Christopher Warren, PhD: Food Allergy Management in the Skies


According to data from the AAAAI 2023 Annual Meeting, individuals with food allergies face numerous barriers when managing their condition while flying, with only 15% receiving epinephrine.

Traveling by air can be a daunting task for individuals with food allergies, and parents of children with food allergies.

An estimated one in ten people in the US have a food allergy, which means that potentially millions of individuals are managing food allergies while flying. Before a presentation of data at the American Academy of Allergy, Asthma & Immunology (AAAAI) 2023 Annual Meeting in San Antonio, TX, very little was known about the experiences, barriers, and desired facilitators of food allergy management in the skies.

“One in 10 people in the US have a food allergy–so if somewhere under 3 million people a day are flying, that is a lot of people managing food allergy in the skies,” Christopher Warren, PhD, assistant professor of preventive medicine and director of Population Health Research at the Center for Food Allergy and Asthma Research, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, said in an interview with HCPLive.

“We just don't know a lot about that and I think one important message for clinicians is you have limited time in the clinical encounter to talk about all of the different contexts in which food allergies are managed,” he explained.

To shed light on this issue, Christopher Warren, PhD, and investigators surveyed individuals with food allergies and their caretakers to understand how food allergies impact their travel experiences. The study involved 4700 participants from 5 different countries, including the US, Canada, UK, New Zealand, and Australia.

He shared that 98% of participants reported that their food allergy added a layer of anxiety to their traveling experience. And while they were willing to report when they were treated well on their flights, the negative reports were notable.

“A lamentably high number of respondents did report having negative experiences–managing their food allergies during air travel, being told one thing at the time of booking and having another thing happen in the moment when they're trying to board the plane, or when they’re onboard the plane–even to the point of 11% of our 4700 participants said that they had been asked to leave a flight, or weren’t allowed to board a flight for a food allergy related issue, or miscommunication,” Warren said.

A total of 400 participants reported experiencing an allergic reaction while flying. Only 15% of these reactions were treated with epinephrine, the recommended treatment for anaphylaxis. The rest were treated with antihistamines or not treated at all.

“One thing we know,” he said, “is reactions happen in the sky as they happen everywhere."

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