Læknablaðið - 01.01.2018, Blaðsíða 17

LÆKNAblaðið 2018/104 17
R A N N S Ó K N
Heimildir
1. Steinke M, Fiocchi A, Kirchlechner V, Ballmer-Weber B,
Brockow K, Hischenhuber C, et al. Perceived food allergy
in children in 10 European nations. A randomised telepho-
ne survey. Int Arch Allergy Immunol 2007; 143: 290-5.
2. Venter C, Pereira B, Grundy J, Clayton CB, Arshad SH,
Dean T. Prevalence of sensitization reported and objecti-
vely assessed food hypersensitivity amongst six-year-old
children: a population-based study. Pediatr Allergy
Immunol 2006; 17: 356-63.
3. Kavaliunas A, Surkiene G, Dubakiene R, Stukas R,
Zagminas K, Saulyte J, et al. EuroPrevall survey on
prevalence and pattern of self-reported adverse reactions
to food and food allergies among primary schoolchildren
in Vilnius, Lithuania. Medicina (Kaunas) 2012; 48: 265-71.
4. Kristinsdóttir H, Jónasdóttir S, Björnsson S, Lúðvígsson P.
Beinkröm hjá barni. Læknablaðið 2011; 97: 477-80.
5. Dogruel D, Bingol G, Yilmaz M, Altintas DU. The
ADAPAR Birth Cohort Study: Food Allergy Results at Five
Years and New Insights. Int Arch Allergy Immunol 2016;
169: 57-61.
6. Kristinsdóttir H, Clausen M, Ragnarsdóttir HS,
Halldórsdottir IH, McBride D, Beyer K, et al. Algengi
fæðuofnæmis hjá íslenskum börnum á fyrsta ári.
Læknablaðið 2011; 97: 11-8.
7. Sampson HA, Ho DG. Relationship between food-specific
IgE concentrations and the risk of positive food challenges
in children and adolescents. J Allergy Clin Immunol 1997;
100: 444-51.
8. Eller E, Kjaer HF, Host A, Andersen KE, Bindslev-Jensen
C. Food allergy and food sensitization in early childhood:
results from the DARC cohort. Allergy 2009; 64: 1023-9.
9. Dinakar C. Anaphylaxis in children: current und-
erstanding and key issues in diagnosis and treatment.
Curr Allergy Asthma Rep 2012; 12: 641-9.
10. Braganza SC, Acworth JP, McKinnon DR, Peake JE, Brown
AF. Paediatric emergency department anaphylaxis: differ-
ent patterns from adults. Arch Dis Child 2006; 91: 159-63.
11. De Swert LF, Bullens D, Raes M, Dermaux AM.
Anaphylaxis in referred pediatric patients: demographic
and clinical features, triggers, and therapeutic approach.
Eur J Pediatr 2008; 167: 1251-61.
12. Gaspar A, Santos N, Piedade S, Santa-Marta C, Pires G,
Sampaio G, et al. One-year survey of paediatric anap-
hylaxis in an allergy department. Eur Ann Allergy Clin
Immunol 2015; 47: 197-205.
13. de Silva IL, Mehr SS, Tey D, Tang ML. Paediatric anap-
hylaxis: a 5 year retrospective review. Allergy 2008; 63:
1071-6.
14. Wang J, Sicherer SH. Section On A, Immunology.
Guidance on Completing a Written Allergy and
Anaphylaxis Emergency Plan. Pediatrics 2017; 139 (3).
15. Deng Y, Misselwitz B, Dai N, Fox M. Lactose Intolerance in
Adults: Biological Mechanism and Dietary Management.
Nutrients 2015; 7: 8020-35.
16. Stamnaes J, Sollid LM. Celiac disease: Autoimmunity in
response to food antigen. Semin Immunol 2015; 27: 343-52.
17. Le TM, Kummeling I, Dixon D, Barreales Tolosa L,
Ballmer-Weber B, Clausen M, et al. Low preparedness for
food allergy as perceived by school staff: a EuroPrevall
survey across Europe. J Allergy Clin Immunol Pract 2014;
2: 480-2.
