Addressing safety measures for students with food allergies in college dining halls

Background: Food allergy (FA) affects approximately 10.8% of college students, impacting students' social lives, on-cam- pus dining experiences, and financial expenses. Fatal food anaphylaxis is most common among adolescent populations, often due to increased risk-taking behavior; nevertheless, data quantifying the resources available to food-allergic college students in university dining halls is limited. Objective: Investigate the dining and residential accommodations currently provided for students with FA in university spaces. Methods: During the summer of 2024, 217 verified schools on the FARE College Search site were investigated for various measures of FA accommodations in dining halls. The presence of labeled ingredients, allergy-friendly station(s), and undesignated stock epinephrine were documented for small, medium, and large institutions of higher education. Results: Of universities with an undergraduate enrollment under 5,000 students, 10% posted full ingredients in dining halls and 2.9% had epinephrine auto-injectors (EAI) available for public use. At dining halls of institutions with 5,000-15,000 students, 12% posted full ingredients and 2.6% stocked undesignated EAI. For large schools with over 15,000 undergraduate students, 16% labeled all ingredients and 10% had EAI available at dining halls. Of the 217 schools, approximately 76% had FA-friendly stations, 42% did not label any ingredients, and over 95% of college dining halls and two-thirds of campus emergency responders lack epinephrine on-hand in case of emergency. Conclusions: Although many schools provide FA-friendly alternatives in dining halls, the lack of ingredient labeling and access to emergency epinephrine may result in delayed epinephrine administration, putting students with food allergy at a higher risk of anaphylaxis. Labeling and epinephrine access may improve the college experience and safety of students with food allergies.