When Lianne Mandelbaum approached a flight attendant to notify them of her son’s life-threatening peanut allergy, she wasn’t expecting any pushback.
She was travelling with her husband and their 17-year-old son Josh on a flight from Texas to New York in 2023, and had made similar requests before.
But this time, instead of addressing her concerns about Josh’s safety, Mrs Mandelbaum claims she was summoned by another staff member before take-off and spoken to rudely, leaving the family embarrassed and distressed.
Mrs Mandelbaum said flying with a food allergy was like “a game of roulette, each flight a random spin around the wheel”.
“On every flight, it is uncertain if and how crew members will accommodate nut allergies, and this adds tremendous unnecessary stress,” she said.
Her family is not alone. Allergic reaction or anaphylaxis?
A new study, co-authored by Mrs Mandelbaum and published in the Journal of Allergy and Clinical Immunology, found airline travel could contribute to “excess anxiety” for people affected by food allergies.
It reflected survey responses from more than 4,700 food allergy patients and families across the world, including more than 300 people from Australia and New Zealand.
Northwestern University population health researcher Chris Warren, who is the lead author of the study, said “the most crystal-clear result” of the survey was “98 per cent of respondents declaring that having a food allergy added anxiety to the air travel experience”.
A ‘concerning trend’
Almost 70 per cent of survey respondents from Australia and New Zealand reported flying with a food allergy adds “a lot” of anxiety to their experience, while another 22 per cent said it added “some” anxiety.
The survey also uncovered what Dr Warren called a “concerning trend” of people deliberately choosing not to tell airline staff about their life-threatening food allergy.
“They see it as potentially more likely to lead to inconvenience or unwanted intervention versus a helpful, informed effort to facilitate their chronic disease management,” he said.
More than a third of participants also reported experiencing “unprofessional or insensitive behaviour” from airline staff regarding their food allergy, with 76 per cent saying these experiences affected, for instance, their choice of airline.
“The consistency of these findings across all the countries and demographic groups we surveyed is remarkable — including Australians,” Dr Warren said.
Allergic reactions during flights
Australia is often known as the “food allergy capital of the world”, with more than 1.5 million of us affected by at least one food allergy.
Maria Said, CEO of Allergy & Anaphylaxis Australia, said there was a lot of fear and anxiety about flying with food allergy.
“There has certainly been reports of [allergic] reactions that have happened in the air.”
The new study found almost 10 per cent of participants reported experiencing an accidental food-related allergic reaction during a flight, with the most common allergen being peanuts.
Of those reactions, approximately 40 per cent were not reported to either flight crew or the airline.How to reduce the risk of child food allergy
Australia has the highest rate of food allergies in the world, with one in 10 babies allergic to foods like peanuts, eggs and milk by their first birthday.
Stephen Adelstein, a clinical immunologist and allergy specialist at Sydney’s Royal Prince Alfred Hospital, who was not involved in the research, said the study provided useful insights into the real-life travel experiences of people with food allergies.
“The low rate of respondents reporting their reactions to flight personnel during the flight is concerning,” he said.
“More education is evidently necessary to ensure that food-allergic individuals appreciate the potential significance of reactions and that alerting aircrew during a flight would be a sensible undertaking to ensure enhanced monitoring and surveillance and treatment where necessary while in flight.”
However, Dr Adelstein cautioned that there may have been potential biases in the data, given it was predominantly sourced from advocacy organisations and may reflect a more severe or affected population.
It’s a limitation the study’s authors also note.
Travellers call for better food allergy policies
Dr Warren said the research showed the food allergy community — a large and growing group — made travel decisions based on factors related to food allergy.
“However, respondents also shared their belief that, with consistent implementation of appropriate food allergy policies, this anxiety would substantially decrease and for some be almost entirely eliminated,” he said.
“This highlights how improving the consistency and quality of accommodations for travellers with food allergy can potentially pay dividends for these airlines down the road.”
He added no airlines were interviewed for the survey: “We focused purely on the perspectives of food allergy patients and their parents/caregivers.”
Tips for flying with a life-threatening allergy
One piece of advice all experts offered is that anyone travelling with a food allergy should notify the airline and flight crew beforehand, even if they feel embarrassed doing so.ABC Health in your Instagram feed
Dr Warren said it was also critical to not store any life-saving medicine in your checked or hand luggage and instead keep it in the pocket in front of your seat.
While it’s important to eat while flying, especially over long distances, people with a food allergy should try not to eat airline food, and bring allergy-safe food instead, Ms Said, who is also a director of the National Allergy Council, said.
If you think you’re experiencing an allergic reaction, she said to “err on the side of caution” and let the flight crew know immediately.
“The sooner you communicate, before you deteriorate even further, the better — and please don’t take yourself to the bathroom on your own,” she said.
“If you’re going to be sick, it’s best to be sick where you are, because standing up and walking to the bathroom and then sitting upright in a bathroom where you could collapse is not a safe thing to do.”
Administer medication immediately, she added, and remember to stay calm, lay down if you can, and follow the instructions on your emergency response plan.
I have Latex related Food Allergies, and the list is very long (google it if you have never heard of it), and it is absolutely amazing the number of people, including Nurses & Doctors that also have never heard of it.
EG:- I the past 3 years of Cancer treatment, I have only come across ONE Nurse who new what I was talking about, out of the, probably hundred that I came into contact with.
Therefore expecting any Aircrew to understand is almost hopeless, and makes normal living as well as Air Travel very uncomfortable at times.