Sunday, February 22, 2009

the War Rages On...

In light of Ben's anaphylaxis diagnosis I have put on my Warrior Mother armour plenty of times to stand up for Ben's rights and safety. I am not under the illusion that I am anywhere near finished so I took an opportunity to vent a little of my feeling on the subject to a Mr. Gardner of the Ottawa citizen for a very offensive, misguided and one sided article written on anaphylaxis called "Why we need to stop treating nuts as toxic waste" This obviously struck a nerve and I couldn't keep my mouth shut about it...or more accurately my fingers still.


Anyone with kids in elementary schools knows what the No. 1 killer of children is. It is peanuts.

Or at least one would think so, given the astonishing efforts schools are making to keep peanuts -- or nuts of any kind -- from contaminating classrooms.

Entire schools are declared nut free. Some have banned home-baked goods, or any food without labels that can prove they are untainted. Signs at entrances warn that nuts are contraband on the premises and ask visitors to wash their hands lest a few molecules of that morning's nut-bearing breakfast contaminate the sterile environment.

Nicholas Christakis, a physician and professor of medical sociology at Harvard University, has personal experience with nut alerts. At the school his children attend, a peanut was recently spotted on the floor of a bus. The children were rushed off as if anthrax had been discovered, and the bus was decontaminated.

This is all ridiculous, Christakis argued in an editorial published recently in the British Medical Journal. Nut allergies are real but the risk doesn't justify anything like these sorts of reactions. Worse, by treating nuts as if they are weapons of mass destruction, schools and other institutions promote false perceptions of the risk that cause needless anxiety and might actually make the problem of allergies worse.

"All told in the United States," Christakis says on the phone from Massachusetts, "about 150 people die each year from food allergies, all food allergies combined. That's children and adults."

Every death is a tragedy but that number has to be kept in perspective.

"A hundred people die from lightning strikes," Christakis says. "Fifty people die each year from bee stings. But we don't remove flowers from schools or playgrounds."

Meanwhile, "45,000 Americans die in motor vehicle accidents. More people die being walked or driven to school than die of nuts. And yet we don't close schools because they're a threat to children."

And then there's the sports children play at school. There are "10,000 hospitalizations each year from children suffering traumatic brain injuries acquired during athletics. And yet we don't see calls to ban athletics from schools."

There's nothing really unusual in this. Psychologists who study risk perception have found countless examples of tiny risks we worry about and substantial risks we don't.

Typically, though, our misperceptions don't have serious consequences. Most people worry more about air travel than they do about the drive to the airport, although the drive is usually the greater risk, but this seldom changes people's behaviour and so it doesn't really matter.

Not so nutophobia. "We are actually causing more harm than good with these responses," says Christakis.

By treating nuts like anthrax, schools "feed an epidemic of anxiety. And this epidemic leads to kids being tested and all kinds of minor allergies being detected." Growing numbers of kids labelled "allergic" leads to even more stringent anti-nut measures, in schools and elsewhere. That adds to the anxiety, which leads to more testing, and so on.

This sort of feedback loop can be found wherever there is disproportionate fear. I documented many of them in my book. Fears of school violence after the Columbine massacre led school officials and the media to look for any hint of student violence, which resulted in a stream of stories, and even more fear of school violence. The same thing happened in the panic over flying truck tires in 1997. And on a far greater scale after the 9/11 attacks.

But this particular feedback loop has a unique element. Children who are not exposed to nuts become more sensitive to them, Christakis explains. "So we're causing the very epidemic we're trying to stop."

This is not to say there is no risk. "Nut allergies definitely exist," Christakis emphasizes. "They can be very serious and life-threatening. It's just that we have overreacted."

There is no evidence that sweeping bans do anything for the safety of children that more modest interventions don't, Christakis argues. What should be done for the few students with serious allergies "depends on the circumstances. It needs to be targeted to ages. Two-year-olds share food and it's hard to stop them. Six-year-olds can be told not to. So nut-free tables would be reasonable. Making sure teachers know that a kid has an allergy is important. Making sure the epi-pen is available. Talking to the children about how to avoid exposure. There are a variety of things that can be done but the kinds of reactions we are seeing are extreme."

.Incidentally, the No. 1 killer of children is motor-vehicle crashes. Kids are actually quite safe in school, with or without nut bans. It's getting them there and back that deserves a little more of our attention.


In response to "Why we shouldn't treat nuts like they're toxic
saw this coming!

I read with saddeness and outrage your article. I am generally very good at
seeing both sides of an issue (albeit I am biased with this one)! I don't
feel you portrayed both sides of this one at all. I didn't see the side of
the anaphylactic child. You did not give canadian stats, talk about the
risks with epi pens and minimized unfairly an issue that is currently
getting worse not better.

I would never send my son to school with a loaded gun for show and tell. If he were to play with it chances are that he could seriously wound seven children and one would die. These are actually the same odds if I were to send him to school with a peanut butter sandwich. It is my son however that could die.

When Ben was seven months old a dog licked his face at a breeding kennel just before we left. Five minutes down the road Ben began developing hives, hundreds all over his face and neck, he turned blood red and his throat and mouth began to swell. I stared in horror at this child who I would do anything to save, helpless to do anything. Miraculously an ambulance was able to meet us on the highway and Ben would be fine. I however would never be the same again.

