Airborne allergies

23 replies [Last post]
By booandbrimom on Fri, 03-30-07, 14:31

Since I went to all the trouble of typing this for another thread, I'm going to repost it here. I hope it reassures some parents who are concerned about this issue. From [i]Understanding and Managing Your Child's Food Allergies[/i] by Scott Sicherer, head of the food allergy research program at Mt. Sinai:

"Casual exposure to food allergens from skin contact or by smell is probably one of the most worrisome notions, engendering much more stress than is truly warranted. Most research studies and clinical experience show that severe reactions occur from ingestion and not from skin contact or breathing fumes. In these situations [where proteins are aerosolized], most reactions to airborne food proteins are similar to a cat-allergic individual's contact with a cat. Symptoms may be hay fever - like itchy eyes and nose and runny nose or an asthmatic response, if the allergic individual has asthma, unlike in severe anaphylaxis where blood pressure can drop. Airborne peanut proteins near peanut butter are harder to detect. My research group had thirty highly peanut-allergic children sniff peanut butter for ten minutes and none reacted." pp. 21-22, for those reading along.

And, from p. 48: "Medical literature on this subject reveals that common reactions from air exposure typically occur while food is being cooked because cooking releases food-protein particles into the air. In these situations, one can usually see the steam rising from the food. Respiratory reactions are typical, such as hay fever symptoms of red, itchy eyes, runny nose, and then coughing and wheezing. These symptoms are usually no different form reactions to other airborne allergens." p. 48

***********************

Incidently, there's another section in the book about the myth of food allergies getting worse over time. It's a good read.

P.S. if your child has a severe inhalation allergy and you want to express your outrage, please direct it toward Dr. Sicherer (scott.sicherer@mssm.edu), not me. Thank you.

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By chanda4 on Fri, 03-30-07, 15:48

everybody is different, with that said, my son has reacted to being around shelled peanuts with the same reactions he does when exposed to cats. His face got really pink/red, eyes water, sneezing, nose running...same thing happens at grandmas house(she has 3 cats). BUT....when he was about 2 1/2 I was eating a peanut cluster in the car and he was in the 3rd row(he didn't know I was sneaking it) and he started grabbing his neck saying it was squeezing..........not sure if it was a coinsidance or what, but it scared me non-the-less. He also reacts to something *in the air* at Burger King(just one resteraunt this happend in twice, never any other BK's) but he started coughing and gagging saying he needed to puke, face flushed, eyes tearing, sneezing....we left(gave Benadryl, he was fine) but to this day I have NO clue what was in the air. I don't think peanuts or nuts, but I have no idea, maybe eggs??? Maybe a cleaner??? So this theory holds 1/2 true....yes his reaction to shelled peanuts was the same as cat exposure, but he also *possibly* had a more serious inhalation reaction as well....I'm of no help!!

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Chanda(mother of 4)
Sidney-8 (beef and chocolate, grasses, molds, weeds, guinea pig & asthma)
Jake-6 (peanut, all tree nuts, eggs, trees, grasses, weeds, molds, cats, dogs, guinea pig & eczema & asthma)
Carson-3 1/2 (milk, soy, egg, beef and pork, cats, dog, guinea pig and EE)
Savannah-1 (milk and egg)

__________________

Chanda(mother of 4)
Sidney-8 1/2(beef and chocolate, grasses, molds, weeds, guinea pig, hamster & asthma)
Jake-6 1/2(peanut, all tree nuts, all seeds(sesame, sunflower, poppy, pine nut) beef, chicken, eggs, coconut, green beans/all beans, trees, grasses,

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By McCobbre on Fri, 03-30-07, 22:57

Sorry for always breaking in, but I think this is relevant.

I am shellfish allergic (only in the last one and a half years) and have become increasingly sensitive to airborne sources.

I get this spacey feeling (won't go into here--have on other threads) and not always, but I have experienced GI symptoms after airborne exposure. (I normally get GI anaphylaxis from ingestion.) My doctor said that GI is just what I do, even if it's not ingestion. It's how my body reacts to shellfish.

He doesn't thik that airborne peanuts are a problem (I disagree with him because I've seen DS' reactions) but do think that airborne shellfish is and that it's really problematic when being cooked. He relies heavily on documented studies, so my anecdotal stories about reacting in the grocery store didn't faze him. But my reactions at work after walking through a shrimpy hall when someone was cooking their shrimp did. Go figure.

[This message has been edited by McCobbre (edited March 30, 2007).]

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My posts may not be published by anyone without getting express written consent by me.

