“Chalks that are labeled as being anti-dust or dustless still release small particles into the air,” Dr. Carlos Larramendi, the lead author, said in a press release.

“Our research has found when the particles are inhaled by children with milk allergy, coughing, wheezing and shortness of breath can occur. Inhalation can also cause nasal congestion, sneezing and a runny nose.”

The authors say casein can also be found in certain inks, papers and glues.

Using skin prick and lung function tests, researchers examined the effects of the chalk dust on 14 kids allergic or sensitive to cow’s milk protein. The children were divided into three groups: exposed (school-aged children), non-exposed (pre-school aged children) and outgrown (school-aged children who had recently outgrown their allergy but were still sensitive).

All of those in the “exposed” group experienced respiratory symptoms while in class. For all of this group of children, symptoms improved when the chalk was swapped with a brand which didn’t contain casein.

Overall, about 40 percent of the children reacted to chalk extract during the skin prick testing, while 100 percent had specific IgE antibodies to casein as well as chalk.

The researchers say this suggests the chalk’s casein appeared to be modified, but not destroyed, during the chalk-making process, making it less allergenic when compared to regular casein.

It is important to note that this study doesn’t suggest that all milk proteins in the chalk are airborne. Rather, the proteins used in the chalk (for their adhesive and compacting properties), become attached to volatile chalk particles, which are then breathed in. Any of the ingredients in the chalk could be inhaled this way, say the authors of the study.

This study suggests that children who don’t outgrow their milk allergy by school age may have their allergy last longer or even worsen, despite avoiding milk, due to hidden exposures such as this.

Using diaries and interviews, Swedish researchers followed a group of nearly 200 infants, checking in at 18 and 36 months of age. They found that the development of eczema was significantly less likely to occur in babies whose parents had “cleaned” infants’ pacifiers by sucking on them.

Infants in this group were also found to have a different composition of microbes in their saliva, when compared to infants whose parents didn’t use this “cleaning technique”. The authors of the study believe that exposure to parental saliva may accelerate the development of complex oral microbes in the infant, which may help the immune system better tolerate allergens.

Gross? Perhaps. But this research actually falls in line with earlier studies which suggest the human microbiome – a collective term for the trillions of microbes which live on and within our bodies (and actually outnumber our own cells) – plays an integral role in immune system development. These bacteria are on the whole poorly understood, but differences in their composition have been linked with the development of asthma, allergies, diabetes and even cancer.

The research also relates to the ‘hygiene hypothesis’ theory of allergy development. It suggests that, in developed countries, anti-microbial products are overused, resulting in the immune system being underused and failing to mature properly. Allergies develop when the immune system begins targeting normally benign substances (such as peanut or milk protein).

At one point, it was thought that a lack of infections in infants in developed countries was to blame for the rise in allergies, but now some scientists believe it is more likely a disruption of the complex interplay between certain microbes and the developing immune system that is to blame.

Previous studies have linked Cesarian delivery and lack of breastfeeding, which are both factors that impact the diversity and amount of bacteria in infants, to a greater risk of developing allergies later in life.

Does this mean parents should start sucking their kids’ pacifiers? Not so fast, say the study’s authors. This study was quite small, dealt with a specific population, and had no long-term follow-up. Further, larger studies are required before it can be established that this practice will actually help protect infants from developing allergies.

A CDC report released in May 2013 estimates that between 1997 and 1999, food allergies affected about 3.4 percent of American children. By 2009 to 2011, that number rose to 5.1 percent – an increase of 50 percent in just over a decade.

Skin allergies also increased in children under 18 years of age between 1997 and 2011.

The prevalence of skin allergies increased from 7.4 to 12.5 percent. Seasonal rhinitis, or hay fever, appeared to remain fairly constant through the years, but remains the most common type of allergy in children at 17 percent.

Interestingly, kids in families with income at or above the poverty level were found to have a greater prevalence of food and respiratory (but not skin) allergies. As family income grew, so did the likelihood of the children having a food allergy or hay fever.

Ethnic background also appears to be a factor. Hispanic children proved to have an overall lower rate of food, skin and respiratory allergies. The CDC’s report found that African-American children have a greater prevalence of skin allergy, but lower rates of respiratory allergy than white children.

