A leading university nurse has joined forces with an expert in food allergens to call for college and university caterers to be allowed to stock epipens for use in medical emergencies.

Emma Dellar, of the Cambridge College Nurse Association, has teamed up with Jacqui McPeake, the former head of catering at Manchester Metropolitan University who now runs her own business providing allergen training, to campaign for a change in the law.  Since 2017, UK law has allowed schools to purchase and supply adrenaline devices without a prescription for emergency use in children who are at risk of anaphylaxis. However, this legislation does not cover higher education institutions – in spite of young adults being at the highest risk. Emma explained: “Young adults have the highest risk of death or serious life-changing outcome from anaphylaxis due to many factors including being awayfrom home, shopping or eating out without parental support, alcohol intake, risky behaviour, erratic/poor sleep, peer pressure,
embarrassment (to take devices) or complacency regarding the seriousness of their diagnosis, to name a few.

“Most deaths have been attributed to food products and, although universities have already gone some way, by working with specialist catering consultants to mitigate risks when preparing, cooking, serving and storing food items, we believe this does not go far enough. “We want a change in the existing law so that it acknowledges those at risk of anaphylaxis in HE/FE institutions because we know this change will save lives.”

In 2014, the Food Standards Agency introduced new legislation that stated where food is served including cafes, restaurants and packaged food, the 14 main food ingredients known to trigger allergies
must be stated. Those at risk must be able to access information from catering staff either verbally or through written information. Despite this many reactions occur when the allergen is not identified and a person at risk inadvertently ingests the substance. Reactions occur quickly and can be fatal, with deaths of young adults from food ingestion numbering between 10-15 a year. In a survey carried out by the Anaphylaxis
Campaign, 44% of 15-25 year olds admitted to not always carrying their devices.

Jacqui added: “Universities and colleges are in a precarious situation. Do they purchase and supply adrenaline devices for use in an emergency situation, following the same criteria as schools, even though
the law does not support this? Or do they avoid doing anything which leaves their students vulnerable? “The alternative for universities currently, is storing two devices per person, named for each individual at risk, in a secure cupboard or obtaining devices by private prescription, which requires local agreement. The first option is deemed impractical and potentially unsafe – to attempt to find the named device for the person in an emergency situation, when the cupboard could contain up to 50 individually prescribed and named devices. The second option relies on varied conditions and does not allow for national uniformity.”

In 1998, Laura Thrasher a first year undergraduate in her first week at a college in Cambridge died after eating a dessert at her first formal hall dinner. She had not been formally tested for anaphylaxis, though medical staff knew of potential risk, and so had not been prescribed an adrenaline device thatmay have saved her. In 2014 in only one college in Cambridge, four people had reactions, only one of whom had their device with them. Thankfully all survived due to prompt recognition of the individuals and staff attending to the seriousness of the situation and rapid response of the emergency services.