Hopkinton High School freshman Reese Robledo stands next to one of the new food allergen signs in town.

What started as a fourth-grade school project for Reese Robledo more than five years ago has blossomed into a public awareness signage campaign at school playgrounds about the dangers of exposure to food allergens.

For Robledo, exposure to even the smallest particles of food that she is allergic to can lead to hives or — in the worst-case scenario — anaphylaxis, which could be fatal. Some of her many allergies include peanuts, eggs, wheat and chicken. The particles can be airborne or spread by surface contact.

For example, Robledo could be in danger if someone ate peanuts at a ballgame a few rows away from her if the discarded shells happened to touch her or anything with which she came into contact.

“We did a project where we had to talk about something we were passionate about,” she explained. “Food allergies was the first thing I thought of, because I have to manage them carefully every day.”

Robledo credited Maribeth Tremblay, her former teacher at Hopkins Elementary School, for helping her brainstorm ideas to bring her allergy awareness project to fruition.

“She really wanted to empower Reese,” said Mareesa Robledo, her mother. “I don’t think this idea would have gone as far as it has without her.”

Tremblay connected Robledo with Health Department Director Shaun McAuliffe, who took a keen interest in the project.

“As allergen awareness and safety are a significant part of our food safety, school and camp inspections, Reese’s project highlighted an educational opportunity that existed within the community that the department could work with her on,” McAuliffe said. “We invited her to present her project to the Board of Health.”

Shortly after that presentation on Feb. 10, 2020, McAuliffe designed and printed signage that he hoped to post at all of Hopkinton’s public playgrounds. But the effort stalled with the onset of the pandemic.

Said McAuliffe: “The pandemic hit, but I had made a promise to Reese.”

Over the next three years, the state’s Department of Public Health created an Academic Public Health Corps to assist local public health departments with COVID-related programming. Its mission expanded to assisting public health departments with implementing innovative public health initiatives. McAuliffe pitched the playground signage idea to the DPH and the APHC. Both agreed about the merit of a statewide playground signage campaign, which is in the works.

Signs have been placed at several Hopkinton school playgrounds this fall.

Dangers of exposure serious

According to foodallergy.org, each year, 200,000 people in the United States require emergency medical care for allergic reactions to food. One in 10 adults and one in 13 children are among the 33 million Americans affected.

“It’s so difficult because you just think food is sustenance,” Mareesa said. “You wouldn’t think it could be such a danger to your body.”

Mareesa discovered that her daughter had food allergies when Reese was only 4 months old. Reese broke into full-body hives after being exposed to supplemental cow’s milk formula. Originally, Mareesa and her husband, Rob, thought Reese had colic. Within two months, Reese began treatment at the Food Allergy Center at Mass General for Children, where she continues to receive care.

As a young child, everyday experiences such as going to the playground or riding the school bus posed potential life-threatening dangers for her.

“I couldn’t just go with my friends and play freely,” said Reese. “I had to be careful of everything I was touching and making sure that I was always washing my hands and not touching my face.”

Her mother explained that when Reese was in the first grade, she would receive calls almost daily that her daughter had broken out into hives.

“We were always on alert for allergy bombs,” said Mareesa. “We felt like firemen waiting for the fire. We had to watch everyone and what they were eating, what they were touching.”

When Reese was in preschool, her parents provided allergen-free snacks for the entire class to limit allergen exposure. In the third grade, the class had a “nut and dairy aware” table at lunch.

“My classmates have been really supportive of me,” Reese said. “They understand that I have allergies, so if they have been eating something I’m allergic to, they will wipe their hands.”

“Where most children use the playground after lunch, picnicking or snacking,” McAuliffe added, “to reduce the potential exposure to allergens transferred from the hands to playground equipment, it is important for children to wash or wet wipe their hands after handling common foods containing the eight most common food allergens,  including peanuts, tree nuts, milk, egg, shellfish, soy, wheat and fish.”

Allergen studies continue

Reese has been able to reduce the number of her allergens by going through “allergen challenges” at the allergy center. She is monitored while being exposed to small amounts of foods to see if her tolerance has increased. She also has participated in a clinical trial. This summer, she had to use EpiPens three times during the allergen challenges.

Mareesa noted that she was afraid of letting Reese take an airplane flight because of what she could inhale or ingest. She began buying masks for airplane trips before the pandemic.

Said Mareesa: “So we were doing masks before it was cool.”

Reese has to carry two EpiPens with her at all times in case an exposure leads to anaphylactic shock.

Said Rob: “We practiced at home on a lot of oranges.”

Both Mareesa and Rob complimented their daughter on her composure in navigating her health challenges. Modifying their diets and preparing food at home has brought them, along with Reese’s brother, Mack, closer as a family.

Said Mareesa: “Reese had to mature quicker than any other kid who didn’t have allergies just to be able to manage herself.”

Reese has refused to let her condition stop her, playing basketball and field hockey while contemplating a career in interior design. She also enjoys studying the sciences, motivated in part by her condition. She is proud that her advocacy has turned into something that can educate families statewide.

“Like most public health projects, Reese’s should allow all children to safely and confidently utilize the playground without the fear of life-threatening allergic reactions,” said McAuliffe. “With the assistance of the MDPH and Academic Public Health Corps, Reese’s efforts will make playgrounds across the commonwealth safer.”