In addition, the rate of skin allergies tended to decrease as the kids got older, while respiratory allergies tended to increase.

See the CDC’s full report here

Is your summer being ruined by what appears to be a drawn-out cold? Make sure you aren’t mistaking cold symptoms for those caused by seasonal allergies by following the American College of Allergy, Asthma & Immunology’s Cold vs. Allergy Checklist:

- Have you experienced symptoms for two weeks or more? If your answer is yes, then your symptoms are more likely to be caused by allergies. Colds usually die out after a week or two, at most.

- Are your symptoms escalating? If your symptoms are escalating or progressing, then you probably have a cold. Colds tend to evolve, starting with a stuffy nose, irritated throat and fever. Then comes the sneezing and runny nose. Mucous also thickens as the cold progresses. In contrast, allergy symptoms tend to appear fairly quickly and don’t evolve.

- Do you have green or clear mucous? Colored mucous that appears yellow or green is usually related to an infection, while clear mucous tends to be allergy-related. But be careful: in some cases, the opposite can be true.

- Are you itching or wheezing? Itchy eyes, mouth, nose, throat or skin all tend to be signs of allergy, rather than a cold. Wheezing is a sign of asthma, which can be triggered by allergens such as mold or pollen. Asthma and allergy are related: between 75 and 80 percent of people with asthma are estimated to have allergies as well.

Pollen typically bears the brunt of the blame for seasonal allergies, but mold can be just as nasty. In fact, according to the ACAAI, mold counts can actually outnumber pollen counts, even during peak pollen season.

Learn more at www.AllergyAndAsthmaRelief.org.

In May, the Asthma and Allergy Foundation of America (AAFA) released its annual Asthma Capitals list – which ranks the 100 largest U.S. cities by how problematic they are for people living with asthma.

Richmond ranked at No. 1, shooting up from spot No. 23 last year. Chattanooga came in second, worsening from last year’s fifth place position. Memphis, last year’s most challenging city in the U.S. to live with asthma, marginally improved, dropping to the third spot.

Tennessee was the only state to have three cities within the top 10, including two out of the top three, suggesting the state has much room for improvement for those living with asthma.

For two years running, San Francisco was ranked at No. 100, meaning it remains the least problematic of the 100 largest metro areas in the U.S. for people living with asthma.

In order to determine the ranking of the cities, 14 factors were examined. These included asthma prevalence, asthma death rate, pollen and air quality scores, ER visits for asthma, number of asthma specialists, and asthma medicine use.

Here are Top 10 2013 Asthma Capitals:

1. Richmond, VA

2. Chattanooga, TN

3. Memphis, TN

4. Philadelphia, PA

5. Oklahoma City, OK

6. Detroit, MI

7. Dayton, OH

8. McAllen, TX

9. Atlanta, GA

10. Knoxville, TN

Not surprisingly, there was some overlap between this list and the AAFA’s Spring Allergy Capitals list released in April. All but four of the top 10 asthma capitals were also found in the top 10 spring allergy capitals list. Chattanooga ranked in the top 3 for each list, suggesting it may be a very difficult place to live for people with asthma, environmental allergies, or other respiratory issues.

See AAFA’s Asthma Capitals List

By studying a sample of 91,000 children from the 2007-2008 U.S. National Survey of Children’s Health, researchers found that children who had been born in another country had lower overall rates of asthma, eczema, hay fever and food allergies. However, that trend reversed for eczema and hay fever (but not food allergies and asthma) as time went on.

Foreign-born children who had lived in the U.S. for more than 10 yearswere found to be more likely to develop hay fever and eczema than those who had been here for up to two years.

“Seeing this loss of childhood protection from eczema and hay fever implies that environmental factors may promote the development of allergic disease,” said Dr. Jonathan Silverberg of New York, lead author of the study presented at this year’s AAAAI meeting.  

According to local news reports, Tanner Henstra, who also had asthma, was at a friend’s house last week when he took a pretzel from a bowl and popped it in his mouth, not realizing these pretzels were filled with peanut-butter. His mother, Stacie Henstra, told The Salt Lake Tribune that her son spat out the pretzel as soon as he tasted peanut, but the allergic reaction had begun. His tongue and throat began to swell.

