The DOI matches its Crossref record; 16 of the 17 references it cites were found in a registry or an index; 2 of the 10 sources its claims cite were checked for support.
A Quantitative Assessment of Gluten Cross-Contact in the School Environment for Children with Celiac Disease
Open accessAbstract
OBJECTIVES: A gluten-free (GF) diet is the primary treatment for celiac disease (CD). Gluten is used in schools, particularly in early childhood, art, and home-economics classrooms. This study aimed to measure gluten transfer from school supplies to GF foods that a child with CD may eat. Also, to measure efficacy of washing techniques to remove gluten from hands and tables. METHODS: Five experiments measured potential gluten cross-contact in classrooms: Play-Doh (n = 30); baking project (n = 30); paper mâché (n = 10); dry pasta in sensory table (n = 10); cooked pasta in sensory table (n = 10). Thirty participants ages 2 to 18 were enrolled. Following activities, gluten levels were measured on separate slices of GF bread rubbed on participant's hands and table surfaces. Participants were assigned 1 of 3 handwashing methods (soap and water, water alone, or wet wipe). Repeat gluten transfer measurements were taken from hands and tables. Gluten measurements made using R-Biopharm R7001 R5-ELISA Sandwich assay. RESULTS: Paper mâché, cooked pasta in sensory tables, and baking project resulted in rates of gluten transfer far greater than the 20 ppm threshold set by Codex Alimentarius Commission. Play-Doh and dry pasta, however, resulted in few gluten transfers to GF bread >20 ppm. Soap and water was consistently the most effective method for removing gluten, although other methods proved as effective in certain scenarios. CONCLUSIONS: The potential for gluten exposure at school is high for some materials and low for others. For high-risk materials, schools should provide GF supplies and have a robust strategy to prevent gluten cross-contact with food.
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Claims the paper makes
2 of 10 cited sources checked · 1 supported · 0 flagged · accuracy not yet measured
- Premisecitation
Children diagnosed with celiac disease early (ages 0-15) who maintain a strict gluten-free diet may experience no effect on academic performance.
“Children diagnosed with CD early (between ages of 0–15) who maintain a strict GFD may experience no effect on academic performance(10)”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [10] source
- Findingown data
After Play-Doh play, only 2 of 30 gluten-free bread slices rubbed on unwashed table workspaces had gluten transfer above 20 ppm.
“Only 2 of the 30 bread slices rubbed on the soiled, unwashed table workspaces resulted in transfer levels above 20 ppm (Figure 1).”
Quote in the paperSubstantial claim - Findingown data
The two Play-Doh table samples with gluten transfer above 20 ppm had visible pea-sized pieces of Play-Doh stuck to the gluten-free bread.
“Both of these samples had visible pea-sized pieces of Play-Doh adhered to the GF bread.”
Quote in the paperNot a substantial claim - Findingown data
After washing hands and tables following Play-Doh play, all 60 samples (30 hand and 30 table) produced gluten-free bread with less than 5 ppm gluten, regardless of washing method.
“All samples tested after washing (30 hand samples and 30 table samples) resulted in GF bread slices with less than 5 ppm gluten, regardless of the washing method (Figure 2).”
Quote in the paperSubstantial claim - Findingown data
After the home economics baking activity, gluten transfer from cleaned tables varied, with 10 of 30 bread slices rubbed on cleaned surfaces having more than 20 ppm gluten.
“Variable amounts of gluten were transferred from the tables after washing, with 10 of the 30 slices of bread rubbed on the cleaned surface containing greater than 20 ppm gluten.”
Quote in the paperSubstantial claim
- Findingown data
The 4-year-old whose hand sample had 30.7 ppm after soap and water washing had visibly more flour on their body, including clothing, face, and both forearms.
“Observation notes indicated that this child had visibly more flour adhered to their body, including on clothing, face, and both forearms.”
Quote in the paperNot a substantial claim - Findingown data
After five minutes of playing with Play-Doh, all 30 gluten-free bread samples rubbed on participants' hands had gluten levels below 20 ppm.
“all 30 bread samples rubbed on the participants hands after the five-minute play activity tested below 20 ppm gluten.”
Quote in the paperSubstantial claim - Findingown data
A three-ounce container of Play-Doh contained 32,253 ppm gluten.
“The concentration of gluten in a three-ounce container of Play-Doh was 32,253 ppm gluten.”
