#225629 - 04/07/04 12:24 AM
Can peanut odors cause anaphylactic reactions?
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Driving Me Nutty
Registered: 05/01/03
Posts: 459
Loc: Arlington Heights, IL, USA
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I recall reading that Dr. Sampson indicated that it is very rare for someone to have an ana. reaction from inhaling peanut proteins. But now I can't find that article.
Has anyone read similar? or opposing information?
Here's a link to the AAAAI websit but it doesn't have any strong basis -
http://www.aaaai.org/aadmc/inthenews/wypr/2003archive/peanut_odors.html
Thanks,
Pamela
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Mom to Karissa 6/29/01 (PA>100 CAP RAST and TNA level 3)
_________________________
~ Mom to 3 y/o dd (PA>100 CAP RAST and TNA level 3) ~
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#225630 - 04/07/04 04:55 AM
Re: Can peanut odors cause anaphylactic reactions?
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Syd's Mom
Registered: 03/14/01
Posts: 711
Loc: Posts pre-2008 are 'Expired' &...
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Here's some supporting information on research into inhalation reactions.
(Obtained from Dr.John Weisnagel research website at: http://www.allerg.qc.ca/peanutallergy.htm
More specifically under the "odor" section:
http://www.allerg.qc.ca/peanutallergy.htm#odor
On Feb 23d, 2002, the AQAA (Association Québécoise des Allergies Alimentaires) held its annual Allergy Day at Hôpital Ste-Justine de Montréal. Dr Marie-Noël Primeau, pediatric allergist of the hospital, gave a talk on Anaphylaxis and adverse reactions to the odor of foods. "ANAPHYLAXIE ET RÉACTION À L'ODEUR DES ALIMENTS". The question of adverse reactions to the odor of certain foods is not clear. Firstly, there is little information on this in the medical literature. Furthermore, because such reactions are rare, the data reported can be applied to only a small number of allergic individuals. Management and recommendations cannot be defined specifically at this point in time. Each case must be evaluated separately. Studies have shown that allergenic particles of certain foods could be air-borne. But this does not mean that these particles will cause a reaction in individuals allergic to the particular food by inhalation. Dr Primeau's conclusion was that adverse reactions can occur simply being exposed to the odor of foods, but they are exceptional. Because this type of reaction is usually mild, limited to the skin or respiratory system. Dr Primeau suggested that the approach in the treatment of such reactions should be conservatory, and no strict avoidance measures undertaken especially if the allergic individual has never reacted to the odor or being in the presence of the food in question. If this type of reaction does occur, it should be brought to the attention of the allergist who will be able to assess its importance and prescribe accordingly. (translation of comments posted at the Allergique.org website Mar 11, 2002) (posted here Mar 22, 2002)
-In the July 2003 J Allergy Clin Immunol, Simonte et al report a study, Relevance of casual contact with peanut butter in children with peanut allergy the objective being to determine the clinical relevance of exposure to peanut butter by means of inhalation and skincontact in children with peanut allergy. Children with significant peanut allergy (recent peanut-specific IgE antibody concentration >50 kIU/L or evidence
of peanut-specific IgE antibody and one of the following: clinical anaphylaxis, a reported inhalation-contact reaction, or positive double-blind, placebo-controlled oral challenge result to peanut) underwent double-blind, placebo-controlled, randomized exposures to peanut butter by means of contact with intact skin (0.2 mL pressed flat for 1 minute) and inhalation (surface area of 6.3 square inches 12 inches from the face for 10 minutes). Placebo challenges were performed by using soy butter mixed with histamine (contact), and scent was masked with soy butter, tuna, and mint (inhalation).
Results: Thirty children underwent the challenges (median age, 7.7 years; median peanut IgE level, >100 kIU/L; 13 with prior
history of contact and 11 with inhalation reactions). None experienced a systemic or respiratory reaction. Erythema (3 subjects),
pruritus without erythema (5 subjects), and wheal-and-flare reactions (2 subjects) developed only at the site of skin contact
with peanut butter. From this number of participants, it can be stated with 96% confidence that at least 90% of highly sensitive children with peanut allergy would not experience a systemic-respiratoryreaction from casual exposure to peanut butter.
