<p>From The Mayo clinic:</p>
<p>[Peanut</a> allergy: Causes - MayoClinic.com](<a href=“Peanut allergy - Symptoms and causes - Mayo Clinic”>Peanut allergy - Symptoms and causes - Mayo Clinic)</p>
<p>Note direct contact CAN trigger a reaction.</p>
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<p>My point is that under some circumstances, a ban is needed to underscore the seriousness of the matter. Especially to those who are ignorant of PA effects on those affected and more importantly, on those who effectively pooh-poohed such information as that parent and child mentioned in previous posts. </p>
<p>It is parents and students like the one I mentioned in my account which were probably a factor in why there has been an increasing trend in banning peanuts and peanut related products in more school districts.</p>
<p>Re: #381: yes, that is consistent with what I posted. The question was whether being near someone eating peanut butter would cause a reaction. I don’t see authority saying that it does.</p>
<p>What happened to posts 374-380? They weren’t especially inflammatory (except that I said I don’t like tuna).</p>
<p>Bay…i was referring to an earlier post where someone said banning peanuts in recipes seemed logical, but not peanut butter. maybe that was you? The fact is, cross contamination is highly likely, hence the ingestion fear and the accidental contact fear. Utensils, cleaning cloths, toasters, waffle irons, etc are all likely culprits for cross contamination… For example…It’s amazing how the scoop girl at 31 Flavors thought that wiping the scoop that was just in the Rocky Road with a paper towel qualified as making it “clean and safe.” Thank goodness they now separate the ice cream. One side for nut varieties, with dedicated scoopers, and the other for non-nut varieties. Still didn’t go there but once while D lived at home…we found the stress negated the joy.</p>
<p>Direct contact can trigger a reaction, but the medical literature does not show anaphylaxis only by touching peanut butter. The reactions described by contact only are not anaphylactic or respiratory in nature. </p>
<p>I would also like to see a citation to the incident that cobrat describes. Cases such as these tend to be described in the medical literature. The student at Brown who died after eating chili thickened with peanut butter has been cited frequently.</p>
<p>Prefect, can you share your qualifications if you haven’t already? Mine are parent of extremely nut sensitive kid and that my daughter is currently in an extensive food challenge study at her university. The many, many doctors and lay folk she’s come into contact with have tales to tell that would curl your toes, some about near misses with an allergen. For instance the little one who found out that one of her MANY food allergies ( not intolerances, but bonafide, verified food allergies…nuts being the most serious/deadly) was to milk. It “burned” her skin on contact. But she could still breathe, you might say. Yep. True statement, but the very nature of allergies is that you never know just how serious your reaction will be. Sometimes you get the hives, then the respiratory reaction. Sometimes vice versa. Still other times one reaction but not the other. A guessing game, which could have dire consequences.</p>
<p>Just because you want to believe that touching a peanut/product will not cause a respiratory reaction doesn’t make it so. Is it likely? From the learned folk my kid has come into contact with this past year, the answer is most definitely Yes…it COULD happen.</p>
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Oh, gosh. I knew someone would compare a peanut ban to a civil rights movement. It’s not the same thing. To say that your allergic loved one not getting peanuts banned in a campus dining hall is the equivalent to the equality movement of a race that has been oppressed for two centuries is ridiculous.</p>
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<p>With all due respect, shellz, prefect is simply asking for anything in the medical literature to support your claims. You are supplying anecdotes and expressing your fears as a parent, not a medical expert (which of course are completely understandable in your position).</p>
<p>I am curious about how you selected a college for your PA daughter, and how you and she manage her allergy from day to day. How can you be completely confident that she is OK all the time? Does she live in a dorm? Is her floor peanut-free? I am sure it would help others to hear more details of your story.</p>
<p>According to the CDC an estimated 4% - 6% of children under 18 have a peanut allergy.</p>
<p>So please, under no circumstance can peanut allergies fall under the definition of COMMON. They are just the most COMMON in terms of all food allergies which are RARE in the general population.</p>
<p>[CDC</a> - Food Allergies - Adolescent and School Health](<a href=“Food Allergies | Healthy Schools | CDC”>Food Allergies | Healthy Schools | CDC)</p>
<p>The article below does great job explaining the way an allergic reaction can and cannot be triggered in a PA sufferer. </p>
<p><a href=“http://www.allergysafecommunities.ca/assets/common_beliefs_faan_2003.pdf[/url]”>www.allergysafecommunities.ca/assets/common_beliefs_faan_2003.pdf</a></p>
<p>"How then do we explain the case reports that have been associated with the odor of peanuts? These can be conditioned physiologic responses, akin to the famous experiment of Pavlov, in which dogs were conditioned to salivate at the sound of a bell. Almost any physiologic response can be conditioned, including changes in blood pressure, heart rate, body temperature, skin rashes, and respiration. The conditioning stimulus can be the sound of a bell or in this case, the smell and aroma of peanuts and peanut butter.</p>
<p>In summary, inhalation of peanut protein can cause allergic reactions (but usually not systemic anaphylaxis), while odors can cause conditioned physiologic responses. In a well-ventilated school cafeteria located away from the kitchen and food preparation areas, the main source of peanut protein would be from direct ingestion or skin contact, not airborne contact.
