Monday, August 27, 2012

Hand-Washing vs. Anti-Bacterial Hand Sanitizers

by Kelley Lindberg

Every year, when I talk to teachers about protecting the food-allergic students in their classrooms, I’m asked if anti-bacterial hand sanitizer gels and liquids will work to eliminate food allergens from kids’ hands.

It doesn’t.

Teachers love hand sanitizer. They can post a big tub inside the classroom door, and have the kids file past it after lunch. Marvelously convenient. And wonderful at curbing illnesses, since everyone knows classrooms are germ factories.

But hand sanitizers don’t kill the proteins that cause allergic reactions, and it leaves the proteins sitting on the hand.

A 2004 study by Perry et al, “Distribution of PeanutAllergen in the Environment,” actually quantified the success rate of various cleaning methods for removing the most common peanut allergen protein, Arachis Hypogaea Allergen 1 (Ara h 1). For hands, they tested liquid soap, bar soap, commercial wipes, plain water, and antibacterial hand sanitizer. For hard surfaces, like tabletops, they tested common household cleaning agents and dishwashing liquid.

This is what they found:

For hands, the peanut allergen was undetectable after washing with liquid soap, bar soap, or commercial wipes. But plain water left the allergen on 3 of 12 hands. Antibacterial hand sanitizer was the worst performer, leaving the allergen on 6 of 12 hands. (Commercial wipes work because they rub the proteins off the hand. Hand sanitizer gels just move them around on the hand, but don’t remove them.)

For hard surfaces, they found that common household cleaners (they tested 409, Target cleaner with bleach, and Lysol wipes) removed the allergen completely. But liquid dish soap left the allergen on 4 of 12 tables.

From this study, it appears that good ol’ soap or commercial wipes are your best friend for keeping hands allergen-free. So talk to your teacher about using antibacterial cleaning wipes instead of that sanitizer gel – that way they’ll prevent food-allergic reactions as well as sniffly noses! And for tables, counters, desks, doorknobs, phones, or anything else, use commercial cleaners instead of a swipe with a soapy dishrag.

For this same study, the authors also tested 6 preschools and schools (1 of which was entirely peanut-free) to see if peanut allergens were a problem on common surfaces. Out of the 6 schools, they found the peanut allergen on only 1 of 13 water fountains, 0 of 22 desks, and 0 of 36 cafeteria tables.

That’s very encouraging! Of course, the chances of food allergens appearing on school surfaces will vary greatly from school to school depending on their cleaning products, cleaning frequency, etc. But it is good news anyway to know that if the school’s cleaning staff is conscientious about using cleaning materials properly and frequently, the chance of accidental contamination can be greatly reduced.

Monday, August 13, 2012

Back to School With Food Allergies

by Kelley Lindberg

Now that school is only 2 or 3 weeks away (at least here in Utah), many parents are getting ready to send their little ones off to a scary place – not that school itself is scary, but the food in the classroom and cafeteria can make it seem that way.

About this time every year I post my back-to-school tips. So I’ll repeat them here, in the hopes that they help smooth the way for other parents over the next few weeks. Good luck, and enjoy these remaining few days of summer!

