Allergic to Risk Analysis

I’ve come to expect robust skeptical discussion in online forums like this one, but I was encouraged last week to witness some of it “in the field”, as an anthropologist might say. I was doing my regular morning grade school drop-off, when I chanced to overhear a debate between my son’s kindergarten teacher and the mother of one of his classmates. It was a debate about the risk of an anaphylactic emergency at school, and what caught my attention was that — against stereotype — it was the mother clamoring for science and reason.

She was complaining about the new school requirement that her child, who is allergic to peanuts, wear an EpiPen waist-pouch during the daily half-hour lunchtime recess. The child already had an EpiPen stored in the school office, in accordance with Sabrina’s Law (discussed below), and the mother was loathe to purchase an extra, especially when she believed exposure to the elements would make the rather expensive pen degrade 3-4x faster. After discussion with her son’s allergist, she was confident that in the unlikely event of a reaction during recess, there would be ample time to retrieve the pen from the office and administer it within the required time frame, which she said was about 5 minutes after onset of symptoms.

The teacher disagreed, citing not just safety concerns, but the fact that she has two allergic children in her class and in the event of a double reaction, 5 minutes might not be enough if she first had to retrieve the pens from the office. Hogwash, said the mother, the likelihood of one lunchtime reaction is small enough — two concurrently is infinitesimal.

Now I was well aware that death by peanut allergy is an extremely low risk, but as tempting as was to simply use the mother’s statements to feed my own confirmation bias, I decided to resist that urge. Partly because I heard the talk track in my own head that started, “This is ridiculous, back when I was a kid…” and recognized it for the appeal to antiquity that it was. But mostly it’s because from a policy perspective, the school’s response to risk must rely not only on raw probabilities, but also on the cost to lower them further. In other words, if it’s cheap enough, policymakers may well strive to make rare risks even rarer.

Anaphylactic Allergies, By the Numbers

We’re fortunate to have up-to-the-minute, Canadian data in the form of the SCAAALAR study just completed by researchers at McMaster & McGill, and sponsored by Health Canada and the AllerGEN research network.  According to its findings, 1.68% of Canadian children are probably allergic to peanuts, 90% of which have had a severe reaction.

While that sounds bad — and indeed the study points out that Canadian food allergy rates are higher than those reported in most other countries — the reality is that the severest of consequences (death) is extremely rare.  A study by Anaphylaxis Canada found only 32 food allergy related deaths in Ontario in the 15 year span from 1986-2000. Twenty of these were from peanuts and tree nuts, and only 6 occurred at a school or camp. That last number is the relevant one here, suggesting that the annual school day mortality rate across Ontario is about 0.4, or one death every 2.5 years.

Policy Response, On the Cheap

At least that was the situation before Sabrina’s Law, enacted in 2005, which formalized the requirement for school boards in Ontario to establish and maintain an anaphylaxis policy that reduces the risk of exposure to anaphylactic allergens; train teachers on the risk and how to respond; and keep detailed case files and EpiPens in the school for students with anaphylactic allergies.

The Toronto District School Board fulfills this legislation via its Operational Procedure PR563, but leaves it up to individual schools how to implement its requirements.  Many schools, including my son’s, are completely nut-free, going far beyond what Sabrina’s Law dictates. In addition to not bringing any nut-based products, children are also not allowed to share food, so it’s a pretty restrictive regime.

There are two key things to note about these policy interventions. First, they’re cheap: other than training teachers, which may require an outside trainer once a year, all of them can be enacted with existing resources. The additional nut-free policy is completely free, putting all of the burden (really just an inconvenience “cost”) on parents. That’s certainly the right price for making a low risk even lower.

Second, there’s no way for an individual to achieve the same aims without such a policy. For example, an allergic student cannot themselves remove exposure risks or make teachers better prepared to deal with a reaction.

