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Managing anaphylaxis in the workplace

Anaphylaxis is a life-threatening allergic reaction that should always be treated as a medical emergency. It occurs after a person with an allergy is exposed to an allergen (usually to foods eaten, insect stings or bites, or medications), to which they are allergic.

There is a growing number of adolescents and adults in Australia with food allergy and a real need for workplaces to consider allergy management and the risk of anaphylaxis. Individuals at risk, employers and Occupational Health and Safety Departments need guidance on managing the risk of anaphylaxis in the workplace, while understanding the individual's need for privacy.  Adults at risk of anaphylaxis are responsible for managing their own health conditions, but workplaces must be aware, accommodate their employee’s health conditions where possible, and be prepared for an emergency.

To be a proactive workplace, subscribe to Allergy & Anaphylaxis Australia (A&AA) for support, information on management and emergency treatment, and helpful resources .

On this page: 

Legal Obligations

Please refer to your state or territory work health and safety authority:

https://www.safeworkaustralia.gov.au/law-and-regulation/whs-regulators-and-workers-compensation-authorities-contact-information

Information may also be available through your workplace Human Resources department.

Responsibilities of the employee at risk of a severe allergic reaction (anaphylaxis)

The employee should be encouraged to tell their employer they have an allergy and are at risk of anaphylaxis at the commencement of employment. An optional question about food allergies could be included on the employee details form as part of their onboarding process.

Any employee who has been diagnosed with severe allergy and been prescribed an adrenaline (epinephrine) injector (such as Anapen®, EpiPen®) should have an ASCIA Action Plan for Anaphylaxis kept with their adrenaline injector. Employees who carry an adrenaline injector should inform the employer, supervisor, or person in charge of its location, for example on their desk or in their bag. The adrenaline injector should always be stored in the same place when the employee is at work. It must always be easily accessible and not be kept in a locked room, drawer or cupboard. If the employee’s role involves travel or visits to different workplace sites, they should carry their adrenaline injector every time they leave their main place of work.

Some allergic reactions can occur very quickly and can be severe. NO employee, no matter how old they are, should be expected to be completely responsible for the self-administration of their adrenaline injector as they may become quite unwell very quickly. Assistance should be provided as they may not be able to administer the adrenaline injector themselves in an emergency.

Responsibilities of the workplace - anaphylaxis management

Staff education and training

The workplace should ensure that an appropriate number of staff, on site at any given time, have first aid training specific to anaphylaxis. A&AA encourages all staff to complete the free online anaphylaxis e-training course developed by the Australasian Society of Clinical Immunology and Allergy (ASCIA - the peak medical organisation for allergic disease). The course teaches people how to recognise and treat anaphylaxis and takes approximately one hour to complete. Staff who successfully complete the training receive a certificate.

It is also recommended that each workplace purchases an adrenaline injector trainer device (with no needle or medication) to practise with. A&AA suggests that staff revise the signs and symptoms of an allergic reaction and practise using the trainer device 2-3 times a year during staff/Occupational Health & Safety meetings. A&AA has short 2 minutes videos that show the signs and symptoms of allergic reactions, how to position a child or an adult in an emergency and EpiPen® and Anapen® administration.

Staff communication

Consider placing some general information about allergies and anaphylaxis in work memos, circulars, newsletters, industry publications. You may even want to put an ASCIA First Aid Plan for Anaphylaxis on the staff notice board.

Make a note of Food Allergy Week (FAW), held in May each year, and consider awareness raising activities. More information on FAW can be found on A&AA website.

Emergency response plan 

It is important that the workplace has an emergency response plan specific to anaphylaxis because it requires urgent and specific emergency care.

If a staff member shows signs and symptoms of an allergic reaction, it is important to follow their individual ASCIA Action Plan or the ASCIA First Aid Plan for Anaphylaxis.  

If it is safe to do so, it is strongly advised that the person lay on the ground wherever they are and call for help. The adrenaline injector (and ASCIA Action Plan) must be brought to the individual and administered either by the individual or by a colleague. Ideally a colleague that has undergone training should administer the adrenaline injector, but if a trained staff member is not present, anyone can read the instructions on the device and give the adrenaline according to instructions on the ASCIA Action Plan.

