Examination of Food Hypersensitivity in Early Years Services, Schools (primary and secondary), and Nursing Homes on the Island of Ireland

Food allergy (FA) is defined as an adverse immunologic response to a food protein. Food-related allergic reactions are associated with a broad range of signs and symptoms that may involve any body system, including the skin, gastrointestinal and respiratory tracts, and cardiovascular system (Waserman et al., 2018). The most severe reaction is anaphylaxis, which is defined as a serious allergic reaction (Waserman et al., 2018).

Food hypersensitivity (FH) is a broad term encompassing both food allergies and intolerances (Johansson et al., 2001). While the prevalence of these conditions is not widely reported, it is estimated that approximately 1.75 million people have been diagnosed with coeliac disease (CD) (AOECS, 2015), and more than 7 million have been reported to suffer from food allergies (EAACI, 2015) in Europe alone. In Ireland, statistics show that approximately 5% of children and 3% of adults suffer from food allergies (INDI, 2019). An overall prevalence rate of 1% for CD has been suggested in EU populations (Mustalahti et al., 2010 & Caio et al., 2019) and rates of 0.5-1% have been reported in the Irish and UK populations (FSAI, 2015; Irish College of General Practitioners (ICGP), 2015; Coeliac Society of Ireland (CSI), 2019; Coeliac UK, 2019).

There is currently no ‘cure’ for a food hypersensitivity. Management of this chronic illness consists of strict avoidance of the “trigger” foods, and emergency medical intervention if accidental consumption occurs (Allen et al., 2014, Crevel et al., 2008, Helfe et al., 2007). While individuals with food allergy typically do not suffer the symptoms of their disease on a daily basis, as with other chronic illnesses, the need for constant vigilance regarding food places is a heavy burden on them and their families (Crevel et al., 2008, FSA, 2002, Miles, 2005). There are many studies highlighting the negative impact of food allergies on the quality of life (QoL) of those affected, their families, and caregivers (Sicherer, 2001, Cohen, 2004, Antolin-Amerigo, 2016). For example, Primeau et al. (2000) reported significantly more daily disruption

in the activities of children with a peanut allergy than for children with rheumatological disease (or other chronic illnesses examined). It is also notable that a study by the UK Food Standards Agency (FSA) found that food allergies were more costly both in terms of money and time (FSA, 2002; Jansson et al., 2014; Picarelli et al., 2014; Protudger et al., 2015).

This study examined and collected anonymised food hypersensitivity information (2,513 institutions were contacted) from public and private organisations in Ireland and Northern Ireland (NI). More specifically this study reports percentages of food hypersensitivity, food allergy and CD among 9,517 children in early years services, 3,233 school children (primary and secondary) and 2,139 residences of nursing homes on the Island of Ireland (IoI).