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By chanda4 on Sat, 03-31-07, 01:55

McCobbre....I know it's irrelevant here, but it's still nice to find someone that knows what you are talking about. I forgot about my sons stomach cramps, until you mentioned the GI symptoms(without ingestion) he was getting them every Monday when the school served pb&j.....they have since gotten better, but I always wondered. It helps to know maybe I'm not crazy when you mention the same reaction. sorry you react though...HUGS

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Chanda(mother of 4)
Sidney-8 (beef and chocolate, grasses, molds, weeds, guinea pig & asthma)
Jake-6 (peanut, all tree nuts, eggs, trees, grasses, weeds, molds, cats, dogs, guinea pig & eczema & asthma)
Carson-3 1/2 (milk, soy, egg, beef and pork, cats, dog, guinea pig and EE)
Savannah-1 (milk and egg)

__________________

Chanda(mother of 4)
Sidney-8 1/2(beef and chocolate, grasses, molds, weeds, guinea pig, hamster & asthma)
Jake-6 1/2(peanut, all tree nuts, all seeds(sesame, sunflower, poppy, pine nut) beef, chicken, eggs, coconut, green beans/all beans, trees, grasses,

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By joeybeth on Sat, 03-31-07, 02:05

my two PA girls have had documented reactions to peanut protein in the air and to peanut protein on their skin. i would also have to say that those reactions were usually less severe than what would happen upon ingestion. (in one case, this was not the case but in all the others it was).

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By Peanut Militia on Sat, 03-31-07, 04:08

Question: If you or your child has had a severe reaction to airborne peanuts--beyond cat allergies, do you allow yourself or your child to be a part of these studies????????

Just a thought.

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By NicoleinNH on Sat, 03-31-07, 04:59

[img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

[This message has been edited by NicoleinNH (edited June 10, 2007).]

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By Corvallis Mom on Sat, 03-31-07, 15:01

Not looking to get into an argument with anyone here over this. I agree that generally this type of exposure is [i]smaller[/i] and therefore tends to result in less severe symptoms.

But my kid is one who [i]does[/i] have these kinds of reactions to [i]just being in a place where PB has been eaten.[/i] Even if she doesn't 'know' it. Her symptoms are subtle initially, but they [i]are not subjective.[/i]

I [i]know[/i] how far-fetched this sounds. I know. Nobody believes it until they [i]see[/i] it happen with their own eyes. Which they inevitably do, if they hang around with us for long.

Our allergist is no longer a skeptic. He does still believe that she is [i]unlikely[/i] to experience a major anaphylactic event from this source. But he's never said it is impossible, because she has experienced anaphylactic (technically) reactions from aerosol exposure. Not just upper respiratory or skin, but both.

My family and I would be pretty happy if we lived with a 'normal' peanut allergy in which ingestion is the only real danger. But I think it is wrong to dismiss experiences like my daughter's as hysteria. We know it is not. She does not even know what pn smell like, and when she first began exhibiting aerosol sensitivity like this, she was far too young for it to be psychosomatic (she was not yet 3 yo, as I recall).

I also, BTW, agree that some things can be triggered psychosomatically, particularly in people who are older at onset. I also agree that for reasons none of us may ever know, some people just aren't so sensitive, and never will be.

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By chanda4 on Sat, 03-31-07, 15:18

Corvallis Mom, I didn't think your post was arguing, your daughter reacts, that's a fact(as you shared). My son has had tummy cramps....I never put the 2 together(well I did, but everyone says it *can't* happen...even the allergist).....I'm glad you shared your story, I am going to pay more attention if he is around pb....he isn't often, so I guess that's best. Thanks!!!

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Chanda(mother of 4)
Sidney-8 (beef and chocolate, grasses, molds, weeds, guinea pig & asthma)
Jake-6 (peanut, all tree nuts, eggs, trees, grasses, weeds, molds, cats, dogs, guinea pig & eczema & asthma)
Carson-3 1/2 (milk, soy, egg, beef and pork, cats, dog, guinea pig and EE)
Savannah-1 (milk and egg)

__________________

Chanda(mother of 4)
Sidney-8 1/2(beef and chocolate, grasses, molds, weeds, guinea pig, hamster & asthma)
Jake-6 1/2(peanut, all tree nuts, all seeds(sesame, sunflower, poppy, pine nut) beef, chicken, eggs, coconut, green beans/all beans, trees, grasses,

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By Peg541 on Sat, 03-31-07, 15:56

[This message has been edited by Peg541 (edited March 31, 2007).]

__________________

Peggy

Son 22 Allergic to peanuts, tree nuts, tomatoes, soy, milk, oats, fish.