Quantifying the Reduction

Since Sabrina’s Law has only been in effect for 5 years, and the nut-free policies in many schools are even more recent, we won’t have actual data to show how much of a reduction we’ve seen for some time yet. However, we can make a reasonable estimate by analyzing each policy and the likelihood that it will make an impact.

While it’s tempting to think that the nut-free policies will reduce the risk to zero, that’s not likely the case. First, remember that nuts were the cause of only 62.5% (20/32) of the food-allergy related deaths in the study above. Second, we’ve got to discount that figure further for non-compliance with the policy, inadvertent or otherwise. Let’s say compliance with the “no-nuts” policy is 80%, and the “no-sharing” policy removes another half of the non-compliance risk. That means the whole policy might remove a total of (62.5% x 90% =) 56% of the risk, bringing the mortality rate down to one death every 5.7 years.

And that’s before taking into account Sabrina’s Law itself, especially the storage of student EpiPens and training of teachers to use them. It’s not a panacea. Given the time-sensitive nature of administration, and the possibility of human error, some proportion of students won’t get it in time. The Anaphylaxis Canada study provides some (albeit weak) indication of what this percentage might be, saying that 4 patients had epinephrine close by at the time of the reaction, and 2 died while trying to get to it. While these numbers aren’t large enough to provide statistical validity, 50% certainly seems like a reasonably conservative ballpark. If we’re correct, that brings the the death rate down to one death every 11.4 years.

Put another way, these policies should lower the number of deaths in each K-12 cohort from 5 to 1. Four children saved every 11.4 years isn’t a lot compared to interventions like seat-belts, but given the low cost, it’s hard to argue that the effort shouldn’t be made.

Debate to the Death

Getting back to the debate that started it all, let’s take a look at the statements made by the mother and the teacher, and see if they hold water. There are essentially two claims we need to consider:

  1. That the incremental benefit of wearing the waist pouch during recess justifies its costs; and
  2. That this is especially true because of the risk of multiple concurrent reactions.

We’ll take #2 first, and chalk up an easy win for the teacher. When looking at the probability of concurrency, you can only multiply probabilities when the two events are independent of one another. In this case, it’s not at all clear that they are, since the same anaphylactic allergen (say, a surreptitiously shared Snickers bar) could be the cause of both reactions. While that’s not the only scenario, it’s considerable enough that we should expect the likelihood of two concurrent reactions to be not much less than the risk of one. Nice work, Teach!

Claim #1 is a bit more nuanced, but just as easy to quantify. We first need to know what percentage of the overall risk can be attributed to that 30 minute period. It’s tempting to try to divide 30 minutes into a 6.5 hour school day, but that’s likely misleading, because the risk is not spread evenly over that time period. The majority of risk of food allergy can be expected to cluster around periodic “feeding events”. Let’s say there are 5 of those during an average day (3 meals, 2 snacks), two of which occur during the school day (1 meal, 1 snack), and one of those during or proximate to the relevant half-hour period. That means that ~50% of the exposure risk is in this period. But we’re not getting rid of that whole exposure risk, since as we saw above, the existing policies result in an EpiPen being administered half the time, so it’s just the other half that we’re reducing by 50%. That means that a policy of recess EpiPen carriage would reduce the mortality rate by another 25%, from one death every 11.4 years, to one death every 15.2 years.

Now we said above that interventions in low risk scenarios may be undertaken if the cost is cheap enough, but is that true here? Recall that the cost of the interventions above were not only absolutely low, but also spread out across the entire Ontario school-age population of 2.3 million kids, whereas the cost of this intervention falls squarely on the mother. An extra EpiPen is about $100 and lasts a year when stored properly. The mother contended it degrades 3-4x faster when exposed to the elements in the pouch, though I was unable to fully verify this contention. The manufacturer insert does say it should be stored at room temperature (25 degrees), with “excursions” permitted between 15 and 30 degrees, and that the pen should be replaced if the liquid is discolored. So it certainly seems plausible that a more rapid replacement schedule could be required due to extreme exposure, but the research from use by paramedics suggests otherwise.

