Here is what flying is like for a person with a severe food allergy

You can forget about eating this.
You can forget about eating this.
Image: Reuters/Nicky Loh
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That peanuts are synonymous with air travel is a fact that most travelers don’t give a second thought to. But for travelers with severe food allergies, this airline tradition poses a significant risk for their ability to fly comfortably, or at all.

It’s not just peanuts. There are myriad allergens—dairy, shellfish, or tree nuts, to name a few—that allergy sufferers may unwittingly encounter in-flight. This can come in the form of accidental consumption of an allergen, cross-contamination with residue from a former passenger—ground-up nuts on the floor or in the seat for example, or Dorito dust on the tray table—or, in some rarer cases, even airborne transmission from an in-flight meal that’s being served.

Worse yet, unlike a severe allergic reaction that happens on the ground, having one in-flight means that people may have to wait hours and hours before they can reach the medical care they might require. It’s a unique risk that puts some passengers in a uniquely difficult situation. 

Consistent inconsistency

The airline industry has come a long way when it comes to ensuring the safety and comfort of passengers who are differently-abled or have disabilities. So it’s curious that when it comes to the potentially life-threatening issue of food allergies, passengers are left to navigate airline policies that run the gamut from accommodating to seemingly unaware, as well as the possibility that disclosing a food allergy at the wrong time could get them kicked off a flight.

“The biggest challenge that we face is that there is not any consistency,” says Allie Bahn, a writer and co-founder of a website that empowers people to travel with food allergies. “The airlines are tricky. You never know who you’re going to deal with. And even if the airline does have a policy, it doesn’t [always] seem like everyone from that airline is aware of that policy or consistent with following it.”

In the US, food allergies are considered a disability under the Americans with Disabilities Act, which in 2008 was amended to include those with severe allergies. But in the skies, it’s the Air Carrier Access Act (ACAA) that is supposed to protect the rights of these individuals. The Department of Transportation told the New York Times (paywall) in 2017 that it considers allergies to fall under the ACAA if they restrict the individual’s ability to breathe. But Lianne Mandelbaum, a campaigner for the rights of allergic passengers on airlines, says the lack of consistent policy means allergic travelers are sometimes barred from flying, or from doing so comfortably.

For example, it’s not unheard of for passengers to be asked to leave a flight when they disclose their allergy. That’s because it is often up to the pilot’s discretion to decide whether to allow a passenger who discloses a severe food allergy to fly. Indeed, even if the passenger has taken the necessary precautions and is comfortable with flying, there are still cases where the pilot has asked for them to deplane.

The FAA told Quartz that it requires commercial airlines to have epinephrine as part of their onboard medical equipment, and to train crew to use such medical equipment. Regarding guidance for passengers with food allergies, the FAA referred Quartz to the trade group Airlines for America. The group said that while in-flight allergic reactions are rare, “customers concerned about allergy exposure should become familiar with the individual policies of the airline before taking flight. It’s important to keep in mind that while specific foods may not be served by the airline, passengers could bring food onboard that could cause a problem to someone with severe allergies.”

Plan for the worst, hope for the best

So what kinds of policies do allergic passengers encounter when they fly?

It starts when choosing which airline to book with. Mandelbaum said while most airlines to put their policies online, they can require some “detective work” to find. Once a passenger does find an airline with a stated policy, there isn’t always a place in the booking process to disclose your allergy, so calling the airline may be necessary.

At that point, the airline may or may not agree to refrain from serving your allergen (peanut packets, say, or steamed salmon) on your booked flight. The reality TV star and entrepreneur Bethenny Frankel recently called for airlines to stop serving food that causes airborne allergic reactions, such as fish, after a high-profile incident in the air. (It should be noted that such reactions are rare.)

When passengers arrive at the gate—epinephrine, snacks, the PDF of the airline’s policy, and medical documents in tow—many hope to be able to pre-board. This gives them time, Bahn says, to adequately wipe down and clean their area to limit the risk of cross contamination with the former passenger’s snacks or food residue. But not all airlines allow this.

What’s worse, Mandelbaum says, is that allergic travelers are often seen by others as asking for special treatment when in reality, “it’s not a privilege to get on a plane and start wiping down and picking peanuts off the floor. That is not fun.”

After general boarding, some airlines will then make a plane or cabin-wide announcement asking passengers to refrain from eating the specified allergen. Others will notify a “buffer zone” around the traveler (the rows in front, behind, and to the side), asking if they are willing to refrain from eating or being served snacks with the stated allergen. If surrounding passengers object, they can be moved to other seats.

Oh, and the in-flight meal? Even if the airline says it’s free of a certain allergen, Bahn says, allergy sufferers can forget about digging in. “I would never trust a meal on an airline. There are things that are worth risking. But that’s not a safe risk.”

Even if all goes according to plan on a given flight, an allergic traveler can’t be sure the same might happen the next week on the same airline. “You can fly the same airline and have a completely different result,” Mandelbaum says.

People with severe food allergies need to fly. The issue is whether airlines are willing to standardize, and follow, policies that allow them to do so safely and without immense uncertainty.

“People say: this is the personal responsibility of the allergic passenger. I totally agree,” Mandelbaum says. “But in order to do that, we need to share this responsibly with the airline… If you tie our hands, how can we take personal responsibility?”