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By McCobbre on Sat, 03-31-07, 16:05

Quote:Originally posted by Corvallis Mom:
[b]Not looking to get into an argument with anyone here over this. I agree that generally this type of exposure is [i]smaller[/i] and therefore tends to result in less severe symptoms.

[/b]

Exactly, but therein lies the rub: [i]tends to.[/i]

The scary thing with FA is that you never know. You have folks one one end of the spectrum like your DD and folks on the other end who don't react. For those in the middle, you don't know where a reaction will take you.

Peg, I think it was good that your son administered the epi in that situation. Too many symptoms for me to feel comfortable with otherwise.

For those who only rely on documented occurrences, how do you get them documented? CM, your DD's allergist has beocme a believer after seeing her, but how did he actually encouter her having a reaction?

Until these types of cases are documented and written up, I fear that airborne exposures will be written off by the medical community as psychosomatic (some no doubt are, but I've seen in DS and experienced myself ones that definitely aren't).

What's a FA community to do?

__________________

My posts may not be published by anyone without getting express written consent by me.

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By Corvallis Mom on Sat, 03-31-07, 16:53

DD's allergist has become a believer because of several factors:

1. He knows us now. We are both professional scientists. Good ones-- we don't ever 'assume' causation without very persuasive evidence. VERY. Preferably with a negative control to compare. Now that he knows this about us, he knows he can rely on fairly objective observations associated with reports of such things. (The Target thing before Xmas this year, for example, and the school gymnasium experience last October, for example.)

2. Yes, he has seen it personally. I don't know [i]what[/i] was in that room before DD was in it, but he watched her turn different colors, sniffle, and itch for close to thirty minutes once after an allergy shot. He has seen her have problems being in his waiting room. I think the one incident may well have been caused by food eaten by a staffer prior to our arrival. While I don't consider this an 'engineered' challenge, it clearly worked out that way.

And yes, I agree with the 'tends' statement being the difficulty. The fact is that DD has experienced systemic symptoms from this mode of exposure, and I truly think it is [i]possible[/i] these reactions could at some point become more severe. They are a clear warning to us all that she is in an unsafe environment, at any rate.

Truthfully, we find aerosol exposures MORE worrisome than skin contact. Reason being that one is an internal exposure and the other is not.

We have found that we can easily identify the mode of exposure by the nature of the symptoms, but more importantly, by the treatment that causes them to resolve.

Aerosol exposures-- instantaneous symptoms (like turning on a light switch-- she literally [i]flashes[/i] with them), always upper respiratory with hives/skin coloration changes (sometimes other symptoms too), and they often resolve with NO treatment other than leaving the area. Sometimes albuterol.

Contact---- slower onset of symptoms (minutes) and always hives.... which won't resolve without benadryl AND washing. Even so, these are slow to resolve and may recur over a period of 24-72 hrs, eventually resulting in a poison-ivy like rash. We've only seen this rarely. Maybe four times total.

Ingestion-- catastrophic symptoms, immediate. Even to traces from shared lines/facilities.

(Her egg symptoms are the same, indidentally.)

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By Peg541 on Sat, 03-31-07, 19:00

Sorry, I erased my entry. I am sometimes reluctant to give my son's information too easily.

He had his first airborne reaction at 17 and used his epi. In retrospect maybe it was not necessary but his airway was involved and he went by his training. We did go to the ER and they put him on a dose pack of steroids. I think we both felt better with the steroids since his tongue was still swollen.

If I had to do it over again I'd tell him to use his epi. Period.

Since then he's had a number of airborne reactions. Once to peanuts being sold at intermission in a theater, he came back to his seat, airway swelled he left and took Benadryl.

Other times it seems to be from peanuts maybe being roasted at a popular pier amusement area here in L.A. He just does not go there anymore.

So yes his reactions to airborne peanut are well documented by us and the ER.

His allergist ALSO reacts to airborne peanut and shellfish. I think it was shellfish being cooked in his presence at a conference though.

McCobbre I consider the ER visit documentation. Plus my son has enough experience and I have enough medical training to be our own documenters. I suppose this is not "legal" but like you say what's a FA community to do?

Peg

[This message has been edited by Peg541 (edited March 31, 2007).]

__________________

Peggy

Son 22 Allergic to peanuts, tree nuts, tomatoes, soy, milk, oats, fish.

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By NicoleinNH on Sat, 03-31-07, 21:07

[img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

[This message has been edited by NicoleinNH (edited June 10, 2007).]

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By Peg541 on Sat, 03-31-07, 23:18

Remember something. My son was diagnosed at age 4. He ate in all of his schools right next to kids who were eating PB. His nursery school served PB every day.

We did not know anything about PA then and DS certainly was not a happy camper. He was repulsed at the smell of peanuts and I believe this was a little gift to help him save his own life until we got more education.

I also imagine that the smell of PB gave him some sort of symptoms and that might be what he was feeling.

So I certainly can say that years of exposure to PB has heightened his allergic response to now he responds to airborne peanut. I won't be talked out of that.

His first ingestion reaction at age 14 was a sight to behold. He reacted the INSTANT that food touched his lips. And he had a BIG secondary reaction after that.

If that was his first ingestion then how did he get so sensitized? Why did the allergist take pictures of his skin test reaction at age 4, there was a streak going up his arm from the peanut test.

I believe he was sensitized all of those years of me eating PB in the house (before he was 4)and him in nursery school (as little as that was timewise) sitting with those kids eating PB. And all of that sensitization led to extreme reactions and airborne sensitivity.

Peggy

__________________

Peggy

Son 22 Allergic to peanuts, tree nuts, tomatoes, soy, milk, oats, fish.

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By Peg541 on Sat, 03-31-07, 23:19

So Nicole I think what I was trying to say up there is your child might not increase her sensitivity. You are keeping her away from peanuts much more diligently than we ever did. This might have a big effect, you don't know that yet.
Peg

__________________

Peggy

Son 22 Allergic to peanuts, tree nuts, tomatoes, soy, milk, oats, fish.

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By TwokidsNJ on Sat, 03-31-07, 23:31

As for the cat comparison...

DH and DS are allergic to cats and it is MISERABLE for them. Swelling eyes, constant sneezing, coughing, feeling awful.

So I wouldn't just blow this off as "nothing" ... I would NOT want my kids having this type of reaction at school. And that is the whole point IMO (which saknjmom has also made) -- I don't want my kids having reactions at school when they are not watched as closely as they would be at home. ANY reaction at school is one too many, IMO, and if my kids do start having contact reactions at school (or worse), I will be on the case immediately. Nothing to sneeze at IMO, *pun intended*.

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By TwokidsNJ on Sat, 03-31-07, 23:32

Quote:Originally posted by Peanut Militia:
[b]Question: If you or your child has had a severe reaction to airborne peanuts--beyond cat allergies, do you allow yourself or your child to be a part of these studies????????

Just a thought.[/b]

Good point. Self selection bias!

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By McCobbre on Sun, 04-01-07, 00:16

Quote:Originally posted by Corvallis Mom:
[b]Truthfully, we find aerosol exposures MORE worrisome than skin contact. Reason being that one is an internal exposure and the other is not.
[/b]

Yes--us, too. In fact, I don't think DS has had a skin contact reaction. I'll qualify that, but first let me say that last year DS and DH went to a ranch, and DS stuck his finger into a bag, and there was PB in there. He pulled it out, and within a minute DH had it cleaned off--even under the fingernail. Then they ate lunch. :GASP: This earned DS his first Diet Coke ever (what was DH thinking with that??? He wanted to give DS a treat, and that was the only one available. Yuck.). But no hives. No reaction. Nothing. I was thrilled. He never seems to have a reaction at dance or after touching railings on stairs in public places (of course, paranoid mommy says, "if you can descend safely without holding the rails, don't!").

I don't know--I'm just not as worried about the contact reactions as much. So he now, on certain days, eats at the "regular" table at school. This would be on the non-Chik Fil A days, which is every day but Wednesday. The school doesn't serve PB, and the kids who bring PB sit somewhere else. If a problem arises, we'll go more conservative again.

The question is when a contact reaction becomes ingestion.

Here's my qualification: He did have a reaction once at dance, and I'm thinking it was airborne. A kid brought PB sandwich and left it on a table, and DS played near that table. HI don't know if that was that it was airborne or he touched something that had PB protein on it from around the table or the barre and then rubbed his eye (so a form of ingestion, although "gest" denotes that it passed through the stomach, and that didn't happen). His eye swelled up. One eye.

He has had several airborne reactions, and he doesnt' know what PB smells like. One involved someone eating peanut M&Ms behind him and over one seat in a theatre. The reaction wasn't "bad;" it inovlved some asthma. But that's bad enough for me.

Because of my own airborne reactions and not knowing where they're heading, I worry about DS'. I think I may be experiencing a decrease in blood pressure (the spaciness). That concerns me far more than stomach cramping. So if I can feel like I am deflated and am about to pass out, then DS could (although I completely understand that my symptoms are very particular to me). Still, there's that realm of possibility for him.