There is also the widely held belief that peanut residue found on surfaces such as sports equipment, toys, doorknobs, and washroom faucets can result in anaphylaxis. There is an unpublished report from Canada of two children with rashes developing after playing with basketballs handled by other children who had eaten peanut butter, with the problem resolving once the basketballs were cleaned. There were no symptoms of anaphylaxis in the two children and no specific evaluation was performed. Other anecdotal reports in the literature regarding exposure to peanut residue consist mostly of similar contact skin reactions, with no reports of anaphylaxis."</p>
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Even for you this post was beyond the pale of offensive.</p>
<p>You don’t think an allergy that affects 4 to 6 % of children is common? That definition means that every single college in the nation will have multiple people with peanut allergies.</p>
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Here I think we need to make a distinction that’s creating lots of problems in this discussion. By far the greatest risk of serious reaction from peanut exposure is from ingestion, and when that happens, it’s usually when the person eats something he didn’t know contained peanuts, or that was cross-contaminated. Imagination doesn’t come into it–the physical reaction is what reveals the fact that exposure has happened.</p>
<p>Again, I’d like to state my view clearly: I think all colleges should take reasonable steps to avoid the risk of unexpected ingestion of nuts by allergic persons. There are steps they can take to do this short of an entirely nut-free dining hall, although a nut-free dining hall would be nice, especially if the school has multiple dining halls. As for people with extreme allergies, I think colleges should try to accommodate them as well, just as they do for people with any kind of physical problem that interferes with their ability to function normally. For such people, the costs of making the dining hall entirely safe may be excessive, and more individualized accommodations may be necessary–just as colleges can’t be expected to install elevators to every floor of the dorm, as long as there are accessible rooms.</p>
<p>Well said, Hunt. The greatest problem with peanuts or any other food allergen is ingestion.</p>
<p>I agree completely with Hunt. I do think reasonable accommodations should be made. My office has one large cafeteria. It is not nut free because people bring their lunch from home. However, there is a smaller “cafe” which is strictly nut free. It’s bright, pleasant and works very well, but since it’s not the only place to eat it is much easier to be sure. That’s my concern with any big organization. If there is only one place to eat for hundreds or thousands of people, it is much easier for someone to slip and it would be almost impossible to prevent that. I wouldn’t send my kid to a place with just one option for that reason. I do not have a kid with a life-threatening food allergy, but I have a child with a very severe respiratory allergy that has sent him to the ER more than a few times and for which we are always prepared. It is our job to be vigilant and I wouldn’t leave his life in the hands of other people, no matter how well-meaning. Having no children, cobrat doesn’t understand that.</p>
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This is my favorite sentence in the English language.</p>
<p>One difficulty with nut allergies is that it’s hard to know how severe the allergy is–unless you’ve had anaphylaxis. My son’s allergy manifested itself with choking and vomiting the first time he had a tiny bite of peanut butter when he was a toddler. We rushed him to the ER, and then saw an allergist. Since then he’s been very careful, and has had minor reactions–generally in situations where there was probably cross-contamination. By minor reactions I mean vomiting, itching throat, etc., that resolved with Benadryl. He hasn’t used his epipen, and he hasn’t been back to the ER. So how severe is his allergy, really? It certainly doesn’t seem to be the kind where peanut particles in the air will affect him–but without some kind of challenge test, it’s not clear how dangerous ingestion of a peanut would be for him. We’re not terribly eager to find out.</p>
