Australia has the highest prevalence of food allergies in the world. More young people than ever are being diagnosed with nut allergies. How are schools and parents dealing with the issues? Claire Thwaites investigates.
A LOT of us would remember a time where a peanut butter sandwich was a lunchbox staple. That was a time where you sat around the playground at primary school and happily munched away, with no teachers batting an eyelid.
These times are long gone and schools now battle to cope with increasing pressure to cater to the growing number of students who suffer from nut allergies.
Statistics produced last year by the Murdoch Institute show that 1 to 2 per cent of Australians have a food allergy.
They also show 10 per cent of children aged one have a food allergy. Based on Australian
Bureau of Statistics birth data from 2010, this is equal to about 29,700 infants across Australia.
Some of these infants will grow out of their allergy, but those diagnosed with peanut allergies will most likely have them for life.
Anaphylaxis guidelines - a resource for managing severe allergies in Victorian government schools states there are eight foods that cause 90per cent of food allergic reactions in Australia. These are peanuts, tree nuts (such as hazelnuts, cashews, almonds), eggs, cows' milk, wheat, soybean and fish and shellfish.
Anaphylaxis is a severe, rapidly progressive allergic reaction that is potentially life-threatening.
The symptoms of a mild allergic reaction include hives or welts, abdominal pain or swelling of the lips.
Anaphylaxis is more severe and symptoms can include difficulty breathing, swelling of the tongue and throat, as well as wheezing or coughing.
The guidelines state that students in the 10-18 age group are at a higher risk of suffering a fatal anaphylactic reaction.
The guidelines say a ban on peanut products within a school is not recommended and a school should not claim to be 'peanut or nut-free'.
"Evidence from experts indicates that this type of claim is not reliable and may lead to a false sense of security about exposure to peanuts and nuts," the guidelines state.
Lee Ann Green, principal of Eastwood Primary School in Ringwood, agrees with this philosophy. She says students need to learn lifelong skills about being vigilant and managing their own allergies.
"We request the parents don't send any products that contain nuts to school, particularly in the classes where we know we have a student who is allergic."
She says the school goes through medical plans for students to ensure consistent practices across the school, and they have Epi-pen (Epinephrine Auto-Injectors) training once a term.
"We believe we have adequate training and we do everything we need to do to provide a safe environment for students."
For Knoxfield mother of three Jessica Wallis, allergies are part of everyday life.
Her son Perry, 6, is allergic to all nuts including nutmeg and coconut, in addition to sesame seeds, sesame oil, raw eggs, dust mites, dogs, cats, pollen and latex.
She first became aware of Perry's allergies when he was just a year old in the playground and he sucked on a bread crust that had peanut butter on it.
"His airways just closed up - we went straight to hospital. He was referred to a specialist and we have been seeing one for five years."
Jessica says the most recent time Perry had a severe reaction was more than two years ago when he ate hommus.
She said it only took a few seconds before his tongue had swelled and he had huge blisters "the size of 20 cent pieces" on his lips.
"His face swelled up and his eyes closed, it was very scary."
Jessica estimates it took her "no more than 10 seconds" to administer his Epi-pen.
She and husband Paul-Simon are in the process of teaching Perry how to administer the Epi-pen himself should the need arise.
Perry goes to Carrington Primary School and Jessica says the school has been very vigilant.
"They have put out notes in the newsletter asking parents to be mindful and not to bring nuts."
Perry is the only student of about 220 at his school with a nut allergy.
"We are just very lucky he always knows to check."
Jessica believes the number of young people with allergies now is "absolutely" greater than it was when she was young.
"You meet a lot of parents with children who have anaphylaxis, but I find that if I am really uptight and stressed about it that will make Perry see it as negative.
"We know we need to be careful, but we also don't see the point of keeping him on the sidelines. He needs to live his life.
"As a parent you don't want your child to miss out."
Associate Professor Mimi Tang is the director of the department of allergy and immunology at the Royal Children's Hospital and the head of allergy and immune disorders research at the Murdoch Children's Research Institute. She says that over the past 50 years the instance of allergies including asthma, hay fever and eczema had grown substantially, but in the past 20 years food allergies have shown the greatest increases.
As part of her research, Professor Tang looked into the number of people admitted to hospital for anaphylaxis between 1994 and 2005 and found a 3?-fold increase.
"We really are in the middle of a food allergy epidemic," she says.
"This rapid rise has occurred too quickly for it to be due to our genes, so it must then be due to environmental factors."
Professor Tang says the food allergy problems were most evident in Western cultures and so far research suggested the fact we live in a sanitised environment was a factor in allergies increasing - "this reduces our exposure to the good bugs".
Other factors she mentions are reduced exposure to sunlight and therefore reduced vitamin D levels and a dietary change that has seen people eating less fish, fruit and vegetables.
"Omega 3 found in fish helps protect our bodies against allergies."
Professor Tang says no expert recommends food bans at schools, as it is up to the child with an allergy to "take some responsibility and manage their care".
That said, it doesn't seem very likely that the peanut butter sandwich will be making a playground comeback soon.