Quote in the paperNot a substantial claim - Findingown data
After the home economics baking activity, all 30 gluten-free bread samples rubbed on unwashed cooking workspaces had gluten transfer above 20 ppm.
“The same was true for all 30 bread samples rubbed on the soiled, unwashed cooking workspaces.”
Quote in the paperSubstantial claim - Findingown data
Baking, paper mâché, and cooked pasta activities, all using wheat flour-based materials, produced substantial gluten transfer above 20 ppm.
“In contrast, there was substantial gluten transfer resulting in levels greater than 20 ppm after the baking, paper mâché, and cooked pasta activities, all of which utilized wheat flour-based materials.”
Quote in the paperSubstantial claim- Rests on an assumption: The simulated classroom activities used in the study are representative of real classroom activities for children with celiac disease.
- Rests on an assumption: Gluten transfer measured in healthy children without celiac disease is representative of gluten transfer in children with celiac disease.
- Findingown data
Soap and water, water alone, or wet wipes were sufficient to create safe surfaces after Play-Doh activities.
“Our data showed that soap and water, water alone, or wet wipes were sufficient to create safe surfaces after Play-Doh activities.”
Quote in the paperSubstantial claim- Rests on an assumption: The simulated classroom activities used in the study are representative of real classroom activities for children with celiac disease.
- Rests on an assumption: Gluten measured on gluten-free bread rubbed on hands is a valid proxy for the amount of gluten a child might ingest from their hands.
- Interpretationown data
A child who interacts vigorously or exuberantly with gluten-containing materials may have a greater risk of gluten transfer, as observed during baking and cooked pasta activities.
“Furthermore, a child who vigorously or exuberantly interacts with gluten-containing materials may experience a greater risk of gluten transfer, as we observed during the baking and cooked pasta activities.”
Quote in the paperNot a substantial claim- Rests on an assumption: The simulated classroom activities used in the study are representative of real classroom activities for children with celiac disease.
- Rests on an assumption: Gluten transfer measured in healthy children without celiac disease is representative of gluten transfer in children with celiac disease.
- Interpretationown data
When gluten transfer to gluten-free bread was detected after Play-Doh, levels were below 20 ppm as long as no visible Play-Doh was present.
“When gluten transfer to GF bread was detected, the levels were less than the 20 ppm threshold so long as there was no visible Play-Doh.”
Quote in the paperSubstantial claim- Rests on an assumption: The simulated classroom activities used in the study are representative of real classroom activities for children with celiac disease.
- Rests on an assumption: Gluten transfer measured in healthy children without celiac disease is representative of gluten transfer in children with celiac disease.
- Interpretationown data
Children with celiac disease may be able to use Play-Doh and dry pasta safely in the classroom, provided the materials themselves are not consumed.
“children with CD may be able to use these materials safely in the classroom environment, provided that the materials themselves are not consumed.”
Quote in the paperSubstantial claim- Rests on an assumption: The simulated classroom activities used in the study are representative of real classroom activities for children with celiac disease.
- Rests on an assumption: Gluten measured on gluten-free bread rubbed on hands is a valid proxy for the amount of gluten a child might ingest from their hands.
- Rests on an assumption: Gluten transfer measured in healthy children without celiac disease is representative of gluten transfer in children with celiac disease.
- Interpretationown data
Some common school activities pose a higher risk of gluten exposure than others, especially those using wet materials and wheat flour.
“Our data shows that some common school activities pose a higher risk of gluten exposure than others, especially those that utilize wet materials and wheat flour.”
- Also stated in: § Conclusions · plain
“The potential for gluten exposure at school is high for some materials and low for others.”
Quote in the paperSubstantial claim- Rests on an assumption: The simulated classroom activities used in the study are representative of real classroom activities for children with celiac disease.
- Rests on an assumption: Gluten transfer measured in healthy children without celiac disease is representative of gluten transfer in children with celiac disease.
- Also stated in: § Conclusions · plain
- Interpretationown data
The risk of gluten ingestion from materials like Play-Doh and dry pasta may have been historically overestimated.
“the data also illustrates that the risk of gluten ingestion associated with use of materials like Play-Doh and dry pasta may have been historically overestimated”
Quote in the paperSubstantial claim- Rests on an assumption: The simulated classroom activities used in the study are representative of real classroom activities for children with celiac disease.
