• Project status: Complete
child with nuts

Schoolnuts: Completed in 2016, this study measured the risk of allergy in children aged 10-14 years in their school.

Thi study has the potential to decrease the number of children suffering from allergy in the future and to improve health outcomes for children who suffer from allergy including poorly controlled asthma.

Thi study has the potential to decrease the number of children suffering from allergy in the future and to improve health outcomes for children who suffer from allergy including poorly controlled asthma.


The SchoolNuts study completed data collection in 2016.

The study aimed to:

  1. Determine prevalence of true food allergy in the critical early adolescent period;
  2. Understand risk factors for recurrent or severe accidental ingestion reactions amongst food allergic children (poorly controlled asthma, knowledge and attitudes about food allergy/anaphylaxis, pubertal status and use of healthcare services); and
  3. Determine clinical predictors of food challenge outcomes.

SchoolNuts recruited 9,790 children and adolescents aged 10-14 years old (participation rate 49%). All Grade 5 and 6 students in selected primary schools and all Year 7 and 8 students in selected secondary schools and their parents were invited to participate in the project. The research was conducted in two parts:

Part 1

  • Parents were asked to fill in a written questionnaire, with 5,244 doing so.
  • Students were then asked to fill in a written questionnaire at school.
  • Schools were offered an allergy information session for all students at the relevant year levels. This ensured students received the correct information about food allergy.

Part 2

Children identified (via parent questionnaires in Part 1) with parent reported food allergy were invited to the SchoolNuts clinic at The Royal Children’s Hospital for assessment and clinical investigation. 353 participants attended a clinic for allergy assessment.

From conducting SchoolNuts, we have found that:

  • Approximately 1 in 20 10- to 14-year-old school students in Melbourne has a current food allergy. This high prevalence suggests that the previously reported rise in food-induced anaphylaxis in this age group may reflect an increasing prevalence of food allergy rather than simply increased reporting of anaphylaxis.
  • Early onset eczema, Asian background, and family history of allergic disease are associated with an increased risk of food allergy, whereas dog exposure in early life reduces the risk in 10- to 14-year-old adolescents. Factors predicting food allergy risk in an adolescent population-based cohort appear remarkably similar to those predicting early onset food allergy in infancy.
  • Adolescents with food allergy are frequently exposed to food allergens. Those with asthma and over 2 food allergies are at the greatest risk for adverse food reactions. Those with nut allergies are most at risk of severe reactions.



Mari Sasaki, Jennifer J Koplin, Shyamali C Dharmage, Michael J Field, Susan M Sawyer, Vicki McWilliam, Rachel L Peters, Lyle C Gurrin, Peter J Vuillermin, Jo Douglass, Angela Pezic, Maia Brewerton, Mimi L K Tang, George C Patton, Katrina J Allen. Prevalence of clinic-defined food allergy in early adolescence: The SchoolNuts study. J Allergy Clin Immunol. 2018 Jan;141(1):391-398.e4. doi: 10.1016/j.jaci.2017.05.041. Epub 2017 Jul 26.

McWilliam VL, Koplin JJ, Field MJ, Sasaki M, Dharmage SC, Tang MLK, Sawyer SM, Peters RL, Allen KJ; SchoolNuts investigators. Self-reported adverse food reactions and anaphylaxis in the SchoolNuts study: A population-based study of adolescents. J Allergy Clin Immunol. 2018 Mar;141(3):982-990. doi: 10.1016/j.jaci.2017.09.012. Epub 2017 Nov 23.PMID: 29174346 Clinical Trial.

Sasaki M, Peters RL, Koplin JJ, Field MJ, McWilliam V, Sawyer SM, Vuillermin PJ, Pezic A, Gurrin LC, Douglass JA, Tang MLK, Dharmage SC, Allen KJ. Risk Factors for Food Allergy in Early Adolescence: The SchoolNuts Study. J Allergy Clin Immunol Pract. 2018 Mar-Apr;6(2):496-505. doi: 10.1016/j.jaip.2017.12.011. Epub 2018 Feb 1.PMID: 29397374

Hameed, R., Peters, R. L., Field, M. J., Koplin, J. J., Dharmage, S. C., & Allen, K. J. (2018). Self-reported asthma prevalence and control in a population-based cohort of Australian school students aged 10–14 years. Archives of Disease in Childhood, 104(6), 612. doi:10.1136/archdischild-2018-316203

Robinson, M., Koplin, J. J., Field, M. J., Sasaki, M., Peters, R. L., McWilliam, V. Investigators, S. (2018). Patterns of Carriage of Prescribed Adrenaline Autoinjectors in 10- to 14-Year-Old Food-Allergic Students: A Population-Based Study. The Journal of Allergy and Clinical Immunology In Practice, 7(2), 437-443. doi:10.1016/j.jaip.2018.06.025

Imran S, Neeland M, Koplin J, Dharmage S, Tang M, Sawyer S, Dang T, McWilliam V, Peters RL, Perrett K, Novakovic B, Saffery R Epigenetic programming underpins B cell dysfunction in peanut and multi-food allergy. Clinical and translation allergy. Article in press 07/21

child in hospital

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