Conclusions: Casual exposure to peanut butter is unlikely to elicit significant allergic reactions. The results cannot be generalized to larger exposures or to contact with peanut in other forms (flour and roasted peanuts).180 (posted July 11th, 2003)
Commercial airlines and peanuts
-At the annual meeting of the AAAA&I (Feb. 1999 in Orlando) Sicherer, Furlong, DeSimone, and Sampson presented a paper entitled: "Peanut Allergic Reactions on Commercial Airlines." the purpose of the study was to describe the clinical characteristics of allergic reactions to peanut (PN) on airplanes. Participants in the National Peanut and Tree Nut Allergy Registry (PAR) who indicated an allergic reaction were interviewed by telephone.
62 of 3,704 PAR registrants indicated a reaction on an airplane
42 patients or parental surrogates consented to further questioning (median age of affected: 2 yrs, range 6 mo-50yrs)
of these, 31 reacted to PN, 3 to tree nuts, and 8 to uncertain exposures, suspected PN
exposures occurred by mouth (20), skin (8), and inhalation (14)
reactions generally occurred within 10 minutes of exposure (32/42);
reaction severity correlated with exposure route (mouth > inhalation > skin)
the causal food was generally served by the airline (37/42)
medications were given in flight to 20 patients (epinephrine to 6) and to an additional 14 on landing/gate return (including IV to 2, one forcing a return to the gate), totaling 81% treated.
flight crews were notified in 33% of reactions.
during 10 PN allergic inhalation reactions, > 25 passengers were estimated to be eating PN at the time of reaction.
initial symptoms generally involved the upper airway with progression to skin or further lower respiratory reactions (no gastrointestinal symptoms).
2 subjects were given epinephrine in flight.
asthma was previously diagnosed in 6 patients.
Conclusion: Food (peanut and nut) allergic reactions occurred during commercial flights but airline personnel were notified in only 33% of cases. Reactions were frequently severe, requiring medication including epinephrine. Severe reactions were primarily due to accidental ingestion, but respiratory reactions occurred from inhalation when many passengers were consuming PN. (posted April 2nd, 1999)
I e-mailed Dr. Hourihane, asking his opinion on the importance of peanut odor, and this was his response: "I am not personally aware of proven anaphylaxis associated with the smell but it is often related by parents that the child has become lethargic and clingy after entering a room with peanuts open in the room. This cannot be called anaphylaxis with any confidence. My feeling is that some people really do degranulate on inhaled exposure (Dr. Hourihane is referring to degranulation of cells involved in allergic reactions, specifically mastocytes, meaning they have a typical allergic reaction) but the reactions are minor - usually upper airway and eyes with some urticaria (hives) maybe. The major problem when exposed like this is panic especially on planes and in other confined spaces." (posted April 8th, 1999)
The paper presented at the Orlando Meeting of the AAAA&I (summarized above) has now been published in the Journal of Allergy and Clinical Immunology, July 1999, vol 104, 186-9.
Further comments from the authors: Allergic reactions to peanuts and tree nuts caused by accidental ingestion, skin contact, or inhalation occur during commercial flights. . . most of the inhalation reactions described were not life-threatening. However, when one considers the whole group experiencing acute allergic reactions by ingestion and inhalation to peanuts or tree nuts while on commercial airliners, the imporance of exercising caution and having emergency medication available becomes apparent. 76(posted Aug. 1st, 1999)
-In the same issue of the journal, John M. James, M.D. summarizes the 'airline-peanut allergy' problem in an artilcle entitled, Airline snack foods: Tension in the peanut gallery. Here are some of his remarks:
-. . . "there has been increasing concern and debate about the potential for individuals with peanut allergy to experience an allergic reaction while on a commercial airplane that is serving peanuts and/or peanut-containing food. . . .The cabin of a plane in flight is certainly a less than ideal environment in which to recognize and properly manage a potentially severe allergic reaction. . . In mid-1998, the Department of Transportation (DOT) issued a proposal that would have mandated that the 10 major US commercial airlines must provide "peanut-free zones" for passengers with allergic reactions to peanuts. . . This met great resistance from the Air Transportation Association. . . the US Congress. . .the mandate was never implemented, one of the reasons cited by members of the Congress was the lack of published, scientific data describing passengers with peanut allergy who had experienced allergic reactions caused by airborne peanut allergen on commercial airliners."
