The strategies that peanut and nut-allergic consumers employ to remain safe when travelling abroad

Thirty-two adults with a clinical history of reaction to peanuts or tree nuts consistent with IgE-mediated allergy participated in a qualitative interview study.Travel 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.Participants 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.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]. Food allergy cannot be cured and management is therefore focused on allergen avoidance and prompt treatment of serious reactions [3]. Morbidity is usually low and food allergy is rarely fatal, with 48 deaths in the UK between 1999 and 2006 [4]. However, the need for constant vigilance to avoid particular food allergens [5,6], the need to carry adrenaline auto-injectors [7,8] and the fear of anaphylaxis, all impact on food allergic individual’s social life, emotional wellbeing and quality of life [9]. Food is central to many social situations and