So we’ll take the conservative position and say that the annual incremental cost of this intervention is merely the $100 to purchase the second EpiPen. Considering that it provides such a modest reduction in an already infinitesimal base rate, and since it’s something that an individual can do themselves even without such a policy, I’d have to fall on the side of making this an optional intervention at best. So chalk this one up for Mom.

Conclusion

It’s great to see some rational debate over risk in the schoolyard, and to hear parents standing on the side of the math. In the end, it seems clear that the parent is right in this case, but that’s not necessarily true with the prior interventions like Sabrina’s Law and nut-free schools, which make a rare risk even rarer at an appropriate price point.

As a parent of a (thankfully) non-allergic child, I may still grumble as I scour the ingredients  list of every granola bar I pack, but I can’t argue that my being slightly inconvenienced is worth a child’s life.

20 Responses to “Allergic to Risk Analysis”

  1. FamilyNature says:

    Great post.

    I’m the parent of four, one who outgrew a peanut allergy, one who has a suspected anaphylactic allergy to tylenol, and one who is allergic and at risk of anaphylaxis to dairy, eggs, bananas and tree nuts.

    Over the years I’ve noticed that different families treat anaphylaxis differently. I think it’s hard to say if any of us are doing things right or wrong. For me, I try to balance the risk and my fears — not always an easy task, I tell you! I could go crazy trying to prevent every possible contact with allergens but I try to be reasonable.

    Personally, I wouldn’t be comfortable with my child NOT having his epipen with him at recess. Recess is the time period in which an allergic reaction is most likely to happen; kids usually bring snacks out with them, or have just eaten (and probably not washed their hands afterwards), plus there is far less supervision at recess and children are often being supervised by teachers who do not know them well, and probably don’t know specific details about their allergies (if they even know about them at all).

    At our kids’ school there are probably a couple hundred kids being supervised by two teachers at recess. If you consider the time it would take for the child to realize that something was wrong, maybe tell their friends, friends to and get the teacher, the teacher comes over, asks questions and figures out what’s going on, then someone runs in for the epipen — I’d guess that a lot more than 5 minutes will have passed.

    I’m also not sure where the mum got 5 minutes. I’ve been told that cases in which there was an anaphylactic death, it was usually because an epipen wasn’t available, or it was not administered soon enough. I’ve never heard an allergist or anaphylaxis organization put a time on it; they usually just say to administer as soon as you notice symptoms and that once too much time has passed there is virtually no treatment. If given too soon, or even if the need is uncertain, there is no harm done. Too late and … well, it’s just too late.

    I think it’s also important to consider the teachers too. Given that (in my opinion) we focus much more on scaring people to death about anaphylaxis that we actually do preparing them for what to do in the case of an actual anaphylactic emergency, it is reasonable for a teacher to want to take the extra precaution of having that epipen carried with the child. I think it must at times feel like an enormous responsibly to teachers: trace amounts can kill, an anaphylacitc reaction will look different for every child, and often will even look different if the same child has a reaction on two different days. It must feel like they are in the presence of a ticking time bomb. Even for me — and I’ve seen my fair share of allergic and even anaphylactic reactions — I never know what’s going to happen if my kid accidentally ingests dairy, the reactions have varied so widely.

    In my opinion, proper anaphylaxis training for all staff that may come into contact with my child (gym teacher, librarian, music teacher, lunch monitors, etc.) is much more important than any food ban. I wrote a post a while back in which I try to explain why I don’t believe in food bans: http://familynature.wordpress.com/2009/09/30/why-i-dont-believe-in-food-bans/

    Good topic! I like seeing it discussed like this.

