School Health Guidelines: Managing Food Allergies In School
School Health Guidelines:Managing Food AllergiesIn SchoolDepartment of Student Services, Alternative Programs & EquityMay 10, 20171
Alexandria City Public SchoolsSchool Health GuidelinesManaging Food Allergies in SchoolTABLE OF sGuidance for Developing a School-based Food Allergy Managementand Prevention PlanPractices for Reducing the Risk of Exposure to Food AllergensResponsibilities for Implementation of a School-based Food AllergyManagement and Prevention PlanA. Parent/GuardianB. School AdministratorC. Health Services CoordinatorD. School Nutrition Services DirectorE. School NurseF. School Clinic Personnel Including: Clinic Assistants and HealthClerksG. Classroom TeachersH. Facilities, Maintenance, and Custodial StaffI. Bus Drivers and School Transportation StaffJ. StudentsAppendicesA. Suggestions for Food Allergy Management and Prevention PlanB. Food Allergy Action PlanC. Standing OrdersD. Food Allergy References33356881013161821232728303131323335These guidelines have been compiled primarily from the following: Voluntary Guidelines for Managing Food Allergies in Schools and Early Care andEducation Programs prepared by the US Department of Health and Human Services,Centers for Disease Control and Prevention, National Center for Chronic DiseasePrevention and Health Promotion, and the Division of Population Health School Health Policy and Practice, 7th Edition, prepared by the AmericanAcademy of PediatricsQuotation marks and references have been omitted for easier readability.2
Alexandria City Public SchoolsSchool Health GuidelinesManaging Food Allergies in SchoolI. IntroductionExposure to allergens may lead to an allergic reaction known as anaphylaxis, “arelease of allergic mediators causing a severe systemic reaction, which may includewidespread hives, wheezing, problems breathing and swallowing, a feeling ofimpending doom, low blood pressure, and unconsciousness” (American Academy ofPediatrics, 2016). In school-aged children, food is the most common allergen leadingto allergic reactions. Since food allergies are becoming increasingly common (1 out ofevery 25 children in school), ACPS has developed guidance for the management offood allergies in the school.The most common food allergens are milk, eggs, peanuts, treenuts, fish, shellfish, soy, and wheat. If left untreated, anaphylaxiscan lead to death, though the majority of food related allergicreactions are not anaphylactic and death is rare (AAP, 2016).II. PurposeThe purpose of this document is to provide guidelines for school staff, parentsand students regarding food allergies and to assist building administrators in developingappropriate procedures to provide safe care for students with food allergies.It is the expectation that specific building-based guidelines/actions will take intoaccount the health needs and well-being of all children without discrimination orisolation of any child. Open and informative communication is vital for the creating andmaintaining a safe environment for all students and their families. These guidelinesalso encourage age appropriate student education and self-advocacy and will take intoaccount the developmental and educational level of students.III. GoalsThe Alexandria City Public Schools (ACPS) overall goals for management ofstudents with food allergies based on the American Academy of Pediatrics and theNational Association of School Nurses.3
ACPS Goals for the Management of Food AllergiesSafeguard the environment: Banning certain foods from school is not recommended. It provides a falsesense of security and is impossible to fully control what is brought into the school. It does not help the studentlearn to manage their own chronic allergic condition and removes a nutritional food staple that some studentsmust rely on for health. Adopting a “No Sharing of Food” policy, using individually wrapped and labeled foods,and teaching students about food allergies is researched based, best practice.Complete advanced planning for students with food allergies: Obtain from parents/guardians foodallergy action plans with individualized health care provider’s orders received by the school nurse thatguide treatment of the student at school, are communicated to the appropriate staff , and establishemergency action guidelines for school use in the event of an episode of anaphylaxis.Provide annual training: Teachers, administrators and staff will be trained on recognition andtreatment of anaphylaxis.Provide available epinephrine for student use: Provide accessible storage of individual student epinephrineand provide epinephrine for use in the school for an undiagnosed case of anaphylaxis.4
IV. Guidance for Developing a School-based Food Allergy Management andPrevention Plan1. Ensure the daily management of food allergies for individual children.a. Develop and use procedures to identify children with food allergies.b. Develop a plan for managing and reducing risks of allergic reactionscaused by food.c. Develop and implement a plan to encourage students to manage theirfood allergy.2. Prepare for food allergy related emergencies.a. Develop and implement a procedure for handling anaphylaxisemergencies that provides clear instructions for all staff members.b. Ensure epinephrine auto-injectors are easily accessible within the schoolboth for identified and unidentified students.3. Provide professional development on food allergies for school personnel.a. Provide general training for all staff members.b. Provide in-depth training for staff that has frequent contact with childrenwith food allergies.4. Educate children and family members about food allergies.a. Teach all children about food allergies.b. Teach parents and families about food allergies.5. Create and maintain a healthy and safe educational environment.a. Implement the practices for reducing the risk of exposure to foodallergens.b. Develop food-handling procedures to prevent food allergens fromunintentionally contacting another food.c. Make outside groups aware of food allergy policies and rules when theyuse school before or after hours.d. Ensure staff is trained in recognition and treatment of anaphylaxis.e. Create a positive school climate that reduces bullying and social isolationand promotes acceptance and understanding of children with foodallergies.5
