Q&A: Allergists can help families prepare for a safe Halloween

Ghosts, goblins and other make-believe monsters come out on Halloween, but allergies and asthma present real dangers to families who want to safely celebrate the holiday —and doctors can play a role in ensuring everyone has a good time.

Healio spoke with Kevin P. McGrath, MD, an allergist and immunologist in private practice in Wethersfield, Conn., as well as division chief of allergy and immunology at Trinity Health of New England, past president of the American Association of Certified Allergists and spokesperson for the American College of Allergy, Asthma & Immunology, to find out more about what specialists can do to guide their patients through this scary time of year.

Healio: Trick-or-treating and Halloween parties can lead to accidental allergen exposures. How can doctors help families avoid these dangers?

McGrath: Doctors can begin with advice. For example, Halloween parties can be organized to have nonfood items for children with food allergies. Or, some families with food-allergic children will organize their own parties without any food items or with safe food items for the children involved.

Kevin P. McGrath

Whether attending a party or trick-or-treating, children also should be told not to eat any food products without their parents reading their labels and examining them first.

Many families can help everyone have fun by giving out alternatives to food to trick-or-treaters, such as small toys or trinkets, stickers, plastic spider rings, plastic fangs, bouncy balls, bracelets, bubbles and other small treats that can be found at most stores this time of year.

Ahead of Halloween, some parents may deliver nonfood toys and trinkets or safe foods in separate bags to the homes of friends and family where their children will visit while trick-or-treating.

Food Allergy Research & Education (FARE) encourages homes that will offer nonfood items to trick-or-treaters on Halloween to identify themselves by putting teal pumpkins or jack o’ lanterns outside. Families who want to take part in the Teal Pumpkin Project can list themselves on FARE’s website so other families can know where they can trick-or-treat safely.

Healio: Food allergy action plans also are essential to this preparation. Could you describe the elements of a good food allergy action plan?

McGrath: FARE, which is a great resource for patients with food allergy and their families, has an excellent food allergy action plan form. Usually completed by the allergist’s office, food allergy action plans include the signs and symptoms of allergic reactions and anaphylaxis as well as a treatment plan for each particular patient.

Healio: What role does epinephrine have in this planning?

McGrath: Parents should always have their child’s injectable adrenaline devices with them at Halloween parties or while trick-or-treating. In fact, parents should always have two injectable adrenaline devices with their child at all times, since 5% to 10% of patients may need a second dose if help does not arrive in 15 to 20 minutes.

Healio: In addition to food, are there any environmental allergens that families should watch out for?

McGrath: Some fog machines may set off or irritate patients with allergies or asthma. Fog created with dry ice and some other compounds actually can decrease the oxygen level in the air. Usually, fog created from liquid compounds does not lower the oxygen level.

Healio: Along with Halloween, the weather is changing for the fall. How will this impact patients with asthma?

McGrath: Certainly, fall weather often can trigger asthma and allergies, especially because molds will increase in the air as leaves hit the ground. It is important for patients with asthma to be sure that they have their rescue inhaler and that they’re taking their control medication regularly prior to trick-or-treating or going to any parties.

Healio: Are there any resources that you can recommend to doctors to help their patients in these efforts?

McGrath: Groups such as the ACAAI and FARE offer online resources that can help physicians in supporting their patients with allergy and asthma as they prepare for Halloween events. For example, physicians can download and print out educational flyers that patients can take home. Also, instead of handing out candy in their office during the Halloween season, physicians can give out stickers, toys and trinkets. They can promote the use of teal pumpkins as well.

Healio: Community awareness also is essential. Do you have any recommendations for doctors who want to improve allergy and asthma awareness in the community?

McGrath: Physicians can reach out to local media, just as many allergists do during this time of year, to help educate the public as well.

For more information:

Kevin P. McGrath, MD, can be reached at kevinmcgrathmd@sbcglobal.net.