PB&J sandwich debate: Should allergies lead to nut ban?

SALT LAKE CITY — An increasing number of children are allergic to peanuts, sparking some school districts to ban the nut entirely from school grounds. But when a lunchroom supervisor recently confiscated a homemade peanut butter and jelly sandwich from a child in Viola, Ark., it sparked a heated debate that has raged on Facebook, news sites and blogs.

"Denise Clifton-Jones started the discussion when a teacher noticed her son, Jenkins, had brought a peanut butter and jelly sandwich to eat in the lunch room. The teacher took the sandwich, helped him get a lunch tray and sent home a note explaining the no-peanut products policy, which was discussed at the school's open house before school began," Area Wide News reported.

The school ban on peanut products has been in place at the grade school for six years, School Superintendent John May said.

"Some parents believe allergy-free students shouldn't have to cater to a few kids' health sensitivities, particularly if it means cutting out healthy or low-cost snacks packaged in their own child's lunchbox," an article on Yahoo.com summarized the controversy.

The Centers for Disease Control and Prevention says that 4 percent of children have some kind of food allergy. Peanut allergies probably occur in about 1 percent of children but they are the most common cause of life-threatening food reactions. The center lists eight foods that account for 90 percent of all food-allergy reactions: cow’s milk, eggs, peanuts, tree nuts (such as walnuts, pecans, hazelnuts, almonds, cashews, pistachios and macadamia nuts), fish, shellfish, soybeans and wheat.

Symptoms of a food allergy can include hives, tingling in the mouth, swelling in the tongue and throat, trouble breathing, cramping, vomiting or diarrhea, skin rashes, wheezing or coughing, dizziness, loss of consciousness, and even death. A 2010 study published in the journal Pediatrics noted that the most serious risk is anaphylaxis, which involves swelling and closure of the airways. Without prompt intervention, it can lead to death.

"In cases of fatalities from food allergy among preschool- and school-aged children in the United States, nine of 32 fatalities occurred in school and were associated primarily with significant delays in administering epinephrine," the study said.

Not quite one-fifth of food allergy reactions have occurred in schools. The CDC noted that one-fourth of the children who experienced a food allergy at school had not previously been diagnosed.

No one disputes that peanut allergies can be very serious, even lethal. Such deaths are rare — about 100-150 a year in the United States across all food allergies. And there are even conflicting views on how that occurs or what level of exposure is dangerous.

Linda Cross, author of several books on food allergies, writes on her website foodallergybooks.com: "The biggest problem in the school setting is food residue. When the other children eat they get food on their hands, and the residue of this food can end up all over the school. ... If the food-allergic child accidentally touches some of this food residue and then rubs his eyes or nose, or touches and eats his food, a life-threatening reaction can be triggered. Peanut butter is an especially troublesome food. This is because peanuts tend to cause the most severe reactions from the smallest amount of exposure, and peanut butter is a sticky and oily substance that is not easily cleaned off of hands or other surfaces."

It is not realistic to expect a child to avoid touching any surface that may contain peanut residue, Cross said — especially with younger children.