Can Aerosolized nut particles circulation in aircraft ventilation system pose risk of allergy?

A new study published in the Archives of Diseases in Childhood showed that passengers at risk of anaphylaxis should always carry two adrenaline auto-injectors during the flight. In the UK, 1% to 2% of adults and 2% to 3% children suffer from a food allergy where the frequency is comparable in other medium-to-high income nations. The kids with food allergies take extra care when travelling, which is likely why allergic responses during commercial air travel are 10 to 100 times less prevalent than the ones on the ground, despite popular perception.

Studies have indicated that peanuts are easily spread by contact and saliva. During a commercial trip when deshelled roasted peanuts were consumed and another flight where no peanuts were given, Jin and team assessed the amount of peanuts found in surface swabs from aeroplane tray tables, seats, and air samples. The evidence for methods to help avoid unintentional allergic responses when flying on commercial aircraft was examined by Paul Turner and his team in this research.

The findings of a systematic review of the literature, which was commissioned by the Civil Aviation Authority of U.K, were compiled for this evidence review. The review covered studies between 1980 and 2022 that examined the risks to food-allergic passengers on commercial flights and potential mitigation strategies.

• According to research investigations (including simulations of airplanes), there is no proof that nut allergens are likely to spread via the air. Therefore, announcements calling for "nut bans" are not encouraged and might provide a false sense of security.
• Passengers cleaning their seat area which included the tray table and seat-back entertainment system was considered to be the most efficient solution. Food proteins are frequently "sticky" and attach to these surfaces, making it simple for them to move from there to a person's hands and onto potentially edible food.
• Through pre-boarding, airline businesses may assist in making this possible. 2 adrenaline [epinephrine] autoinjector devices should be recommended for passengers who are at risk of anaphylaxis and should always be carried on board, especially during flights.

Overall, in the event of an emergency, airlines should think about including a separate supply of "general use" adrenaline autoinjectors in the onboard medical kit. Every airline should have transparent food allergy rules that are readily accessible on their websites or upon request. To reassure passengers with food allergies and their caretakers, ground crew and cabin crew should implement these regulations uniformly.

Reference:

Turner, P., & Dowdall, N. (2024). Flying with nut and other food allergies: unravelling fact from fiction. In Archives of Disease in Childhood (p. archdischild-2024-327848). BMJ. https://doi.org/10.1136/archdischild-2024-327848