New review finds risk of allergic reactions on commercial flights is lower than on the ground

The Civil Aviation Authority have published a review of the evidence on the risks of allergic reactions on commercial flights for those with food allergies and how to manage them. The results are reassuring, showing that the risk of a reaction in the air is up to 100 times lower than on the ground.

The research was led by Dr Paul Turner, allergy expert based at Imperial College London and member of the Anaphylaxis UK Clinical & Scientific Panel.

The key findings are:

1. The rate of “in-flight medical events” due to allergic reactions is low. For a typical food-allergic passenger on a commercial flight, the risk is around 10-100 times lower than when “on the ground”. This may in part be due to those will allergies taking extra care when travelling by plane.
2. One of the most effective measures to reduce risk is for passengers to wipe down their seat area, including the tray table and the seat-back entertainment system. The allergy-causing proteins can cling to surfaces which can transfer onto a person’s hands or food.
3. Airlines could support this by providing food-allergic passengers with non-latex disposable gloves and wipes, which can then be thrown away.
4. Research studies, including aircraft simulations, demonstrate that there is no evidence to support airborne transmission of peanut/tree nut allergens (so you won’t breathe in the proteins that cause reactions). This means nut bans on flights are not supported. Local “buffer” zones may help limit any risks but evidence is lacking to support them. But buffer zones may provide reassurance to food-allergic passengers.
5. Food-allergic individuals at risk of anaphylaxis should be prescribed two adrenaline auto-injectors (AAIs) which they should carry with them at all times, including on aircraft. Airlines should also consider stocking a separate supply of “general use” AAIs in the on-board medical kit for use in an emergency.
6. All airlines should have clear policies around food allergies, which are easily available on their websites or on request, and applied by ground staff and cabin crew.

The findings supports the August 2023 review which also found that the risk of a reaction on a commercial flight is much lower than on the ground in day-to-day life, with only one accidental allergic reaction estimated for every 1.5 million passengers.

The findings supports the August 2023 review which also found that the risk of a reaction on a commercial flight is much lower than on the ground in day-to-day life, with only one accidental allergic reaction estimated for every 1.5 million passengers.

Read the review: CAP2621: Evidence base for risks and best management of food-allergic individuals on commercial airliners: a systematic review

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