18. Lýðheilsustöð. Handbók fyrir leikskólaeldhús. http://
reykjavik.is/sites/default/files/skjol_thjonustulysingar/
Handbok_leikskolaeldhus_april_2009.pdf - mars 2017.
19. Winberg A, West CE, Strinnholm A, Nordstrom L,
Hedman L, Ronmark E. Assessment of Allergy to Milk,
Egg, Cod, and Wheat in Swedish Schoolchildren: A
Population Based Cohort Study. PLoS One 2015; 10:
e0131804.
20. Prescott SL, Pawankar R, Allen KJ, Campbell DE, Sinn J,
Fiocchi A, et al. A global survey of changing patterns of
food allergy burden in children. World Allergy Organ J
2013; 6: 21.
21. Dydensborg S, Toftedal P, Biaggi M, Lillevang ST, Hansen
DG, Husby S. Increasing prevalence of coeliac disease in
Denmark: a linkage study combining national registries.
Acta Paediatr 2012; 101: 179-84.
22. Karagiozoglou-Lampoudi T, Zellos A, Vlahavas G,
Kafritsa Y, Roma E, Papadopoulou A, et al. Screening for
coeliac disease in preschool Greek children: the feasibility
study of a community-based project. Acta Paediatr 2013;
102: 749-54.
23. Maki M, Mustalahti K, Kokkonen J, Kulmala P, Haapalahti
M, Karttunen T, et al. Prevalence of celiac disease among
children in Finland. New Engl J Med 2003; 348: 2517-24.
24. Stordal K, Bakken IJ, Suren P, Stene LC. Epidemiology of
coeliac disease and comorbidity in Norwegian children. J
Pediatr Gastroenterol Nutr 2013; 57: 467-71.
25. Ozen A, Boran P, Torlak F, Karakoc-Aydiner E, Baris S,
Karavus M, et al. School Board Policies on Prevention and
Management of Anaphylaxis in Istanbul: Where Do We
Stand? Balkan Med J 2016; 33: 539-42.
26. Protudjer JL, Jansson SA, Heibert Arnlind M, Bengtsson U,
Kallstrom-Bengtsson I, Marklund B, et al. Household costs
associated with objectively diagnosed allergy to staple
foods in children and adolescents. J Allergy Clin Immunol
Pract 2015; 3: 68-75.
ENGLISH SUMMARY
Introduction: The aim of the study was to explore prevalence of food
allergies and intolerances among children in preschools in Reykjavik,
Iceland. Also, to investigate how well preschools maintain a safe environ-
ment for children with food allergies.
Materials and methods: In 2014, a questionnaire designed specifically
for this study, was sent to 65 preschools. Forty-nine participated (75%)
representing a total of 4225 children. Prevalence of food allergy and
intolerance was determined based on medical certificates from physi-
cians delivered to the preschools. Descriptive statistics were used to
assess whether there were protocols related to food allergy, and if there
was a difference between schools based on staff‘s education and num-
ber of children.
Results: The prevalence of documented food allergies/intolerances in
children aged 2-6 years was 5%, 1% had severe allergy and 1% had
multiple food allergies. Lactose intolerance was most frequent (2%),
then milk allergy (2%) and egg allergy (1%). Only 41% preschools had
a protocol that was activated if food with an allergen was accidentally
given. Moreover, only 55% of preschools with children with severe
allergy reported all of their staff to have knowledge of symptoms related
to anaphylaxis and only 64% were trained to respond to an anaphylactic
shock. The education of preschool principals, kitchen employees and
number of children in preschool were not related to having an active
protocol at site.
Conclusion: Prevalence of food allergy and intolerance was 5% in
preschools in Reykjavik. Strategy for an active protocol related to food
allergy was lacking in 59% of pre-schools.
Protocols Related to Food Allergies and Intolerances in Preschools in Reykjavik, Iceland
Aðalheiður Rán Þrastardóttir1, Fríða Rún Þórðardóttir2, Jóhanna Torfadóttir1,3
1Centre for Public Health Sciences, 2University of Iceland, 3University hospital.
Key words: Prevalence, food allergy, food intolerance, safety protocol, preschools, children.
Correspondence: Jóhanna Torfadóttir, jet@hi.is