Flying Allergic

in Managing Allergies, Travel & Dining
Published: July 2, 2010

In one DOT complaint, a woman who had informed an airline of her severe peanut allergy ended up having breathing difficulties when the flight attendants refused to stop serving peanuts throughout the plane.

In another, a 3-year-old girl became covered in hives, her face swelled and her breathing grew laboured on a flight where peanuts were handed out – even though her parents were promised they wouldn’t be. Again, the crew would not stop.

“The airlines are usually reactive and not so much proactive,” says Dr. Donald Stark, the Vancouver allergist who, in 1996, was the first to show that peanut dust can be circulated through airplanes’ ventilation systems, and can pose a problem for allergic passengers. “It’s only when the issues get brought to their attention, and particular reactions have occurred, that they are more likely to do something.”

Until recently, there has been little information about just how common on-board reactions really are. But a new study, “Allergic reactions to peanuts, tree nuts, and seeds aboard commercial airlines,” out of the University of California at Davis’s School of Medicine, shows that high-flying allergic reactions are not unusual.

The study surveyed 471 people known to have severe peanut, nut or seed allergies. Forty-five reported reactions in the skies – that’s nearly 10 per cent – and three-quarters of those involved symptoms such as vomiting, wheezing, hoarseness, hives, diarrhea and lightheadedness.

More than half attributed their reactions either to inhaling the allergen as dozens of passengers opened packages of peanuts or tree nuts – which tend to be associated with more serious reactions – or to coming into direct contact with the potent allergens on the seats and elsewhere on the plane. (Because peanuts and nuts are oily, their proteins tend to literally stick around.)

Two allergic passengers who inadvertently ate food that contained allergens went into anaphylactic shock. Six ended up in emergency departments after landing.

“In hindsight, it’s not surprising that people are having reactions on airplanes, especially people with very severe allergies,” says Sarah Comstock, a PhD graduate in nutritional biology and the lead author on the study, which also involved high-profile professor of allergy and immunology Dr. Suzanne Teuber.

“You have an enclosed environment where the airline serves food you’re allergic to, and people eat it with their hands – and they don’t wash their hands afterwards. Food gets stuck in seats and seat-back pockets.

“You have individuals coming onto the airplane who are exquisitely sensitized to the food, and they’re in turn touching the seats, they’re touching the handles, they’re in the cabin when the peanuts are being opened. So they have a high likelihood of being exposed to one of the proteins that they are sensitized to.”

But while the University of California study, and others before it, demonstrate the risks to allergic passengers, the airline industry has done little in response. Some airlines have phased out peanuts, which has made an enormous difference in the lives of peanut-allergic passengers.

Others refuse, insisting that the highly allergenic legumes are part of the in-flight experience. Most of those that did remove peanuts, including Air Canada and American Airlines, introduced tree nuts such as almonds or cashews.

Nearly all airlines say, “We cannot guarantee an allergen-free flight” – even though that’s not what allergic passengers are seeking. Many who are speaking out about this issue hope that eventually, airlines will stop serving highly allergenic foods such as nuts and peanuts altogether.

For now, most who are seeking change say they would like airlines to develop clear allergy policies, and to avoid serving the highly allergenic foods on flights where there is an allergic person on board. (This would not include items that “may contain traces” of an allergen products, as that would be nearly impossible.)

They would also like the flight crews to make an announcement politely asking fellow passengers to avoid eating foods that contain the allergen in question.

Some flight crews on airlines such as Air Canada already provide such courtesies, but some don’t – and because they’re not part of a formal policy, passengers don’t know what they’ll face until they get to the gate. Other carriers are miles away from such practices.