Air travel can be a miserable experience for passengers with severe nut allergies. But as new research shows, the real danger of air exposure during a flight may not be as bad as people think.
A widely held fear of flying may not have much scientific backing to it. In a new review of the evidence, researchers concluded that peanut allergens cannot spread easily, if at all, through an airplane’s ventilation system. Although passengers with allergies can still reduce the risk of contamination by wiping down the area where food may come into contact, other policies such as “nut bans” during flights are less likely to be effective and may be counterproductive, the researchers said.
Concerns that traces of peanuts and tree nuts—both common sources of food allergies—could travel through the air while flying and cause someone to have a life-threatening allergy attack in a confined space are certainly common. As recently as this May, there were reports of people experiencing severe anaphylaxis just from being around peanuts on a plane, and there’s an ongoing Change.org petition to end an industry-wide ban on peanuts during flights. . Some airlines, if requested, will now stop serving peanuts and peanut products in-flight; some have even stopped selling them altogether. But the researchers behind this new study, published Wednesday in the journal Archives of Childhood Diseasesthey argue that this concern is overblown.
The authors of this paper, Paul Turner and Nigel Dowdall, are experts in allergy medicine and aviation, respectively. To make their case, they cite a number of studies, including a previous review commissioned and released by the UK’s Civil Aviation Authority last year that was endorsed by Turner.
For one thing, the reported incidence of any food allergy while flying appears to be much lower (anywhere from 10 to 100 times lower) than on the ground, although researchers note that this reduced risk may be influenced by people’s higher level of caution before boarding airplanes. . That said, studies have found that nuts are not aerated (that is, when the particles are exposed to air), even when they are shelled and opened. Worse, deshelling appears to kick very low levels of peanut dust into the air, but only at close range and for a short time. Other studies have had people who develop respiratory illnesses or live near nuts and nut products, such as peanut butter, in conditions that simulate an airplane cabin. This study found that such exposure usually causes no symptoms in most people, and only mild, transient symptoms in a few.
Another major stumbling block is the design of the aircraft’s ventilation system itself, which is designed to circulate air throughout the aircraft, not around the cabin, which further reduces the risk of spreading any airborne hazards, whether they are viruses or imaginary peanut dust. Passengers on the plane also breathe a mixture of air and recirculated but filtered air from outside the plane. As a result, and as noted in the new paper, the air in the cabin is usually completely replaced every three minutes, which is much better than the exchange rate seen in hospitals (about 10 minutes). Overall, the evidence points to little potential harm to airborne peanuts, the researchers said.
“Research studies (including flight simulations) show no evidence to support airborne transmission of peanuts as a possibility,” they wrote. “So announcements calling for a ‘nut ban’ are not supported, and may instill a false sense of security.”
The pair’s findings are consistent with other expert advice. In its most recently updated statement on the topic (February 2020), the American Academy of Allergy, Asthma, & Immunology states that “there is no evidence to support peanut fumes as the cause of the reaction or that peanut dust itself circulates and causes the reaction. “
That doesn’t mean that peanuts or other food allergies can’t be dangerous on airplanes. The researchers note that food proteins tend to be “sticky,” meaning that the potential threat from foodborne illness comes from settling in places other foods or people’s hands can touch. And since airlines, especially budget ones, tend to lightly clean their cabins between flights, passengers prone to allergies could benefit from using their wet wipes, the researchers said. “In addition to avoiding allergenic foods, cleaning the seating area (including the tray table and rear entertainment system) may be the most effective step that allergic passengers can take to reduce the risk of inadvertent allergies. ,” they wrote.
Airlines can help passengers who are allergic to this measure by allowing them to board first and clear their space, although this is already a common practice. Researchers also recommend that people at risk of allergic reactions carry at least two adrenaline autoinjector devices (Epi-pens is the popular brand name version) at all times, including when traveling by plane. And airlines should also have clear policies related to handling unhealthy food that are easily accessible through their websites or on request, which can help reassure passengers.
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