The death of an 11-year-old student who was allergic to dairy products after she ate a school lunch in Chofu, Tokyo, in December 2012 has prompted a public discussion of how to prevent similar tragedies at school. To this end, the education ministry in March 2013 instructed boards of education across the nation to take necessary measures. This month, the ministry also plans to establish a panel of experts to develop new ways to prevent a recurrence of food-allergy accidents at school.
Although the plan came late, not only the ministry but also local governments, school authorities, teachers and school-lunch providers should take adequate steps to ensure that students will not be given food that can cause allergic reactions.
According to the 2007 ministry data based on surveys of public elementary and junior and senior high schools, about 330,000 students, or about 2.6 percent of the total, had food allergies. Surveys taken by the Tokyo Metropolitan Government every five years show that the percentage of 3-year-olds having food allergies increased from 9.4 percent in 1999 to 21.6 percent in 2009. The cause of the increase in allergies is not well understood but is under investigation.
It is regrettable that local governments as well as education and school authorities have failed to fully utilize tools made public in 2008 by the Japanese Society of School Health to prevent food allergy accidents.
Under the auspices of the organization and under the supervision of the education ministry, doctors and school health teachers worked out a guideline for schools to cope with allergic responses and a guidance table for school life management.
The guideline and the guidance table enable local governments and education and school authorities to take detailed measures to prevent allergy accidents. The guidance table has entries for allergens and drugs to be used in case allergic symptoms happen. Parents submit the table to schools after filling out the entries. The ministry should order officials concerned to make full use of these materials.
Food allergies can cause anaphylaxy, which rapidly affects a number of organs simultaneously. Anaphylactic shock, accompanied by a drop in blood pressure and loss of consciousness, can cause death. An injection of adrenaline alleviates anaphylaxy. These days, epinephrine auto-injectors for injecting adrenaline — which are supposed to be carried by allergic people at all times — are covered by the public health insurance system. A student to whom the auto-injector was prescribed, or his or her parent, is supposed to give the shot in an emergency. If a third party, such as a teacher, gives the shot, there is the possibility that they may be accused of violating the Medical Act.
In the Chofu accident, the student told the teacher not to give her the shot when the teacher inquired about it. Legal steps must be taken so that a third party can give adrenalin shots in such emergencies without worrying about being held liable later.
The government should also consider placing auto-injectors in public places, as is done with automated external defibrillators.