New Study Records Allergy Policy Preferences in Schools

Staff from schools across the United Kingdom express desire for enhanced staff preparedness and internal allergy policy review after being surveyed by investigators.

Investigators from the United Kingdom found that a face-to-face school allergy training program enhanced self-reported staff preparedness and promoted internal allergy policy review, which in turn contributed to the safety and quality of life of children with severe food allergies.

Though non-statutory allergy management guidance for schools were recently introduced in the United Kingdom, the implementation process had been limited.

Investigators, led by George Raptis, MD, MSc, PhD, FRCPCH, considered this to be problematic, citing that the prevalence of allergic diseases in children reached “epidemic levels” and was considered a public health problem.

Hospital admission rates for anaphylaxis increased by 72% in the last 5 years for patients aged 18 years and younger.

Further, up to 20% of anaphylaxis cases occur within school grounds, with 1 in 4 occurrences reported in pupils not previously deemed at risk.

Raptis and colleagues previously reported that school preparedness for anaphylaxis was below the safety standards set by the Department for Education and those recommended by the European Academy of Allergy and Clinical Immunology.

With the newest study, they set out to evaluate the effect of a face-to-face training program for schools in England on school's self-reported preparedness in managing the needs of children living with severe allergies, as well as determine if the delivery of the training program stimulated an allergy policy review within the schools.

The Study

Between 2015 and 2016, Raptis and fellow investigators invited primary and secondary schools across Cumbria, North West of England to participate in a survey of school preparedness for anaphylaxis.

Training, which included peer-reviewed material, was arranged for after school hours and included teachers, teacher assistants, administrative, catering and cleaning personnel, and bus drivers.

The training was comprised of an interactive presentation covering the overall management of the child with severe food allergy and drills in the management of severe allergic reactions/anaphylaxis.

Additionally, an allergy specialist delivered a 90-minute training session which consisted of a theoretical and a practical workshop.

After 8 weeks after the training, head teachers were asked to complete a 26-item follow-up questionnaire.

Pre- and post-survey responses were analyzed alongside the chi-square test, the Mann–Whitney test, and the McNemar test, all of which were used to identify differences in responses from participating schools.

The Findings

The survey was accepted by 18 primary schools, with a total of 191 school personnel that participated.

About 29% (5/18) of the schools had pupils at risk of anaphylaxis and carried an auto-adrenaline injector (AAI), while 2 of these schools (12%) reported that a personalized allergy action plan was not available.

Additionally, more than one third of the head teachers (39%, 7/18) reported that preventative measures for accidental exposure to food were not in place prior to the training.

However, all the head teachers reported that they had adopted such a policy (pre-training 61% vs. post-training 100%, and about 71% (10/14) of the head teachers put in place special supervision for high risk pupils during meal times.

Most head teachers (83%, 15/18) expressed the need for national guidelines on the management in school of children with severe allergies at the baseline survey, with the number jumping to 18 (100%) post-survey.

The investigators found the data collected in the study to be promising and indicative of a brighter future for allergy awareness in schools.

“The fact that a number of trained schools implemented an emergency management protocol for the first time following the training confirms the value of training programs in supporting schools with and without registered pupils with allergies,” they wrote.

The study, “School allergy training promotes internal policy review and enhances staff's preparedness in managing pupils with food allergy,” was published online in Clinical and Transitional Allergy.