Air travel with food allergy – FAQs

No, according to a 2023 study, researchers looked at the number of in-flight medical events related to allergic reactions. They discovered that,  even with the increasing number of people travelling by plane over the past 30 years and the rise in the number of people with food allergies, the rate of recorded moderate to severe allergic reactions during air travel has not increased during this time.¹ Allergic reactions account for approximately 2-3% of medical events on flights, which equals about 0.7 cases per million passengers.^1.  Importantly, severe allergic reactions that required adrenaline were extremely rare, occurring in only 0.08 cases per million passengers.^1. The researchers found that people are 10 to 100 times less likely to experience an allergic reaction to food on a plane compared to their everyday lives.^1.

 Passengers with food allergies often do things to reduce the risk of having an allergic reaction, such as taking food from home and avoiding food given to passengers by the airline flight crew.^1. These steps help make travel safer showing that with proper planning, the risk of having an allergic reaction is low, and the chances of needing to use adrenaline are very low.^1.

^1. Turner PJ, Mamula J, Laktabi J, Patel N. How Common Are Allergic Reactions During Commercial Flights? A Systematic Review and Meta-Analysis. J Allergy Clin Immunol Pract. 2023;11(11):3400-3406.e4. doi:10.1016/j.jaip.2023.07.025

Yes,  but you must follow some rules.

It is safer to take your own food than to eat food provided by the airline.

More information can be found at Food for a long flight with allergies

The Australian Food Standards Code, which includes laws related to food allergen safety, applies to domestic and international flights in Australian airspace. However, once a flight leaves Australia or enters or passes through international airspace, Australian food laws no longer apply. This means Australian food allergen labelling and food service rules cannot be enforced.

Although the airline is responsible for serving food, like any food service, staff cannot guarantee its safety because they do not make every component of the meal. Meals are provided to airlines by contracted third-party catering suppliers. Allergen management depends on these food manufacturers and their processes, which the airline does not control.

For example, on an international flight, one meal may be provided by an Australian catering company, while the meal served after a stopover in Singapore might come from a Singaporean catering company, where food is prepared according to Singaporean food labelling laws, which are different from those in Australia.

Ingredient lists on packaged food help people make informed choices about whether to eat it. However, food labelling laws vary between countries, resulting in different rules on what must be included on a food label. If food is imported into Australia, it must be labelled according to Australian food law.

Language and translation challenges can also complicate matters when on an airline or in another country.  If a food is made in another country and served while outside of Australia or its airspace, Australian food labelling rules do not apply. 

Also, Precautionary Allergen Labelling (PAL) statements, such as “May contain” on packaged food are not regulated in Australia or in most other countries, so they are not enforceable under the law. In Australia, food manufacturers do not have to include a PAL statement on their packaged food, even if there is a risk of cross-contamination. While some manufacturers use formal risk assessments to help them decide whether to include a PAL statement, others do not. A&AA strongly advises people with food allergies not to eat any food with a PAL statement during air travel, even if they typically eat foods these foods, as it is hard to get medical help while in a plane.

Special meals for people with other dietary, religious and cultural needs (not food allergy) very rarely cause a life-threatening emergency if the wrong meal is served. It is not likely that a person’s physical health is greatly harmed from being served the wrong special meal. As a result, airlines are more likely to offer these special meals.

Some airlines do offer a nut fee meal. Even if a nut free meal is offered, we recommend you don’t eat it because:

• There is a risk that the passenger with food allergy will not get the right meal. Meals sometimes go missing or are given to another passenger by mistake. The passenger with food allergy could either get the wrong meal or not get a meal at all.
• There is no guarantee that the nut free meal will not accidentally contain nuts.

People can be allergic to any food, so nut free meals are not safe for people allergic to foods other than nuts.

Taking your own food is the safest option. Reasons for this include:

• Airline staff serving the meal are not aware of the manufacturing processes. They may not be able to provide passengers with all the correct information when asked questions about the food content.
• Many meals on flights now have allergens listed; however, common allergens and labelling laws vary between countries.
• Eating a meal on a plane is like eating out in a restaurant, mistakes can be made, and the meal may accidentally contain the allergen. However, there is a greater risk if something goes wrong during air travel, as there is no access to emergency care.
• Even if an airline does provide allergen free meals, there is a risk that a passenger with food allergies could either get the wrong meal or not get a meal at all if it is accidentally given to someone else.

It’s not just peanuts and tree nuts that can trigger anaphylaxis. An allergy to any food for example milk, egg or wheat is just as serious as an allergy to peanut and tree nuts.

• Passengers can bring their own food on to a plane and this could include peanuts and tree nuts. The airline has no control over this.
• In some countries, peanuts and tree nuts are used in many foods. People from these countries who fly may want to eat foods they are used to when they travel.
• Food allergy is much less common in some countries and so some airlines do not think it is a priority
• In some countries, peanut and tree nut allergies are uncommon

People with peanut and tree nut allergy are sometimes worried about hundreds of people opening packets of peanuts or tree nuts at the same time. While some airlines choose not to serve peanuts or tree nuts as snacks, others do. If you are worried about this, you can contact the airline to ask whether they serve these snacks before buying your air tickets.

Research shows that the risk of anaphylaxis caused by inhaling food particles is extremely low.²

Can people with food allergy react to food particles in the air of the plane cabin?

Aerosolising means changing something like a food into particles small and light enough to be carried in the air. This does not happen easily with most food proteins.

