Precautions in school canteens for allergies

In recent years the prevalence of food allergies and anaphylaxis have been increasing. 7.5% of children currently suffer from a food allergy. According to the European Academy of Allergy and Clinical Immunology, 20% of allergic reactions occur in schools 1 . In this article we will see what precautions should be taken so that these allergic reactions do not occur in school canteens.

The foods that are frequently involved in an allergic reaction are cow’s milk, egg, fish, anisakis, legumes, fruits and vegetables, nuts, seafood, cereals, legumes, additives and sports-induced. The egg being responsible for the greatest number of cases in 5-year-old children, followed by cow’s milk. 

If you suspect that your child suffers from an allergy, consult your pediatrician or go to an allergist who can guide you. Another option is to obtain diagnoses or tests with Salud Savia or similar websites that provide budgets for consultations with allergists depending on your area of ​​residence.

What is a food allergy?

A food allergy is the adverse reaction suffered by people susceptible to an allergic substance in a food, usually a protein . This reaction is classified as non-toxic, since it only affects individuals who are hypersensitive to the allergen in question. This reaction is caused by an immune mechanism, that is, the individual’s own immune system recognizes the allergenic substance of a food as foreign and before it its defense mechanism is to create an allergic reaction. 

Symptoms may occur after contact, ingestion or inhalation of a food or latex. They vary widely among individuals, but can roughly be classified as:

  • Mild or moderate: Rash, hives, inflammation, itching, tearing, eye redness, nasal irritation, cough, abdominal pain, diarrhea, vomiting, blood in stool.
  • Serious: respiratory distress, asthma, hypotension, chest tightness, palpitations or dizziness. It can reach anaphylaxis and can produce until death.  

To avoid an allergic reaction the main treatment consists in the total elimination of the food involved from the diet. After the medical diagnosis, it is essential to contact a dietitian-nutritionist for the correct advice and adaptation of the allergic person’s diet to avoid possible nutritional deficiencies.

The role of the school, parents and the student himself in an allergy

What should the center do?

  • When the student enrolls in the center, a personal action plan will be formed, which will be included in the student’s academic record. Its objective is: the identification of the student, the establishment of preventive measures and the protocol to be followed in case of allergic reaction 1 .
  • Teachers must demonstrate a socializing attitude towards allergic students. The latter always has to participate in all the activities of the educational center and from this they have to normalize the use of any medication, including that which can be used in emergency situations 2 .
  • In educational centers with students with food allergies or intolerances, diagnosed and certified by a doctor, special menus adapted to those allergies or intolerances will be developed . In the event that it is not possible to assume such a menu, adequate cooling and heating means must be provided, so that the menu provided by the family can be preserved and consumed.

What can families or guardians do?

  • One of the main tasks that fathers, mothers or guardians have is to inform the student’s diagnosis center as soon as possible through a detailed medical report. 
  • Provide the educational center with the material and medication, prescribed and prescribed by a doctor or allergist. If necessary, they must also provide the necessary emergency material with an individual label containing the action plan.
  • Provide the school with written authorization so that if necessary the medication can be administered and disclaimer of the person administering the medication 2 .
  • In the event that the management of the school canteen depends on the AMPA, it would be the responsibility of the association to require the catering or cooking company accreditation and compliance with the HACCP (Critical Point Analysis) system.
  • Provide a list of products and additives that the student has to avoid. It is also very useful to provide the name of suitable and unfit brands. Although the list of ingredients of these will have to be reviewed by the kitchen staff constantly.

Student Precautions

  • Depending on your ability you should know what type of allergy you suffer, what it is, why it occurs and what are the main symptoms in the event of an emergency. 
  • Assist and actively collaborate, depending on their age and stage of development, teachers, medical staff and peers. 
  • You must learn to use emergency medication if necessary. Always with the supervision and help of an adult or doctor. 
  • It must carry with it an identification that facilitates the recognition of the allergy, both food and latex.

The role of the school canteen

The training of personnel is essential to avoid triggering an allergic reaction. Both kitchen staff and dining room monitors must have sufficient training in food allergy. It is essential that school canteen staff be able to identify the child without problems and know where rescue medication is found in an emergency.

In kitchen…

Both when storing and preparing a special menu, you have to have a place and exclusive utensils (iron, pans, ladles, etc.) , which must be separated from the rest. In case this is not possible, the special menu will always be prepared at the beginning of the day, extreme cleaning of all the utensils, as well as the work surfaces. Once prepared, it should be kept in the proper temperature and form, as well as being properly labeled and differentiated from the rest of the menus to avoid possible cross contamination. The cleaning protocol must also be carried out correctly . All surfaces must be scrupulously cleaned prior to the preparation of the special menu. 

As for labeling, it should be checked periodically, excluding all those products that contain traces, additives or as an ingredient the allergen itself. If there is any doubt, you should always consult with the parents / legal guardians and / or discard the product. Any label broken, stained and that cannot be read properly, incorrectly or incompletely must be a reason for rejection. 

As a general rule, raw materials that have not been in contact with the allergen in question will always be used in the kitchen : cooking water, first-use frying oil, batter flour, etc.

When making a special menu, we will always start from a baseline menu. From there, we will make the necessary adaptations, eliminating the allergenic ingredients, trying to make the special dish as close as possible to the basal menu dish.

Once the menu has been prepared following good practices, it will be stored in closed trays and correctly identified . In the event that the food was provided by the family itself or by an external catering, the same protocol will be followed. Menu identification, correct storage, heating and service. When heating the food, an exclusive oven, microwave or pot will be used or heated with the container closed. 

From the dining room itself …

As in the previous case, the monitors must know and have all the necessary information about the student’s allergy . 

Surveillance should be increased in these cases, without making a noticeable difference between students. This is essential to prevent students from exchanging food with each other. An easy way to achieve this is to always sit the student in the same place. In no case will we sit the child alone or apart from his peers.

When serving, we will always serve the student’s food with allergy first and on their own plate or tray. Avoiding bread rolls or salads to share. In order not to create differences between equals, a good solution is for everyone to have their own salad and piece of bread. 

We will only offer the child foods that do not contain the allergen and are therefore safe.

To avoid cross contamination, proper personal hygiene is essential. It must be carried out by all the children in the dining room. Therefore, good hygiene practices should be promoted, such as washing hands and teeth after eating.

Bibliography

  1. Spanish Association of people with food allergies and Latex (AEPNAA). Food and Latex Allergy Guide for Educational Centers and School Canteens . 2013
  2. Ministry of Education, Culture and Sports, Government of Spain, Ministry of Health, Social Services and Equality. Consensus document on recommendations for safe schooling of students allergic to food and / or latex. 2013: 60.

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