The Almighty Food Allergy Lobby
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Questioning the seriousness of food allergies is the definition of a thankless task. When I argued that it's possible to overeact to the dangers of nut allergies a couple of years ago, I got not just hate mail, but the kind of hate mail that trickles on for months and includes people you know, who tell you that they now think enormously less of you. And so I've pretty much stopped brattily griping about peanut-free classrooms and camps, especially after Sydney Spiesel, Slate's medical columnist, pointed out that about 100 people in the United States who are extremely allergic to peanuts die annually from accidental exposure. When risks are small but deadly, we're often irrational about them, and overpay for prevention. But it's harder to protest about how one's own happily allergy-free children are being asked to give up their PB&J.
Still, this piece in Slate by Meredith Broussard, about the conflicts of interest in the work of the non-profit Food Allergy and Anaphylaxis Network, got me feeling manipulated again. Broussard says that FAAN has enormous influence in the food allergy arena, and that it's spreading its money around so as to fund studies that hype the danger of seafood allergies and get TV stations to air infomercials without labeling them that way, among other things. Broussard has taken on the allergy lobby before, and gotten slammed for it. So I'll leave her to defend herself. But I do indeed wonder, as she prods us to, who will get the millions of dollars in allergy education funding that she says is in this proposed piece of federal legislation.
Photograph by Getty Images.
Emily Bazelon is a founding editor of Double X, and a writer and editor at Slate.
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accommodations, not bans, and using Section 504 plans
By: knitdoc | Sun, 09/20/2009 - 11:53
Food allergies are real and endlessly debating the statistics won’t make them go away. However, misinformation about allergic reactions needs to be addressed. Research has shown that casual skin contact with food allergens doesn’t cause anaphylaxis although they may cause localized skin reactions such as rashes or hives, and pure odor without aerosolized proteins can’t cause any reactions. Ingestion of any food allergen, not just peanuts, may cause anaphylaxis. Reasonable accommodations should be made for persons with food allergies, but overbearing policies such as banning are not medically necessary. Even the FAAN doesn't support banning because it's not enforceable, and tends to be polarizing. The Aug. 2009 Journal of Allergy and Clinical Immunology review article "Management of food allergies in schools: A perspective for allergies" summarizes much of the research done into food allergies, and none of the research supports banning.
School policies such as no food sharing, hand washing after eating, and having allergen-free tables are reasonable. Schools should clean eating surfaces routinely after use, and offer special meals to meet Section 504 non-discrimination plans for food allergic kids. Education about recognizing and responding to food allergy reactions in schools is a good idea. Parents will generally agree with checking for food allergens when they send in special treats for birthdays or holiday parties.
However, once a public school implements a food ban, it means all parents are required to check the ingredients of every food item brought into school on a daily basis, as though they have a food allergic child. This imposition is what causes controversy and resentment. It is not just about whether peanut butter sandwiches are allowed for lunch. Peanuts and nuts are hidden ingredients in many foods--just read the ingredients in any baked item or snack bar. Banning just one or two foods also causes resentment within the allergic community because it marginalizes the needs of children allergic to other foods and opens the door to demands of more food bans in the name of fairness.
Section 504 non-discrimination plans can be used to address the needs of both food allergic children and non-allergic children with special dietary needs, without requiring expensive lawyers or lawsuits. Food allergic children can get individual Section 504 accommodation plans if parents feel their needs are not being met at school. However, schools can stop short of banning because other accommodations are deemed medically sufficient. Schools that have food bans usually do it because of pressure from parents of food allergic kids, not in response to individual 504 plans because it is difficult to get a doctor to write that a ban is medically necessary, and schools are not allowed to make accommodations under 504 that are detrimental to other children.
On the other hand, if there is a ban, such as to peanuts/nuts, and you feel your child needs peanut butter for lunch else he simply won't eat, a pediatrician can write a letter stating that your child "must be allowed to have peanut butter" for lunch, because of a medical reason (feeding issues, other food allergies, autism, diabetes, vegetarian, etc). This meets the criteria for a Section 504 non-discrimination plan because eating is a major life activity, and not eating because of a ban can adversely affect a child's ability to learn, so the school must accommodate your child's dietary needs. Logistically, a school just needs to follow FAAN guidelines of separate allergen-free and/or allergen-allowed tables, hand washing after eating, etc. to meet the needs of all children, with or without food allergies.
