Peanut Alergies and Flying
Psychophysiological entity
I'm astonished to read this. I have flown with someone that had a severe peanut reaction.
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I'm sorry to hear about your plight. And whilst I fully realise how unpleasant a nut allergy is, I'm truly glad that I don't fly with anyone who has one. To be incapacitated in flight for due to a nut allergy is not acceptable. There are too many sources to contaminate crew food and I think the likelihood of ingestion is too great a possibility. When your medic confirms that you'll neve, ever need an Epipen, that'll be different. Unfortunately, this isn't a normal job.
Psychophysiological entity
The thing is that anyone can have a severe reaction for the first time after a lifetime of no symptoms.
By the grace of God, I'd finished flying when I went into severe Anaphylactic shock. First symptoms were severe itching of my hands while driving, of all places, from hospital.
I put a huge amount of work into finding out just what happened, and the only thing I could come up with is the strong soap in the hospital lavatory. To this day, my hands react to washing up liquid.
My GP told me of his father who also happened to be a GP. They were leaving a Chinese restaurant together, when his father suffered his first ever reaction. It was totally disabling.
I wrote this in a funny vein for JB, but believe me, it was far from funny.
http://www.pprune.org/jet-blast/2973...ml#post3654185
By the grace of God, I'd finished flying when I went into severe Anaphylactic shock. First symptoms were severe itching of my hands while driving, of all places, from hospital.
I put a huge amount of work into finding out just what happened, and the only thing I could come up with is the strong soap in the hospital lavatory. To this day, my hands react to washing up liquid.
My GP told me of his father who also happened to be a GP. They were leaving a Chinese restaurant together, when his father suffered his first ever reaction. It was totally disabling.
I wrote this in a funny vein for JB, but believe me, it was far from funny.
http://www.pprune.org/jet-blast/2973...ml#post3654185
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Loose Rivets - That really must have been terrifying from reading your post! (Touch wood) I have never gone into Anaphylactic shock, so cannot fully appreciate how scary it really is. The problem with allergies is that there is no real hardcore evidence to suggest what causes them, although there are a few theories. One of which is that we are all living in a disinfected world where we are less in contact with dirty bacteria. But doesn't mean to say I'm going to be rolling around in dirt and eating worms because it is a lot more complicated than that. Probably why the CAA don't have anything on their website regarding allergies.
Anyway straying off the point a bit, I am still going to go for my PPL and Night rating, and tackle the Class 1 Med after then. The more flight experience I get without encountering any medical problems, the better case I could have to argue against my Multi crew limitation and upgrade to a class 1. I fully appreciate that the CAA are there to help rather than hinder when it comes to health issues and at the end of the day it is the general public's safety which is priority. But i'll push on and see what happens. I'm just glad that I'm not hypersensitive to nuts, or I would be living in a bubble!
Anyway straying off the point a bit, I am still going to go for my PPL and Night rating, and tackle the Class 1 Med after then. The more flight experience I get without encountering any medical problems, the better case I could have to argue against my Multi crew limitation and upgrade to a class 1. I fully appreciate that the CAA are there to help rather than hinder when it comes to health issues and at the end of the day it is the general public's safety which is priority. But i'll push on and see what happens. I'm just glad that I'm not hypersensitive to nuts, or I would be living in a bubble!
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It sounds like the CAA is overreacting, perhaps because nut allergies are so much in fashion these days.
There are a couple of things to keep in mind. First, you don't know if you have an allergy until your first allergic reaction, so there may well be pilots with severe allergies flying who don't know about them. Second, food allergies generally only produce a reaction when the allergic person actually consumes the food. The mere proximity of that food or the smell of that food isn't enough, despite many apocryphal stories that assert otherwise. Third, anaphylaxis is rare in food allergies (actually it's rare for all allergies); you're more likely to stroke out during a flight than you are to experience anaphylaxis, even if you actually munch on a food to which you are allergic (unless you actually have a prior history of anaphylaxis). Fourth, psychology is important in allergies: allergic reactions can be psychogenic as well as physiological … a person with asthma can experience an attack simply from emotional stress, for example, even in the absence of any allergen. And a reaction trigger by an allergen can be worsened by psychological stress. This makes it hard to prove that an attack actually results from exposure to an allergen, in some cases.
The priorities of aviation medical authorities mystify me at times. It's as if they base their disqualifications on what they can detect, as opposed to basing them on what might actually incapacitate a pilot. Smoking is a lot more likely to kill a pilot during a flight than a food allergy, and yet being a smoker doesn't disqualify someone from being a pilot.
There are a couple of things to keep in mind. First, you don't know if you have an allergy until your first allergic reaction, so there may well be pilots with severe allergies flying who don't know about them. Second, food allergies generally only produce a reaction when the allergic person actually consumes the food. The mere proximity of that food or the smell of that food isn't enough, despite many apocryphal stories that assert otherwise. Third, anaphylaxis is rare in food allergies (actually it's rare for all allergies); you're more likely to stroke out during a flight than you are to experience anaphylaxis, even if you actually munch on a food to which you are allergic (unless you actually have a prior history of anaphylaxis). Fourth, psychology is important in allergies: allergic reactions can be psychogenic as well as physiological … a person with asthma can experience an attack simply from emotional stress, for example, even in the absence of any allergen. And a reaction trigger by an allergen can be worsened by psychological stress. This makes it hard to prove that an attack actually results from exposure to an allergen, in some cases.
