Emergency Epinephrine Use for Food Allergy Reactions in Chicago Public Schools

DeSantiago-Cardenas, Lilliana; Rivkina, Victoria; Whyte, Stephanie A; Harvey-Gintoft, Blair; Bunning, Bryan; Gupta, Ruchi S.

doi:10.1016/j.amepre.2014.09.005

Cited by 45 publications

(38 citation statements)

References 16 publications

(20 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…29 The results can be lifesaving; in Chicago alone, 38 epinephrine autoinjectors were used in 1 year, with >50% by children with no known history or documentation of allergic reactions. 30 Additionally, work must be done to ensure that families can access safe foods at low cost. All grocery stores should have designated aisles for affordable foods free of the most common allergens.…”

Section: Discussionmentioning

confidence: 99%

Socioeconomic Disparities in the Economic Impact of Childhood Food Allergy

et al. 2016

Self Cite

View full text Add to dashboard Cite

We compared direct medical costs borne by the health care system and out-of-pocket costs borne by families for children with food allergy by socioeconomic characteristics. METHODS:We analyzed cross-sectional survey data collected between November 2011 and January 2012 from 1643 US caregivers with a food-allergic child. We used a 2-part regression model to estimate mean costs and identified differences by levels of household income and race or ethnicity. RESULTS:Children in the lowest income stratum incurred 2.5 times the amount of emergency department and hospitalization costs as a result of their food allergy than higher-income children ($1021, SE ±$209, vs $416, SE ±$94; P < .05). Costs incurred for specialist visits were lower in the lowest income group ($228, SE ±$21) compared with the highest income group ($311, SE ±$18; P < .01) as was spending on out-of-pocket medication costs ($117, SE ± $26, lowest income; $366, SE ±$44, highest income; P < .001). African American caregivers incurred the lowest amount of direct medical costs and spent the least on out-of-pocket costs, with average adjusted costs of $493 (SE ±$109) and $395 (SE ±$452), respectively.CONCLUSIONS: Disparities exist in the economic impact of food allergy based on socioeconomic status. Affordable access to specialty care, medications, and allergen-free foods are critical to keep all food-allergic children safe, regardless of income and race.

show abstract

Section: Discussionmentioning

confidence: 99%

Socioeconomic Disparities in the Economic Impact of Childhood Food Allergy

et al. 2016

Self Cite

View full text Add to dashboard Cite

show abstract

“…Unfortunately, this has also allowed for wide variations in the provision of allergen information to consumers across the EU. 57 The supply of AAI to schools is not without cost and may only be cost-effective where a school's own supply can be used instead of a child having to provide their own devices 58 ; this may not be a disadvantage, as limiting the number of AAI in schools may improve staff familiarity with emergency procedures and avoid the issues with school children failing to remember to bring their own AAI to school on a daily basis. 14,15,17,20-25 Important data have been generated by a pilot study in Chicago (USA) where all public and charter schools were provided with AAI in 2012 (with commercial funding).…”

Section: Advantages Limitations Advantages Limitationsmentioning

confidence: 99%

Food‐induced fatal anaphylaxis: From epidemiological data to general prevention strategies

Pouessel

Turner

Worm

et al. 2018

Clin Experimental Allergy

137

View full text Add to dashboard Cite

Background: Anaphylaxis hospitalizations are increasing in many countries, in particular for medication and food triggers in young children. Food-related anaphylaxis remains an uncommon cause of death, but a significant proportion of these are preventable.Aim: To review published epidemiological data relating to food-induced anaphylaxis and potential risk factors of fatal and/or near-fatal anaphylaxis cases, in order to provide strategies to reduce the risk of severe adverse outcomes in food anaphylaxis. Methods:We identified 32 published studies available in MEDLINE (1966MEDLINE ( -2017, EMBASE (1980EMBASE ( -2017, CINAHL (1982CINAHL ( -2017, using known terms and synonyms suggested by librarians and allergy specialists.Results: Young adults with a history of asthma, previously known food allergy particularly to peanut/tree nuts are at higher risk of fatal anaphylaxis reactions. In some countries, cow's milk and seafood/fish are also becoming common triggers of fatal reactions. Delayed adrenaline injection is associated with fatal outcomes, but timely adrenaline alone may be insufficient. There is still a lack of evidence regarding the real impact of these risk factors and co-factors (medications and/or alcohol consumption, physical activities, and mast cell disorders).Conclusions: General strategies should include optimization of the classification and coding for anaphylaxis (new ICD 11 anaphylaxis codes), dissemination of international recommendations on the treatment of anaphylaxis, improvement of the prevention in food and catering areas, and dissemination of specific policies for allergic children in schools. Implementation of these strategies will involve national and international support for ongoing local efforts in relationship with networks of centres of excellence to provide personalized management (which might include immunotherapy) for the most at-risk patients. K E Y W O R D Sanaphylaxis, fatal anaphylaxis, fatality, food-induced anaphylaxis, mortality, mortality rate

show abstract

“…Anaphylaxis can also occur in children not previously identified as being at risk of anaphylaxis. In one US school's study, 55% of adrenaline autoinjectors (AAIs) for general use were administered to individuals not previously identified as being at risk of anaphylaxis, with similar findings (55%) in WA schools . A more recent survey base study of American schools reported that 21.9% of episodes of anaphylaxis occurred in individuals with no known allergy at all …”

Section: Reducing the Risk Of Anaphylaxis: Key Principlesmentioning

confidence: 79%

ASCIA guidelines for prevention of anaphylaxis in schools, pre‐schools and childcare: 2015 update

Vale

Smith

Said³

et al. 2015

J Paediatrics Child Health

View full text Add to dashboard Cite

Abstract:The aim of these guidelines is to assist staff in school and childcare settings to plan and implement appropriate risk minimisation strategies, taking into consideration the needs of the allergic child, the likely effectiveness of measures and the practicality of implementation. Although these guidelines include risk minimisation strategies for allergic reactions to insect stings or bites, latex and medication, the major focus relates to food allergy. This is due to the higher relative prevalence of food allergy in childhood (compared with other allergic triggers) and the higher likelihood of accidental exposure in these settings. Care of the allergic child in the school, pre-school or childcare settings requires accurate information obtained from parents and carers, staff training in the recognition and management of acute allergic reactions, planning for unexpected reactions (including in those not previously identified as being at risk), age appropriate education of children with severe allergies and their peers, and implementation of practical strategies to reduce the risk of accidental exposure to known allergic triggers. Strategy development also needs to take into account local or regional established legislative or procedural guidelines and the possibility that the first episode of anaphylaxis may occur outside the home. Food bans are not recommended as the primary risk minimisation strategy due to difficulties in implementation and lack of proven effectiveness.

show abstract

Emergency Epinephrine Use for Food Allergy Reactions in Chicago Public Schools

Cited by 45 publications

References 16 publications

Socioeconomic Disparities in the Economic Impact of Childhood Food Allergy

Socioeconomic Disparities in the Economic Impact of Childhood Food Allergy

Food‐induced fatal anaphylaxis: From epidemiological data to general prevention strategies

ASCIA guidelines for prevention of anaphylaxis in schools, pre‐schools and childcare: 2015 update

Contact Info

Product

Resources

About