West Coast Allergy and Asthma Network (WestCAAN)
West Coast Allergy and Asthma Network (WestCAAN) is dedicated to
"Creating a safer environment in California Schools for those
affected by severe allergies and asthma through awareness, education,
training, and advocacy." WestCAAN was organized to work with
schools to better enable them to respond to life-threatening anaphylaxis
and asthma effectively in the public school setting.
About West Coast Allergy and Asthma Network
WestCAAN was founded in February 2006 by Dr. Larry Posner and
Jamie Hintzke. Dr. Posner is a Pediatric Allergist and a principle
of North Bay Allergy and Asthma Associates, Past President of Northern
California Allergy Pediatric Allergists, and the Board President
of WestCAAN. Jamie Hintzke is the mother of a food allergic and
asthmatic child. She has a long history of advocating for quality
health care in schools and currently serves as the Executive Director
of WestCAAN. Together, Dr. Posner, Jamie, and the WestCAAN Board
of Directors share a growing concern for the well being of allergic
and asthmatic children at school.
California Asthma and Allergy Situation
One in five children with food allergy will experience a reaction
in school. Severe food allergies currently affect three to eight
percent of children (representing an estimated 203,000 to 541,000
children in California), and the prevalence of food allergies among
children in the U.S. has increased substantially with the incidence
of peanut allergies doubling in the last five years.
In two different studies, at least 25% of students who were treated
with epinephrine were not known previously to have an allergic condition.
The Food Allergy and Anaphylaxis Network published study, "The US
Peanut and Tree Nut Allergy Registry; Characteristics of Reactions
in Schools and Day Care", cites that the school reaction represented
the first reaction for 25% of the children treated with epinephrine.
Of people who have asthma during their lifetime, 80% have the onset
by 5 years of age. In California, 784,000 children under age 17
have had asthma symptoms in the past year, an increase of 210% since
1980. According to the California Health Kids Survey (2001-2003),
California's lifetime prevalence for asthma in 7th, 9th and 11th
graders is 18.4%. African Americans, at 25.8%, had the highest lifetime
asthma prevalence rates, followed by Whites at 20%.2. In California,
there were 19 deaths in 2002 due to asthma in children 0-14. Nationally,
123 deaths occurred among children 5-14 years of age in 2002 as
the result of asthma.
Currently, California has in place AB 559 (Wiggins), which allows
schools to voluntarily have emergency epinephrine on site for anaphylaxis
only. Across the State, it appears that few schools have implemented
an emergency epinephrine program on a voluntary basis. One of the
barriers is the lack of standardized training materials; school
board adopted policies and updated information. State guidelines
should include other epinephrine auto-injectors now on the market
and be consistent with new national guidelines for anaphylaxis management.
For example, second doses can be repeated in 5-10 minutes rather
than 15-20 minutes. This information could be the difference between
life and death of a student.
Also in California, SB 1912 (Asburn) allows students to carry and
self-administer epinephrine and asthma inhalers with a doctor's
note. This is an excellent law and a move in the right direction.
However, many school nurses and staff will tell you that when the
student needs their inhaler, they may have forgotten it, the medication
has run out or parents cannot afford a duplicate prescription for
the student to carry. In the case of asthma management for a mild
to moderate attack, the parents are called to supply medicine. In
the case where the student is having a life-threatening asthma attack,
lack of medication becomes an emergency health issue. There is no
statewide protocol in place to help a child at a public school site
while waiting for emergency medical teams to arrive. The school
staff, after calling for emergency services, can only watch as the
child experiences, increasing difficulty breathing, turning blue,
possibly losing consciousness, and possibly dying before help arrives.
WestCAAN is working on strategies to create a pilot to explore
best practices in implementing an emergency epinephrine protocol
that AB 559 now allows. As well as collecting data to help further
our mission. By seeking partners and additional funding, we feel
this is a necessary and huge step in protecting our food allergic
We are exploring the possibility of bringing forward new legislation
that would improve the emergency care of anaphylaxis and life-threatening
asthma in California public schools.
Please contact us if you would like more information or would
like to help.