Students Inattentive to Food Allergies

Study Shows Many College Students Don't Pay Attention to Their Food Allergies

By Patricia Kirk
WebMD Health News

Reviewed By Louise Chang, MD

Nov. 14, 2007 -- College undergraduates have a somewhat nonchalant attitude about their food allergies that may put them at high risk for accidental exposure.

A new study of college students shows that about half of those reporting a history of food allergies continue to eat foods that they are allergic to. Among those who reported physician-diagnosed food allergy, 42% said they will still eat food they know contains an allergen.

The study, conducted by the University of Michigan Health System (UMHS), included 513 undergraduate students who responded to an Internet questionnaire.

When students were asked why take the risk of eating food containing an allergen, researchers were given answers such as: "I thought I could eat around it," "The food item did not contain enough to cause a reaction," "I knew it could be treated," or "I've outgrown my allergy, says Matthew Greenhawt, MD, a pediatrician and fellow in the division of allergy & clinical immunology at UMHS.

Just as worrisome, the students were unprepared for an emergency. Only 22% of students who reported a history of allergic reaction said they possessed a self-injectable device, such as an EpiPen or Twinject, to treat a severe reaction. About 28% of those who have one say they always carry it with them. Of the 55 students reporting a severe reaction to a food allergen in the past, 27 of them did not have the device, which delivers a quick dose of medication to counteract a potentially fatal allergic reaction known as anaphylaxis.

Opportunity for Intervention

Greenhawt says the tendency for students to engage in risky behavior and a desire to not be viewed as "different" by peers may help to explain widespread irresponsible behavior among college students regarding their food allergies.

On the other hand, he added, "Many of these students are accustomed to their parents being in charge of their health care. Now that they're in college, they have to take this responsibility for themselves."

The study revealed the need for students to better inform friends, roommates, and people preparing their food about their allergy. Greenhawt recommends that parents also inform the appropriate college personnel.

The study also pointed out areas where education or college dining hall policies could improve prevention, including labeling all foods in dining halls that contain one of the "big eight" food allergens (milk, tree nuts, peanuts, shellfish, eggs, soy, wheat, and fish).

Additionally, he stressed that children with food allergies need to be educated about preventing exposure and treating it if it happens. Greenhawt notes that the study did indicate that some doctors have been successful in teaching their young patients to treat a reaction, as nearly all of students who carried an injectable device knew how to use it properly.

Low-Income Children at High Risk

In another study, Ekta Shah, MD, of Children's Hospital Chicago at Northwestern University-McGaw Medical Center (NWU-MMC) explored demographic factors that may put some children at higher risk for accidental exposure to food allergies. The hypothesis was that children living in low-income and/or non-English speaking households will have a higher prevalence of accidental exposure to food allergens than children from higher-income homes where English is spoken.

A study included 100 children diagnosed with a food allergy who were patients at the Pediatric Allergy and Outpatient Clinic at NWU-MMC.

More than half of the children were from homes with an annual income greater than $100,000. Forty-one percent of participants had experienced accidental exposure to a food allergen. Of this group, 67% were from households with incomes below the Cook County, Ill., median income of $40,000 annually.

The study established a significant correlation between household income and accidental exposure to food allergens, says Shah, but the sample of non-English-speaking households was too small to make a conclusion about the role of language. Only 13 of the children were from ethnic homes with a different primary language.

Commenting on this study, Greenhawt says based on clinical experience he would expect language to be a more important factor in accidental exposure than income level.

The studies were presented Nov. 12 at The American College of Allergy, Asthma & Immunology Annual Scientific Meeting in Dallas.

SOURCES: The American College of Allergy, Asthma & Immunology Annual Scientific Meeting, Dallas, Nov. 8-13, 2007. Matthew Greenhawt, MD, pediatrician, division of allergy & clinical immunology, University of Michigan Health System.

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