The role of peanut-free school policies in the protection of children with peanut allergy.

Peanut allergy that affects 1.4-4.5% of North American children, has increased in prevalence in the past 20 years, is often diagnosed early in life, and outgrown in fewer than 20-32% of children by age 6. Recent self-reported data suggest that over 50% of peanut allergic individuals have had a severe reaction. Because food (and peanut in particular) is a ubiquitous part of school attendance, this raises the potential for reactions to accidental peanut ingestion at school. Accordingly, there is increasing interest in creating policy to protect peanut allergic children in the school environment-sometimes as a ban on peanut-containing items either in the classroom, the lunchroom, or even in the entire facility. We review the evidence for, and against, peanut bans in schools.