A review that looked at all the recent studies of allergic reactions during flights found that reactions to airborne food particles are very rare.²

Aerosolisation of nut allergens from other passengers removing the shell of peanuts or other nuts and eating them has not been shown to cause anaphylaxis, even in small, closed-in spaces, like on a plane.²

However, allergen particles can stick to surfaces such as tray tables, screens and seat belts, for example.² If someone touches a surface that has an allergen on it, they could experience an allergic reaction. Most reactions caused by touching an allergen cause mild to moderate skin reactions that can be treated with antihistamines. Touch reactions rarely lead to anaphylaxis unless a contaminated hand is put in the mouth.

A study found that when 84 children with peanut allergy were put in a room and sat half a meter away from a bowl of peanuts for 30 minutes, there were no moderate to severe allergic reactions, and only two children (2%) had mild symptoms during the hour of observation sitting in the room near the bowl of peanuts.³

Studies show that peanut allergens that can be transferred through touch are more of a risk than the breathing in of nut particles in the air when other passengers eat nuts during a flight.²

Some people with food allergy do not like the smell of the food they are allergic to. This is the case for many people with peanut allergy, for example. Smelling peanut butter or satay can make them feel uncomfortable. However, the particles responsible for the smell are not the proteins that trigger allergic reactions. Wearing a face mask may reduce the smell of the allergen.

Can food allergens be spread through aircraft cabin ventilation systems?

Companies that make air filter systems, including those for planes, use HEPA filters that remove 99.97% of particles, including allergens. Air circulation in the cabin moves across the plane rather than along it and is also filtered many times. This helps prevent the spread of airborne particles.²

^2. Turner P, Dowdall N. Flying with nut and other food allergies: unravelling fact from fiction. Arch Dis Child. Published online December 28, 2024. doi:10.1136/archdischild-2024-327848

^3. Lovén Björkman S, Sederholm U, Ballardini N, et al. Peanuts in the air – clinical and experimental studies. Clin Exp Allergy. 2021;51(4):585-593. doi:10.1111/cea.13848

Take your own food. See Food for a long flight with allergies.

Keep adrenaline devices near you. Store your adrenaline devices and your ASCIA Action Plan for Anaphylaxis where you can easily reach them when you have your seatbelt on, such as under the seat in front of you or in your seat pocket.

Clean surfaces to remove any possible allergen to reduce the risk of an allergic reaction.

• Research shows that particles of food allergens, including peanuts, can be found on surfaces such as seats, trays, entertainment systems (TV screens) and seatbelts.² However, studies also tell us that cleaning all surfaces that you may touch with detergent is a good way to remove food allergens.² Wet wipes and soap-based cleansers are better than water. Many airlines let passengers with food allergies board the plane before other passengers so they can clean these surfaces before the rest of the passengers are allowed on.
• Hand sanitiser, which kills germs, does not remove food allergens from hands or surfaces.

Wear long pants and long sleeves. This limits skin contact with the seats, armrests and tray tables and may reduce the risk of becoming itchy.

Wash your hands. Wash your hands before eating. If you cannot go to the bathroom to do this, use disposable wipes.

Consider where you seat children with food allergies. It may be safer to sit them between parents or carers or in a window seat, where food is less likely to spill or fall on them. Think about what is best for your situation.

Things that may make you feel more comfortable but are not proven to reduce risk

Wear a mask. There is no evidence that people are at risk of anaphylaxis from breathing in food allergens on planes. Still, a mask may make people feel more comfortable and may make strong smells less worrying while others are eating.

Don’t eat while others are eating. Some people with food allergy feel more comfortable not eating at the same time as other people who may be eating food that they are allergic to.

^2. Turner P, Dowdall N. Flying with nut and other food allergies: unravelling fact from fiction. Arch Dis Child. Published online December 28, 2024. doi:10.1136/archdischild-2024-327848

You should travel with your ASCIA Action Plan for anaphylaxis and your ASCIA Travel Plan for people at risk of anaphylaxis.

Some airlines ask you to bring a letter or medical clearance from a doctor when flying with food allergy. Check with your airline.

For more information see Airline policy comparison for food allergy

A customer may be asked to sign a waiver, or separately, an indemnity. A customer may also be asked to sign a document containing both types of agreement.

A waiver is a contractual agreement that requires one party (usually the customer) to agree that it will not make any legal claim against the other party (the business), often in the context of the customer experiencing harm or injury while using the business’ service.

An indemnity is a further agreement by a party (the customer) that it will compensate the other party (the business) for any legal liability or loss sustained by the business, as a result of harm or injury suffered by the customer.

Examples of loss for which a business might ask for compensation include the cost of any medical assistance they arrange for the customer, damages for harm to its reputation, or where there is disruption to the business due to the customer’s injury, a business may ask for compensation for the profits it would have made if not for the disruption.

Each airline has its own policies and conditions which explain the changes they will make and the level of risk they will take on. It is important to review these policies before buying your ticket, as many of the rules will apply as soon as you buy your ticket. Airline policies will likely say whether a waiver/indemnity form is needed.

Passengers travelling with a food allergy should read the airline terms of service and conditions of travel (sometimes referred to as conditions of carriage) as these should explain whether the airline is willing to make any changes (for example wiping down the tray table) if not told in advance of passenger allergies, and whether the airline will refuse to accept responsibility for an anaphylaxis.

Most airline terms of service say they are not responsible for any loss due to an anaphylaxis on board their aircraft. Further, some airlines require that passengers do not hold the airline responsible for any costs due to an allergic reaction. The conditions of flying with the airline are often agreed to at the time an airline ticket is purchased, regardless of whether the airline later asks that passengers sign an indemnity/waiver. If a passenger’s allergic reaction increases costs to the airline (for example, where the airline has to divert the aircraft), the passenger may have to pay these costs.