Your Frequently Asked Questions, Answered
Nut allergies are not set off by airborne inhalation.
This statement has been proposed on numerous occasions and indicates the growth and large-scale nature of the petition in question. Over the past week, well-known charities and organisations who seek to better the way in which allergies, and reactions to such allergies, are controlled within the lives of sufferers, issued statements on their reasons for rebutting the petition. We have read these and feel their decision is fair. Their choice to refrain from signing is reasonable, in that they only sign petitions started from their own organisation. Some of the statements in question further comment on the reasons why they believe the underlying justification for the petition is questionable. The petition has been created to achieve one aim to a nut allergy sufferers: to reduce risk. It is as simple and as clean as that. Risk of a reaction is known, both empirically and in research, to occur from various means, including, but not exclusive of, digestion, touch or inhalation. Digestion is the most severe means of having a reaction to nuts. The research on touch contamination and inhalation is, as rightfully pointed out by various groups and organisations, varied. As a general consensus of research, the extent of a reaction from both these means (touch and inhalation) is subject to the severity of an individuals allergy. Research on touch contamination indicates a greater risk to nut allergy sufferers from cross-contamination, while the research on a reaction from inhalation is broad. Tests on a population using solid nut products, such as a whole nut or peanut butter, indicate only small proteins are released into the air and not all nut-allergy sufferers will be triggered into a reaction from this quantity. Other research (Hourihane, et. al, 1997) suggests ‘as little as 100 micrograms (one-millionth of a gram) of peanut protein provokes symptoms in subjects with peanut allergy’. Other studies highlight the level of reaction depends on the state of the food product. Simonte et. al (2003) suggests, while contact through touch or inhalation of a whole nut is unlikely to cause a reaction, ‘the situation would likely be different for powered forms of peanut that can become airborne’ (Sicherer and Sampson, 2007). Sicherer et. al (1999) states ‘Allergic reactions to peanuts and tree nuts caused by accidental ingestion, skin contact, or inhalation occur during commercial flights [...]. Reactions can be severe, requiring medications, including epinephrine.
Further to the body of research, a study by Sicherer (2002-2003) highlights four primary concerns from research in this field. The conclusion states: Firstly, ‘studies are often limited to peanut butter, not other forms of nut. [Secondly], the amounts studied, which were chosen to simulate accidental touching or being near someone eating a peanut butter sandwich, may be different from, for example, inhaling peanut dust on an airplane; [thirdly] since even tiny amounts of peanut butter, if ingested, could cause a severe reaction, no school policies or other policies in place should change (please note, this article was written to question the relaxing of current policies); [and lastly], the study cannot be used as evidence that there are no patients who may be more sensitive to touch or smell of peanut.’
While the research is varied and conclusions mixed on both sides of the argument, the question remains: is the risk truly worth taking? If policy or law can be passed in favour of this petition, to either ban nuts and/or provide air staff with the rights to inform a passenger that they are not at liberty to consume nuts during a flight, the risk will be significantly reduced, providing a clear benefit to the overwhelming majority.
Please note, in relation to the above-stated research, nuts are dry products. They are not contained within a liquid. They flake and often sit within a packet on a layer of flaked, powered seasoning and nut residue.
If we ban nuts, where does it stop?
The answer to this is two-fold, with the first a simple response. While not directly related to the above question, it has been asked if we will campaign for further changes to be made of other allergy-causing products. The Amy May Trust will not be campaigning to make a change to any other food product. The Trust is, and will forever remain, a body to aid the rehabilitation of Amy May who’s incident was caused by a severe nut allergy. While we will not stop or be unsupportive of other petitions, our only focus is on Amy, the raising awareness of nut allergies and the aiding and reducing of risks to other sufferers.
In answer to ‘where does it stop?’. We are not unfair and nor do we question the seriousness of other allergies and the potential reactions to them. If an allergy is proven to have possible consequences as it has with Amy, we will be in support of making a change proportionate to the possible effect. As stated above, however, our interest is with nut allergies and should someone feel there is a need to aid the wider issues of allergens in a given environments, we will not be a hinder to their cause.
What is your next step?
To date, the petition has been running for 11 days (Sunday, 3rd September). We have begun to extend our strategy to suggest a change to the relevant parties but will let the petition run to give our cause greater leverage. We will inform you via change.org and on our social platforms when we begin the following stage.
Will this petition, if passed by law or policy, make air travel risk-free for sufferers of nut allergies?
Risk is the underpinning feature of this discussion and petition. Life, whether you’re crossing the road or traveling in a confined environment with a serious allergy, will always hold risks. To a degree, life is, in itself, a risk. In being fully aware of the extent of Amy's allergy for almost 30 years, we have never come across a nut allergy sufferer who is complacent. The potentially fatal consequences of their allergy mean sufferers are always on alert, and this, will habitually and inherently not change. The proposed change via the petition will provide greater reassurance that all that can possibly be done, is being carried out.
If nuts were banned and aircrew were given the rights to prevent consumption of nuts from fellow passengers, it would not eradicate the risk, sadly. It would, however, achieve two objectives which are of immeasurable importance to nut allergy sufferers: it will significantly reduce the risk (the level of which is a subjective measure) and secondly, it will give the sufferer and their family/friends, reassurance that the airline is fully aware of the seriousness of nut allergies and will, in accordance to their change off the back of this petition, allow them to fly with greater confidence or in some cases, allow themselves to take the risk and board an aircraft. We have had many emails and tweets from individuals informing us that they are too scared to fly and thanking us for the awareness we are achieving (media activity which aircrew would naturally be aware of). If we can change the mindset of allergy sufferers and give them the confidence that the airline they choose to fly with is fully informed and aware of what a nut allergy can do (see Amy’s story) and are taking the appropriate precautions to reduce the risk of anaphylaxis during flight, then both the passenger and the airline seek benefits.
Summary
In summary, we are not asking for a large change from any party: a nut allergy sufferer, a non-nut allergy passenger and the airline themselves. While we appreciate the hoops which will need to be jumped through, we believe, and are of the advice, the change will be of disproportionate benefits to nut allergy sufferers and airlines, compared to the degree of the change which will need to be implemented.
References
Sicherer, S and Sampson, A. (2007). Peanut allergy: Emerging Concepts and Approaches For an Apparent Epidemic.
Sicherer, H, Furlong, J, DeSimone, J and Sampson, H. (1999). Self-Reported Allergic Reactions to Peanut on Commercial Airliners. Journal of Allergy and Clinical Immunology. Volume 104, Issue 1, Pages 186-189.
Hourihane, J, Kilburn, S, Nordlee, J, Hefle, S, Taylor, S and Warner, J. (1997). An evaluation of the sensitivity of subjects with peanut allergy to very low doses of peanut protein: A randomized, double-blind, placebo-controlled food challenge study. Journal of Allergy and Clinical Immunology. Volume 100, Issue 5, pages 596-600.
Simonte, S, Ma, S, Mofidi, S and Sicherer, S. (2003). Relevance of casual contact with peanut butter in children with peanut allergy
Sicherer, S. (2002-2003). Allergic Responce to Peanut Inhalation and Skin Contact.