Comment by rtkwe
4 days ago
The American Academy of Allergy Asthma and Immunology disagrees, which I'm surprised by and totally thought they could too. Someone linked to this in another thread.
> What can occur is that the patient smells an allergen, and that smell triggers a strong memory of a past reaction or the fear of having a reaction and signs and symptoms of panic may occur – including an increase in heart rate, tight breathing, flushing of the skin and nervousness, all of which could be mistaken as signs and symptoms of anaphylaxis. ... While smells can linger in the air, the allergen proteins do not, which is why smelling a food will not trigger anaphylaxis.
Interestingly some allergens like those in shellfish /can/ aerosolize in a boiling pot, however according to them peanuts cannot. I can still absolutely see airlines reacting to passengers thinking they're having attacks and eliminating peanut snacks out of caution and to avoid the issues even an imagined attack can cause on a flight. That and the risk of surface contamination probably?
https://www.aaaai.org/tools-for-the-public/conditions-librar...
edit: dang scooped by 5 minutes.
Yes, the panic attack thing is pretty real. Know someone that had a severe allergic reaction, basically started choking to death, paramedics involved, all that. The experience imprinted itself deeply, such that she's deathly afraid of it happening again, and gets triggered with panic attacks. She's like two years on from the experience and through a lot of work she's much better, but it's pretty crazy how broadly it has impacted her life as an anxiety disorder. She knows it's not logical, but describes it as a fear of death and of a spiraling nature such that if she can't arrest it in the moment it compounds very badly, which reinforces the phenomenon - panicking about panicking. Anxiety over a panic reaction. So to be clear, it's not an allergic reaction she's experiencing but trauma from one in the past.
When I told my doctor about my oldest having a reaction to a chocolate bar with peanuts, one of his first questions was "did he react before he knew it had peanuts?"
He's pretty anxious about food in general, so it actually made a lot of sense.
I'm not sure it's fair to describe that fear response as "not logical."
It's not logically thought out, emotion is a parallel decision making process to logical thought. It may be that in some circumstances, fear is a logical outcome of a stimulus, but that's not the same thing.
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Why are you not sure?
To me it seems like if they logically know the smell can not cause harm having a strong emotional fear reaction is illogical. Of course most emotions are so that's not meant to be a blame or anything...
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Yeah, if I almost died from something I imagine I would have the same response.
Yes. In fact, last time I checked (4 years ago), no one has ever had a reaction from (for example) kissing someone who just ate peanut butter too, which for a while everyone claimed could case a reaction. There was a reported case 12+ years ago in Montreal, but it was soon retracted as a mistake.
I personally have definitely had a reaction from kissing someone after they ate peanuts, just not full-blown anaphylaxis.
Dust can also be an issue. It's definitely a cause of concern for pistachios, where cracking the shells releases enough pistachio dust to cause skin rash to my allergic daughter, even though she's never touched a pistachio in her life. Cracking shelled peanuts can likely cause the same issue, I'd wager.
Although peanuts served in planes are not in the shell, I can imagine how having potentially allergic people in close contact to people potentially oblivious to allergy issues eating peanuts sitting right next to them and eating peanuts could be problematic.
> The American Academy of [...] disagrees ...
> I can still absolutely see airlines reacting to passengers thinking ...
That, plus a dozen other scenarios which airlines do not want paying out in their airplanes. Or even post-flight, if some lawyer wanted to argue that the fatal peanut fell into mommy's purse during her flight back home to her family.
Thank you, I always found that story hard to believe, despite flight attendants confidently repeating it on PA. My most bizarre experience was when they one time announced a "very, very special guest among us today", which turned out to be somebody "so allergic to peanuts, if anybody anywhere on the plane opens any food containing peanuts, they will go into anaphylactic shock IMMEDIATELY, so please don't"...
Even though I know this, smelling peanuts (especially peanut butter) makes me intensely uncomfortable and I'm happy they're not served on most flights anymore. I'm not trying to ban anyone from taking their own peanuts on the flight (although I wish they wouldn't) but not needing to worry about it coming from the airline is a huge load off my mind.
Also, thinking as the airline, I'd do anything possible to avoid causing anaphylaxis on a flight, starting by simply removing common allergens from the menu. In the modern world, pretty much the only times an anaphylaxis attack would actually threaten my life would be camping in the wilderness and on a flight. Anaphylaxis has a great survival rate if you have an epipen and can get to a hospital quickly, and if you can't it's all down to how bad your allergy is and what meds you have available. Maybe I'm stupid but I don't bring on a flight the steroids that I'd bring camping, and I doubt the airplane has a supply either.
At least if you are in the USA they do keep epinephrine in the medical kits onboard. It’s an FAA requirement
This explains a lot. I always wondered why airlines eliminated peanuts but never ask passengers to avoid eating peanut products they'd brought on themselves, and why peanut based foods can be so common in public if there are "airborne peanut allergies".
I have been on several flights in the last couple of years where the flight attendants have asked that no one open/consume peanuts or peanut snacks while on board due to a passenger with a severe allergy.
All considering for the person affected (and my desire to not end up at an alternate airport for hours/overnight) has always seemed like an easy thing to do.
Well, according to the AAAAI, "airborne peanut allergens" are not actually a thing.
I'm all for consideration for others, especially when crammed into a tight space for hours on end, but once we get into the realm of purely psychological effects, where do we draw the line? For example, there are people that are absolutely convinced that my phone's electromagnetic radiation will cause them discomfort, yet in-flight Wi-Fi is a thing.
To be clear, I'm totally on board with limiting common allergens in airplane food, but please let me eat my own peanuts in peace instead of further facilitating mass hysteria.
Many airlines do that if they know if there is someone with a not allergy on the flight.
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I think the key part is the _boiling pot_.
Yeah that's definitely the issue with the shellfish. I'm just more surprised the allergen is sufficiently different from the smell that they are disconnected in peanuts.
Molecules responsible for smells tend to be small, on the order of 100-300 Daltons—otherwise they aren’t able to diffuse easily in the air.
The vast majority of allergens, on the other hand, are proteins, with the very smallest proteins being on the order of 1 kiloDalton. Large proteins get up into hundreds to thousands of kDa.
I suspect that peanut boiling in a pot would also be problematic. The oil and water vapor and would provide a carrier.
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