Parental adherence to peanut-free lunch guidelines in schools in Montreal, Canada

Abstract

Rationale The increasing prevalence of peanut allergy and the potential for fatal reactions has led to controversial attempts to eliminate peanuts from some Canadian school classrooms by such measures as implementation of peanut-free lunches. Given that classes vary in their level of guideline enforcement, we examined the level of parental adherence to a policy of peanut-free lunches. Methods With parental consent, a dietician inspected lunches for peanut products in 14 primary school classrooms implementing peanut-free policies. Parents and students had not been informed of the date of inspection. Parents also completed questionnaires regarding knowledge of policies designed to achieve peanut-free schools. Results 333 parents were invited to consent to inspection of their children's lunches and to complete questionnaires. 167 agreed to inspections and completed questionnaires (kindergarten, grades 1 to 3: n=37, 45, 38, and 47, respectively). 36 completed questionnaires only. No peanut-containing substances were found in the lunches inspected (0%, 1-sided 97.5% CI, 0 to 2.3%). When parents allowing inspections were compared with those only completing questionnaires, there was no significant difference between levels of awareness of guidelines (95.8% [95% CI, 91.6%, 98.3%], and 94.4% [81.3%, 99.3%]). Parents not consenting to lunch inspections were as likely to have a peanut-allergic child in school as those consenting (8.3% [95% CI, 1.8%, 22.5%], and 10.8% [6.5%, 16.5%]). Conclusions Implementation of peanut-free guidelines was successful in the classrooms surveyed as measured by adherence to guidelines. However, further evaluation of their effectiveness in both eliminating peanut and decreasing accidental peanut exposure is required before widespread implementation.