Once the adrenaline is given, an ambulance must be called.  If another adrenaline injector is available, it should be brought to the individual in case they need another dose.  Instructions on when to give a second dose are on the ASCIA Action Plan. Whoever calls the ambulance should stay on the call with ambulance control (and with the patient) until the ambulance arrives.

A staff member should go to the building entrance to direct the ambulance to the patient. If the person having anaphylaxis is in an unsafe location and needs to be moved, they must be moved in the lying position (for example on a stretcher). They must not stand up or walk.  

Remember: If an allergic reaction occurs always follow the instructions on the ASCIA Action Plan.

Those who work closely with employees with an allergy who are at risk of anaphylaxis should know where the staff member’s medical kit containing their adrenaline injector and ASCIA Action Plan is kept.

The workplace needs to have an emergency plan for the management of anaphylaxis in different locations of the workplace and consider all aspects of emergency care including, for example:

  • Who brings the medical kit to the employee having the allergic reaction?
  • Who gives the adrenaline injector if the employee having the anaphylaxis cannot self-administer it?
  • Who calls an ambulance?

Who stands on the roadside and in other areas to direct paramedics to the patient quickly?

Adrenaline (epinephrine) injector for general use

Food, insect and medication allergies are on the increase, as are anaphylaxis presentations to hospitals. Workplaces should consider having an adrenaline injector for general use in their first aid kit. This device can be used in an emergency when an individual at risk of anaphylaxis cannot access their device quickly; if another dose of adrenaline is required 5 minutes after the first dose if there is no response, or if a person not previously prescribed an adrenaline injector has their first anaphylaxis at work.

The ASCIA First Aid Plan for Anaphylaxis (orange in colour) must be stored with the adrenaline injector for general use and instructions on the plan must be followed when someone is thought to be having a severe allergic reaction (anaphylaxis).

An EpiPen® or Anapen® for first aid kits (not prescribed to an individual through the Pharmaceutical Benefits Scheme) can be purchased over the counter at a pharmacy at the cost of approximately $100 per device. You should ask for an adrenaline injector with an expiry date of at least 10 months.

The EpiPen®300 or Anapen®300 (containing 300mcg of adrenaline) is for children over 20kg and adults. The EpiPen®300 or Anapen®300 or Anapen® 500 (containing 500mcg of adrenaline) is for children and adults over 50kg.

A&AA has further information on adrenaline injectors in first aid kits.

ASCIA has information on adrenaline injectors for general use.

Adrenaline injector trainer devices (with no needle or medication) can be purchased through the A&AA online shop. It is recommended that you purchase the brand of adrenaline injector trainer that matches the adrenaline injector that you have on site. If you have both brands of adrenaline injectors on site, it is recommended that you purchase one or more of each trainer.

Adrenaline injector trainers should always be clearly identified as a trainer (put tape around the injector with TRAINER written on it) and stored away from an actual EpiPen® or Anapen®. This is so that the trainer is not confused with a real adrenaline injector in an emergency.

Tips for managing food allergy in the workplace

  1. Consider people with food allergy when eating in the workplace.

    Staff should wash their hands after eating something their colleague is allergic to.  

    People should not eat at the workstation/desk of a colleague who has a food allergy.

    When planning either in-house or off-site events involving food, discuss menu choices and venues with the employees who have food allergies.  Where possible, changes may need to be made to reduce the risk of an allergic reaction. The Food allergy aware catering checklist for workplace events can help staff organise catering events for workplaces.

    It is not reasonable for a person with food allergy to expect all food served at a function to be free of the food they are allergic to. However, if it is a food that can easily be removed from products ordered/delivered/served this can be considered. For example, if someone has a kiwi fruit allergy, asking caterers not to include kiwi fruit on a fruit platter or no peanut or tree nuts in a sandwich platter brought to an office meeting if someone has peanut or tree nut allergy.