V. Practices for Reducing the Risk of Exposure to Food AllergensSchool onAvoid use of food in thecurriculum. If food isrequired, notify parents ofall students of the use offood in the curriculum.Instruct students andstaff to avoid foodsharing.Train transportationstaff to recognizeanaphylaxis and useepinephrine autoinjectors if self-carriedby a student.Avoid ordering food fromrestaurants because foodallergens may be present,but unrecognized.Have rapid access toepinephrine auto-injectorsin cases of food allergyemergency and trainclassroom staff to usethem.Meals andSnacksUse non-food incentivesfor prizes, gifts, andrewards.Help students with foodallergies read labels offoods provided by othersso they can avoidingesting hidden foodallergensConsider methods toprevent cross-contact offood allergens fromlunches and snacksstored in the classroom.6Have rapid access toepinephrine autoinjectors in cases offood allergyemergency and traincafeteria staff and/orcafeteria hostesses touse them.Make reasonablemealaccommodations afterreceiving a signedFood Allergy ActionPlan from a healthcare provider.Create standardprocedures foridentifying studentswith known foodallergies identifiedwith a FAAP thatmeet FERPAField Trips andActivitiesConsider safety ofchildren with foodallergies whenplanning field tripsand/or schoolactivities.P.E. and RecessHave rapid access toepinephrine autoinjectors in cases offood allergyemergency and trainstaff to use them.Do not excludechildren or requireparent attendance forstudents with foodallergies.Avoid food on busesexcept by childrenwith special needslike diabetes orprolonged trips.Encourage studentsto clean hands beforeand after handling orconsuming food.Inform school nurse offield trips andactivities to ensurehaving rapid accessto epinephrine autoinjectors in cases offood allergyemergency and trainstaff to use them.Identify special needsbefore field trips oractivities.Package meals andsnacks appropriatelyto prevent crosscontamination.Encourage children towash hands beforeand after handling orconsuming food.Encourage children towash hands beforeand after handling orconsuming food.
requirements.Support parents ofchildren with food allergieswho wish to provide safesnack items for their childin the event of unexpectedcircumstances.Encourage children towash hands before andafter handling orconsuming food.Include information aboutchildren with specialneeds, including thosewith known food allergies,in instructions to substituteteachers.Clean all surfaces afterfood is used in theclassroom.Designate an allergensafe preparation area.If needed, will work toaccommodate foodlabels, recipes, andingredients whenrequested.Keep current contactinformation forvendors and suppliersso you can get foodingredient information.Be aware of foodlabels for potentialfood allergens.Wash all tables withsoap and water.Encourage children,school staff, andvolunteers to washhands before andafter handling orconsuming food.7
VI. Responsibilities for Implementation of a School-based Food AllergyManagement and Prevention PlanImportant Notice:Area responsibilities include shared as well as individualresponsibilities. Locate your role to read responsibilitiesimportant for you.A. PARENT/GUARDIAN1. Participate with the school’s coordinated approach to managing food allergies.a. Provide feedback, if needed, on the guidelines.b. Ensure the daily management of food allergies for individual students.Notify the school nurse or the principal or his/her designee if the schoolnurse is unavailable of your child’s allergies prior to the opening of schooleach year, during the enrollment process or as soon as possible after adiagnosis has been made.c. Provide the school nurse with a Food Allergy Action Plan from yourlicensed health care provider with a list of food allergens, symptoms thatmay occur, medication orders, and emergency contact information beforeyour child enters school.d. Deliver/provide approved medications in proper containers to the schoolnurse on the first day your child enters school and maintain a non-expiredsupply in the School Clinic for the duration of the school year.2. Educate family members about food allergies.3. Educate your child in the self-management of his/her allergy as age appropriate,including:a. Safe and unsafe foods;b. Strategies for avoiding exposure to unsafe foods;c. Symptoms of an allergic reaction;d. How and when to tell an adult they are having an allergy-related problem,ande. How to read food labels.4. Create and maintain a healthy and safe school environment.a. Consider purchasing a medical alert bracelet/necklace and encourageyour child to wear it at all times.b. Provide the school with safe snacks for your child and have this noted inthe IHCP. Provide a nonperishable lunch to keep in school in case yourchild forgets lunch one day.8
