Food allergy and airline travel
(Revised July 2005)

Airline meals

For people who suffer severe allergic reactions to food, airline meals may pose a particular risk. Many airlines will organise a special meal according to individual requirements, but mistakes can sometimes occur. Even when an airline has promised a meal free from a certain ingredient, it is important to ensure the information has been passed on down the line. Enquire while checking in, and when boarding the plane. If you want to play safe, the best advice is to take your own food.

Peanut snacks

Some people with peanut allergy report that they experience symptoms while travelling on aircraft. In some cases at least, the cause would appear to be the free peanut snacks handed around to passengers with their drinks. Once the packets are opened, the strong smell can cause streaming eyes and wheezing for particularly sensitive people.

How great is the risk? Are all people with peanut allergy affected? Could such a reaction be fatal?

Unfortunately there is not enough hard information available to quantify the risks, but medical advisers to the Anaphylaxis Campaign have agreed that some reassurance can be offered to people with peanut allergy who are planning to fly.

Our advisers believe that any reaction caused by inhaling peanut allergen is likely to be relatively mild in the vast majority of cases. The symptoms usually reported include runny nose, streaming eyes and slight wheeze, but rarely anaphylaxis. An appeal to our members to describe their experiences while flying drew very few responses and some of those who wrote reported no symptoms at all.

The Department for Transport in London told us in 2002: “It is worth noting that the environmental control systems on all large modern airlines use High Efficiency Particulate Air (HEPA) filters. These were developed to prevent cross-infection and air contamination in hospitals and are designed to remove bacteria, virus and other particles with an efficiency of 99 per cent. HEPA filters should therefore remove the possibility of the re-circulation of air containing allergens.”

The most likely cause of reactions in flight is through ingestion of airline food. This is solved by taking your own food, which is not ideal, but ensures there are no catering mix-ups.

The second most likely cause of reactions is skin contact. If a passenger handling allergens (particularly peanuts) has touched the fold-down tray or another surface, there is a risk that a subsequent, allergic passenger may touch the same surface, possibly transferring peanut allergen to the face or mouth. To minimise the risk, you can always take “wet wipes” and clean surfaces as soon as you get on the plane.

Reactions caused by inhalation are less likely, but may sometimes occur – particularly if you are extremely allergic and fellow passengers sitting near you are eating peanuts. Please be guided by your doctor or consultant, and your allergy history. If you know you are at the high end of the risk scale (for example, you have reacted by inhaling peanut allergen in the past) then it would be sensible to seek a peanut-free flight by contacting the airline well in advance.

The response of the airlines

Some airlines, such as British Airways, have removed peanut snacks altogether from certain classes of flight. Others will withdraw them from specified flights if they are contacted well in advance. Others will not withdraw them under any circumstances. If possible, contact the airline you plan to fly with well in advance and find out their policy. If you succeed in booking a peanut-free flight, seek confirmation when you check in.

Further advice

• Take responsibility for your own safety. Ensure that you communicate your needs to all relevant parties (e.g. travel agent and airline staff).

• If you plan to negotiate the removal of nut snacks on your flight, take a non-confrontational stance. Use a softly-softly approach. Try not to worry the airline so much that they refuse to carry you and your party. Make it clear that you have a problem, and need help.

• Think ahead. Communicate well in advance with your travel agent and the airline you will be flying with. Try to obtain any verification in writing. Communicate directly with the airline’s customer services/in-flight services. Ensure that your request is fully understood.

• Ensure that the airline you are dealing with is the one actually operating the flights. Some are franchised out to different airlines who may not have the same policy or not be advised of special arrangements.

• In your letter outlining your needs (e.g. removal of peanut snacks on your flight) explain the potential problems which may occur. When many passengers open packets of peanuts the allergenic properties are released into the air and can enter the eyes nose and mouth, causing problems in mid flight for some people with allergies.

• Seek to educate. Make it clear that one in 70 children has peanut allergy. If you consider that the allergic person’s family and friends will be flying with them, that amounts to a lot of passengers.

• Avoid using the phrase “nut free flight”. Airlines have no control over passengers bringing their own packets of nuts on board.

• If you are concerned, discuss your proposed flight with your GP or specialist. Some airlines may request written medical evidence of the allergy.

• Take some high energy snacks with you in case flights are delayed.

• If you are successful in securing special arrangements ensure these are in place for all connecting and return flights. Take copies of airline letters with you.

• When checking in, make sure the arrangements that have been promised are in fact in place.

• Don’t forget your prescribed medication (e.g. adrenaline injections).

• Take some wet wipes to clean the immediate area around your seat. It’s possible that peanut allergen could remain from a previous flight.

• If you do have a reaction on a flight – or think you may be reacting – try to keep calm. Panic is likely to make symptoms worse.