- Rests on an assumption: Gluten transfer measured in healthy children without celiac disease is representative of gluten transfer in children with celiac disease.
- It may state two separate claims as one. 20
- Probably not a substantial claim. 13
It may state two separate claims as one.
PremisecitationA dedicated gluten-free zone may be more important than dedicated equipment because washing kitchen utensils and pots with soap and water or water alone is sufficient to remove gluten.
“A dedicated gluten-free zone may be more important than dedicated equipment as washing kitchen utensils and pots with soap and water or water alone is sufficient to remove gluten(15).”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [15] source
The Results report that rinsing pasta pots with water alone was as effective as scrubbing with soap and water in preventing detectable gluten transfer, and that all three tested knife-cleaning methods removed gluten. The paper does not establish that a dedicated gluten-free zone is more important than dedicated equipment; its Discussion instead says that dedicated equipment or preparation areas may be unnecessary with consistent cleaning. (LLM, conf=0.87)
Experimental — accuracy not yet measured
It may state two separate claims as one.
Findingown dataAfter five minutes of playing with dry pasta in a sensory table, all 10 gluten-free bread samples rubbed on participants' hands had less than 20 ppm gluten, with 9 of 10 below 5 ppm.
“All 10 GF bread samples rubbed on participant hands after the five-minute play with dry pasta in a sensory table contained less than 20 ppm gluten, with 9 out of 10 samples testing below 5 ppm.”
Quote in the paperSubstantial claimIt may state two separate claims as one.
Findingown dataAfter the home economics baking activity, all three washing methods effectively removed gluten from participants' hands, except one bread sample had 30.7 ppm after being rubbed on the hands of a 4-year-old who washed with soap and water.
“Nevertheless, all three washing methods effectively removed gluten from participant hands, with the exception of one piece of bread that contained 30.7 ppm gluten after being rubbed on the hands of a 4-year-old who washed their hands with soap and water.”
Quote in the paperSubstantial claimIt may state two separate claims as one.
Findingown dataOf the 10 gluten transfers from cleaned tables after home economics baking, 8 occurred when water alone was used, while 1 occurred in each of the soap and water and wet wipe groups.
“Eight of the 10 gluten transfers occurred when water alone was used, while just one transfer occurred in each of the soap and water and wet wipe groups (Table 2).”
Quote in the paperSubstantial claimIt may state two separate claims as one.
Findingown dataAfter the paper mâché balloon art project, gluten transfer from participants' dried hands to gluten-free bread was above 20 ppm, with most samples above 84 ppm.
“gluten transfer from participants dried hands after the paper mâché balloon art project activity resulted in gluten transfer to the slices of GF bread of greater than 20 ppm gluten, with most of the samples testing greater than 84ppm.”
Quote in the paperSubstantial claimIt may state two separate claims as one.
Findingown dataAfter the home economics baking activity, all 29 gluten-free bread slices rubbed on participants' hands had gluten transfer above 20 ppm, with most exceeding 84 ppm.
“all 29 GF bread slices (one sample was lost during processing) rubbed on participant hands after the home economics cooking activity resulted in gluten transfers of greater than 20 ppm, with most of the samples exceeding the upper limit of quantification of greater than 84 ppm.”
Quote in the paperSubstantial claimIt may state two separate claims as one.
Findingown dataAfter five minutes of playing with cooked and dyed pasta in a sensory table, 9 of 10 gluten-free bread samples rubbed on participants' hands had more than 20 ppm gluten, with 8 of 10 exceeding 84 ppm.
“Nine of the 10 bread samples rubbed on participant hands after the five-minute play with cooked and dyed pasta in a sensory table contained greater than 20 ppm gluten, with 8 out of 10 exceeding the upper limit of quantification of greater than 84 ppm gluten.”
Quote in the paperSubstantial claimProbably not a substantial claim. The paper’s conclusions may not depend on it.
Findingown dataThe one cooked and dyed pasta sample that tested below 20 ppm came from a 4-year-old participant.
“The one sample that tested below the 20 ppm threshold was from a 4-year-old participant who described the pasta material as “feeling like gross worms.””
Quote in the paperNot a substantial claimProbably not a substantial claim. The paper’s conclusions may not depend on it.
Findingown dataThe 4-year-old whose cooked pasta sample tested below 20 ppm had visibly less pasta residue on their hands than other participants.
“There was a visibly less pasta residue on this child’s hands compared to the other participants.”
Quote in the paperNot a substantial claimIt may state two separate claims as one.
Interpretationown dataPlay-Doh and dry pasta were associated with the lowest risk of gluten exposure.
“Specifically, Play-Doh and dry pasta were associated with the lowest risk of gluten exposure.”
Quote in the paperSubstantial claim- Rests on an assumption: The simulated classroom activities used in the study are representative of real classroom activities for children with celiac disease.
- Rests on an assumption: Gluten transfer measured in healthy children without celiac disease is representative of gluten transfer in children with celiac disease.
It may state two separate claims as one.
Interpretationown dataHand washing and cleaning of surfaces are generally effective strategies to mitigate the risk of gluten transfer.
“Furthermore, hand washing and cleaning of surfaces are generally effective strategies to mitigate the risk of gluten transfer.”
Quote in the paperSubstantial claim- Rests on an assumption: The simulated classroom activities used in the study are representative of real classroom activities for children with celiac disease.
- Rests on an assumption: Gluten measured on gluten-free bread rubbed on hands is a valid proxy for the amount of gluten a child might ingest from their hands.
- Rests on an assumption: Gluten transfer measured in healthy children without celiac disease is representative of gluten transfer in children with celiac disease.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
PremisecitationGluten at school is often a source of anxiety for children with celiac disease and their parents.
“Gluten at school is often a source of anxiety for children with CD and their parents(6, 16).”
Quote in the paperNot a substantial claim0 of 2 sources checkedProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
Study design and conductnone givenTrained observers used a rating sheet to document each participant's interaction with school materials for each activity, to ensure adherence to the planned experimental design and to account for potential outliers.
“Trained observers used a rating sheet to document each participant’s interaction with school materials for each activity (e.g., enthusiasm, duration, and messiness), to ensure adherence to the planned experimental design and to account for potential outliers in the data.”
Quote in the paperNot a substantial claimProbably not a substantial claim.
Study design and conductown dataParticipants in the Play-Doh and home-economics baking scenarios were randomly assigned to one of three hand and table washing methods.
“Participants in the Play-Doh and home-economics baking scenarios were randomly assigned one of three hand and table washing methods (soap and water, water alone, or wet wipe (Wet Ones Antibacterial Hand Wipe, Edgewell, North Bergen, NJ).”
Quote in the paperSubstantial claimIt may state two separate claims as one.
Study design and conductown dataThe efficacy of the cleaning methods between activities was verified using gluten-free bread rubbed on children's hands and surfaces, and none of the control samples contained detectable gluten.
“The efficacy of these cleaning methods was verified using GF bread rubbed on children’s hands and surfaces. None of the control samples contained detectable amounts of gluten.”
Quote in the paperSubstantial claimProbably not a substantial claim. The paper’s conclusions may not depend on it.
Study design and conductnone givenResults are reported as 95% confidence intervals based on a binomial distribution.
“Results are reported as 95% confidence intervals based upon binomial distribution.”
Quote in the paperNot a substantial claimProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
Study design and conductnone givenThe study did not test gluten transfer from low-risk supplies to the hands of children with celiac disease, nor how much could be consumed from actions like thumb sucking and nail biting.
“Furthermore, we did not test the level of gluten possibly transferred from low risk supplies to the hands of children with CD nor how much could be consumed from actions like thumb sucking and nail biting.”
Quote in the paperNot a substantial claimProbably not a substantial claim. The paper’s conclusions may not depend on it.
Study design and conductnone givenThe study was approved by the Children's National Medical Center IRB.
“This study was approved by Children’s National Medical Center IRB.”
Quote in the paperNot a substantial claimIt may state two separate claims as one.
PremisecitationGluten-free food can be safely prepared concurrently with wheat-based flour in a shared commercial kitchen if proper sanitation methods are followed and gluten-free foods are at least 2 meters away from areas where gluten-containing flours are used.
“Miller et al(14) found that GF food could be safely prepared concurrently with wheat-based flour in a shared commercial kitchen space provided that proper sanitation methods are followed (clean surfaces, equipment, and utensils) and the GF foods were at least 2 meters (6.56 feet) away from areas where gluten-containing flours were used.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Miller et al(14)
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
PremisecitationThose with undiagnosed, untreated celiac disease may have lower educational attainment.