<p>The other problem with peanut butter is that it is just so easy for it to hide in places one wouldn’t expect. Which really does leave the responsibility on the family to be relentless in making sure it isn’t present. While a kid might have a right to something and principles are important, among the ugliest phrases in the English language is “if only.” “Janie would be alive if only I wasn’t so determined to send her to Tiny Liberal Arts School With one Kitchen and One Cafeteria that couldn’t accommodate her needs instead of Big University with countless cafeterias.”</p>
<p>Well, I’m not sure the Big University is necessarily more likely to be accommodating than the tiny LAC. It really depends on the attitude of the people who make the decisions–as well as how likely they are to do dumb things, which may be hard to tell in advance. My son went to Yale, which was generally pretty good about accommodations in all of the dining halls, although they didn’t keep the PB separate enough. But then, one day, they had a special peanut dinner sponsored by the Peanut Council in which all the dishes in all the dining halls except one featured peanuts. Now it was nice that one dining hall didn’t participate, but all the others were significantly cross-contaminated. It was a stupid thing to do. Maybe the folks at the tiny LAC would have turned down the free peanuts.</p>
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That’s not the point I was making. What I was saying was that if a particular place seems unsuited, for whatever reason, to be able to reach an acceptable level of security, then pick a different school. We always tell kids that there are plenty of schools that could be a good fit. This is that. If it’s not a good fit in this circumstance, the mistake could be fatal, rather than resolved by a transfer later. This is simply not a battle worth sacrificing the life of one’s child over. And it’s not a battle about attitudes. It’s the schools which logistically or physically can’t be made safe enough or would require such expensive and far-reaching changes.</p>
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I agree with this, and especially if the kid has a severe allergy, it would be important to find out what the school actually does, and not just what they say. They might give lip service to accommodating allergies, but actual practice may be sloppy.</p>
<p>For somebody like my son, I think he could have coped at most colleges–the difference would have been how much inconvenience he would have had to endure to avoid ingesting nuts. He might have had to limit what he ate more at some colleges than others. As it was, he didn’t eat very many baked goods in the dining hall, often including bread, because of the risk of cross-contamination. There were always things he could eat though–except on peanut night.</p>
<p>@390, 392:</p>
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<p>[Socioeconomic</a> Status Linked to Childhood Peanut Allergy](<a href=“http://www.acaai.org/allergist/news/New/Pages/SocioeconomicStatusLinkedtoChildhoodPeanutAllergy.aspx]Socioeconomic”>http://www.acaai.org/allergist/news/New/Pages/SocioeconomicStatusLinkedtoChildhoodPeanutAllergy.aspx)</p>
<p>The incidence of peanut allergy may be much higher in the population of college students, especially at private colleges, than in the population at large.</p>
<p>Our local public school switched to peanut- & nut-free status some years ago. Some parents pushed for it. There are substitutes for peanut butter–sunbutter, and soynut butter. Even if a university has multiple dining halls, food purchases and food preparation may well be centralized, for efficiency of scale. Any system can have lapses–the wrong bread gets routed to the wrong dining hall, and the university has a lawsuit on its hands. </p>
<p>I found multiple instances of a severe nut allergy defined as a disability under ADA online. “Reasonable” would be in the eye of the beholder, of course. What if the dining halls are peanut-free, but there’s a PBJ kiosk on campus, for those who can’t live without peanut butter?</p>
<p>It’s a free country. Students and families are also free not to apply to a college because the dining hall doesn’t offer peanut butter.</p>