(Remember, there are links to several school-related resources on the Utah Food Allergy Network's website, so be sure to check those out. And last week I posted my Back-To-SchoolFood Allergy Shopping List, so you might want to look at that, as well.)
  1. If your schedule allows, volunteer a lot, so the staff knows you and counts on you (not just for allergy issues). If the only time they see you is when there's a food allergy issue, then you may start feeling like they're whispering "Oh no, here she comes again." But if they see you as a "Gosh, what would we do without her" kind of volunteer, then the occasional food issue will be coming from a great mom who's making a reasonable request.
  2. If someone else is already the class mom, or you can't volunteer for that position, tell the teacher you really need to attend all parties and field trips because of the food allergy. The teacher may want to let the other parents know that you'll be selected for all the special events because of the food allergy, so that they don't think the teacher is playing favorites or something.
  3. Ask the principal if there are other food allergic kids in the same grade, and if they can be assigned to the same teacher. That makes it easier for the allergic parents to trade off field-trip and party chaperone duties, it puts all the kids in the same class so that the classroom can be more allergen-free, and gives you some backup in food issues. (It's nice to NOT be the only one.) Statistically, about one in twenty kids has a food allergy, so chances are good there will be more kids than just your child.
  4. Volunteer to shop for all the snacks or food materials for classroom parties or food educational units (like making noodle necklaces or gingerbread houses, etc.). Tell the teacher if she'll collect money donations, you'll go buy all the ingredients. They're usually delighted to get out of having to shop.
  5. Make several copies of your Food Allergy Action Plan (available on FAAN’s website) and ask to hang one in the office, the cafeteria kitchen, and the classroom, so that your child's photo and "What to do in case of a reaction" instructions are handy no matter where he is.
  6. Practice with your child what he should do if he "feels funny." Role-play and pretend you're the teacher, and have him come up and tell you what's wrong. Often our kids are too shy about asking for help, so have him practice with you, and with the teacher if possible. Not only does that give your child words to use if something happens, but it helps impress upon the teacher how important it is.
  7. I get on my principal's staff meeting agenda at the first of the year and give a 15-minute talk about allergies and demonstrate the EpiPen. I also give a presentation to my son's class, and all the teachers and aides he comes into contact with. If you're not comfortable doing this, ask if there are other allergic parents that you can contact. Talk to them about ways to teach the teachers -- maybe another mom would be willing to give the presentation if you make the photocopies. It's easier when there are two of you involved!
  8. Remember, In Utah, your child can legally carry his EpiPen. But he probably can't administer it to himself in an emergency, so make sure the teachers and everyone else know where it is and how to use it. My son carries his in his backpack so that it's always in the classroom, and I also fill a second prescription and they keep it in the office. So he has two sets at school. (I also attach a luggage tag with his photo on it to his backpack, so the teacher can find his backpack in a hurry.)
  9. If he's going to be having lunch at school, talk to the Lunch Lady and cafeteria monitor. Introduce your child, tell her what your child is allergic to, and let your child know that the Lunch Lady is a friend that will help keep him safe. Then remember the Lunch Lady and the cafeteria monitor on holidays with little thank you cards or gifts to show you appreciate them. Few people do that. But it will help keep your child's food issues fresh in their mind, and they'll get to know him well.
  10. Ask about setting up a food table just for allergic kids. All that’s required is a table with a sign that says allergies only, and the cafeteria monitors clean it with a separate marked bucket and cloth. Don’t let them make your child eat in a separate room or the principal’s office. He shouldn’t be punished just because he’s allergic to some foods! Ask the principal to mention the allergy table in a newsletter or other information that goes home with kids at the beginning of the year. You may find other kids with allergies expressing an interest in sitting at the table if they know it’s available.
  11. Ask the parents of your child’s friends to send safe lunches with them every once in a while, so they can eat with your child. Make it a fun place to be!
  12. Most peanut-allergic kids don’t react to the smell of peanut butter in the air, but a few do. If you are worried if your child will react to the air in the cafeteria, ask to take him in for a “practice run.” Sit in the cafeteria for half an hour and see if he reacts. If he doesn’t, cross that worry off your list.
  13. Eat lunch with him for the first few days. That will reassure both of you that you can both handle this!
  14. Talk to the teacher about which cafeteria door your child should use to avoid peanut butter contact (usually the one furthest from the playground), where to put his lunch bag after lunch, and where his EpiPens will be.
  15. Remind your child NOT to throw away his lunch trash. Tell him to bring it home in his lunch bag, so that he can avoid using the trash can. If another kid slam-dunks a half-full milk carton in the trash can, you don’t want your milk-allergic child to get splashed.
  16. If you and your kid want to, you can order medical alert jewelry to alert teachers and other staff about your child’s allergy. Sometimes, it’s a good visual reminder to the teacher to stop and think about food. (But not always – sometimes you see something so often you stop seeing it, you know what I mean?) If you’d like to order one, I like the sports band versions at American Medical ID. They come in lots of colors, and are especially cool for boys, who don’t usually like the regular bracelets.
  17. Be aware and be prepared, but don't panic! School is going to be a lot of fun, and your child will do just fine. And believe it or not, so will you!

Monday, August 6, 2012

Back to School Shopping List for Allergies

by Kelley Lindberg

It’s amazing how much power and emotion are packed into those magical “three little words”:

“Back to school.”

Some folks (mostly parental-type folks) are giddy with happiness. Others (mostly kid-type persons) are less enthusiastic. Still others (my son) become overwhelmed with despair and gloom.

Like it or not, the stores are packed with Back-to-School supplies now, and it’s time to stock up.

Of course, those of us with food-allergic kids have to add a few extra items to our back-to-school shopping lists. So if you, too, are preparing a back-to-school shopping list for the food-allergic student in your life, don’t forget these essentials:
  • Epinephrine Injectors – Have yours expired? It may be time to get new ones. I get a pair to leave at the school’s office, and a pair for him to carry in his lunch box (along with instructions). Be sure you check the expiration dates on the new ones to make sure they’ll last through the school year.
  • Antihistamine (Benadryl, Zyrtec, Claritin, Allegra, etc.) – Like with the EpiPens, I put some in the office, and some in his lunch box. Again, check the expiration dates.
  • Lunch Box – He always takes a home lunch and sits with his food-allergic buddy.
  • Thermos for hot foods – He lives on noodles, but these are great for safe soups, chili, and casseroles, too.
  • Food Containers – Invest in a few plastic containers that will fit inside the lunch box for things like salads, dressings, sandwiches, fruit, etc. They’re more economical, more ecological, and far less “squishable” than plastic baggies.
  • Beverage Thermos or water bottle
  • Handi-Wipes – I always put a couple of individually wrapped Handi-Wipes in his lunch box so he can clean off the table if he needs to.
  • Food Allergy Action Plan – Make an appointment with your child’s allergist or pediatrician now, and have them fill out a Food Allergy Action Plan to give to your school. I attach a current photo of my son, and then I make a few color copies of it. I give one to the school office, one to each of his teachers for them to hang in their classroom, and one to the school cafeteria manager for her to hang in the kitchen, so that the lunch workers will know him and recognize him if he has a reaction. If your doctor doesn’t have their own form, use this Food Allergy Action Plan from FAAN (Food Allergy and Anaphylaxis Network). It’s probably the most widely used form in the U.S., and most doctors recognize and use it.
  • Medical ID Bracelet or Necklace – If your child will wear one of these, it’s a great idea. It is a visual reminder for teachers of your child’s allergies, and it’s an instant help for EMTs who might be summoned if your child has a reaction.
  • Clean-up Wipes – I always take a couple of tubs of wipes to his teacher, for cleaning desks. (I usually take tubs to the teacher throughout the year, too, since they often go through them quickly.)
Do you have any other great suggestions for allergy-aware back-to-school supplies? Be sure to share them with us!

Happy shopping!