Flying with food allergies: new review confirms commercial flights are much safer than you might think
- 22 July 2025
- News
- Research
For anyone living with food allergies—or caring for someone who does—the thought of experiencing a reaction at 30,000 feet can understandably trigger serious worry. People are well aware that help is far from being immediately available in the air, and media stories about in-flight reactions can add to the stress. In fact, a recent global survey found that 98% of people with food allergies, or their carers, reported increased anxiety whilst flying, with many taking extra steps to try to stay safe.
Given those concerns, experts at Imperial College London were commissioned by the UK Civil Aviation Authority to publish a major review to help sort fact from fiction and give clear answers as to how much risk really exists for passengers with food allergies on commercial flights today. The report also assessed the best precautions they can take to make sure they don’t have an allergic reaction.
How common are in-flight reactions?
Experts reviewed how information about in-flight allergic reactions is collected and what the strengths and limits of the data may be. The data was collected from three main sources:
- Airline reports: airlines document in-flight incidents, but not all allergic reactions get reported to cabin crew, for example mild reactions that people manage themselves, such as with antihistamines.
- Ground-based medical services (GMBS): for more serious events during a flight, airlines often contact medical services on the ground for advice. These systems mainly capture more significant incidents that have been reported to cabin crew and acted upon, for example, anaphylaxis.
- Passenger surveys: some studies have collected data from people with food allergies, asking them if they remember ever having an allergic reaction whilst flying. This can include mild reactions that weren’t reported to airlines or crew. However, because they rely on memory and self-reporting, they can sometimes be overestimates of the true number of events.
This means that the real number of mild allergic reactions could be higher than what was reported (if dealt with privately), however, serious reactions such as anaphylaxis are usually reliably identified and recorded.
What does the data show?
- Allergic reactions on flights are rare: the risk for people with food allergies of having a reaction during a flight is 10 to 100 times lower than having one on the ground – probably because of the steps people with food allergies take to stay safe, like bringing their own food or wiping down their seat.
- Serious reactions are even rarer: for every 3,600 passengers with food allergies flying in a year, only one may experience any reaction, with serious cases (like anaphylaxis) even less common than this.
- Rates have not increased: despite rising rates of food allergy and more passengers flying, in-flight reaction rates remain low.
- Surface contact is the key risk: most reactions are caused by touching leftover food traces, for example on tray tables and seatbacks, then touching the mouth or the face.
Why are in-flight reactions so uncommon?
Modern airplanes use highly effective air filtration systems:
- Cabin air is exchanged every 3-4 minutes and filtered through HEPA filters that remove 99.97% of airborne particles, including food proteins.
- This means that the filtration system will capture any aerosolised food particles, so allergenic proteins do not travel along the cabin and cause reactions.
Airborne allergic reactions are extremely rare:
- Most foods don’t release allergenic proteins into the air easily.
- For example, with peanuts, research shows particles are only detectable directly above the nuts, and only when taking them out of the shells — they do not become airborne or spread through the air.
- Fish and seafood are different: some people with allergies to fish or seafood can react to vapours from fish being actively cooked nearby (such as in kitchens), or to large quantities of raw fish (such as in markets). However, pre-cooked fish in sandwiches, like those served on flights, are very unlikely to cause airborne reactions. Aircraft ventilation further reduces any risk.
- Touch, not air, is usually the problem: the most common danger while flying comes from allergens lingering on surfaces, not in the air.
What does this mean for passengers?
If you or someone you care for has a food allergy, it’s completely understandable to feel anxious about flying — but this expert review should offer reassurance that, with the right precautions, most people with food allergies travel safely.
- Stay prepared: always carry two adrenaline auto-injectors with you, pack safe meals or snacks, wipe down your area, and inform the crew about your allergy.
- Be vigilant about surfaces: the greatest risk is from touching traces of allergens left on seats, tray tables, menus, and handles, rather than from airborne exposure.
- Check the airline policy: airline policies vary, and some staff may be more familiar with allergy management than others. Stay calm, explain your needs, and check policies before you fly.
The review also urges airlines to improve their policies by making them clear, consistent, and supportive for passengers with allergies. Experts at Imperial College London will continue to work with the Civil Aviation Authority to develop straightforward guidelines aimed at standardising these policies, so that allergy management becomes more consistent and reassuring for travellers.
At Anaphylaxis UK, we promote practical, evidence-based ways to manage food allergy risks. With clear and consistent instructions, airlines and passengers can improve safety and comfort for those with serious allergies.
By working together, we can reduce risks and make air travel easier and safer for those with food allergies.
You can find out more about how to fly safely with allergies here:
Navigating Allergens on Airlines: Safety, Precautions, and Passenger Rights
Travelling with Allergies Factsheet
You can read the expert reviews here:
