Removal of peanut allergen Ara h 1 from common hospital surfaces, toys and books using standard cleaning methods

Allergen Removal and Transfer with Wiping and Cleaning Methods Used in Retail and Food Service Establishments

ABSTRACT

Preventing the transfer of allergens from one food to another via food contact surfaces in retail food environments is an important aspect of retail food safety. Existing recommendations for wiping and cleaning food contact surfaces is mainly focused on preventing microorganisms, such as bacteria and viruses, from contaminating foods. The effectiveness of these wiping and cleaning recommendations for preventing the transfer of food allergens in retail and food service establishments remains unclear. This project investigated (i) allergen removal from surfaces by wiping with paper wipes, terry cloth, and alcohol quaternary ammonium chloride (quat) sanitizing wipes; (ii) cleaning of allergen-contaminated surfaces by using a wash-rinse-sanitize-air dry procedure; and (iii) allergen transfer from contaminated wipes to multiple surfaces. Food contact surfaces (stainless steel, textured plastic, and maple wood) were contaminated with peanut-, milk- and egg-containing foods and subjected to various wiping and cleaning procedures. For transfer experiments, dry paper wipes or wet cloths contaminated with allergenic foods were wiped on four surfaces of the same composition. Allergen-specific lateral flow devices were used to detect the presence of allergen residues on wiped or cleaned surfaces. Although dry wipes and cloths were not effective for removing allergenic foods, terry cloth presoaked in water or sanitizer solution, use of multiple quat wipes, and the wash-rinse-sanitize-air dry procedure were effective in allergen removal from surfaces. Allergens present on dry wipes were transferred to wiped surfaces. In contrast, minimal or no allergen transfer to surfaces was found when allergen-contaminated terry cloth was submerged in sanitizer solution prior to wiping surfaces. The full cleaning method (wash-rinse-sanitize-air dry) and soaking the terry cloth in sanitizer solution prior to wiping were effective at allergen removal and minimizing allergen transfer.

HIGHLIGHTS

How to manage food allergy in nursery or school

PURPOSE OF REVIEW

The aim of this review is to describe effective management strategies in nursery or school based upon research findings.

RECENT FINDINGS

The prevalence of food allergy and number of emergency department visits for food-related anaphylaxis are increasing in children and adolescents. As there is currently no cure, the most effective strategy to decrease allergic reactions is food allergen avoidance. However, allergic reactions are inevitable in both food allergic children as well as in first-time reactors. Misconceptions exist on the safety of products with advisory labels and questions remain on whether school-wide bans decrease the risk of allergic reactions in school. Recent legislation has prompted schools to consider requiring unassigned epinephrine autoinjectors to better manage those who have allergic reactions in nursery or school.

SUMMARY

A collective effort is required to keep children with food allergies safe at school. Families, healthcare providers, and school personnel should be informed on food allergen avoidance strategies, symptoms consistent with allergic reactions and anaphylaxis, how to respond to allergic reactions, and the impact the diagnosis of food allergy may have on quality of life for affected children and their families.

The Allergist's Role in Anaphylaxis and Food Allergy Management in the School and Childcare Setting

Anaphylaxis and food allergy management in childcare facilities and schools are growing challenges. An increasing number of children experience severe allergic reactions on school grounds as evidenced by reports of epinephrine use. Data also suggest that the prevalence of food allergy may be increasing, with a large percentage of school-aged children at risk for anaphylaxis. Moreover, anaphylaxis may occur for the first time in a previously undiagnosed child at school or childcare setting, suggesting that general preparedness is essential. Management includes strategies for minimizing the risk of reactions and allergen exposures as well as readiness to recognize and treat allergic reactions of any severity. The primary objective of this report is to offer health care providers an overview of relevant evidence, resources, and expert opinion to assist with developing interprofessional collaborative counsel on school food allergy management and anaphylaxis preparedness with families, schools, and childcare settings. We present the current evidence base, suggest resources, and highlight areas of current controversy that warrant further study.