In the Journals

Children with peanut allergy face greater exposure risk at home vs. school

Accidental exposures to peanut allergens in children are more likely to occur at home than at schools, and most events are managed inappropriately, according to study results.

“We discovered that children are most at risk of exposure in their own homes,” Sabrine Cherkaoui, MD, division of allergy and clinical immunology, University of Montreal, said in a press release. “Furthermore, when children do have a moderate or severe reaction to an exposure, parents and medical professionals often do not know how to react appropriately.”

Cherkaoui and colleagues recruited 1,941 children with peanut allergy from two hospitals and allergy advocacy organizations between 2004 and 2014. Patient demographics, history of atopy and initial reaction to peanut were collected through questionnaires, and accidental exposures (AEs), including food ingested, signs, symptoms, location and treatment, were recorded.

Five hundred and sixty-seven AEs occurred in 429 patients across 4,589 patient-years for an annual incidence rate of 12.4%. Initial reactions to peanut were considered moderate (50.1%), mild (26.3%) and severe (11.3%).

Thirty-seven percent of AEs occurred at the child’s home, 14.3% occurred at a relative or friend’s house, 9.3% occurred at a restaurant, and 31.6% took place at unknown locations. Exposures at school were minimal: 4.9% occurred at schools prohibiting peanut, and 3% took place at schools that allowed peanut.

No epinephrine was administered to 36.5% of participants with mild AEs, 25.6% of participants with moderate exposures and 14.1% of participants with severe exposures.

The researchers said longer disease duration, likely due to adjustments made over time, reduced the risk for an AE (adjusted HR = 0.9; 95% CI, 0.88-0.93).

“The most significant finding of this study is the discovery that most moderate and severe accidental exposures are managed inappropriately by caregivers and physicians,” Cherkaoui said in the release. “We believe that more education is required on the importance of strict allergen avoidance and the need for prompt and correct management of anaphylaxis.” – by Ryan McDonald

Disclosure: Cherkaoui reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.

Accidental exposures to peanut allergens in children are more likely to occur at home than at schools, and most events are managed inappropriately, according to study results.

“We discovered that children are most at risk of exposure in their own homes,” Sabrine Cherkaoui, MD, division of allergy and clinical immunology, University of Montreal, said in a press release. “Furthermore, when children do have a moderate or severe reaction to an exposure, parents and medical professionals often do not know how to react appropriately.”

Cherkaoui and colleagues recruited 1,941 children with peanut allergy from two hospitals and allergy advocacy organizations between 2004 and 2014. Patient demographics, history of atopy and initial reaction to peanut were collected through questionnaires, and accidental exposures (AEs), including food ingested, signs, symptoms, location and treatment, were recorded.

Five hundred and sixty-seven AEs occurred in 429 patients across 4,589 patient-years for an annual incidence rate of 12.4%. Initial reactions to peanut were considered moderate (50.1%), mild (26.3%) and severe (11.3%).

Thirty-seven percent of AEs occurred at the child’s home, 14.3% occurred at a relative or friend’s house, 9.3% occurred at a restaurant, and 31.6% took place at unknown locations. Exposures at school were minimal: 4.9% occurred at schools prohibiting peanut, and 3% took place at schools that allowed peanut.

No epinephrine was administered to 36.5% of participants with mild AEs, 25.6% of participants with moderate exposures and 14.1% of participants with severe exposures.

The researchers said longer disease duration, likely due to adjustments made over time, reduced the risk for an AE (adjusted HR = 0.9; 95% CI, 0.88-0.93).

“The most significant finding of this study is the discovery that most moderate and severe accidental exposures are managed inappropriately by caregivers and physicians,” Cherkaoui said in the release. “We believe that more education is required on the importance of strict allergen avoidance and the need for prompt and correct management of anaphylaxis.” – by Ryan McDonald

Disclosure: Cherkaoui reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.