Avoiding food allergy tragedies

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.

  • トム ( Tom )

    Working in the public school system, I see this all the time.

    The parents and students are very good with submitting food allergy information… But the “Over Worked” teachers don’t and can’t keep track.

    Intersiting about the Milk…. I have a milk allergy and I refuse the milk when I get my tray of food but there is no alternative.

    I would really like to know what Chofu was give the her inreplacement of the milk… Did they give her a Soy Milk Option?

    As far as I know, most elementary + middle public schools in Chiba don’t.

  • Masa Chekov

    What kind of risk is there for someone misapplying an epi pen? If someone acts and injects a person who is not in shock, is it a serious issue?

    If not, I wonder what the concern is for third parties to inject someone in distress.

    • Lexy

      Giving the epipen does not cause harm. In Australia we are trained “when in doubt, do it”. The deaths occur due to delays in administering epipen.

  • Japanese food culture in general has very little understanding about food allergy. It’s very difficult to get any food without dairy in it, and many professionals working in the field doesn’t seem to understand this fact. Not only at schools, this needs to be understood by general public and all the restaurants in this nation. A funny example is that I asked to bring a plain bread, not the buttery garlic toast mentioning I cannot have dairy food, and the waiter brings me plain bread with the butter on the side. He probably don’t know where the butter is coming from.

  • Disgusted

    Food allergies are very serious and education about it needs to greatly improve in Japan. My son has a peanut allergy and we only found out b/c the grandmother gave him a cookie w/ peanuts on it as a 2 yr. old. Told his preschool before school started but guess what was served the first day of school?! After that, they had a meeting and stopped serving peanuts for all meals and snacks.
    It is sad to see how many people look at you when you mention any kind of food allergy. Some Japanese TV shows have mentioned the food allergy problems, but the reaction is always the same from the guests and audience: “EHHHH… Never hear of this before. ”
    Step it up before another life is lost!

  • If the Japanese government wants to avoid future food allergy deaths, the only way to be consistent is to pull out of the TPP, which is sure to bring Western dietary problems and new allergies to Japan.

    “Yeah, this cedar tree is great! Let’s just plant a whole bunch without an environmental or human impact analysis! Yeah!”

    Meaning: “We feel obliged to do these things because our socialist democracy has so cramped the private sector that the country hasn’t been able to economically grow for the past 20-some years. Thus, instead of re-evaluating the effectiveness of our bloated programs and hands-in-every-pie political philosophy, let’s temporarily get a fiscal boost by sacrificing our long-term health! At least Taro-sama will get what he wants when old people start dying much earlier. On second thought, it’s a win-win situation, desu ne?