huffaker, William J. Sheehan, Watcharoot Kanchongkittiphon, Carter R. Petty, Robert Leibowitz, Marissa Hauptman, Michael C. Young, Wanda Phipatanakul. "Impact of School Peanut-Free Policies on Epinephrine Administration." J Allergy Clin Immunol (in press). Published online: 2017. DOI: 10.1016/j.jaci.2017.01.040
mmmmmmmmikey on April 7th, 2017 at 14:18 UTC »
As someone with a semi-severe peanut allergy (anaphylactic, but anything short of eating them won't set me off) and a less severe tree nut allergy, I can say that the whole idea of a peanut-free school is riddled with problems. Firstly, this could make school staff complacent and give them false confidence that a reaction won't ever happen, and thus they aren't aptly prepared for when it inevitably does. Secondly, the rule could never be effectively enforced. Peanut-free tables, though they may or may not be effective, are something I grew up with. Because I was always careful, unless a bunch of people brought peanut butter or I felt unsafe about something, I would just sit at the normal tables. I think they could provide a good space for children with more severe allergies to sit though.
LoisWilkerson on April 7th, 2017 at 13:48 UTC »
Of course it doesn't work. Everyone in this thread keeps saying peanut butter - but peanuts and peanut oil are in far more products than just peanut butter. For a "peanut free school" to work, every parent in the school would have to have the same level of vigilance that the parent of the allergic kid does.
Laharya on April 7th, 2017 at 13:25 UTC »
This data seems to show that anything bigger than peanut-free tables in the cafetaria is impossible to enforce. If peanut-free tables work (as the data suggests), then an entire peanut-free school should as well since then ALL the tables would be peanut-free. This doesn't seem to be the case, so peanuts must get through somehow. My guess is that tables are easier to manage and keep a strict rule on, also the children may find it easier to adhere to and respect those rules. A peanut free table for the allergic fellow student? Gonna steer clear with my peanut butter sandwich. Fair enough. Can't bring a peanut butter sandwich because someone might be allergic? Pfsh, I'll just eat it quickly, no one will notice.