Airlines and Peanut Snacks

From Twitter:

• Re-introduction of peanuts on Northwest Airlines prompt protests from allergy sufferers http://is.gd/jIzO
  
  
• "If someone is sitting next to her and eating peanuts, the odor is enough to trigger an allergic reaction" http://is.gd/jIzO
  
  
• NWA and peanut allergy: "We'll create a buffer zone of three rows in front of and three rows behind your seat" http://is.gd/jIzO
  
  
• According to most studies, skin contact or inhalation are unlikely to cause systemic reactions in food-allergic patients http://is.gd/jIL1
  
  
• Airlines that don't provide packaged peanuts are Air Canada, AirTran, American, Continental, JetBlue, Midwest, Sun Country, United and US Airways.
  
  
• If alerted that someone with a peanut allergy is on board, Southwest will not serve peanuts on that flight.
  
  

Eight top allergens account for 90 percent of all food allergies. The 8 top allergens can be remembered by the mnemonic TEMPS WFS.

Two of the few studies showing a correlation between "inhalation" of food particles and allergic reactions consisted only of self-reported events. Please see the discussion below.

Skin contact and inhalation

Allergic reactions occur after ingestion. Skin contact or inhalation are unlikely to cause systemic reactions in food-allergic patients.

Contact urticaria to peanut is not uncommon but systemic reactions secondary to skin exposure are unlikely.

There is a difference between smelling a food and inhaling an aerosolized food.

In inhalation of aerosolized food, there is a contact between actual food matter and the respiratory mucosa in the nose and lungs.

Aerosolization of food can occur in boiling, frying, grating, shredding, grinding.

Inhalation of aerosolized food can induce wheezing in sensitive individuals.

References:
Northwest serving peanuts again: Families of children with allergies angry over snack change. Suzanne Ziegler | McClatchy/Tribune newspapers, 02/2009.
Food Allergen Avoidance
Food Allergen Avoidance. UpToDate, 16.2.
Self-reported allergic reactions to peanut on commercial airliners. Sicherer SH, Furlong TJ, DeSimone J, Sampson HA. J Allergy Clin Immunol. 1999 Jul;104(1):186-9.
Allergic reactions to peanuts, tree nuts, and seeds aboard commercial airliners. Comstock SS, DeMera R, Vega LC, Boren EJ, Deane S, Haapanen LA, Teuber SS. Ann Allergy Asthma Immunol. 2008 Jul;101(1):51-6.

Related:
Hiding from nuts on planes. CNN.

Parents upset children use extensive cleaning measures to ensure they don’t sicken a classmate with peanut allergy http://goo.gl/mK2Qb

Peanuts on planes protected by a law passed in 1999 - CNN.

"Allergic to cashews, but thought it would be OK to eat almonds on AirFrance flight" - allergist on board saved his life http://goo.gl/P8Yh4