Parents tend to worry most about their children when they are outside of the home, but for those suffering from peanut allergies, being at home carries the highest risk of exposure. A new study found that over a third of all exposures to peanuts happen in the home, accounting for a majority of the incidents observed. The study also revealed that parents and even medical professionals can have a poor track record of responding appropriately to these potentially life-threatening situations.
Clinical and Translational Allergy journal published the study, which was conducted by the University of Montreal. It followed 1,941 Canadian children with an average age of 6.9 who all had peanut allergies and a history of at least one peanut exposure. The purpose of the study was “to determine how exposure occurs, how serious the outcomes of the exposure are, and what treatment is given,” according to its lead researcher Sabrine Charkaoui.
Children were followed for an average period of 2.9 years. During the course of the study, 429 of the children had new exposures, resulting in 567 total incidents. The circumstances surrounding these exposures and the follow-up response were both diligently documented.
11.3 percent of the reactions to exposure were categorized as “severe” and 50.1 percent as “moderate.” Despite the apparent danger during severe reactions, only 42 percent of them were evaluated by a medical professional. Nearly one in six went completely untreated. “For moderate reactions, the situation is far worse,” expressed Cherkaoui. “Medical attention was sought only 25% of the time.”
When looking at the location of the exposure, 37% of all incidents occurred in the child’s own home. Other people’s homes were 14.3 percent of incidents and restaurants were 9.3 percent. A surprising discovery was that while schools had a relatively low incidence of exposure overall, schools and daycares that banned peanuts and peanut products had a slightly higher level of exposure than schools or daycare centers that allowed peanuts — accounting for 4.9 percent and three percent of exposures respectively.
“Other” or unknown locations were the second-highest category with 31.6 percent of exposures.
Cherkaoui and her team noticed several trends when looking at the data. First, accidental exposures decreased in likelihood as time went on, indicating that parents and children learned from exposures and adopted better avoidance strategies. Second, adolescents carried a particularly high risk thought to stem from their natural risk-taking behavior.
The researchers had two explanations for why exposures were more frequent in schools and daycares that had intentionally banned peanuts. “Schools and daycares that allow peanuts may be doing a good job of controlling risk due to heightened awareness of the dangers,” stated Cherkaoui. As for schools that attempted to be peanut-free, she noted that “the child may be lulled into a false sense of security, as peanut-foods may inadvertently be brought in and shared with the child.”
This same sense of complacency could explain why homes had the highest incidence of exposure, but further research will be needed on the matter to know for sure. The most concerning aspect of the study, though, was that parents, caregivers and even physicians present after moderate and severe exposures managed the incidents “inappropriately.” Cherkaoui cautioned: “We believe that more education is required on the importance of strict allergen avoidance and the need for prompt and correct management of anaphylaxis.”
Anyone with a child who has severe or even mild peanut allergies should be aware that a tendency to take food allergy safety for granted in familiar settings like the home can create a risky environment. Consulting an expert allergist and responding to any exposure promptly and with grave seriousness can help reduce the likelihood of dangerous complications.
Visit Atlanta ENT to receive a peanut allergy consultation and suggestions on how to manage peanut allergies and treat incidents should they occur. Click here to visit our food and peanut allergy section and learn more.
