The studies have also shown us what we can do to prevent these tragedies.
SM: Ms. Broussard implied that FAAN's medical board and advising doctors are in some way colluding to disseminate exaggerated evidence. Do you know anything about FAAN's studies' objectivity?
MP: FAAN's medical board and advising doctors are many of the leaders in food allergy and academic allergy and have been responsible for many of the studies leading to information that has dispelled fear and has increased patient safety. The studies published by these authors have been in well respected, peer reviewed journals which are scrutinized by other allergists and experts in the field prior to their publication. This identical process goes for studies that have received funding by FAAN. This process leaves little room for the dissemination of confabulated or manipulated data for self gain.
SM: Ms. Broussard wrote, "...exaggerating the threat may actually do as much harm as the allergies themselves. The peril is now perceived as so great that psychosomatic reactions to foods and their odors are not un-common". Are you seeing this in your practice?
MP: I have experienced fear first hand while watching my own child have a severe, life threatening allergic reaction and not having the appropriate medication that could save his life. After my son recovered and my family had time to process what had happened we put into place well thought-out strategies, based on existing literature, to attempt to prevent this from happening again (avoidance strategies) and in the event that it did, a treatment plan to save his life (allergy action plan and epinephrine). Although we have a healthy respect for his allergy and are vigilant we are no longer afraid.
Pictures of children in gas masks holding food (such as the cover of the November 5, 2007 issue of Newseek) do little to combat fear while at the same time downplaying the very real significance of food allergy and anaphylaxis does little for the emotional or physical wellbeing of the food allergic and their families.
Education and empowerment are key ingredients to combating the natural fear that comes with having food allergies. Misinformation and unaddressed fear has lead to social isolation, anxiety and eating disorders for some. I have met families that kept their children from interacting with others for fear of allergen exposure. With education and support, people with food allergies can have manageable and enjoyable lives.
**
Dr. Michael Pistiner:
Dr. Michael Pistiner is currently a fellow in Allergy and Immunology at Children's Hospital Boston, Harvard Medical School and is in his final year of the Scholars in Clinical Science Program of Harvard Medical School (masters program in patient based research). Over the last 2 years he has developed a special interest in pediatric food allergy and in the management of food allergy in schools. Within the last 4 months he has seen first hand the critical importance of community wide education as his pre-school aged son experienced anaphylaxis (life-threatening allergic reaction) after eating a small amount of walnut. He is committed to the use of practical food allergy education to replace fear and divisiveness with empowerment, confidence, and unity. Upon completion of his fellowship in July 2008, he will return to New York State and join Allergy & Asthma Consultants of Rockland & Bergen.
ENDNOTES
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8. Lieberman P, Decker W, Camargo CA, Jr., Oconnor R, Oppenheimer J, Simons FE. SAFE: a multidisciplinary approach to anaphylaxis education in the emergency department. Ann Allergy Asthma Immunol 2007; 98:519-23.
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