JHCCB-E-7: Strategies in Prevention and Management of Anaphylaxis in the School Setting

J: Students



It is impractical to achieve complete avoidance of all allergens. Schools are encouraged to find innovative ways to minimize the risk of exposure without depriving the anaphylactic child of normal peer interactions or placing unreasonable restrictions on the activities of other children in the school. One school developed a “red card” system, where any child who ate peanut butter left a red card on the table, signalling it as a high-risk area for the anaphylactic student until properly cleaned.


Providing Allergen-free Areas

Eliminating allergens from areas within the school, where the anaphylactic child is likely to come into contact with food, may be the only way to reduce risk to an acceptable level.

  • If possible, the classroom of an anaphylactic child is avoided as a lunch room.
  • If the classroom must be used as a lunch room, an “allergen free” area is established, using a co-operative approach with students and parents.
  • At least one common eating area, or a section of the single common eating area, is established as “allergen-free”.
  • Strategies are developed for monitoring allergen-free areas and for identifying high-risk areas for anaphylactic students.
  • As a last resort, if allergen-free eating areas cannot be established, a safe eating area for the anaphylactic child is provided. 

Establishing Safe Lunchroom and Eating-area Procedures

The most minute quantities of allergen can trigger a deadly reaction. Peanut butter on a friend’s hand could be transferred to a volleyball or skipping rope. Therefore, protection of the anaphylactic child requires the school to exercise control over all food products, not only those directly consumed by the anaphylactic student.

Anaphylactic students are required to eat only food brought from his or her home.

  • The sharing of food, utensils, and containers is discouraged.
  • The anaphylactic child is encouraged to take mealtime precautions like:
    • placing food on wax paper or a paper napkin rather than directly on the desk or table;
    • taking only one item at a time from the lunch bag to prevent other children from touching the food; and
    • packing up their lunch and leaving it with the lunch supervisor if it is necessary to leave the room during lunchtime.
  • A hand-washing routine is established before and after eating.  Success will depend on the availability of hand-washing facilities.
  • If the school has a cafeteria, the allergen, including all products with the allergen as an ingredient, is kept off the menu. In-service for cafeteria staff is provided, with special emphasis on cross-contamination and labelling issues.
  • If the school has a vending machine, products containing the allergen are not available.
  • Tables and other eating surfaces should be washed clean after eating, using a cleansing agent approved for school use.  This is particularly important for peanut-allergic students because of the adhesive nature of peanut butter.

Allergens Hidden in School Activities

  • Not all allergic reactions to food are a result of exposure at meal times.
  • Teachers, particularly in the primary grades, should be aware of the possible allergens present in curricular materials like:
    • play dough;
    • bean-bags, stuffed toys (peanut shells are sometimes used);
    • counting aids (beans, peas);
    • toys, books, and other items that may have become contaminated in the course of normal use;
    • science projects; and
    • special seasonal activities, like Easter eggs and garden projects.
  • Computer keyboards and musical instruments may be wiped before and after use.
  • Anaphylactic children should not be involved in garbage disposal, yard clean-ups, or other activities that could bring them into contact with food wrappers, containers, or debris.
  • Foods are often stored in lockers and desks.  Allowing the anaphylactic child to keep the same locker and desk all year may help prevent accidental contamination.

 Holidays and Special Celebrations

Food is usually associated with special occasions and events. The following procedures will help to protect the anaphylactic child:

  • the anaphylactic child is limited to food brought from his or her own home;
  • activities rather than food mark special occasions.

DMT Responsibility: AS-HR