We went to an allergist that month and discovered Ben had anaphylactic allergies to tree nuts, peanuts and eggs. The dog who licked him had consume nuts shortly before. Since that day I have viewed the world differently. I wash down shopping carts, read the oils on hand lotions, call ahead to restaurants, cook our food from scratch, never leave home without at least two epi pens and antihistamine and we dread his first day of school. We are responsible for our son’s allergy. We do not expect others to understand it to the depth that they must to keep him safe and although this is a life threatening condition we are grateful that it is 100% preventable.

When I read articles like the one printed in the Ottawa Citizen I fill with fear once again. I am dumbfounded that someone would insinuate that my son’s life is not worth an inconvenience.

“Only”150 deaths a year was the statistic quoted for deaths attributed to anaphylaxis each year in the United States. Perhaps this number is lower then it would have been because of the precautions the author labels extreme. For a parent of a child with this condition however this number feels too high. To the parents of these people that are included in the statistic I would imagine that to them their child was much more then “only one”.
Is it really inconvenient to ask parents to not bring an item to school that could harm a portion of children at the school and even prove lethal for a couple? Can’t you put nuts in the school in the same category as guns, knives and poison, because the effects are potentially the same?

If my son in third grade had to sit away from his friends at lunch at an “allergen free” table like the author suggested that would be his last day of public school. Can you imagine anything worse to an eight year old boy then to sit away from the others and be automatically labelled “different”. I am sure this would do wonders for his self esteem and self image. I am once again shocked that common sense tells you this is a more reasonable solution then asking the other children to switch their peanut butter cookie for an apple. Keeping food away from these children is not keeping them safe anyhow as so much of the school supplies are shared. My son may return to class only to borrow a pencil from a boy who just ate a peanut butter sandwich and through cross contamination have a reaction. His epi pen could misfire, be injected incorrectly and an ambulance could be too late. You will think I am being overly dramatic when I suggest that he could die in minutes right there on the classroom floor. The fact is however that this reality is not much of a stretch and it was one hundred percent avoidable. By keeping the schools safer for all the children and asking children to make a (small) sacrifice for the sake of another child may even teach them some compassion and acceptance in the process. It may send the message that everyone matters equally and we make allowances and support for those whose needs are different.

Do I think that evacuating a bus in hysterics and disinfecting it because a lone nut was found on the floor was an over the top reaction. Of course I do. This was an isolated incidence and the majority of attitudes are made up of a quiet awareness. Even when schools are guaranteed nut free, parents of allergic children know they are only as safe as one mistake. I would hope my son is prepared for the worst regardless and do not teach him to have a false sense of security. It is however a decrease in risk every time another nut product is NOT brought into the school.

The argument that avoiding nut products heightens the risk of allergies developing is unfounded, considering we are talking about schools specifically. We are not asking that all nut products be banned completely, only that they are kept out of public schools were all children have the right to attend without fearing for their lives. There are twenty one meals to be consumed each week. Only five of these occur during school hours. Your child will have plenty of opportunity then to consume nut products.

Benjamin didn’t ask to be born this way and we didn’t do anything to cause it. He is otherwise a happy, funny, intelligent and well liked child who deserves every chance available to him. We are teaching him to be responsible for himself and a condition that shouldn’t be treated as a disability. We don’t expect others to make unrealistic accommodations for him but we do expect that he can be safe in school. In light of how many more children are being diagnosed with anaphylaxis it would seem that I speak for more and more parents of children with this condition that now more then ever we need to be doing more not less for in order to keep them safe until a vaccine is available. The most poignant argument remains that my child’s right to live supersedes your child’s right to eat a sandwich.

Jennifer Neeb


Ms. Neeb,

I've received many emails like yours. With due respect, they are all based
on a misreading of what I wrote -- I absolutely did not say that mere
inconvenience outweighs the risks to allergic children, or any of the
similarly vile thoughts attributed to me.

What I said is that the risks must first be accurately understood and then,
in devising protective measures, we must beware exaggerated responses
because these, too, can inflict harm. Reasonable people can disagree about
what the outcome of that investigation should be. But I don't think there's
anything unreasonable in looking at the problem this way. And I don't think
there's any cause to accuse someone who does look at the problem this way
of not valuing every child's life. That's simply unfair and untrue.

Dan Gardner


Mr. gardner,

Thank you for taking the time to read my letter. I did not mean to imply
that I believe you do not value the lives of all children, only that the
position you are taking in your article could lead some to read it this way.
I am included in this but would give you the benefit of the doubt since your
writing ability would lead me to conclude you are in fact a thinking,
feeling adult of intelligence who would not publicly write that the safety
measures put in place to protect children with allergies are too extreme.
You must admit however that perhaps if you are receiving many emails
challenging your viewpoint and suggestions, that you did not successfully
write your point as intended. If you lived for one day with a child with
allergies as severe as sensitive as mine has you would be grateful for any
ounce of prevention and support received in order to breath a tiny bit
easier. So some people freaked out a bus... at least they are being careful.
I would hope that you would consider the other side a little more thoroughly
next time you write on such a charged topic.

Thank you again for entertaining my rant.



Ms. Neeb,

You're right that if many people take a column a certain way, it may have been poorly written. But not this time. What people did repeatedly is read in the sorts of attitudes they have previously encountered -- people who really do see no reason why they should suffer even mild inconvenience for the safety of others. I understand their frustration, but as I say, that attitude is not my own.

Dan Gardner


No comments:

Related Posts Plugin for WordPress, Blogger...