title: Statewide prevalence of school children at risk of anaphylaxis and rate of adrenaline autoinjector activation in Victorian government schools, Australia.
abstract: The prevalence of school students at risk of anaphylaxis in Victoria is unknown and has not been previously studied. Similarly, rates of adrenaline autoinjector usage in the school environment have yet to be determined given increasing prescription rates.
  
  
  
  We sought to determine time trends in prevalence of school children at risk of anaphylaxis across all year levels and the annual usage rate of adrenaline autoinjectors in the school setting relative to the number of students at risk of anaphylaxis.
  
  
  
  Statewide surveys from more than 1,500 government schools including more than 550,000 students were used and prevalence rates (%) with 95% CIs were calculated.
  
  
  
  The overall prevalence of students at risk of anaphylaxis has increased 41% from 0.98% (95% CI, 0.95-1.01) in 2009 to 1.38% (95% CI, 1.35-1.41) in 2014. There was a significant drop in reporting of anaphylaxis risk with transition from the final year of primary school to the first year of secondary school, suggesting a change in parental reporting of anaphylaxis risk among secondary school students. The number of adrenaline autoinjectors activated per 1000 students at risk of anaphylaxis ranged from 6 to 8 per year, with consistently higher activation use in secondary school students than in primary school students.
  
  
  
  Statewide prevalence of anaphylaxis risk has increased in children attending Victorian government schools. However, adrenaline autoinjector activation has remained fairly stable despite known increase in the rates of prescription.
authors.affiliation: Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Australia.
authors.forename: Paxton
authors.initials: P
authors.lastname: Loke
authors.affiliation: Murdoch Childrens Research Institute, Parkville, Australia; Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, Australia.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Koplin
authors.affiliation: Murdoch Childrens Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia.
authors.forename: Cara
authors.initials: C
authors.lastname: Beck
authors.affiliation: Murdoch Childrens Research Institute, Parkville, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Field
authors.affiliation: Murdoch Childrens Research Institute, Parkville, Australia; Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, Australia.
authors.forename: Shyamali C
authors.initials: SC
authors.lastname: Dharmage
authors.affiliation: Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Australia; Murdoch Childrens Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia.
authors.forename: Mimi L K
authors.initials: ML
authors.lastname: Tang
authors.affiliation: Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Australia; Murdoch Childrens Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia; Institute of Inflammation and Repair, University of Manchester, Manchester, United Kingdom. Electronic address: katie.allen@rch.org.au.
authors.forename: Katrina J
authors.initials: KJ
authors.lastname: Allen
mesh_terms: D000707:Anaphylaxis / Q000453:epidemiology* / Q000209:etiology; D001315:Australia / Q000453:epidemiology; D002648:Child; D004837:Epinephrine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D011159:Population Surveillance; D015995:Prevalence; D012424:Rural Population; D012574:Schools; D013334:Students; D014505:Urban Population
chemical_list: D004837:Epinephrine
keywords: Prevalence; adrenaline autoinjector; anaphylaxis; school students