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Monday, 30 October 2006
Page: 51

Dr WASHER (3:39 PM) —Like the previous speaker, I thank the member for Chisholm for bringing this important issue before the House and I thank all the previous speakers for their great interest. Anaphylaxis is a serious rapid onset allergic reaction that can cause death. Severe anaphylaxis is characterised by life-threatening upper airway obstruction, bronchospasm and/or hypotension. Studies have shown that food allergy is the most common cause of anaphylactic reactions in children. Although almost any food can trigger an allergic reaction, most reactions are triggered by eggs, cow’s milk, peanuts, tree nuts, soy, wheat, seeds or seafood. In adults, insect venom, such as that of the honeybee, wasps and Australian native ants—the jack jumper ant in particular—and medication can also cause problems. The myrmecia ant species, or jack jumper ant, is worth mentioning as in areas where it is present one in 50 Australian adults has reported an anaphylactic episode following stinging. In some cases cofactors can play a role in provoking an anaphylactic reaction. This so-called ‘summation anaphylaxis’ can explain the occurrence of intermittent anaphylactic episodes, despite frequent allergen exposure. In young people especially, physical activity is one of the most common cofactors contributing to anaphylaxis.

Although allergic reactions to food are common in children, severe life-threatening reactions such as anaphylaxis are uncommon. In Australia the prevalence of food-induced anaphylaxis in preschool aged children was one in 170 and in school aged children one in 1,900. In fact, a survey of 4,000 children showed 90 per cent of anaphylactic food reactions occurred in preschool aged children. However, more than 90 per cent of the fatal reactions to foods occurred in children aged five years and over.

Although anaphylactic episodes are rare, schools must have policies in place to deal with a life-threatening situation should it arise. With quick, effective action the severity of the reaction can be easily managed and a potential tragedy averted. Most state and territory government education systems have this in place already, except, unfortunately, the Northern Territory. Information about and guidelines for the management of anaphylaxis are at present in these schools. These policies recommend individual healthcare management plans for students who are at risk. The ACT, New South Wales and South Australian policies provide the most comprehensive information about anaphylaxis and its management. But, as the previous speaker said, this should be a national policy.

Any policy introduced would need to include the following four steps. First, the school must obtain medical information about each child. This must include clear identification such as a photo, documentation of the allergic triggers, documentation of the first aid response and any prescribed medication and contact details of the doctor who signed the documentation. As food allergies can change, this medical information needs to be reviewed every one to two years. Second, education of those responsible for the care of children concerning the risk, prevention and action that needs to be taken in the event of a child having a severe allergic reaction must be provided. This would include instructions on the use of an adrenaline auto-injector device such as an EpiPen.

Third, there must be the implementation of practical strategies to avoid exposure of susceptible children to known triggers, such as no trading or sharing of food; prevention of cross-contamination during the handling, preparation and serving of food; and restricted use of food in crafts, cooking classes, science experimentations and so on. Fourth, there should be age-appropriate education of children with severe food allergies.  Obviously, in childcare centres and preschools children are dependent on carers for providing a safe environment.

I strongly urge state governments and private education sectors that have not implemented comprehensive policies to do so.  Deaths from anaphylaxis are preventable if quick and effective action is taken. It is unforgivable for any child to be at risk due to unnecessary ignorance or inadequate policy. The motion is one of excellence.

The DEPUTY SPEAKER (Hon. DJC Kerr)—May I acknowledge the excellent contributions by members on all sides of the House in relation to the motion proposed by the member for Chisholm. The time allotted for this debate has expired. The debate is adjourned and the resumption of the debate will be made an order of the day for the next sitting.