“whereas those with undiagnosed, untreated CD may have lower educational attainment(11).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [11] source
Probably not a substantial claim. The paper’s conclusions may not depend on it.
PremisecitationThe R5 Mendez ELISA method is endorsed by the Codex Alimentarius Commission as a type 1 method for detecting gluten in foods.
“The R5 Mendez ELISA method is endorsed by the Codex Alimentarius Commission as a type 1 method for the detection of gluten in foods(5).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [5]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
It may state two separate claims as one.
Interpretationown dataDry school supplies caused very low gluten transfer, while wet and/or sticky materials tended to cling to children's hands and table surfaces.
“we found that school supplies that are dry had very low gluten transfers while materials that were wet and/or sticky tended to cling to the hands of children and table surfaces.”
Quote in the paperSubstantial claim- Rests on an assumption: The simulated classroom activities used in the study are representative of real classroom activities for children with celiac disease.
- Rests on an assumption: Gluten transfer measured in healthy children without celiac disease is representative of gluten transfer in children with celiac disease.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
Study design and conductnone givenThe study had limitations including subsampling of homogenized foods and relatively small sample size for some scenarios.
“Acknowledged limitations of our study include subsampling of homogenized foods and relatively small sample size for some scenarios.”
Quote in the paperNot a substantial claimProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
PremisecitationSchool functioning is impacted by untreated celiac disease, with over half of patients in the cited study experiencing significant impairment in school performance, such as missing school or being unable to concentrate or keep up with schoolwork.
“A recent study by Shull et al(9) found that school functioning is impacted by untreated CD, with over half of patients in the study experiencing significant impairment in school performance, such as missing school or being unable to concentrate or keep up with schoolwork.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Shull et al(9)
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
Study design and conductnone givenThe paper mâché, dry pasta, and cooked and dyed pasta samples were run in duplicate according to manufacturer instructions.
“The latter samples were run in in duplicate according to manufacturer instructions.”
Quote in the paperNot a substantial claimIt may state two separate claims as one.
Interpretationown dataGiven consistent data on very low gluten transfer from Play-Doh and dry pasta to gluten-free food, students may be able to use them as long as there is no concern that the child will eat the gluten-containing supplies.
“Given the consistent data on the very low possibility of significant gluten transfer from Play-Doh and dry pasta to GF food products, students may be able to use them so long as there is no concern that the child will eat the gluten-containing school supplies.”
Quote in the paperSubstantial claim- Rests on an assumption: The simulated classroom activities used in the study are representative of real classroom activities for children with celiac disease.
- Rests on an assumption: Gluten measured on gluten-free bread rubbed on hands is a valid proxy for the amount of gluten a child might ingest from their hands.
- Rests on an assumption: Gluten transfer measured in healthy children without celiac disease is representative of gluten transfer in children with celiac disease.
It may state two separate claims as one.
PremisecitationChildren and adolescents frequently report feeling left out and different from peers because they had to eat food brought from home or say no, and often felt isolated because adults did not know appropriate management strategies for a child with celiac disease.
“Children and adolescents frequently report feeling left out and feeling different from their peers because they had to eat something they brought from home or they had to “say no”(12, 13) and that they often felt isolated because adults did not know the appropriate strategy to manage a child with CD.”
Quote in the paperNot a substantial claim0 of 2 sources checkedIt may state two separate claims as one.
Study design and conductown dataEven with small sample sizes, the lower bound of the 95% confidence interval was 85%, which allowed identification of high-risk activities.
“Nevertheless, even with these small sample sizes, the lower bound of the 95% confidence interval was 85% which allowed for identification of high-risk activities.”
Quote in the paperSubstantial claim
The paper relies on this without support.
Gluten is used in schools, especially in early childhood, art, and home-economics classrooms.
“Gluten is used in schools, particularly in early childhood, art, and home-economics classrooms.”
The paper relies on this without support.
Many common school supplies, such as modeling clay, paper mâché, and pasta, contain gluten, and wheat flours are commonly used in home-economics classrooms.
“Many common school supplies, including modeling clay (e.g., Play-Doh), paper mâché, and pasta (cooked and uncooked), contain gluten and gluten-containing flours are commonly used in home-economics classrooms.”
The paper relies on this without support.
No prior studies have reported gluten levels in school supplies or the amount of gluten that may transfer from those supplies to foods a child with celiac disease might eat.
“However, there have been no investigations to date reporting the levels of gluten in school supplies or how much gluten may transfer from those school supplies to foods that a child with CD may eat.”
The paper relies on this without support.
The gluten protein is too large to pass through the skin, so touching gluten-containing materials does not pose a problem for children with celiac disease unless they have a contact allergy.
“It is generally believed that the gluten protein is too large to be absorbed through the skin; thus, touching gluten-containing materials should not pose a problem for children with CD unless they have a contact allergy.”
The paper relies on this without support.
The simulated classroom activities used in the study are representative of real classroom activities for children with celiac disease.
“Healthy children aged 2 to 18 without CD or another health condition necessitating gluten avoidance participated in simulated classroom activities using gluten-containing materials.”
The paper relies on this without support.
Gluten measured on gluten-free bread rubbed on hands is a valid proxy for the amount of gluten a child might ingest from their hands.
“Upon completing each timed classroom activity or washing activity, children rubbed their hands with a fresh slice of GF bread (Artisan White Bread, Schar, Lyndhurst, NJ).”
The paper relies on this without support.
Gluten transfer measured in healthy children without celiac disease is representative of gluten transfer in children with celiac disease.
“Healthy children aged 2 to 18 without CD or another health condition necessitating gluten avoidance participated in simulated classroom activities using gluten-containing materials.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
There was a low risk of cross-contact in projects including dry materials and higher risk when using wet and sticky materials.
“There was a low risk of cross-contact in projects including dry materials and higher risk when using wet and sticky materials.”
As shown in one study on school-projects with gluten-containing foods, gluten may be transferred to children's hands depending on the type of project.
“As shown in one study on school-projects with gluten-containing foods, gluten may be transferred to children's hands depending on the type of project (62).”
Cleaning hands and surfaces after the activities effectively reduced gluten residues on the child's hands.
“Cleaning hands and surfaces after the activities effectively reduced gluten residues on the child's hands.”
Cleaning kitchen utensils, including knives, pots, ladles, and colanders, solely with water is enough to prevent cross-contact between kitchen utensils and gluten-free foods.
“Cleaning kitchen utensils, including knives, pots, ladles, and colanders, solely with water is enough to prevent cross-contact between kitchen utensils and gluten-free foods (60, 62).”
Sharing the same ladle and colander did not result in gluten cross-contact >20 mg/kg.
“Sharing the same ladle and colander did not result in gluten cross-contact >20 mg/kg (62).”
From Gluten-free diet for pediatric patients with coeliac disease: A position paper from the ESPGHAN gastroenterology committee, special interest group in coeliac disease. (2024) · cites this paper as [62]
The Methods and Results describe gluten transfer during classroom activities, not food prepared using a shared ladle or colander. A search for those utensils and for shared pasta-cooking equipment found no passage reporting whether that practice kept gluten cross-contact at or below 20 mg/kg; the Discussion mentions washing utensils but does not test the claimed scenario. Page numbers were not available in our copy. (LLM, conf=0.72)
Experimental — accuracy not yet measured
Shared utensils (metal and wooden) for serving pasta or cutting bread did not result in gluten cross-contact.
“Shared utensils (metal and wooden) for serving pasta or cutting bread did not result in gluten cross-contact (62).”
From Gluten-free diet for pediatric patients with coeliac disease: A position paper from the ESPGHAN gastroenterology committee, special interest group in coeliac disease. (2024) · cites this paper as [62]
The Methods and Results describe gluten transfer from classroom activities to hands and bread, not from shared serving or cutting utensils. The Discussion says washing kitchen utensils can remove gluten, but does not address whether shared metal or wooden utensils used for pasta or bread cause cross-contact. Searches for those utensil materials and uses found no matching passage. (LLM, conf=0.78)
Experimental — accuracy not yet measuredWiping kitchen utensils with a cloth or towel which was in contact with gluten does not result in hazardous cross-contact.
“Wiping kitchen utensils with a cloth or towel which was in contact with gluten does not result in hazardous cross-contact (62).”
