Op-Ed: Anaphylactic passengers must be considered

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Between 1997 and 2011 researchers estimate that food allergies in children have increased by 50% and that 1 in 13 children currently suffer from food allergies. With this rise in airline passengers affected by this life-threatening illness, the question of how airlines are going to prepare for these passengers is not only necessary, but it is also of immediate importance. While I write this from my perspective as the parent of a child with an anaphylactic tree nut allergy, much of what I say here can easily be translated for those children who live with any other serious food allergy.

“Yes, I need to inform you that my five year old daughter has an anaphylactic tree nut allergy and I wanted to know if you have any accommodations for her during our flight.” 

The usual response I receive to this question from commercial airlines is, “We can add a note about the peanut allergy.” This is my first obstacle. I didn’t say peanuts. I then proceed to break down how peanuts are not nuts; they are legumes. I follow this with examples of tree nuts; “almonds, pecans, cashews, walnuts…” Still, it is not airline employees’ fault that they have not been educated in food allergy awareness, nor is it their fault that they have probably never even seen an Epinephrine injector, let alone been trained to use one while airborne. That responsibility is clearly in the hands of their employers. However, empathy is something that every employee is charged with, and unfortunately in my personal experience very few airline employees demonstrate competence in that area. Without proper education and training it is impossible for employees to truly have empathy.

It’s incredibly important that airlines understand that intolerance to food is very different from anaphylaxis. With that piece of knowledge, airlines can be more proactive and prepared for those people who are quickly becoming a significant number of airline customers. Essentially, every airline should already have a plan of action in place for accommodating passengers with anaphylaxis, such as alternative snacks free of the top eight allergens, appropriate announcement procedures for flights where a passenger with an allergy is present, and a thorough sanitation process for wiping down seats in between flights. This plan of action should also include an in-flight Epinephrine injector as part of the first aid kit that each employee has been trained in using should a passenger succumb to a severe allergic reaction.

Our family loves to travel but there are many times when we decide to drive instead of fly because of the fear that someone would open up a bag of almonds in a seat next to us, or the fear of cross contamination in that the seats and trays were not wiped down after the flight before ours. Preparing for the possibility that your child could go into an anaphylactic shock or possibly die is something that no parent wants to think about when planning to visit Walt Disney World, but this is my life and precautions need to be in place. That’s where empathy plays a huge role. Airlines that can make us feel comfortable will have customers for life.

We have had good and bad experiences with airlines. To date, our best experience has been with Southwest Airlines and our worst experience was with its sister company AirTran Airways (which is being merged into Southwest). We have a pre-flight ritual that we must follow, which is to call the airline directly when our flight reservations are first made and then follow up the week of the flight to ensure the allergy has been documented for the flight crew. The next step is to inform the ticket counter that we have arrived, ensure that we can pre-board and ask about the wipes and inflight snack. We also ask if an announcement can be made to passengers to abstain from eating food with tree nuts. Southwest has always let us board first, which gives us the time to wipe down the seats. Our last flight let us sit in the front row to make the process easier for us. Not only did they make the announcement, but they also changed out the inflight snack to one that was tree nut/peanut safe.

Is this stressful? Yes, but I take all these steps to ensure that my child is safe. I have seen her hand swell from accidentally touching a pecan. I have seen her go into anaphylaxis after ingesting a pecan at a food challenge with her allergist. I have had to inject, not one, but two Epi-pens into her thigh while she was coughing and struggling to breathe, even as she managed to squeak out “Mama, no!”

On a similar flight we had an experience that was not so positive. My family flew on AirTran a year ago, and the staff would not let us board early, refused to make the announcement, and when we got to our seats my heart stopped when I saw crumbs from unknown food products all over the seats and mashed into the carpet right where her feet were going to be. When I alerted the steward he simply took a tissue and tried to pick it up. The frustration comes from the flight crew acting as if we were bothering them. That asking to pre-board so we can sanitize the seats was absurd. Couple that with having to explain to the same flight attendants over and over again that her allergy is not peanuts it is tree nuts. Add to that the response that we received of, “Sorry, but we cannot make the announcement because we don’t want to offend our other passengers.” I can’t imagine that there are passengers that feel that eating nuts is far more important than the life of one or two people sitting nearby.

In a perfect world, no child would have to deal with food allergies. But this is the real world. It is my world, and the world of many other parents. It is also the world of every person involved in service industries where the potential for causing anaphylaxis is common. As adults, caretakers, and professionals we all bear the responsibility of caring for children with food allergies. We tell our children to look both ways to cross the street so they don’t get hit by a car. We would never leave a room with a loaded gun and a child in it. But if the airline crew ignores our requests about avoiding nuts on a flight, then you might as well turn that bag of nuts into a gun and hand it to my child. Unfortunately, it is that real.

In my quest to have more support for food allergy children I have created a brochure called REDS (Read labels, Empathy, Designate a plan, and Social responsibility) that explains what anaphylaxis is and can be downloaded for free from my Facebook page Food Allergy Acceptance, Not Resistance. It is a simple brochure that breaks down some important tools and can be helpful to professionals in the airline industry.

About the author, Kelly Sheehy DeGroot:

Pictured above with her daughter, Kelly Sheehy DeGroot, MS is a mom, teacher, children’s book author, owner of Tuxedo & Beans Publishing, LLC, and founder of Food Allergy Acceptance, Not Resistance. Follow her on Twitter @FoodAllergyMam1 and Facebook.com/REDS4FA 

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