Lead author and pediatrician Dr. Matthew Greenhawt of the University of Michigan's Food Allergy Center and C.S. Mott Children's Hospital and study co-authors from Allergy & Anaphylaxis Australia and the International Food Allergy & Anaphylaxis Alliance asked passengers to answer an online survey about their in-flight experiences.
More than 3,200 people from 11 countries completed the survey and those and 349 reported having an allergic reaction during an airline flight.
"We still think the risk of an in-flight reaction is small, but it's hard to imagine a more helpless situation than having a reaction while you're at 35,000 feet in an airplane," Greenhawt said in a statement. "But this study identifies some things passengers can do to reduce their anxiety."
Greenhawt said passengers with peanut/tree nut allergies who reported taking the following actions significantly lowered their odds of reporting a reaction:
-- Requesting an accommodation to the allergy.
-- Requesting a peanut/tree nut-free meal.
-- Wiping their tray table with a commercial wipe.
-- Avoiding use of airline pillows.
-- Avoiding use of airline blankets.
-- Requesting a peanut/tree nut-free buffer zone.
-- Requesting other passengers to not consume peanut/tree nut-containing products.
-- Not consuming airline-provided food.
The study also found that epinephrine, a common and effective treatment, was drastically underused in-flight. Only 13.3 percent of passengers reporting a reaction received epinephrine as treatment, but flight crews were notified regarding 50 percent of reactions, Greenhawt said.
"These findings provide a starting point for airlines to consider in terms of their own policies, where they could work with passengers to mitigate risk," Greenhawt said.
The findings were published in the Journal of Allergy and Clinical Immunology-In Practice.