Stacie Henstra said Tanner usually carried an epinephrine auto-injector with him, but he did not have the emergency device with him at his friend’s house. She also said that the boy, who had been diagnosed allergic as an infant, had never needed to use one before.

Tanner did have some other allergy or asthma medicine with him, which he took immediately before calling his mother, who is a nurse, to come pick him up.

“He sounded worried but otherwise OK,” Stacie Henstra told the Tribune. But during the drive home, Tanner began to have trouble breathing. When they got home, about four minutes away, a neighbor came outside and performed CPR on Tanner while his mom ran inside to get the EpiPen.

She gave him the injection, but it had little effect. He was transported to a local hospital in St. George (which is north of Las Vegas), then to a larger hospital in Salt Lake City. After two days in hospital, Tanner was removed from life support.

Young Tanner’s death adds to a tragic and concerning list of children and teens who have experienced fatal anaphylactic reactions this spring. (See our report: Tragic Spring: 3 Food Allergy-Related Deaths)

Allergic Living reminds readers of the need for constant vigilance with food allergies. Most important of all, we remind you that anaphylaxis can progress swiftly and that the drug epinephrine is most effective when used immediately. Please take a moment to review our emergency procedures slideshow – Six That Save Lives.

See also: The Salt Lake Tribune’s full report.

A fund has been established to help Tanner’s family pay for hospital and funeral expenses. Donations can be made here.

posted: April 26, 2013

EpiCenter Medical, Inc was founded by allergist Dr. Mark Greenwald and lawyer Elizabeth Goldenberg

A comprehensive new training course for understanding and managing anaphylactic emergencies has just launched online.

“First Aid For Anaphylaxis: An Allergic Emergency” fills an important educational gap by providing clear instructions for what steps to take if witnessing an anaphylactic reaction. It provides easy-to-follow, standardized information in line with World Allergy Organization (WAO) guidelines.

“We have created this course to protect allergic individuals by ensuring that the first on the scene are trained to recognize an allergic emergency – anaphylaxis – and respond immediately with life-saving first aid,” said Dr. Mark Greenwald, the Toronto allergist who co-created the course with Elizabeth Goldenberg, a lawyer and allergy advocate.

“This medical emergency requires immediate first aid – the individual can’t wait for emergency crews to arrive,” said Greenwald, referring to the need for quick response with emergency epinephrine when an anaphylactic reaction is in progress.

Greenwald and Goldenberg founded EpiCenter Medical Inc., the company that offers this online course, which provides excellent guidance for parents of allergic children, their caregivers and school and daycare staff. But the course is also designed to be used more widely in the community: staff in restaurants, dental offices, airlines, government offices, hotels, and sports venues are among those Greenwald sees benefiting from its emergency training.

“When staff in those locations are called to respond to a reaction on their premises, they will know how to recognize anaphylaxis, to treat anaphylaxis immediately with epinephrine for the best survival rate, and what life-saving steps to take next,” he says.

Anyone with Internet access can take the course, which is divided into modules:

• It begins with definitions of allergy and anaphylaxis, and moves into an explanation of epinephrine and easy instructions on how to use an epinephrine auto-injector. (So far, the course gives details on the widely prescribed EpiPen, but this may be updated soon to include the new Auvi-Q/Allerject injector.)
• As the lessons progress, participants learn how to spot anaphylaxis, and are given clear steps to follow (and remove any lingering doubt) during an anaphylactic emergency.
• As legal questions can arise among would-be good Samaritans, legal consequences are also covered, from injecting the life-saving shot into someone else, to the ramifications of deciding not to do so.

To confirm the participant’s comprehension (and keep the user engaged), quizzes are taken throughout to test knowledge. Users cannot move on to the next section until they have passed the previous one.

Allergic Living was glad to see that EpiCenter Medical’s course stresses that it’s always better to give the shot, and immediately, in the case of a suspected anaphylactic reaction. Delay can reduce the chance of epinephrine being effective, and there are no harmful effects associated with giving the shot to a healthy person who doesn’t require it.

Those who complete the online course are able to print out a personal certificate stating that they are S.A.V.E. certified – which stands for Save Anaphylaxis Victims in an Emergency.

EpiCenter Medical also offers sale of an ‘Epi-Kit’, which is a case of multiple EpiPens designed to be placed in public locations, in a manner similar to automated external defibrillators. The idea is that an Epi-Kit should always be available within 60 seconds of an anaphylactic emergency.