c. Investigate field trip destinations for potential issues (exhibits, activities)that may pose a risk, and inform your child’s teacher if you have anyconcerns.d. Provide the school administration and nurse with updated emergencycontact information including when any mobile/cell phone numbers arechanged.The most important thing you can do to preventanaphylaxis from food allergies at school istraining: Know how to recognize anaphylaxisand how to use auto-injection epinephrine.Food Allergy MythFood Allergy Fact“Nut-Free schools aresafest.”Comprehensivepolicies that includeprevention andpreparednessstrategies that applyto all allergens arecritical and cannot bereplaced by attemptsat specific allergenrestriction.www.allergyhome.org9
B. SCHOOL ADMINISTRATORSThe school administrator can be a principal, assistant principal, dean and academicprincipal.1. Lead the school’s coordinated approach to managing food allergies.a. Coordinate planning and implementation of a comprehensive Food AllergyManagement and Prevention Plan (FAMPP) for your school with theschool nurses.b. Make sure staff understand the school’s responsibilities under Section 504of the Rehabilitation Act of 1973, the Americans with Disabilities Act(ADA), the Individuals with Disabilities Education Act (IDEA), and theRichard B. Russell National School Lunch Act to students who are or maybe eligible for services under those laws. Make sure they understand theneed to comply with the Family Educational Rights and Privacy Act of1974 (FERPA) and any other federal and state laws that protect theprivacy of student information.c. Communicate school division policies and the school’s practices formanaging food allergies to school staff, substitute teachers, classroomvolunteers, and families.d. Make sure staff implements school division policies for managing foodallergies.e. Help staff implement the school’s FAMPP.f. On a regular basis, review and evaluate your school’s FAMPP and reviseas needed.Keep in mind the school administrator needs totake the lead to ensure proper care is given tostudents with food allergies in their schools.2. Ensure the daily management of food allergies for individual students.a. Make sure that mechanisms—such as health forms, registration forms,and parent interviews— are in place to identify students with foodallergies.b. Assist the school nurse as they work with the parents of children with foodallergies and their doctor to develop a written Emergency Care Plan (ECP)(sometimes called a Food Allergy Action Plan). This plan is needed tomanage and monitor students with food allergies on a daily basis, whetherthey are at school or at school-sponsored events. If a student has beendetermined to be eligible for services under Section 504 or, if appropriate,IDEA, make sure that all provisions of these federal laws are met.10
c. Share information about students with food allergies with all staff memberswho need to know, provided the exchange of information occurs inaccordance with FERPA and any other federal and state laws that protectthe confidentiality or privacy of student information. Make sure these staffmembers are aware of what actions are needed to manage each student’sfood allergy on a daily basis.Remember: The School Nurse is your expert inthe school on food allergies and is always readyto help.3. Prepare for and respond to food allergy emergencies.a. Make sure that responding to life-threatening food allergy reactions is partof the school’s “all-hazards” approach to emergency planning.b. Make sure that parents of students with food allergies provide epinephrineauto-injectors to use in food allergy emergencies, if their use is called forin a student’s ECP.c. Set up communication systems that are easy to use for staff that needs torespond to food allergy reactions and emergencies.d. Make sure that staff that are designated and trained to administerepinephrine auto-injectors can get to them quickly and easily.e. Prepare for food allergy reactions in students without a prior history offood allergies or anaphylaxis.f. Make sure that staff plan for the needs of students with food allergiesduring class field trips and during other extracurricular activities.g. Contact parents immediately after any suspected allergic reaction andafter a child with a food allergy ingests or has contact with a food that maycontain an allergen, even if an allergic reaction does not occur. If the childmay need treatment, recommend that the parents notify the child’s primaryhealth care provider or allergist.h. Document all responses to food allergy emergencies. Review data andinformation (e.g., when and where medication was used) from incidentreports of food allergy emergencies and assess the effect on affectedstudents. Provide input to modify your school division’s emergencyresponse policies and practices as needed.4. Support professional development on food allergies for staff.a. Make sure staff receives professional development and training on foodallergies annually.b. Coordinate training with the school nurses. Invite parents of students withfood allergies to help develop the content for this training, if needed.5. Educate students and family members about food allergies.11
a. Encourage the presentation of information about food allergies to raiseawareness among students.b. Communicate the school’s responsibilities, expectations, and practices formanaging food allergies to all parents through newsletters,announcements, and other methods.6. Create and maintain a healthy and safe school environment.a. Increase awareness of food allergies throughout the school environment.b. Emphasize and support practices that protect and promote the health ofstudents with food allergies across the school environment, during beforeand after-school activities, and during transportation of students.c. Make sure that students with food allergies have an equal opportunity toparticipate in all school activities and events.d. Reinforce the school’s rules that prohibit discrimination and bullying asthey relate to students with food allergies.Food Allergy MythFood Allergy Fact“Food allergies tofoods other than nutsare mild.”Practically any foodcan cause a reaction.Life threateningreactions can occurwith milk, eggs, wheat,and others.www.allergyhome.org12
