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KMID : 1143120170070020092
Asia Pacific Allergy
2017 Volume.7 No. 2 p.92 ~ p.96
Medical certification reduces the number of children requiring allergen elimination diets for school lunches
Korematsu Seigo

Toyokuni Kenji
Handa Yousuke
Gotoh Chika
Wasada Rieko
Kato Rie
Kawano Nanae
Ikeuchi Mayo
Okamoto Tomoko
Kiriya Maki
Takahashi Mizuho
Takano Tomoyuki
Haigo Atsuhiko
Abstract
Background: Following the increase in the number of children with food allergies, support systems are now required for school lunches, but a large-scale factual investigation has not been carried out.

Objective: We evaluated the features of elimination diet due to food allergy and the support system in kindergartens and schools.

Methods: A prefecture-based questionnaire survey regarding measures for food allergies in school lunches of all kindergartens, public elementary schools, and public junior high schools (631 facilities) was conducted in Oita Prefecture, Japan.

Results: The recovery rate of the questionnaire was 99.5%, which included 106,008 students in total. A total of 1,562 children (1.5%) required elimination diets. The rate of children on elimination diets in kindergartens and elementary/junior high schools that required medical certification by a physician was 1.2% (324 among 27,761 children), which was significantly lower than the 1.8% of children (1,227 among 68,576 students) on elimination diets at the request of guardians without the need for medical certification (p < 0.0001). A total of 43.9% of the kindergartens and schools said that they would contact guardians if symptoms were observed after accidental ingestion, while a low 8.1% stated that they provided support to children themselves, including the administration of adrenaline auto-injectors.

Conclusion: Medical certification reduces the number of children requiring elimination diets, but it has not been adequately implemented. Furthermore, waiting to contact guardians after symptoms are observed may lead to the delayed treatment of anaphylaxis. Cooperation between physicians and teachers is desired to avoid the overdiagnosis and undertreatment of children with food allergies.
KEYWORD
Food allergy, Anaphylaxis, School lunches, Medical certification
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