As many as 15 million people in the United States have food allergies, with 6 million of them being children. Every 3 minutes a food allergy reactions sends someone to the ER. 15% of school aged children with food allergies have a reaction at school, peanuts are most commonly associated with severe allergic reactions.
Unfortunately there is widespread misinformation regarding the triggers of allergic reactions. These myths force patients and families to live in a perpetual state of alarm. These fears and anxieties further worsen the burden of disease. Occasionally, a personal history of touching peanut butter eliciting a reaction is narrated. These fears cause a significant impairment of quality of life and lead to stringent measures in schools (peanut free tables.)
Research has revealed that severe reactions to non-aerosolized food allergens such as peanut butter almost always occurs through ingestion or contact of the allergen with mucus membranes, not by touching peanut butter on the skin. There have been rare reports of symptoms being triggered by being in the presence of or smelling peanut butter, but those have been disproven. Needless to say, casual exposure may present a greater risk to preschoolers who could inadvertently ingest peanut butter.
Concern has arisen about the possibility of being exposed to peanuts on commercial planes. Many airlines still serve peanuts on planes and patients are self-reporting subjective reactions to peanuts. A recent study showed that the only way peanut allergen would show up in the air of a commercial plane is if the peanuts were boiled or removed from the shells, so just serving peanuts on a plane should not cause an anaphylactic reaction. Nevertheless, it would be better if planes did not serve peanuts as many patients have a great fear.
A recent Food Allergy Practice Parameter update states “Teach patients that ingestion, rather than casual exposure through the skin or close proximity to (peanut), is almost the only route for triggering allergic/anaphylactic reactions.”
A study was done taking 30 children with severe peanut allergy. They were either exposed to peanut butter by inhalation or by touching peanut butter. None of the 30 children experienced a systemic or respiratory reaction. Although some children did develop redness on the skin after touching peanut butter.
The conclusion is that most individuals with peanut allergy will not experience a systemic or respiratory reaction touching, inhaling or smelling peanut butter, but only through ingestion.
Speak to your allergy doctor if you have any concerns, proximity food challenges can be done by your allergist to help alleviate any questions regarding what happens after exposure to peanut in you or your child.
For more information on Peanut Allergy