C. HEALTH SERVICES COORDINATOR1. Participate in the school’s coordinated approach to managing food allergies.a. Help develop a school division’s comprehensive approach to managinglife-threatening food allergies that will support the FAMPP used in eachschool.b. Provide leadership and obtain the resources needed to implement thedivision’s comprehensive approach to managing food allergies.c. Promote, disseminate, and communicate the food allergy policies andpractices to all school staff, families, the school community, and the localmedical community.d. Know and educate others about federal and state laws, includingregulations and policies relevant to the obligations of schools to studentswith food allergies and make sure policies and practices follow these laws.e. Make sure the plans are review by the School Health Advisory Board.f. Create other plans as needed.g. Provide direct assistance to help schools develop procedures and plansfor monitoring students with food allergies, including, if appropriate,through Section 504 plans, or IEPs.h. Coordinate with other division staff, including the food service director,curriculum coordinator, and Chief of Student Services, AlternativePrograms, and Equity director.i. Make sure that food allergy policies and practices address competitivefoods (foods and beverages sold outside of the federal reimbursableschool meals program), such as those available in vending machines, inschool stores, during class parties, at athletic events, and during afterschool programs.j. On a regular schedule, review and evaluate the school division’s foodallergy policies and practices and revise as needed.The Health Services Coordinator will assistthe school administrators to develop safepractices within the schools.2. Ensure the daily management of food allergies for individual students.a. Help the school team responsible for the FAMPP write this plan. If astudent is eligible to receive services under Section 504 or, if appropriate,IDEA, make sure all provisions of these federal laws are met.b. Create standard forms, such as health forms, school registration forms,and ECPs, for schools to use to identify students with food allergies and13
develop individual management plans for them. Establish protocols fortasks related to developing management plans, such as how to interviewparents, get appropriate documentation from doctors, and coordinatemeals with food serv
A. Suggestions for Food Allergy Management and Prevention Plan 31 B. Food Allergy Action Plan 32 C. Standing Orders 33 D. Food Allergy References 35 These guidelines have been compiled primarily from the following: Voluntary Guidelines for Managing Food Allergies in Schools and Early Care and
Types of food environments Community food environment Geographic food access, which refers to the location and accessibility of food outlets Consumer food environment Food availability, food affordability, food quality, and other aspects influencing food choices in retail outlets Organizational food environment Access to food in settings
Food allergy is the most common trigger for anaphylaxis in school-aged children and is a growing concern for food safety and public health. According to the Voluntary Guidelines for Managing Food Allergies in Schools and Early Care and Education Programs, food allergies affect approximately 4%-6% of children, many of whom are school-age.
Food Fraud and "Economically Motivated Adulteration" of Food and Food Ingredients Congressional Research Service 1 Background Food fraud, or the act of defrauding buyers of food and food ingredients for economic gain— whether they be consumers or food manufacturers, retailers, and importers—has vexed the food industry throughout history.
Apr 07, 2020 · Food Webs and Food Chains Worksheet 1 Look at this food chain. lettuce greenfly ladybird thrush cat a What does the arrow mean in a food chain? b Name the producer in the food chain c Name the third trophic level in the food chain. d Name the tertiary consumer in the food chain. e What is the ultimate source of energy that drives the food chain?
6.2.5 Impact of food aid on food availability 153 6.2.6 Impact of food aid on food accessibility 153 6.2.7 Impact of food aid on food utilisation 154 6.2.8 Impact of food aid on vulnerability 154 6.2.9 Impact of food aid on local markets in Ngabu 154 6.3 RECOMMENDATIONS 154
food serial numbers as follows; No. 1 means food received food serial numbers from the Food and Drug Administration. No. 2 means food received food serial numbers from provinces. 5.5 The fifth series (YYYY) consist of four digits represent the order of food produced by each food production premises or importing premises separate licesors'
As modified from the School Guidelines for Managing Students with Food Allergies and Voluntary Guidelines for Managing Food Allergies In Schools and Early Care and Education Programs. Allergies can be life-threatening. The risk of accidental exposure to foods can be reduced in the school
others are just rough paths. Details are given in a document called the Hazard Directory. 1.3 Signals Most running lines have signals to control the trains. Generally, signals are operated from a signal box and have an identifying number displayed on them. Signals are usually attached to posts alongside the track but can also be found on overhead gantries or on the ground. Modern signals tend .