  2. Anna says:

    Your math isn’t completely correct. One epi-pen left in the office. What about at home in the evenings and weekends. Does this child not carry an epi-pen then? When my son started school I stopped carrying his epi-pen, and he started carrying it himself all the time. He’s worth at least $200 a year. ;)

  3. Simon M says:

    Hi Erik,

    While I appreciate the effort that you put into your numbers, I’m going to take issue with your approach. The reality is that circumstances involving an anaphylactic reaction boil down to a binary response – one of two options: one either has an Epipen that can be administered promptly, offering a high probability of survival; or one doesn’t, resulting in a high probability of death. No further analysis is necessary.

    That there may be an Epipen at the school office (which may be ‘manned’ by students at recess) in some drawer somewhere (maybe in a filing cabinet…) is effectively useless. To risk a child’s life on the assumption that somebody will be able to find and deliver the Epipen fast enough is crazy.

    Regarding the scenario you witnessed, there could be many subjective reasons for the mum’s argument. Perhaps she feels her child is old enough to handle him/her self; perhaps she has severe financial constraints; or maybe, she just doesn’t get it! To suggest that what seems to work for her is in any way broadly applicable is a leap of logic that I just don’t accept.

    My own experience started with the dreaded ‘appeal to antiquity’ you so wisely resisted. I plum didn’t believe in ‘peanut allergies’ (bah!) until I saw my son react to the peanut skin test. I was shocked, then scared, then humbled… then probably scared again. I’ve since seen an anaphylactic reaction, and the mere memory of it upsets me years later. This is just my personal two cents (appeal to emotion!), but I can’t see any justification in, or even a reason to try to justify, resisting that extra bit of care – and sometimes money – that goes with having kids with severe allergies.

    • Richard says:

      Hi Simon,
      I think Erik is significantly better at the math than you. You discard the broad risk of an event happening (anaphylactic reaction) for the immediate response to it. No rational decision can be made on that basis. If a meteorite hits your child’s school, if you sent him he will die, if you didn’t sent him he will survive. Yet, you choose to send your child to school because the risk of the (meteorite / terrorist attack / random shooting / etc.) is very low. The same logic applies to the anaphylactic reaction case.
      While you may feel the very small increase in safety the extra EpiPen provides justifies the cost, Erik presents a very good argument that it doesn’t.

      • Lisa says:

        The thing is, though, that the math isn’t quite that simple. According to FAAN, the average food allergic person has at least one reaction every few years no matter how careful that requires the epi pen and 911 transport to the ER for 4+ hours of monitoring. This is not a rare event. I’m VERY careful and my son has had about 6 anaphylaxis events in the past 6 years. Anaphylaxis will almost always self-resolve even without the epi pen. Most people won’t die even if they never have epi pens. But anaphylaxis is very unpredictable. Past reactions do not predict future reactions. Nearly all people who die of anaphylaxis did not get the epi in a timely way. It is true that if a person can get the epi within 5 minutes of a reaction becoming systemic that that should be safe enough. I have only heard of one fatality that happened within less than that time (and there certainly could be more). However, I agree with the above poster–counting on staff members to notice the start of a reaction becoming systemic and counting on them to be able to find the epi pen and retrieve it on time is a risk that I can’t discount as meaningless or compare to a meteorite strike. If we did that we could say that no one should need epis and those rare few who die–well they are just unlucky. Epi pens are easy to use, easy to carry, relatively inexpensive compared to the tragedies they can prevent, and I think they should be with allergic people at all times.

  4. Travis says:

    If my son had an allergy severe enough to require him to have access to an epi-pen to prevent his possible death, I couldn’t imagine putting him at any extra risk just to save $100 a year. I also wouldn’t have 100% faith that his teachers would get the job done. Too many things can go wrong when a child in the playground needs a pen that’s locked in a drawer inside the school. I’d want to do everything in my power to prevent any type of mishap.

    Let me ask you this, if your government came to you and told you that based on their back of the envelope risk analysis, the odds of your child catching polio are extremely small, therefore they can’t justify the incremental expense of providing a polio vaccination for your child, would you be ok with that?