-Citing the paper by Sicherer and co-workers summarized above, Dr James underlines that this paper "represents the first published investigation describing the clinical characteristics of allergic reactions to peanuts on commercial airliners in subjects with peanut allergy. . . the self-reported allergic reactions, however, were very consistent with allergy. . .this investigation does not provide all the data needed to resolve this ongoing debate, but it certainly provides a solid foundation to better address these potentially life-threatening exposures and allergic reactions."
-"There are some disturbing findings in this investigation. First, why was there such a low level of notification of flight crews and airline personnel?. . .Second, could other potential irritants (eg. strong perfumes, passive tobacco smoke on clothing of smokers, and cleaning agents) have contributed to the inhalation reactions in some of the subjects, especially those with asthma? . . Finally, 5 subjects received epinephrine while in flight to manage severe allergic reactions. This observation relates to another relevant debate focusing on the availability of injectable epinephrine on board commercial airliners and the availability of trained flight personnel to administer this medication."
-"Two things are very clear to me as this debate continues to develop: education and preparedness should prevail. . . In the final analysis, more objective data and proper education will help guide us in the ultimate resolution of this important debate and lower the tension in the peanut gallery." 77 (posted Aug. 1st, 1999)
_________________________
Posts made by me prior to '08 are 'Expired' & "Moldy".Do Not Consume.Editing is verboten/outlawed.
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#225631 - 04/07/04 12:13 PM
Re: Can peanut odors cause anaphylactic reactions?
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MommaBear
Registered: 09/23/02
Posts: 16881
Loc: Chicago
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Originally posted by Syd's Mom:
-"Two things are very clear to me as this debate continues to develop: education and preparedness should prevail. . . In the final analysis, more objective data and proper education will help guide us in the ultimate resolution of this important debate and lower the tension in the peanut gallery." 77 (posted Aug. 1st, 1999)
(quote from article posted by syd's mom)
Meaning: having a *good* emergency plan and increasing "awareness" possibly are pivotal?
Anyone?
another quote from article:
"I e-mailed Dr. Hourihane, asking his opinion on the importance of peanut odor, and this was his response: "I am not personally aware of proven anaphylaxis associated with the smell but it is often related by parents that the child has become lethargic and clingy after entering a room with peanuts open in the room. This cannot be called anaphylaxis with any confidence. My feeling is that some people really do degranulate on inhaled exposure (Dr. Hourihane is referring to degranulation of cells involved in allergic reactions, specifically mastocytes, meaning they have a typical allergic reaction) but the reactions are minor - usually upper airway and eyes with some urticaria (hives) maybe. The major problem when exposed like this is panic especially on planes and in other confined spaces." (posted April 8th, 1999)
The paper presented at the Orlando Meeting of the AAAA&I (summarized above) has now been published in the Journal of Allergy and Clinical Immunology, July 1999, vol 104, 186-9."
Mast Cell Degranulation.
noting.
[This message has been edited by MommaBear (edited April 07, 2004).]
_________________________
"Artificial intelligence is no match for natural stupidity."
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#225632 - 04/07/04 01:27 PM
Re: Can peanut odors cause anaphylactic reactions?
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Driving Me Nutty
Registered: 05/01/03
Posts: 459
Loc: Arlington Heights, IL, USA
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Originally posted by Syd's Mom:
suspected PN exposures occurred by mouth (20), skin (8), and inhalation (14)
reactions generally occurred within 10 minutes of exposure (32/42);
reaction severity correlated with exposure route (mouth > inhalation > skin)
Thanks Syds Mom for posting all of that! Very interesting studies. I had always assumed that an inhaled reaction wouldn't be as severe as a contact/skin exposure but this study (based on an airplane environment) indicates otherwise.