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My children have rights too.
By: VeganMom | Sat, 09/05/2009 - 14:10
They do not have to choose between their spiritual beliefs and their health. Nuts, peanuts, and other legumes are an important source of nutrition in a vegan family. Very active children like mine need their protein, and it cannot come from animal sources.
We have fought this nut ban battle three times now, and while the lawyers were expensive, it was worth it. In all cases the situation was resolved without depriving my children of eating healthful meals with their friends at school.
They died
By: warrior513PU | Fri, 09/04/2009 - 08:40
20 years ago anaphylaxis sufferers existed, but they just died. 50 years ago we didn't have ubiquitous peanuts, peanut butter, peanut oil, it was the postwar baby boom that started to change what America sent in lunchboxes, and diners/restaurants/fast food places (using peanut oil) have increased tremendously since then also. Exposure to an allergen can often increase sensitivity over time, and in the case of peanuts, exposure of the general population has dramatically increased over the last 50 years in north America. Moms are now being told not to eat peanuts or peanut butter whilst pregnant, as that's connected to development of this allergy in the child. How many moms, pre-1960, would have deigned to eat peanut butter?
I am very interested in what Chinese medicine did for my son and wonder if it could be helpful to others who suffer from anaphylaxis. He still does not deliberately eat tomato, but he knows he's had those minute exposures over the last two years (the same type that nearly killed him) but has had no reactions. It's quite dramatic.
The mind boggles
By: Dark King | Thu, 09/03/2009 - 20:46
Just how did this incredibly sensitive and death-prone species ever survive this long? It seems that mere nuts are now deadly killers!
OK, so the anecdotal evidence given in this thread seems convincing. What I want to know is: where were all these deadly allergies 20 years ago? What has changed that has elevated the peanut from "a tiny minority have an allergy, but it is manageable" to the current "IT IS DEATH TO MY CHILDREN, YOU EVIL PEANUT EATING BASTARDS!" position?
Methinks other environmental factors are playing a role here. But woe betide any person who suggests the medical community research the role of the total environment in allergy diagnosis; that would deprive them of the excuse to sell more drugs to kids.
RE: Flyboyer
By: joss | Thu, 09/03/2009 - 15:19
The rational thing to me would be to make those decisions based on which allergies are actually present in a particular given school, not every allergy that may exist in the human population. The common food allergy in Japan is to rice, apparently; that would be no reason to ban rice in, say, Houston TX.
After it's been determined which allergies are present, I would rank them by transmission and by severity. If you have a child who is allergic to milk only if he or she personally consumes it, then there is no reason the other children can't have it in their lunches. If on the other hand, the child would experience anaphylactic shock from contact with a trace of milk, then you'd resort to stronger precautions.
But you're not going to find a school in which every allergy trigger is present and every one of those triggers works through contact. So it's a bit hyperbolic to fret that this is a slippery slope to lunches of nothing but turkey and apple wedges.
Please try a dose of empathy
By: warrior513PU | Thu, 09/03/2009 - 08:46
My son, now 29, is a highly productive person, kind and considerate and hard-working. He just re-shingled my roof for me. He is workforce manager for a technical support company and has saved or created hundreds if not thousands of jobs for entry-level workers. He also has had several near-death experiences from anaphylaxis. He reacts to tomato.
This started when he was 16. You can imagine how socially limiting it was, no teenage pizza, salsa, no potluck suppers with the family. But it was what was required to keep him alive.
He lost a semester at university when he lived in a house with several other fellows, a tomato-free house to be sure. But the others would go out, and when they came back, a doorknob was a threat, the cabinet handles had to be washed. He had so many episodes of anaphylaxis he spent the semester in a Benadryl-induced haze and failed his classes.
He was once carried off a city bus that had to divert to take him to the hospital, after he deployed his epi-pen and had 15 minutes to live. I have held his hand when he was blown up like a red balloon, lying on a gurney in emergency, a cortisone drip keeping him breathing.
He no longer reacts to tomato, he's been "safe" for a few years due to Chinese medicine. He was able to travel on trans-Pacific flights for the first time when he found this cure.
Sending my young daughter to school without a peanut butter sandwich is no inconvenience. Anyone who thinks it is, needs to have their head examined.