  5. Erik Davis says:

    FamilyNature – you’re absolutely right that the teachers are generally acting in good faith, and I sympathize with them. Caring for another person’s child is a terrible responsibility that can often cause people to be more risk averse than they might be with their own child. (It’s that tension between sociology and psychology…a topic for another post). You also make some good points about food bans in your post that I hadn’t considered…the position of the major anaphylaxis organizations is quite salient. It sounds like you don’t live in Ontario or a jurisdiction with an equivalent to Sabrina’s Law, which here addresses your “Recognizing and Treating Anaphylaxis is Key” point, but I agree it’s way more important than bans.

    Anna – I think I was clear that I was only looking at the risk in the half hour recess, which was the subject of the discussion I witnessed. As I said above, this was primarily a discussion about the incremental safety provided by a specific policy intervention, relative to its costs.

    Simon – I think Richard captures the point I would have made.

    Travis – I don’t think I recommended a parent not pack a kid with an EpiPen pouch. I merely suggested that it didn’t make sense as a policy intervention, in part because it was something parents could do on their own without the help of government. As for your hypothetical, two points: (1) you can’t compare policy interventions for infectious diseases to food allergies — it’s a completely different set of public health concerns, and (2) if the risk were actually that low, then yes I would be OK with it, but since we know what polio did before the vaccine, I’m not sure what point you’re trying to make.

    • FamilyNature says:

      Erik: I do live in Ontario. The problem with Sabrina’s Law is that not all schools follow it the way they should. I have had some experience with the TCDSB and the TDSB and overall there is a real lack of consistency.

      In the case of the TCDSB, the Ontario Ministry of Education was investigating, on my behalf, our kids’ school for non-compliance with Sabrina’s Law. We ended up switching to a TDSB school (our kids had been on the waiting list and we found out at the last minute that they got in). Once we switched schools the Ministry dropped my complaint like a hot potato.

      Unfortunately, the anaphylaxis training required by Sabrina’s Law, is nothing more than a 30 second demonstration of an EpiPen trainer for some schools. For others it means a qualified trainer hired from Anaphylaxis Canada. It’s a real mix. Even with training, people often just don’t get it. I can’t tell you how many times people (including teachers who’d supposedly had anaphylaxis training) have said to me “Banana can cause a life threatening reaction? I thought it was just peanuts.”

      (Yes, in fact the one of the only anaphylactic reactions I’ve ever seen was my 2 year old son having an anaphylacitc reaction to a banana the very first time he ate one. At the time, neither me nor my husband recognized it as an anaphylactic reaction — and we’d had plenty of experience with food allergies by that point. It was only in hindsight that we realized that we’d really dodged a bullet.)

  6. Susan says:

    I don’t understand why the mother thinks she needs to purchase another Epipen. Presumably she keeps one on hand at home in case of emergencies. The mantra amoungst the allergic is “No Epi = no food.”

    All she really needs to do is find a way to keep the auto injector on the child. Belts made specifically for this purpose run from $14.99 to $149.99. Dollar stores often have fannypacks that can be used as well.

    To think that anyone could not afford to purchase this life saving medicine is outrageous! Canada has good health care coverage and if you can’t afford life saving medication, there are programs out there to help offset the cost.
    Check out this discussion on the issue:
    http://www.allergicliving.com/forum/viewtopic.php?f=27&t=1728

    Also, according to Allergy Safe Communities a website created by the Canadian Society of Allergy and Clinical Immunology (CSACI):

    “Patients who have been prescribed epinephrine are advised to have at least one epinephrine auto-injector with them at all times.

    Optimally, patients should also have access to a back-up auto-injector in case a second dose of epinephrine is required.

