Airplane Etiquette for Food Allergies

Snacks may pose a food allergy risk to travelers. Hero Images/Getty Images

Flying on an airplane poses a risk for the person with food allergies. How big is that risk? For some who are highly sensitive to food allergens the risk is large, while for others with minor sensitivities, it may be more manageable. Only you know how big the risk for an allergic reaction while flying is, based on your own set of food allergies and sensitivities.

Peanuts are still served on some flights, as well as other allergens such as wheat (found in pretzels and other snacks) and milk (for coffee, and included in snack and meal foods).

Other flyers may bring their own food, from home or from the airport vendors, making the regulation of allergens and the exposure to them challenging.

Experiencing a medical emergency, such as a life-threatening anaphylaxis reaction, while thousands of feet in the air and potentially without medical assistance, is a big concern for individuals with food allergies, as well as the airlines managing flights.

All said, flying on an airplane with food allergies produces stress and anxiety and can pose a real risk if you’re not prepared.

While you cannot control other people, or the airline, it may help you to know a bit more about the research, and what you can do to keep yourself free from an allergic reaction.

Research shows

Most of the research in this area is conducted using surveys and tends to focus on peanut and tree nut allergens, as these are two food allergens that may cause an anaphylactic reaction.

One survey showed that less than 2% of food allergic individuals had an allergic reaction in-flight. Another research study using telephone interviews found that 9% of interviewees had an in-flight allergic reaction. One of these reactions was serious enough to require an emergency landing. Yet another survey found that 33% reported having an in-flight allergic reaction, noting symptoms that were consistent with anaphylaxis.

Many of the respondents did not inform the airline of their allergic reaction and they didn’t require epinephrine to treat their reaction.

A more recent study (2013) looked at international travel and allergic reactions to peanuts and tree nuts; they found that about 11% had reactions in-flight. Most reactions were not severe, however, about 13% required epinephrine. The researchers acknowledged inhalation-related reactions, but suggested that unknown ingestion from contaminated surfaces was more likely. No fatalities were reported in any of these studies.

Airline Etiquette

There are several steps you can take to keep yourself or your family member safe when embarking on an airline flight:

  1. Alert the airline about your food allergy in advance of your travel.
  2. Ask for a buffer zone between yourself and others who don't have a food allergy. For example, non-food allergic individuals may sit in front or behind you, or in an adjacent row separated by the aisle.
  3. Request an announcement alerting travelers of the presence of a food allergy on the flight and asking them to refrain from eating the potential allergen.
  1. Request that known food allergens, such as peanuts, not be served on the flight.
  2. Let the airline attendant know about your food allergy and be willing to provide information to him or her so that everyone is comfortable and informed.
  3. Wipe down your seat and tray table when you board the plane. Residual allergens can contaminate your allergen-free snacks or meal.
  4. If you will be offered a meal in-flight, make sure to order an allergen-free meal in advance.
  5. Bring your snacks from home, or purchase allergen-free snacks in the airport.
  6. Avoid using the pillow and blanket provided by the airline.
  7. When in doubt, leave it out. Never, ever, take a risk with a potential food allergen while flying.

In the end, your safety is tied to your thoughtful preparation for airline travel.

Resources:

1. Sicherer S, Furlong T, DeSimone J, Sampson H. Self-reported allergic reactions to peanut on commercial airliners. J Allergy Clin Immunol. 1999;104(1):186-189.

2. Comstock SS, DeMera R, Vega LC, et al. Allergic reactions to peanuts, tree nuts, and seeds aboard commercial airliners. Ann Allergy Asthma Immunol. 2008;101(1):51-56.

3. Greenhawt M, McMorris M, Furlong T. Self-reported allergic reactions to peanut and tree nuts occurring on commercial airlines. J Allergy Clin Immunol. 2009;124(3):598-599.

4. Greenhawt M, MacGillivray F, Batty G, Said M, Weiss C. International study of risk-mitigating factors and in-flight allergic reactions to peanut and tree nut. J Allergy Clin Immunol. 2013;1(2):186-194.

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