719 Impact Of School Peanut-Free Guidelines On Epinephrine Administration
Dr. Lisa M. Bartnikas, MD et al
Rationale: Some schools are peanut-free or have peanut-free areas. The impact of these interventions on allergic reactions has not been evaluated.
Methods: Schools nurses were queried regarding peanut-free policies from 2006-2011. Rates of epinephrine administration were compared to schools’ policies.
Results: We received responses from 421 schools. In 2010-2011, 88.2% of schools allowed peanuts from home; 46.6% served peanuts; 92.9% had peanut-free tables; and 66.0% had peanut-free classrooms. 3.1% of schools considered themselves peanut-free and none served peanuts. Of peanut-free schools, 69.2% banned peanuts from home; 23.1% allowed peanuts from home but had peanut-free tables and classrooms; and 7.7% allowed peanuts from home and did not have peanut-free tables or classrooms. During 2006-2011, 1.5% of schools reported epinephrine administration for peanut or tree nut exposure. Incidence rate (IR) of epinephrine for peanut or tree nut was 1.1/10,000 students in peanut-free schools and 0.2/10,000 students in non-peanut-free schools (p<0.05). IR of epinephrine for peanut or tree nut was 0.2/10,000 students in schools with peanut-free tables and 0.8/10,000 students in schools without peanut-free tables (p<0.001). For policies including allowing peanuts from home, served in schools, or peanut-free classrooms, there was no signi?cant difference in epinephrine for peanut or tree nut. Conclusion: Schools with peanut-free tables had lower rates of epinephrine administration compared to schools without peanut-free tables. Unexpectedly, peanut-free schools had higher rates of epinephrine administration compared to non-peanut-free schools. This is one of the first studies investigating the impact of peanut-free policies on epinephrine administration and may inform guidelines for children with food allergies.