Professor Jonathan Hourihane:

It must be. Simply because the HSE has not said that it is, does not mean that it is not.

A very interesting question is how we screen for nut allergy. I do not know how one screens for nut allergy. We know that 80% of children with nut allergy have eczema and we know that 95% of children with peanut allergy have other forms of allergic disease. One might be able to find just the allergic children and test them for it. The problem we have with that, Chairman and members, is that the positive tests are less useful than the negative test. A negative test for a peanut allergy is very likely to be true that one is not allergic to it, so 95% likely and we send people home with a negative testing. The problem is that if one has a positive test it is only 50% likely that one is allergic. It is less useful as a positive test. There is an issue of sensitivity and specificity of the medical test so it is not amenable to screening because it does not work as well with either result. It is conclusive if it is negative but it is inconclusive if it is positive in the absence of a history of reactivity. If somebody has had a reaction, the likelihood of it being a true result goes up. If I tested everybody in a male hurling changing room with pregnancy tests and found a positive, it is likely the test is wrong. If I did it in a camogie changing room, that poor girl is pregnant. The likelihood of it being there affects how the test works. We use these examples when we explain our test to parents so it takes only a few minutes. However, that is what we say to them.

I do not know how much they hear. Do they need to hear it again? Are there other resources that we could use? There is the Inernet, there are apps, even a talking pen that gives one instructions like the defibrillators do. We give them what we think they need but that might not be what individual families need and we might need to rehearse it and deliver it in other formats. Bracelets are a very good idea. It is not a new idea as they are already available for those with diabetes, sarcoidosis and long-term illnesses that cause the sufferer to seek emergency care. We advise families to have them. The take-up is very low. We want the teenagers to wear them but they do not want to wear a medical bracelet, they want to have a tattoo or earrings. I am not saying that we should allergy earrings or allergy tattoos. I have, however, seen people in the United States with allergy tattoos so that when they are unconscious it is available. As Senator Crown said these are rare tragedies. I have made the comparison with maternal deaths and the national response to those cases. I think it could be made mandatory for the providers of food who are making profit from food that they make their restaurant a safe place to eat. The mandate for training cannot come from restaurateurs, it has to come from health authorities. I would be very keen to see even a temporary elimination of liability so that we can perform our pilot before we go to the wider availability. If it does not work, we should not do it.