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Travel With Allergies

Flying Into Stormy Skies with Food Allergies

Inconsistent allergy policies are leaving travelers stressed and angry. What can be done?

Posted June 2013 – Dr. Brett Greenberger vividly recalls the dream vacation that imploded. Four years ago, the Baltimore psychiatrist and his wife Emily, a social worker, planned a Caribbean getaway for the family – including their three kids and his parents. Since their daughter Lily, then 5, has serious allergies to peanuts and nuts, the couple researched staying in a condo on the Leeward Island of St. Kitts, figuring they could do their own cooking and ensure the food was safe.

They looked into flights. The times worked well with American Airlines, which doesn’t serve peanuts, so the next step was to inquire whether nuts would be served on these particular routes. “We were assured they would not be,” says Greenberger. So they booked the seats and prepaid the condo. On their travel day, the flight from Baltimore to Miami went well. The family checked in at the ticket counter in Miami – just to confirm that nuts wouldn’t be served on the flight to St. Kitts.

The first hint of trouble came when a supervisor responded that this was up to the crew. When the Greenbergers headed to the entranceway of the plane and began to speak to a flight attendant about Lily’s allergies and previous assurances, she told them that nuts were being baked, as they spoke, in the front ovens to be served in first class. The couple immediately noticed the strong aroma.

Next, the pilot and gate supervisor were there, telling them that the snack service could not be changed and further, the pilot felt their child and her serious allergies presented a flight risk to the whole plane. With Lily now sobbing, the Greenbergers say they were not allowed to board.

So could they get another flight? Not to the Caribbean. The airline’s representatives said they could fly them elsewhere but heated nuts would be served in first class on all St. Kitts flights. “Multiple people from the airline said there would be no issue with nuts, then one individual and the pilot made the decision not to accommodate or problem-solve in any way. It was just not fair,” says Greenberger.

These are turbulent times for North Americans traveling with peanut or nut allergies. On the upward bounce, some airlines are taking positive steps forward. JetBlue and Southwest Airlines often receive positive reviews for allergy awareness, and Canadian airline WestJet has become the shining star of food accommodations. (WestJet doesn’t serve peanut or nut snacks and, to reduce the risk of residue, its crews will make an announcement asking fellow passengers to refrain from eating nut or peanut snacks.)

But on the stomach-flipping downward bounce, the negative stories and tales of inconsistent promises about allergy accommodations abound. In Allergic Living’s view, they are becoming more frequent.

One of the big problems is that some airlines’ own staff members seem unaware of their employer’s exact policy on food allergies.

In a 2008 study from the University of California at Davis, researchers phoned several airlines three times and asked the same questions, including: “Would you be willing to remove peanuts or tree nuts from a flight?” Airlines responded consistently only 31 per cent of the time. Anecdotally, this situation persists with many carriers.

On board, it’s the same story: some cabin crews will serve alternative snacks and make a P.A. announcement that there is someone on board with a nut or peanut allergy and ask passengers not eat those foods. But customers often don’t realize that, at most airlines, these are the sympathetic actions of an individual crew, not a policy you can rely on.

During the recent years of a tough economy, large carriers like United Airlines and American Airlines also became attached to the prestige value of tree nuts (usually almonds and cashews) to attract the high-paying customers in the first-class section.

“The warm nuts are something we can offer the premium passenger to make the travel experience better and to help differentiate our product,” said American’s spokesman Ed Martelle.

While food allergy consumers need airlines to be overt about their practices regarding peanuts and nuts especially – since they are common snacks and potent allergens – some airline websites offer only a terse allergy policy. Offering consumers adequate online information is helpful – and cost-effective. Case in point, the Greenbergers ended up with a full refund on their seven flights.

***

The idea of reducing the risk of reaction at 35,000 feet often seems like a no-brainer to those living with food allergies. But there are those who strongly object, and not just those who like their nut snacks. From the peanut grower to the big confectioner, there are lobby groups that say there’s no proof that peanuts or nuts in an airline cabin cause severe reactions.

This came up in late 2010, when the U.S. Department of Transportation (DOT) proposed banning the serving of peanuts on planes. DOT backed away from such a ruling because of a law, passed in 1999, that demands a peer-reviewed study that shows “severe reactions by passengers to peanuts as a result of contact with very small airborne peanut particles” before any peanut-restricting edict can be issued. But on a smaller scale, there is, in fact, evidence of risk.

Three studies have examined air travel and found that, based on passengers’ reports, there have been peanut and tree nut reactions. In the University of California study of 471 people known to have severe peanut, nut or seed allergies, almost 10 percent reported experiencing a reaction.

Of significant concern in a 2009 study from the University of Michigan was that one-third of the reactions were consistent with anaphylaxis. Dr. Matthew Greenhawt, an allergist and author of the Michigan research, says that a more rigorous study “would require diligent in-flight assessment of how peanut or tree nut particles may distribute within a pressurized cabin, how different cabin configurations may alter this, and how these dynamics may be affected by different aircraft models.”

That’s tough data to come by, especially since the airlines haven’t been open to that kind of aircraft scrutiny. Greenhawt says that while proof beyond self-reporting is ideal, “the passenger reports continue to pour in and should not be dismissed.” Organizations like FARE (Food Allergy Research & Education) and Allergic Living also receive e-mail accounts of reactions on flights. While most of them are mild, all of them are troubling when at such a distance from a hospital.

Next: Proving “Fitness” to Fly

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