Dustless chalk is commonly used in classrooms as it provides ease in keeping hands and classroom clean. Children who are allergic to milk may also be allergic to chalk, according to the latest study published in the May issue of Annals of Allergy, Asthma & Immunology, the scientific journal of the American College of Allergy, Asthma and Immunology (ACAAI).
Low-powder chalk is mainly composed of a certain quantity of casein, a milk protein. When a child is having allergy from milk, he may inhale some quantity of chalk contains casein then that can cause severe asthma attacks and some other respiratory disorders.
“Chalks that are labeled as being anti-dust or dustless still release small particles into the air,” said Carlos H. Larramendi, MD, lead study author. “Our research has found when the particles are inhaled by children with milk allergy, coughing, wheezing and shortness of breath can occur. Inhalation can also cause nasal congestion, sneezing and a runny nose.”
It is estimated that approximately 300,000 children in US are suffering milk allergy, as reported by ACAAI. It was believed that when children grew up in the age of three, he no longer has milk allergy but recent studies have contradicted this theory, as there were some school aged children that were still suffering milk allergy.
“Chalk isn’t the only item in a school setting that can be troublesome to milk allergic students,” said James Sublett, MD, chair of the ACAAI Indoor Environment Committee. “Milk proteins can also be found in glue, paper, ink, and in other children’s lunches.”
It is the duty of the parents to advise their children who have milk allergies that they should back of the classroom where there are least chances of chalk intake, said by Sublett.
“Teachers should be informed about foods and other triggers that might cause health problems for children,” said Sublett. “A plan for dealing with allergy and asthma emergencies should also be shared with teachers, coaches and the school nurse. Children should also carry allergist prescribed epinephrine, inhalers or other life-saving medications.”
The abstract of this article is as following.
Nondietary exposure to milk proteins may be a risk for children who do not outgrow milk allergy by school age.
To study the allergenicity of casein containing chalk.
A 6-year-old, milk allergic child developed asthma and rhinoconjunctivitis while in school. The suspected cause was dust-free chalk containing casein. To study the relationship of dust-free chalk containing casein with asthma and rhinoconjunctivitis, 13 additional milk allergic patients were studied: 3 school-aged children, 8 preschool-aged infants, and 2 children with outgrown milk allergy. Skin tests and/or specific IgE with chalk and casein were performed. A chalk use test was performed in older children. Milk allergens contained in chalk were characterized by sodium dodecyl sulfate–polyacrylamide gel electrophoresis, immunoblot, and IgE inhibition experiments.
All school-aged, milk allergic children were exposed to chalk and reported symptoms attributed to chalk exposure. The skin test result to chalk was positive in 5 of 12 cases, and the specific IgE test result was positive in all 12 study participants in which it was performed. Casein strongly inhibited the binding of IgE to chalk. Chalk sodium dodecyl sulfate–polyacrylamide gel electrophoresis showed proteins with molecular weight similar to caseins. Immunoblot demonstrated strong binding of IgE to chalk in a blurred pattern and a band at 30 kDa, inhibited by casein. The chalk challenge test result was positive in 2 school-age children who had a positive skin test result to chalk. Their symptoms improved after avoidance of chalk in the school. In 2 other cases in which the challenge test result was negative, chalk was reintroduced without problems.
Inhalation of chalk dust containing casein can induce asthma symptoms in milk allergic patients. Hidden and nondietary sources of exposure should always be considered in food allergic patients.
You can read full article here.
Reference: Carlos H. Larramendi, MD, Francisco M. Marco, MD, PhD, Mónica Llombart, MD, Ana de la Vega, MD, Eusebi Chiner, MD,
- José Luis García-Abujeta, MD,
- José Miguel Sempere, MD, PhD.
Allergenicity of casein containing chalk in milk allergic schoolchildren. 2013. Annals of Allergy, Asthma & Immunology.
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