Opinion - Health
2:27 pm
Wed March 19, 2014

School Districts Need a Uniform Policy for Allergens in the Classroom

IPFW Associate Professor and medical ethicist Abraham Schwab.
IPFW Associate Professor and medical ethicist Abraham Schwab.
Credit Courtesy / Abraham Schwab

In a 2013 comedy special, Louis C.K. provides a provocative contrast of good thoughts and bad thoughts he calls “Of course . . . But maybe” (Ed.: video contains content some readers may find offensive).

His first example: “Of course” we should protect children with nut allergies by segregating their food. Of course we should. “But maybe” if you touch a nut and it kills you, you’re supposed to die.

As with the rest of us, Louis C.K. wants the good thoughts to win out, he wants children with nut allergies to be protected. But maybe our current policies risk these children’s lives.

Look, for example, at the Food Allergen Labeling and Consumer Protection Act of 2004. Manufacturers must list any of the eight major allergens (milk, eggs, fish, shellfish, peanuts, tree nuts, soy, and wheat) included in their product. Importantly, these manufacturers are NOT required to list these ingredients separately (e.g., in a separate line that reads: “Contains: eggs”)—so any consumer trying to protect children with allergies needs to read the entire ingredient list of every food they buy. Cumbersome, but doable.

What this policy does not address is cross-contamination. Vanilla bean ice cream, for example, typically doesn’t include peanuts or tree nuts. But vanilla bean ice cream might be manufactured in the same factory as butter pecan ice cream.

Some of the pecan pieces may end up, by accident, cross-contaminating the vanilla bean ice cream. Pecans aren’t an ingredient in vanilla bean ice cream, but they might end up in the ice cream just the same. A well-meaning adult could give a tree nut allergic child the ever-innocuous vanilla ice cream, unintentionally putting that child’s life at risk.

For this reason, some manufacturers include statements like “May contain tree nuts” on their packaging. Other manufacturers include a different statement: “Processed in a plant that also processes tree nuts.” What’s the difference between these two statements? The consumer is left to guess—there are no regulatory standards governing this labeling.

What all this means: there could be three batches of vanilla bean ice cream, all made with the same level of risk of cross contamination, but because they are made by different manufacturers, they may be labeled three different ways.

Finally, there is this confusing ingredient list from a box Russell Stover chocolates, which our family received as a gift this year.

The ingredient list from a box of Russell Stover chocolates.
The ingredient list from a box of Russell Stover chocolates.
Credit Courtesy / Abraham Schwab

At the bottom: a bolded note that the chocolates were processed on equipment that also processes tree nuts and wheat. This note accompanies an ingredient list that includes peanuts (not to mention walnuts, pecans, and almonds) and soybeans. Someone with a soy allergy should not eat these candies, but if they read only the bolded warning at the bottom, they would be entirely unaware of the risk.

By now, you can see that avoiding allergens can be difficult (and we haven’t even talked about trying to eat at a restaurant). And this has some important implications for the policies of our local school districts.

For the last four years, my son has eaten his lunches in the cafeteria at a separate, “peanut free” table. His risk of cross-contamination from other kids’ peanut butter and jelly sandwiches is minimized as a matter of policy.

But in the classroom, there is no such table. There is no uniform policy for the school district. Each teacher is left to establish their own policy regarding snacks and other uses of food in the classroom. This is a mistake.

My son’s current teacher has been exemplary in her handling of his allergies, and for that we are grateful. But that’s a matter of luck. A different teacher’s niece, for example, may have only a mild food allergy (i.e., they’ve never had a severe reaction) or a mild gluten sensitivity, leading that teacher to have a lax policy about allergens in the classroom. If however, that teacher was related to Natalie Giorgi or Giovanni Cipriano, they would have a more aggressive and restrictive plan, banning all peanuts and potential cross-contaminants from the classroom.

Policies for potentially deadly conditions should not be left to the vagaries of individual experience. I know all of my son’s teachers have meant well and I thank them for their difficult and underpaid work. But when these teachers are asked to make allergen policies for their classrooms, they are unfairly asked to make good judgments in an area where they lack expertise.

We shouldn't ask my son’s allergist to determine the best pedagogical approach for teaching my son, and we shouldn't ask my son’s teacher to determine how best to handle a potentially deadly allergy.

Each school district should have a clear, uniform policy for classroom snacks that protects students with potentially deadly allergies. The policy should be designed in consultation with an allergist or other expert in the area. And there’s no need to reinvent the wheel: in late 2013, the Centers for Disease Control and Prevention released guidelines for managing food allergies in schools.

These are exemplary for their clarity. For example, on page 40, they provide clear suggestions for the classroom, including: “Avoid the use of identified allergens in class projects, parties, holidays and celebrations, arts, crafts, science experiments, cooking, snacks or rewards.”

In the meantime, Fort Wayne school districts could follow the lead of an Illinois public school district, whose suggested snack policy eliminates concerns about the eight major allergens.

The only snack that parents are allowed to send in: fruits and vegetables.

Abraham Schwab is an associate professor of philosophy and medical ethicist at IPFW.

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