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2008-12-10 10:19:05
Measures to protect children with nut allergies are becoming increasingly
absurd and hysterical, say experts.
A peanut on the floor of a US school bus recently led to evacuation and
decontamination for fear it might have affected the 10-year-old passengers.
Such extreme steps to reduce exposure to nuts are not isolated and are fuelling
fear and anxiety, reports the British Medical Journal Online.
A UK allergy expert said a similar "epidemic" was present in Britain.
'Gross over-reaction'
Professor Nicolas Christakis, a professor of medical sociology at Harvard
Medical School, told the BMJ there was "a gross over-reaction to the magnitude
of the threat" posed by food allergies, and particularly nut allergies.
In the US, serious allergic reactions to foods cause just 2,000 of more than 30
million hospitalisations a year and comparatively few deaths - 150 a year from
all food allergies combined.
In the UK there are around 10 deaths each year from food allergies.
Professor Christakis said the issue was not whether nut allergies existed or
whether they could occasionally be serious. Nor was the issue whether
reasonable preventative steps should be made for the few children who had
documented serious allergies, he argued.
"The issue is what accounts for the extreme responses to nut allergies."
He said the number of US schools declaring themselves to be entirely "nut free"
- banning staples like peanut butter, homemade baked goods and any foods
without detailed ingredient labels - was rising, despite clear evidence that
such restrictions were unnecessary.
"School entrances have signs admonishing visitors to wash their hands before
entry to avoid [nut] contamination."
He said these responses were extreme and had many of the hallmarks of mass
psychogenic illness (MPI), previously known as epidemic hysteria.
Fuelling fear
Often seen occurring in small towns, schools and other institutions, outbreaks
of MPI involve healthy people in a flow of anxiety, most often triggered by a
fear of contamination.
Being around individuals who are anxious heightens others' anxiety, leading to
a self-perpetuating cycle which can spiral out of control.
"Well intentioned efforts to reduce exposure to nuts actually fans the flames,
since they signal to parents that nuts are a clear and present danger," said
Professor Christakis.
John Collard, nurse consultant and clinical director of Allergy UK, said people
in Britain were also going overboard in their reaction to allergies.
"I heard a similar story in the UK about a school making children wear gowns
over their clothing during meal times so there would be no contamination fear
from milk.
"There is a tendency to go over the top.
"Food allergies can be deadly, and every death is clearly a tragedy so we need
to do what we can to prevent them. But you have to balance that against the
impact on the quality of life of everyone else.
"The risk has been blown out of all proportion."
He said most people with diagnosed food allergies had only mild reactions.
Also, many cases labelled as food allergy were simply intolerance to food and
posed no health threat, he argued.
Food labelling is also to blame for fuelling fear, according to Mr Collard.
"People read on food labels that a product has been made in a factory with
nut-based products and it creates the impression that nuts are everywhere."
He said some parents avoided taking their children to birthday parties and
restaurants because they were worried about triggering an allergy.
However, a recent study has suggested that early exposure to peanuts actually
reduces, rather than increases the risk of allergy.
Mr Collard said this might well change the current advice to avoid eating nuts
for the first years of life.