In summary: This course provides highly valuable information and life-saving instructions. It is excellent as a standalone course, and could also be integrated into CPR courses, so that any first responder in an anaphylactic emergency will know what steps to take to save a life.

The course is available at epipentraining.com
Cost for an individual: $29.95
Discounted group rates available for groups larger than 10

Researchers from Italy and the United States have analyzed the entire genome, or DNA structure, of the grain and have shown it to be free of gluten on a molecular level. This confirms earlier reports, studies and successful food challenges which all suggested the cereal contains no gluten and is considered safe for those with celiac disease.

Because the sorghum genome was only recently published, until now scientists had no way of proving on a molecular level that the grain was safe for people living with celiac disease. Allergic Living reminds, however to always check the label in case of potential cross-contamination.

In the West, sorghum has traditionally been used as feed for livestock, while in Africa and parts of Asia it has been used as a food for people for a long time. Farmers have developed ‘food-grade’ sorghum, which is meant for human consumption and is already used in a variety of products including some tortillas and flours. It can even be popped, like popcorn.

The researchers note in their report that in addition to being gluten-free, sorghum is nutritious, making it an ideal option for those with celiac disease. Previous studies of sorghum have suggested it may have a wide range of health benefits, including slowing the growth of tumors, reducing cholesterol levels and having higher levels of anti-oxidants than other grains and fruits. Other benefits as a gluten replacement include its low cost and neutral taste.

On April 7, 2013, Adrian Gutierrez, an 8-year-old boy from Monmouth County, New Jersey, experienced a severe reaction and died in hospital. The reaction came over the boy on his family’s drive home from church, following a visit to a coffee shop. The boy’s mother suspects that Adrian, who was allergic to dairy and peanuts, may have accidentally sipped from his brother’s hot chocolate with milk. (Adrian had ordered a hot chocolate with  soy milk.)

One news report stated that an epinephrine auto-injector was administered to the boy. However, it is not clear whether the shot was given immediately after the reaction began, or  whether there was a significant delay. In the case of a severe allergic reaction, epinephrine should always be administered right away, as the drug can be less effective if a reaction has progressed.

On March 13, 2013, Maia Santarelli-Gallo, a 12-year-old girl from Burlington, Ontario (in Canada), appears to have experienced anaphylaxis during an outing to a shopping mall with her father and older sister. Local news reports suggest Maia had reacted to dairy and egg in the past, but her parents had been told she was intolerant rather than allergic, and she had never been prescribed an auto-injector. At this point, it is not definitively known what caused the reaction, but milk is suspected – since the last thing Maia ate was an ice cream cone.

Asked to comment on the girl’s fatal reaction, allergist Dr. Susan Waserman expressed profound concern to the local press. “It speaks to the need for proper diagnoses, proper education, how the family was told to handle this supposed food intolerance,” she said, adding that better support for the family would have led the girl to have an auto-injector. “The whole community feels terrible when we feel something like this,” she said.

On March 8, 2013, Cameron Groezinger-Fitzpatrick, a 19-year-old from Plymouth, Massachusetts, died from his peanut allergy while home from university for spring break. His family has said that a friend had offered him a cookie, which was supposed to be peanut-free but turned out to contain peanut butter.

According to ABC News, Cameron’s mother was told over the phone by a 911 operator not to administer an expired EpiPen which was in a nearby cupboard. Cameron’s current auto-injector couldn’t be found in time, as he had not finished unpacking for his visit.

“I didn’t know you can die from nut allergies. I feel foolish,” Robin Fitzpatrick, Cameron’s mother, told ABC News.

These tragic events reinforce the need for allergy education and having epinephrine always ready to access for those with food (and sting) allergies.

In more positive news, several states are beginning to see the importance of readily available epinephrine and are passing bills that allow doctors to prescribe “stock” auto-injectors to schools. These devices can used in emergencies for students who don’t have an auto-injector on school premises (in some cases, it may be a first allergic reaction).

Kentucky, Nevada, Oregon, Georgia and Tennessee have all seen recent progress in such bills in their state legislatures. In fact, Kentucky Governor Steve Beshear will be holding a formal ceremony to sign that state’ stock epinephrine bill into law on April 22, 2013.