    The person with food allergy should always tell staff about their allergy again at the time of the function and ask about the allergen content of the food when it arrives.  Some employees with food allergy may prefer to provide their own food or have a particular meal prepared for them rather than taking food off a shared plate or from a buffet.

    The workplace should assess the staff meals area and staff kitchen. Consider:  

    • The provisions available for refrigerating and heating food.
    • Providing a storage container with a lid that can be placed on the top shelf of the fridge for the food of the person with food allergy to store their food.
    • Washing cutlery and crockery in the dishwasher or hot soapy water after use.
    • If using a sandwich press, wipe it clean with hot soapy water and for staff with food allergy, wrapping their sandwich in baking paper.
    • Staff with food allergy providing their own equipment, such as a cutting board.

    Further advice for workplaces:

    • Staff with peanut/tree nut allergy: Bowls of nuts at an office celebration are not recommended as cross contamination risk is high. People put their hand in the nut bowl and then go directly to the chip bowl, contaminating chips which may originally have been fine for the individual with a peanut/tree nut allergy. It is not as simple as expecting the person with an allergy to just avoid the nut bowl.
    • Asian style restaurants are generally not recommended for those with peanut and tree nut allergy due to the high use of peanut and tree nut ingredients in dishes.
    • Some venues/activities pose a greater risk E.g. a buffet meal on a harbour cruise would be considered high risk. The risk of cross contamination in buffet style meals is high as people can swap serving utensils and food can drop into other food containers when serving themselves. Access to prompt medical help is critical to emergency management and in remote places or on a cruise this could be delayed.
    • For staff with a fish/shellfish allergy, choosing a seafood restaurant would exclude them from this outing as vapours from fish/shellfish cooking can cause a severe reaction in very sensitive individuals. Choosing other cuisine styles which may still have seafood dishes on their menu poses less risk to the individual with fish/shellfish allergy.
    • It may help to speak with the employee with food allergy for guidance on which restaurant may be less of a risk.

    For workplaces that prepare meals on site for staff as part of their working conditions (such as mining camps) make sure the following policies and procedures are in place:

    1. Food allergen management policy
    2. Register of staff dietary requirements including food allergies.
    3. Training in food allergen management for food service staff.
    4. Document the allergen content of all meals in a food allergen matrix
    5. Risk minimisation procedures 
    6. Audit process for food allergen management

Tips for managing latex allergy in the workplace

Workplaces needing to manage latex allergy are encouraged to reduce the amount of latex in the work environment where possible. Unlike food allergy, latex allergy can worsen with ongoing exposure.

The products that pose greatest risk to someone with a latex allergy are latex gloves, contents of the first aid kit, balloons, and elastic bands.

Latex products can be avoided in workplaces:

  • gloves can be replaced with vinyl or other non-latex alternatives.
  • non-latex elastic bands are available.
  • the workplace can have a no balloon guideline/policy for work-related functions and on the rare occasion when a person brings a balloon into the workplace, they can be asked to leave the balloon outside. Children’s dummies and toys can contain latex, but it is unlikely they will cause the employee a problem unless touched.

If a staff member identifies a potential risk product, such as mouse pads thought to contain latex, it is advisable to contact the manufacturer to confirm if the product does contain latex. If it does, change to a mouse pad that poses less risk to the employee with latex allergy. Ensure the person with latex allergy has their own desk and does not desk share if there are other mouse pads in the workplace that contain latex.

First aid kits often contain band aids, tape and bandages which contain latex. Staff with latex allergy may need their own first aid kit, including latex free gloves and band aids. Staff need to know that the person with latex allergy has a personal latex free first aid kit and where to access it. Alternatively, it may be easier for the workplace to stock a completely latex free first aid kit that is used for all staff.

Emergency services must be advised of the latex allergy at time of calling triple zero (000) because medical equipment in an ambulance and at hospital often contains latex.

Some recommended resources:

Posters

Free, online food allergen management training for people preparing and serving food

All about Allergens

The Food allergy aware catering checklist for workplace events

Website information

Food Allergy in the workplace – teens

https://allergy250kya.org.au/food-allergies-and-the-workplace/

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A&AA© April 2024

Content created April 2024