MB, I would agree that pretty mundane statement "education and preparedness should prevail" but yes, I agree. Unfortanately it only seems that United and American airlines are 'listening' to these studies.
_________________________
~ Mom to 3 y/o dd (PA>100 CAP RAST and TNA level 3) ~
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#225633 - 06/13/04 06:31 PM
Re: Can peanut odors cause anaphylactic reactions?
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usmcwife4ever
Registered: 09/28/02
Posts: 41
Loc: Virginia Beach, VA USA
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Our daughter had a pa reaction to airborne particles at the mall. It was not anaphylactic. Well, it was hives, runny nose, and runny diaper so *technically* it more than two body systems. We were in Old Navy and the peanut shop outside was cooking nuts in an open cooker, the smell got to her in Old Navy and she started reacting. The great part, our inlaws own that store. We now have to avoid that entire row of stores at the mall and I am very worried about future airborne reactions.
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#225634 - 06/24/04 07:50 PM
Re: Can peanut odors cause anaphylactic reactions?
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Lovey
Registered: 03/22/04
Posts: 114
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Although this study was not with peanuts, the principles are basically the same.
http://allergy.edoc.com/1997_archives/pdf/jan_97/35.pdf
Inhalation reactions do happen with food allergies and can be severe.
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#225635 - 06/25/04 02:06 AM
Re: Can peanut odors cause anaphylactic reactions?
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rebekahc
Registered: 12/02/99
Posts: 1074
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My DS and I both have airborn reactions and technically they could be called anaphylactic if you use the 2 body system definition. I have always removed us from the airborn exposure as soon as we started reacting (which I assume most people do get the he!! out of there). Maybe anaphylaxis is "rare" or "unlikely" from airborn exposure because people get out of the situation. I believe that if my DS or I stayed in the situation our reactions could easily progress to full-blown anaphylaxis. I believe inhalation reactions are slower to progress thus giving the allergic person time to remove themselves before reaching a critical state.
My DS's airborn reactions usually are asthma and eyes swelling. I will do any or all of the following (usually at least 3 or 4 of them) - sneeze constantly, profusely runny/watery eyes and nose, face itching, eyes swelling, rash on exposed skin, lips swelling, throat itching, wheezing. My symptoms usually go away quickly when I leave the situation. DS's symptoms usually take longer to disappear.
Rebekah
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#225636 - 06/25/04 12:09 PM
Re: Can peanut odors cause anaphylactic reactions?
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MQriley2
Registered: 05/25/04
Posts: 177
Loc: Beaufort, SC Beaufort County
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That is nice to know because my allergist just told me last week that airborne cannot cause ana. I asked him if he was sure, because I could have sworn I had read here were someone had, and he said nope that it had to be touched and ingested.
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Renee athma/EA
Quinton: PA/TNA/Soy/EA/Severe Asthma/whole egg/onion/cocoa bean/chicken/turkey/string beans/potato
Mykiaja: EA/asthma
Taylor: EA/asthma
_________________________
Renee asthma/EnA
Quinton: PA/TNA/Soy/EnA/Severe Asthma/whole egg/onion/cocoa bean/chicken/turkey/string beans/potato
Mykiaja: EnA/asthma
Taylor: EnA/asthma
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#225637 - 06/25/04 12:50 PM
Re: Can peanut odors cause anaphylactic reactions?
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mamagaona
Registered: 12/29/00
Posts: 288
Loc: NJ, USA
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I don't give a bleep what the research says about it. My dd gets a migraine when she is around the "smell" of peanut butter, even when she is not aware it is around. That is good enough for me to keep her at the peanut free table at school.
Migraine also happens to be her first sign of anaphylaxis.
Arlene
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#225638 - 06/25/04 02:59 PM
Re: Can peanut odors cause anaphylactic reactions?
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Scared Nutless
Registered: 01/13/04
Posts: 93
Loc: Canada
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My dd has also had nasty reaction to peanut fumes. DD started reacting with itchy face (hives starting to form), runny nose, ear pain (which doc said indicates throat swelling), dizzyness. We looked around and there was a little boy eating pn. We didn't even know until dd started reacting. We gave benadryl right away and reaction stopped.
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