Abstract

BackgroundAn understanding of the management strategies used by food allergic individuals is needed as a prerequisite to improving avoidance and enhancing quality of life. Travel abroad is a high risk time for severe and fatal food allergic reactions, but there is paucity of research concerning foreign travel. This study is the first to investigate the experiences of, and strategies used by peanut and tree nut allergic individuals when travelling abroad.MethodsThirty-two adults with a clinical history of reaction to peanuts or tree nuts consistent with IgE-mediated allergy participated in a qualitative interview study.ResultsTravel abroad was considered difficult with inherent risks for allergic individuals. Many participants recounted difficulties with airlines or restaurants. Inconsistency in managing allergen avoidance by airlines was a particular risk and a cause of frustration to participants. Individuals used a variety of strategies to remain safe including visiting familiar environments, limiting their activities, carrying allergy information cards in the host language, preparing their own food and staying close to medical facilities.ConclusionsParticipants used a variety of allergen avoidance strategies, which were mostly extensions or modifications of the strategies that they use when eating at home or eating-out in the UK. The extended strategies reflected their recognition of enhanced risk during travel abroad. Their risk assessments and actions were generally well informed and appropriate. A need for airline policy regarding allergy to be declared and adhered to is needed, as is more research to quantify the true risks of airborne allergens in the cabin. Recommendations arising from our study are presented.

Highlights

  • Food allergy is an important health problem, with an estimated 1% of the population having an IgE mediated food allergy, and evidence that the prevalence continues to increase [1,2]

  • Besides surveys focusing on air travel, little has been reported about the difficulties of travelling abroad with a peanut or tree nut allergy

  • Our study demonstrates that nut allergic individuals use a range of strategies to minimise the risks, primarily based on patterns that they implement at home

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Summary

Introduction

Food allergy is an important health problem, with an estimated 1% of the population having an IgE mediated food allergy, and evidence that the prevalence continues to increase [1,2]. The difficulties of air travel for food allergic individuals, are confirmed by a survey of in-flight paediatric medical emergencies which reported that 9% were due to allergic reactions [15]. Besides surveys focusing on air travel, little has been reported about the difficulties of travelling abroad with a peanut or tree nut allergy. This study is the first detailed report on the experiences, challenges and decisions made by peanut and tree nut allergic individuals when considering travelling at home and abroad. Travel abroad is a high risk time for severe and fatal food allergic reactions, but there is paucity of research concerning foreign travel. This study is the first to investigate the experiences of, and strategies used by peanut and tree nut allergic individuals when travelling abroad

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