Food fears run amuck: Government outlaws aromas
Government officials in Sydney, Australia, have determined that employees must be protected from any exposure — the mere whiff of a scent of food that might be harmful to some. Officials have banned peanut butter sandwiches from a government building, which houses seven government agencies. According to the Daily Telegraph, employees were told in an email that the ban was put into place because “the smell could trigger a deadly allergic reaction.” As reporter Byron Kaye writes:
The Human Rights and Equal Opportunity Commission building in Sydney's CBD has outlawed all peanut products from the building for fear an employee could go into shock and die from the fumes. Taking the nanny state mentality to the extreme, the commission has begun erecting signs in hallways, kitchens and conference rooms declaring them a “Peanut Free Zone".... As well as the peanut butter sandwiches, the ban prevents staff from eating chicken satay, Pad Thai, Snickers bars, Crunchy Nut Cornflakes and anything else containing peanuts at work....Staff said they were “bemused" by the new rule but were prepared to obey it to save a colleague's life.
Once again, by not following science, government agencies perpetuate popular myths and heighten fears.
One of the most commonly held beliefs is that the odor from peanut products, such as peanut butter, can result in an allergic reaction and anaphylaxis, said Dr. Michael C. Young, M.D., assistant clinical professor of pediatrics, allergy and clinical immunology at Harvard Medical School in Boston. Dr. Young is also the peanut allergy expert, helped to develop the first guidelines for schools in managing food allergies as a member of the Massachusetts Dept. of Education Task Force on Anaphylaxis, and authored The Peanut Allergy Answer Book. In an article [available here] for the Food Allergy and Anaphylaxis Network, he said: “It is important to examine the scientific basis of these ideas before accepting them as fact.”
As he explained about the popular myth that the odor from peanut products could bring on a severe allergic reaction:
There are, in fact, a number of case reports in the medical literature of patients who report symptoms of difficulty breathing, chest tightness, skin rashes, itching, and various other symptoms—all from smelling peanut butter or being in the presence of peanut products. However, a recent blinded, placebo-controlled trial of children exposed to open peanut butter was unable to document any reactions.
Based on these reports of allergic reactions resulting from “inhalation”, many parents express concern that the mere presence of any peanut product can contaminate the surrounding airborne environment resulting in an entire room or area being unsafe for a child with peanut allergy. In evaluating these reactions from “airborne exposure,” it is important to remember several facts. First, allergic reactions to food are triggered by specific food proteins. Without contact with protein, there is no allergic reaction.
The study Dr. Young referenced was conducted by researchers at Mount Sinai School of Medicine. They took thirty young children with documented severe peanut-specific allergies (using IgE antibody testing and clinical anaphylaxis, contact reactions or positive reactions on double-blind, placebo-controlled oral challenges). These children underwent double-blind, placebo-controlled randomized exposures to peanut butter through skin contact and inhalation. Neither the children or researchers knew which exposure contained the peanuts or placebo (scent was masked with soy butter, tuna and mint) and contact exposure used soy butter with histamine. There were no serious reactions. They concluded that “casual exposure to peanut butter is unlikely to elicit significant allergic reactions,” even in at least 90% of highly sensitive children with peanut allergy.
Dr. Young’s article goes on to explain how food particles containing proteins can become airborne, such as during the peanut shelling process which can create a cloud of peanut particles, or releasing particles under pressure in an enclosed space; or high heat processing of peanuts; all of which can affect food industry workers. So, while there are case reports of severe asthma from airborne exposure to food in these extreme situations, “the typical inhalation reaction would be similar to that suffered by a cat-allergic person exposed to a cat walking into a room: itchy eyes, sneezing, and runny nose.” As he said, the “chance of a life-threatening anaphylactic reaction from airborne exposure is very small.”
But smelling peanuts or the odor of any other food cannot cause an allergic reaction, he stressed.
To understand this, we have to understand what actually happens when we smell an odor, he said. The chemicals responsible for the odor and flavor of foods, including peanuts, are volatile organic compounds but they have no protein and cannot cause allergic reactions. So, the reports that some have had reactions to the odor of peanuts is like the nocebo effect [see here, here and here], or a conditioned response to the fear of peanuts in those who’ve had a severe reaction.
“There is also the widely held belief that peanut residue found on surfaces such as sports equipment, toys, doorknobs, and washroom faucets can result in anaphylaxis,” he said. While an unpublished report from Canada said two children developed rashes after playing with basketballs handled by other children who had eaten peanut butter, the problem resolved once the balls were cleaned and they had no symptoms of anaphylaxis. His extensive research has found anecdotal reports of contact skin reactions in sensitive children but there are no reports of anaphylaxis, he said.
“There is no evidence that casual contact and minor exposure from inhalation or skin contact, have an additive or cumulative effect, resulting in a worsening of the overall allergy.” This knowledge that the most risky exposure remains direct ingestion should allay anxiety, he said.
It’s natural and necessary for families of children with severe peanut allergies to be meticulous in preventing their child’s exposure, said Dr. Young. However, the anxiety this causes, along with widely held beliefs that seem to make peanuts impossible to avoid, is stressful and makes factual information important.
PBS Kids also had an indepth interview with Dr. Young, answering parents questions and concerns about peanut allergies, what to do and how best to protect sensitive youngsters. If you suspect your child has food allergies, he said, it’s important to discuss it with a pediatrician and have legitimate allergy tests performed.
Several other concerns and myths about peanut allergies were discussed with Dr. Young on WebMD. One belief, for instance, is that children will develop allergies if their mothers eat peanuts while they’re pregnant or nursing, but he said there are no credible studies “to put anyone on a guilt trip.” While there are a number of recommendations out there, definitive studies do not exist showing that alteration of the diet during pregnancy or while breastfeeding impacts future allergy to peanuts, he emphasized. Another belief is that “each time a person is exposed...that the reaction may get worse, [but] this is actually a myth,” he said. On average, reactions tend to be similar from time to time, he said, but severity is unpredictable which is why it is always important for parents to be cautious and be prepared.
The government’s recent ban of peanuts from a government building because of fears that the mere smell could be deadly to someone with an allergy was based on no science. It reinforced fears and myths, while adding to feelings that even adults are vulnerable and need the government’s protection from the remotest possibility of harm. Explaining the facts could have, instead, helped to lessen those suffering “extremely distressed and anxious” concerns.