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Food Allergies and Flying

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Studies show that allergic reactions are common on board flights. About 9% of people with peanut allergies have experienced some form of allergic reaction during a flight.

About 2 – 4% of medical emergencies on board commercial flights are allergic reactions. Between 2002 and 2007, “allergy” was the 7th most common cause of in-flight medical problems and asthma was the 14th.

Allergic reactions are most often caused by foods (peanuts, tree nuts and seafood) and medications.

There are reports of passengers experiencing idiopathic anaphylaxis in-flight, self-injecting adrenaline in the lavatory and not notifying a flight attendant. There are also reports of flights being diverted to the nearest airport to due allergic reactions.

Treating allergic reactions on board a flight

Treating allergic reactions in flight is a major challenge and air travel is an important concern for people with asthma and/or a history of allergies. Resources on board an aircraft are limited. In the US, the Federal Aviation Authority (FAA) requires that epinephrine is included in the on board emergency medical kits.

The World Allergy Organisation (WAO) recommend:

– For asthmatic emergencies: inhaled bronchodilator and oxygen. For moderate to severe symptoms, an oral, intramuscular or intravenous corticosteroid and intramuscular epinephrine can be considered for severe symptoms.
– For allergic emergencies: for mild, moderate, and severe reactions, intramuscular epinephrine should be injected in the anterior lateral thigh and repeated as necessary.Preventing Allergic Reactions on airplanes

Prevention strategies for allergic reactions on board aircraft should be planned early. Advice should be sought from a physician or allergy specialist about prevention measures that need to be implemented before and during the flight. A treatment plan should be instituted in case of contact with an allergen.

Contact the airline in advance to discuss your allergy. A study has shown that making your allergy known and asking for accommodations reduces the likelihood of an allergic reaction in flight. Once you board the plane, remind the air stewards of your allergy and wipe down the tray table, armrests and seat.

Make sure your adrenaline pen is close by and easily accessible, not in the over head locker. In the event of a reaction, inform the flight attendants immediately and use your adrenaline.

Airline crew should immediately call for a doctor on board for any emergency to determine what treatment is needed and if the plane should divert to the nearest airport.

Measures to reduce peanut and tree nut exposure have resulted in less in flight reactions from these foods. However, these measures are not implemented by all airlines due to difficulty, discomfort for other passengers or higher costs.

Measures that reduce the risk of an in-flight reaction to peanut and tree nuts
1 Passengers requesting any kind of special accommodation.
2 Peanut/tree nut-free meals.
3 Wiping of tray tables
4 Avoidance of airline pillows or blankets
5 Buffer zones around which peanut or nut products cannot be consumed

6 Request other passengers not to consume peanut/tree nut-containing products

7Announcement that passengers do not eat peanut/tree nut containing goods

8Not consuming airline-provided food

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