__________________

My posts may not be published by anyone without getting express written consent by me.

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By chanda4 on Sun, 04-01-07, 00:41

(edited)....I really appreciate when you share things that happened to you as a child, it helps me understand my son more...things I wouldn't think about on my own, because I'm not peanut allergic. I just wanted to say thanks. [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

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Chanda(mother of 4)
Sidney-8 (beef and chocolate, grasses, molds, weeds, guinea pig & asthma)
Jake-6 (peanut, all tree nuts, eggs, trees, grasses, weeds, molds, cats, dogs, guinea pig & eczema & asthma)
Carson-3 1/2 (milk, soy, egg, beef and pork, cats, dog, guinea pig and EE)
Savannah-1 (milk and egg)

__________________

Chanda(mother of 4)
Sidney-8 1/2(beef and chocolate, grasses, molds, weeds, guinea pig, hamster & asthma)
Jake-6 1/2(peanut, all tree nuts, all seeds(sesame, sunflower, poppy, pine nut) beef, chicken, eggs, coconut, green beans/all beans, trees, grasses,

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By mfharris on Mon, 04-02-07, 03:39

This is slightly OT, but my pa/tna daughter has started associating the smell of chocolate to peanuts. Maybe because of all the chocolate/peanut butter candy? My brother was eating a Tootsie Roll about 10 feet away from her and she yelled "I smell peanuts!" and when he came over to investigate she wouldn't go near him because of the smell of the Tootsie Roll. Interesting, but again OT. Sorry!

__________________

Meg

5 year old DD allergic to peanuts/all tree nuts
2 year old DS allergic to milk/soy

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By Going Nuts on Mon, 04-02-07, 11:21

My son has had airborne reactions to both peanuts and sesame which involved full body hives and wheezing. His allergist was initially surprised, but no longer. [img]http://uumor.pair.com/nutalle2/peanutallergy/rolleyes.gif[/img]

One thing to keep in mind is that I think the highly sensitive are probably over-represented on these boards. We're the ones who sought out support like this because we felt we really, really needed it. While many of us have these reactions to share, my guess is that they are less common in the larger allergic community. Our kids just may be the exception.

Amy

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By notnutty on Mon, 04-02-07, 13:03

My son has had 1 airborne reaction. We were at a parade and free bags of peanuts were handed out to the entire crowd from one of the floats. Within minutes of the crowd opening the peanuts my son had difficulty breathing.

However, he does attend school where peanut butter is an option everyday and has not had a reaction. So for him I think that in the shell peanuts or shelled peanuts are more of a problem than pb. I would be interested in a study that uses in the shell peanuts being opened v. peanut butter.

Also, whenever my son has contact reactions his asthma goes crazy for days. He is miserable. So I never think "it's just his asthma" because he feels very sick for days.

__________________

No longer a member.

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By Peanut Militia on Mon, 04-02-07, 15:46

Quote:Originally posted by Peanut Militia:
[b]Question: If you or your child has had a severe reaction to airborne peanuts--beyond cat allergies, do you allow yourself or your child to be a part of these studies????????

Just a thought.[/b]

This past weekend my daughter had a contact reaction to Peanuts (only thing she has ana to so far). We are as sure as you can be that was the source (see thread in reactions 5 1/2 years...).

What I hate about these kinds of studies that minimalize PA- and ana reactions -if by air or contact- is that when you do have the zebra reaction it is not taken serious.

When we told the ER doc she had only contacted - no ingestion they suddenly had a slow down. 'O'h' the doc said, she is going to be just fine (insert eye rolling and put on smile). Meanwhile, DD was going to the bathroom with diarrhea,the swelling had not gone down and she was still getting hives. Later he said "You need to understand, children rarely go into ana with contact to food and it is even more rare they need emergency care." (I wish I could put his tone to paper). He discharged her after 3 hours with gunk still pouring out of her eyes, stomach still upset.... and recommended we watch her (like duhhhh)
I know that was a little off topic, but he was speaking authoritative and holding a slip he had printed that said 'Allergy induced Anaph..." on it.

So, was it a study like this one that said contact would only cause 'cat like' symptoms? She had already had benedryl and Epi 15 min before he saw her so he did not see the full contact exposure. Thank God I didn't say it was probably from an airborne exposure!!!!! And--what if I was wrong??? Was the exposure less than if she would have ingested?? I hope I don't find out!

Unless the children in this study were all children who had airborn problems in the past and were being verified I would question if it is a true-end all debate study.

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