How dangerous are airplanes for people with allergies? It might not be as risky as you think, new research suggests.
Nearly one in three U.S. adults has an allergy, according to the U.S. Centers for Disease Control and Prevention. Around 20 percent of these are food allergies, one of the most common of which is an allergy to nuts.
Common allergy symptoms include hives, rashes, nausea and other gastrointestinal problems. However, in severe cases, wheat exposure in those affected can result in anaphylaxis, a potentially life-threatening reaction that hinders our breathing and can cause our blood pressure to drop dangerously low, limiting blood flow to our vital organs.
Those with severe allergies will go out of their way to avoid exposure to foods that might trigger this reaction. But what happens when you are trapped in an enclosed tin can thousands of feet in the air?
Paul Turner of Imperial College London and Nigel Dowdall of Aviation Medical Consultancy Limited wrote a paper investigating the risks associated with flying with food allergies.
The study, published in the journal Archives of Disease in Childhood, drew on 30 years of research into in-flight allergies to determine whether these concerns were warranted.
Contrary to popular belief, food-induced allergic reactions were 10 to 100 times less common during flights than "on the ground," although Turner and Dowdall said that this may be due to food-allergic precautions taken by affected passengers.
They found that while peanut allergens can be detected at very low levels in cabin air when nuts are shelled, the dust settles very quickly and can be detected only in close proximity to the nuts, suggesting that these allergens do not circulate through the cabin. What's more, they added, aircraft ventilation systems are designed to circulate across the aircraft rather than along it, minimizing the potential for spreading contaminants and diseases throughout the cabin.
In modern aircraft, half of the air supply comes from outside the aircraft, while the other half is typically recirculated through high-efficiency filters that they said can remove 99.97 percent of particulates like aerosolized food particles.
"With a few notable exceptions, e.g. fish/seafood, occupational wheat allergy, reactions to aerosolised foods are very uncommon and rare," they write.
With peanut allergies, the most significant risk comes from surfaces like tray tables, seats and in-flight entertainment screens. Cleaning these surfaces thoroughly is therefore the most effective method for minimizing allergen risks, the authors say.
"The main risks are due to either failure of dietary avoidance, or allergen residues on surfaces, which can then be transferred through touch—a situation exacerbated by the very short turnaround times with many low-cost carriers," they write.
"Airlines should have clear policies relating to food allergies which are easily available from their websites or on request," they continued. "These policies should be applied consistently by both ground staff and cabin crew, in order to provide reassurance to food-allergic passengers and their caregivers."
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Reference
Turner, P., & Dowdall, N. (2024). Flying with nut and other food allergies: unravelling fact from fiction. Archives of Disease in Childhood. http://dx.doi.org/10.1136/archdischild-2024-327848
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