    It is important for persons at risk of anaphylaxis to take extra precautions when planning trips or camping outdoors. When travelling, they should try to be within a reasonable distance to a medical facility should an emergency occur.” http://www.allergysafecommunities.ca/pages/default.asp?catid=14&catsubid=21

    If the auto injector is kept on the body, degredation due to exposure to the elements is unlikely.

  7. Alex says:

    Erik, you said:

    “We’ll take #2 first, and chalk up an easy win for the teacher … since the same anaphylactic allergen (say, a surreptitiously shared Snickers bar) could be the cause of both reactions. While that’s not the only scenario, it’s considerable enough that we should expect the likelihood of two concurrent reactions to be not much less than the risk of one.”

    I’d have to disagree. Since we’ve established that only 1.6% of the population has these allergies, the probability of the child managing to share a snickers bar with one of the 5-6 other students in the school who have the same allergy seems rather slim. It seems even slimmer when we consider the fact that children mostly socialize with their classmates, or with other children who are in the same grade as them, rather than, say, grade 6 students sharing food with grade 8 students. You’re right in pointing out that we can’t simply multiply the probabilities as we would with completely unrelated events, but you also can’t conclude that the probability of two simultaneous occurrences is “not much less” than a single occurrence.

    On a different note, I think you completely missed the point Anna was making. She was pointing out that a child with an allergy is unlikely to have only one epi-pen, stored in the school office; the parents would need to have a second pen for use at home. It doesn’t cost them anything to have the child take that pen to school, and take it home after school. The ONLY policy which puts an extra financial burden on the parents is the policy of storing an epi-pen in the school office.

    Good job otherwise though; you obviously did a good deal of research on this topic, and I’ve learned a lot from your article. Thanks!

  8. Bogeymama says:

    Not only is storing an Epipen in the office a more expensive option, but it is also foolish. Not getting her Epipen on time is one of several factors that contributed to Sabrina’s tragic death. Anaphylaxis can occur up to several hours after a food is consumed, in some cases due to the need for some partial digestion of a food before the protein is “recognized”, so it is pretty standard now for schools to insist that the Epipen be worn by the allergic child. Sabrina’s reaction (to milk protein contaminated fries) occurred in class after lunch period was over. Over and over again I have heard from allergists that there are 2 main contributors to anaphylaxis death – NOT giving an Epipen on time, and uncontrolled asthma. My 10 year old son, who has the same type of milk allergy as Sabrina, has carried an Epi on his waist in a belt since he started school. There is an extra one stored in his teacher’s desk in the event that he needs a 2nd dosage (also necessary in many cases).

    Financial burden or not, the best advice for all children with potential for anaphylaxis is to ensure that their asthma is well-controlled (that means taking preventer puffers every day!! ) and to ensure epinephrine is always readily available…. NEVER under lock and key. I’m shocked that the mother in this situation was comfortable with the Epi in the office. Haven’t heard that one is many years. Just FYI, I’m not just the Mom of an allergic child – I’m a health care professional with special training in asthma (CAE) and anaphylaxis.

    Enjoyed the article ! Haven’t seen that info presented before!

  9. Lisa says:

    One more thing–there is a horribly tragic death of a food allergic preschooler in, I believe, Australia (either there or New Zealand). The preschool teacher accidentally injected the first epi pen into her finger and the 2nd failed to work. It was after reading that story that I (who live 20+ min from a hospital) put a 3rd epi in my bag. My son certainly has more than one epi at school. Accidents happen. Epis often can reverse anaphylaxis but when they do not they buy about 10 minutes of time to get to the hospital. Allergists now recommend people carry at least 2 at all times because one can fail and because a HUGE percentage of people who have anaphylaxis *require more than one* before the get to the hospital. So, I think there is more to this than the writer knows and while I do appreciate his POV and intelligence I have to disagree with the idea that one lone epi per child is enough. It isn’t what is recommended and I don’t think it is safe.

    Also, the reason there are so few food allergy fatalities is at least in large part due to the use of epi pens so looking at stats of fatalities alone doesn’t tell us a full picture of risk.

  10. Lynn says:

    As an parent of a peanut allergic child in Texas I found it ironic that this parent is complaining about the school requirement that is actually something I had to fight for my child to have the ability to do.

    For safety reasons school policy has required that all medication including inhalers and epi-pens must be secured in the nurses office. Only recently has this changed and in our local area it tool some convincing to ensure that my son’s Epi – pen be with him at all times. Yes one is in the school nurse’s office but the other is on him at all times.

    Yes the risk of a life threatening reaction is low but it is still there. Our school is not peanut free the school does take reasonable action to reduce exposure risk but as long as that allergen is present the possibility of a reaction exists. Having an epi immediately available reduces the chances of death have the second or back-up does available with the nurse provides a second line of protection.

  11. Anna says:

    But Erik, you said it was the additional epi-pen, at $100 that “provides such a modest reduction in an already infinitesimal base rate,” But it doesn’t even cost $100 because the child MUST have an epi-pen at home.

  12. Thank you for posting this article and for all the ensuing comments. I found it’s been difficult to find meaningful dialogue about food allergies, sensitivities and intolerances. I am a dad of two teenagers who have been lactose intolerant from day one (including myself). I can’t imagine being a parent of an anaphylactic child however if I was, I would do everything to keep my child safe and reduce the risks or possibility of risks to a minimum. Everybody talks about the statistical risks, chances of, the odds, and what experts say but at the end of the day, it’s your decision as a parent of your child.

  13. jo says:

    what a great article, I don’t agree with everything but obviously there was lots of thought and research. The comments were exceptional to. I am from outside Ontario and see Sabrina’s Law as such a victory for children with anaphlyaxis, to hear about it’s inconsistent application makes me wonder what’s a person to do to get the right people consistently training so that my child or anothers isn’t a statistic.

  14. Andrew says:

    I didn’t hear of the costs of not being able to bring peanut butter for lunch, which is the cheapest sandwich to bring to school, besides maybe jam. Nobody seems to care that the healthiest, cheapest ingredient in a sandwich has been banned because of pseudoscience. I don’t actually believe the numbers floated around about the prevalence of these incidences. It seems people are just willing to believe them because they want them to be true. CBC ran a story about how the liberal media claimed a woman died from kissing a man that had eaten peanuts, CBCs story had experts that said the girl died from asthma, but the organization that deals with food allergies was ready with an education campaign that used her death as a reminder. Seems they couldn’t actually find any deaths from anaphylactic shock that could be attributed to food allergies. Just goes to show when people believe something how easy it is to make into mainstream thought.

  15. Kim says:

    As the mother of a severely allergic 9 year old boy, I am encouraged by the low death rate and probability of reaction. I would have to add however, that there are many many random factors outside of those proposed in this study. Life with children is seldom predictable.

    For instance; my son is being regularily bullied with dangerous foods in his (gasp) unsupervised lunch room. Add to that a teacher who has washed her hands of any responsibility to help in the situation, and top it off with a generous helping of a brand new principal who finds my insistance upon regular lunch room supervision for this grade 4-5 room a nuisance, and a project that falls to the very bottom of his priority list. A powderkeg to be sure. These factors up the probability of reaction just a tad.

    This mother’s heart is deeply disturbed, and the fact that my son wears an epibelt is our number one defense. If it gives even a tiny bit better chance of sparing his life, I’m all for strapping in on.

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  • Erik Davis

    Erik is a technology professional based in Toronto, focused on the intersection of the internet and the traditional media and telecommunications sectors. A reluctant blogger, he was inspired by the great work Skeptic North has done to combat misinformation and shoddy science reporting in the Canadian media, and in the public at large. Erik has a particular interest in critical reasoning, and in understanding why there’s so little of it in the public discourse. You can follow Erik's occasional 140 character musings @erikjdavis