From Gluten-free diet for pediatric patients with coeliac disease: A position paper from the ESPGHAN gastroenterology committee, special interest group in coeliac disease. (2024) · cites this paper as [62]
The Discussion (page unavailable) says washing kitchen utensils with soap and water or water alone is sufficient to remove gluten. The Methods describe clean paper towels and wet wipes used on hands or tables, but no passage addresses wiping utensils with a cloth or towel that has contacted gluten. Our copy therefore does not establish whether that practice causes hazardous cross-contact. (LLM, conf=0.76)
Experimental — accuracy not yet measured
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Shull, M., Ediger, T. R., Hill, I. D., & Schroedl, R. L. (2019) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/mpg.0000000000002465 · Cited by 24
Meyer, S., & Rosenblum, S. (2018) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/mpg.0000000000001635 · Cited by 19
Namatovu, F., Strandh, M., Ivarsson, A., & Nilsson, K. (2018) · Archives of Disease in Childhood · doi:10.1136/archdischild-2017-312830 · Cited by 11
Gluten-free diet among school-age children in Olmsted County, Minnesota
Almallouhi, E., & Absah, I. (2017) · Avicenna Journal of Medicine · doi:10.4103/ajm.ajm_42_17 · Cited by 2
Flagged first, then by citations
1 of the 17 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Current and emerging therapies for coeliac disease
Kivelä, L., Caminero, A., Leffler, D. A., Pinto-Sánchez, M. I., Tye–Din, J. A., & Lindfors, K. (2020) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/s41575-020-00378-1 · Cited by 124
Food Safety and Cross-Contamination of Gluten-Free Products: A Narrative Review
Wieser, H., Segura, V., Ruiz-Carnicer, Á., Sousa, C., & Comino, I. (2021) · Nutrients · doi:10.3390/nu13072244 · Cited by 97
“A quantitative assessment of gluten cross-contact in the school environment for children with CD measured the gluten transfer from school activities to gluten-free foods that a child may eat afterwards [38].”
Luque, V., Crespo‐Escobar, P., Hård af Segerstad, E. M., Koltai, T., Norsa, L., Roman, E., Vreugdenhil, A., Fueyo‐Díaz, R., & Ribes‐Koninckx, C. (2024) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1002/jpn3.12079 · Cited by 44
“62 There was a low risk of cross ‐ contact in projects including dry materials and higher risk when using wet and sticky materials.”
InfluentialWagh, S. K., Lammers, K. M., Padul, M. V., Rodríguez‐Herrera, A., & Dodero, V. I. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms231911748 · Cited by 25
“However, due to the wide use of wheat in most food ingredients, gluten can be difficult to avoid, resulting in accidental gluten exposure [54], as summarized in Table 1.”
BackgroundAssociation between intestinal neoplasms and celiac disease: A review
Wang, M., Yu, M., Kong, W., Cui, M., & Gao, F. (2021) · World Journal of Gastrointestinal Oncology · doi:10.4251/wjgo.v13.i9.1017 · Cited by 20
Celiac Disease: Risks of Cross-Contamination and Strategies for Gluten Removal in Food Environments
de Vargas, F. M., Cardoso, L. T., Didoné, A., Lima, J. P. M., Venzke, J. G., & de Oliveira, V. R. (2024) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph21020124 · Cited by 20
Psychological Considerations for Food Intolerances
Coburn, S. S., Germone, M. M., McGarva, J., & Taft, T. (2022) · Gastroenterology Clinics of North America · doi:10.1016/j.gtc.2022.07.003 · Cited by 16
Self-citationDietary assessments in individuals living with coeliac disease: key considerations
Lee, A. R., Dennis, M. D., Lebovits, J., Welstead, L. A., Verma, R., Therrien, A., & Lebwohl, B. (2024) · Journal of Human Nutrition and Dietetics · doi:10.1111/jhn.13380 · Cited by 15
Ediger, T. R., & Hill, I. D. (2021) · Pediatrics in Review · doi:10.1542/pir.2020-000711 · Cited by 6
The Contribution of Non-Food-Based Exposure to Gluten on the Management of Coeliac Disease
Hall, S. W., Shaoul, R. R., & Day, A. S. (2020) · Gastrointestinal Disorders · doi:10.3390/gidisord2020014 · Cited by 5
“Hlywaik [16] Weisbrod [17] Play-dough, finger paint, dry pasta Possible exposure if swallowed Gluten has become an increasingly used component in the materials used for this and related products, reflecting an increased demand for biodegradable yet sturdy materials.”
