March 3, 2010 (New Orleans) -- Some children with peanut allergies are at risk of potentially fatal allergic reactions because they don't have their lifesaving epinephrine medication on them at school, Canadian researchers report.
At issue are autoinjectors such as EpiPen or Twinject -- syringes filled with epinephrine and encased in a self-injecting device that can be used anywhere, anytime. For a person with food allergies, they're the first line of defense against anaphylaxis, a life-threatening condition characterized by difficulty breathing and loss of consciousness.
"Previous studies show the major factor controlling whether an anaphylactic reaction is fatal is whether or not the victim is carrying an EpiPen on himself," says Moshe Ben-Shoshan, MD, a research fellow in allergy at McGill University Health Center in Montreal.
"That means keeping the EpiPen on you, not in the locker or the nurse's office," he tells WebMD.
Ben-Shoshan references a young schoolgirl in Quebec who died from a fatal allergic reaction before she could get to her EpiPen in her unlocked school locker.
About Two-Thirds of Children Carry EpiPens at School
The researchers interviewed the parents of 706 children, aged 5 to 8, with documented peanut allergies throughout Canada.
The findings were presented at the annual meeting of the American Academy of Asthma, Allergy & Immunology (AAAAI).
Sixty-eight percent of parents said their children carried an autoinjector with them to school, starting just shy of their sixth birthday, on average. Of those, 80% said they believe that their child actually knows how to use the device.
Nearly three-quarters of the children who didn't have an EpiPen on their bodies kept it in the classroom or school nurse's office, but only two-thirds of these classrooms and offices were staffed by personnel who knew how to use the device.
About one-third of children who didn't carry an EpiPen attended schools that forbid them, Ben-Shoshan says.
No Set Age to Start Carrying EpiPen
There's no consensus regarding the age at which a child should start carry an autoinjector, he says. "It depends on the maturity of the child and if he knows how to use it," he says.
"But the decision shouldn't be made by the parents alone, but by the parents, teacher, and allergist," Ben-Shoshan says.
The majority of states have enacted legislation allowing peanut-allergic students to carry their EpiPens with them at school, and the AAAAI is supporting legislation extending the rule to all states, according to AAAAI outgoing president Paul Greenberger, MD, professor of allergy and immunology at the Northwestern University Feinberg School of Medicine in Chicago.
But it's not always practical for children to carry the EpiPens on their bodies, he says.
"It should be nearby, though -- not left at home," he tells WebMD.