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Tuesday, July 29, 2014
If peanuts or peanut products are consumed on a school bus, how long is there an airborn threat to children with peanut allergies? Can children, days later, be exposed to peanut allergins in the air if they were not present when the original peanut product was consumed but are now on the same bus? (Even if no residual peanuts or peanut butter exists)
The American Association of Allergies, Asthma, and Immunology state that it is rare for airborne peanut fumes to cause an allergic reaction. Direct contact with peanut protein and ingestion of peanut protein are likely to promote reactions in peanut allergic persons, while non-ingestion contact is very unlikely to provoke reactions.
The conditions in which it has occurred are when people are eating peanuts from the shell in an enclosed space causing small particles of peanut protein to accumulate in the air or when peanut oil is used for frying and remains in the air. In a study published in 2004 by researchers at Johns Hopkins, extensive simulations of peanut allergen distribution in the air and on surfaces in schools found only a very small amount of allergen on surfaces and none in air samples.
Peanut protein allergens are readily removed from hands and surfaces by washing with soap and water, but not with hand sanitizers or antibacterial wipes. Both hand sanitizers and wipes are used more frequently today than are soap and water.
The safest strategy for school buses, where children may consume peanut products, would be to wipe the seats and mop the floors with a water and detergent solution and to open the windows to thoroughly air the bus after the morning run and at the end of the day.
Despite the prevalence of peanut allergy among children and the severity of the reactions, there is little research evidence to guide strategies to limit and eliminate peanut allergen exposure in child care, preschool, and school settings. The best strategy is still for parents to make sure their child always has an emergency plan in place and an epi-pen handy to treat exposures.
Mary M Gottesman, PhD, RN, CPNP, FAAN
Professor of Clinical Nursing
College of Nursing
The Ohio State University