BackgroundGuandalini, S., & Discepolo, V. (2021) · Springer eBooks · doi:10.1007/978-3-030-80068-0_40 · Cited by 4
Gluten‐free schooling: Navigating challenges and triumphs for children with celiac disease
Weisbrod, V. M., Khavari, N. S., Absah, I., Lee, D. Y., Mallon, D., Raber, C. L., Badalyan, V., Shull, M., Verma, R., Dunn, A. L., et al. (2025) · JPGN Reports · doi:10.1002/jpr3.70013 · Cited by 2
Self-citationKhan, A., Rani, S., Verma, A., et al. (2025) · The Journal of Clinical and Scientific Research · doi:10.4103/jcsr.jcsr_126_24 · Cited by 1
Celiac Disease and Disorders of Gut–Brain Interaction: What School Nurses Need to Know
Bultas, M. W., & Brueggemann, E. M. (2023) · NASN School Nurse · doi:10.1177/1942602x231175374 · Cited by 1
Therapeutic targets based on the modulation of immune function by gut bacteria
Caminero, A., & Verdu, E. F. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-821594-4.00004-9 · Cited by 1
Mpakosi, A., Cholevas, V., Cholevas, S., Pastrikou, A., Fragkiadaki, A. I., Tziraki, F., Vogiatzis, I., Lianou, A., Tzouvelekis, I., Rallis, T., et al. (2026) · Nutrients · doi:10.3390/nu18183042
“Additionally, papier-m â ché art (with newspaper and adhesive made from wheat flour, salt, and water), dry or cooked and dyed pasta are all used at this age and constitute hidden sources of gluten for children with CD [33].”
InfluentialImam, U. A., Bunza, N. M., Bunza, J. M., Mainasara¹, B. M., Ogunwale, K. A., Oladele, B. S., Umar, A. M., & Jidda, M. L. (2026) · Research Square · doi:10.21203/rs.3.rs-9579106/v1
Is a gluten-free diet enough to treat celiac disease?
Oreshko, L. S., & Tskhovrebova, Z. M. (2023) · Meditsinskiy sovet = Medical Council · doi:10.21518/ms2023-383
Making Research Flourish Through ESPGHAN
Gasparetto, M., Strisciuglio, C., Assa, A., Gerasimidis, K., Giachero, F., Nowak, J. K., Robinson, P. S., Tél, B., Zilbauer, M., & Jenke, A. C. W. (2021) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/mpg.0000000000003250
Metadata
- Authors
- Weisbrod, V. M., Silvester, J. A., Raber, C., Suslovic, W., Coburn, S. S., Raber, B., McMahon, J., Damast, A., Kramer, Z., & Kerzner, B.
- Affiliations
- Children's National (US)
- Boston Children's Hospital (US)
- Temple Sinai Early Childhood Education Program Summit NJ
- Corresponding author
- Weisbrod, Vanessa M.
- Raber, Catherine
- Suslovic, William
- Coburn, Shayna S.
- Raber, Blair
- McMahon, Joyana
- Kramer, Zachary
- Kerzner, Benny
- Venue
- Journal of Pediatric Gastroenterology and Nutrition
- Publisher
- Wiley
- Published
- 2020-03
- Volume
- 70
- Issue
- 3
- Pages
- 289-294
- ISSN
- 0277-2116 (ISSN-L)
- 1536-4801
- PMC
- PMC7857141
- OpenAlex
- W2994783271
- Cited by
- 20
- References
- 17
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 3 · 2023: 2 · 2022: 3 · 2021: 6 · 2020: 2
- FWCI
- 2.51
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Pediatric Gastroenterology and Nutrition (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (T32DK007760, K23DK119584)
- Topics
- Health Sciences › Medicine › Gastroenterology › Celiac Disease Research and Management
- Life Sciences › Agricultural and Biological Sciences › Food Science › Food Safety and Hygiene
- Health Sciences › Medicine › Immunology and Allergy › Food Allergy and Anaphylaxis Research
- Keywords
- celiac disease, gluten-free diet, school environment, children, hand washing, hand hygiene, school supplies, paper mache, Play-Doh, bakery products, gluten-free bread
- MeSH terms
- Adolescent, Bread, Celiac Disease, Child, Child, Preschool, Glutens, Humans, Schools, Diet, Gluten-Free
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-09-28, under version 3 of the claim definition (prompt extract-v3).
A second model labelled each claim on 2026-09-28 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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