The priorities of aviation medical authorities mystify me at times. It's as if they base their disqualifications on what they can detect, as opposed to basing them on what might actually incapacitate a pilot. Smoking is a lot more likely to kill a pilot during a flight than a food allergy, and yet being a smoker doesn't disqualify someone from being a pilot.
This is confusing! It sounds from your post that you were formally tested for various triggering agents. If so, was there a reason? What actual reaction did you have, how severe was it and what treatment did you have?
Once that is established, why is the CAA restricting you? It may be gobbledegook to you but if you pm me I can give you some advice. If you havent been told, ask. Certainly I know of many pilots flying with allergies that are not restricted so there must be a reason.
Finally the suggestion that nobody knows what causes an allergic reaction is wrong. We know very well what happens, and the various types of immune response. We also have well developed methods both of finding out why a reaction is happening (providing samples are taken immediately) and also of testing patients afterwards to see what they react to.
Once that is established, why is the CAA restricting you? It may be gobbledegook to you but if you pm me I can give you some advice. If you havent been told, ask. Certainly I know of many pilots flying with allergies that are not restricted so there must be a reason.
Finally the suggestion that nobody knows what causes an allergic reaction is wrong. We know very well what happens, and the various types of immune response. We also have well developed methods both of finding out why a reaction is happening (providing samples are taken immediately) and also of testing patients afterwards to see what they react to.
Psychophysiological entity
It's an interesting subject, and one that's caused me more than a little trouble over the years.
I'm not convinced by any means, but I'm suspicious that early childhood programming has a lot to do with it. A sensitive and intelligent child can pick up on all sorts of parental ramblings, and start to fear all sorts of things. "Sitting in a drought will give you a bad back." And it does - despite the fact you were hanging over the side of a sailboat in a force five for hours, and it left you felling like Superman. A far-fetched analogy, but you know what I mean.
Migraine is horrific, and so often comes at a time that tallies with long term worry. So counter-productive. Yet something seems to not just trigger the onset, but actually plans it. (a recent paper )
That something is very real, and I confess multiple sentience is a hobby-horse of mine, but I think there's a lot of sub-processing going on based on reasoning that has no place in a modern world; a world filled with new and exotic molecules. 'It' hasn't a clue how to react productively.
I'm now in a situation where I can't touch wheat. Yep, and that includes best malt
Not even a little bit. I'm scared stiff of washing up liquid, and using cheap soap makes me ill within an hour. There was a hint of it when I was c 40, but it went away after extensive tests by AVM Cook, head of aviation medicine. They didn't find a thing wrong, but the mystery took its toll on my career despite being very transitory.
I was in my early 60s when the main issues started, and the first experience would have left me on the floor of the flight deck. It was totally disabling for 10 of the 30 mins it lasted.
I'm not convinced by any means, but I'm suspicious that early childhood programming has a lot to do with it. A sensitive and intelligent child can pick up on all sorts of parental ramblings, and start to fear all sorts of things. "Sitting in a drought will give you a bad back." And it does - despite the fact you were hanging over the side of a sailboat in a force five for hours, and it left you felling like Superman. A far-fetched analogy, but you know what I mean.
Migraine is horrific, and so often comes at a time that tallies with long term worry. So counter-productive. Yet something seems to not just trigger the onset, but actually plans it. (a recent paper )
That something is very real, and I confess multiple sentience is a hobby-horse of mine, but I think there's a lot of sub-processing going on based on reasoning that has no place in a modern world; a world filled with new and exotic molecules. 'It' hasn't a clue how to react productively.
I'm now in a situation where I can't touch wheat. Yep, and that includes best malt
Not even a little bit. I'm scared stiff of washing up liquid, and using cheap soap makes me ill within an hour. There was a hint of it when I was c 40, but it went away after extensive tests by AVM Cook, head of aviation medicine. They didn't find a thing wrong, but the mystery took its toll on my career despite being very transitory.I was in my early 60s when the main issues started, and the first experience would have left me on the floor of the flight deck. It was totally disabling for 10 of the 30 mins it lasted.
'but it went away after extensive tests by AVM Cook'
Nope. An allergy is an abnormal learned response of the im,mune system. Once you have an allergy it doesnt go away (unless you are desensitised - a rare and far from simple procedure).
A significant proportion of patients who tell me they are allergic arent. Period. There is also controversy as to whether allergy is increasing in frequency or occurance or frequency of diagnosis.
Nope. An allergy is an abnormal learned response of the im,mune system. Once you have an allergy it doesnt go away (unless you are desensitised - a rare and far from simple procedure).
A significant proportion of patients who tell me they are allergic arent. Period. There is also controversy as to whether allergy is increasing in frequency or occurance or frequency of diagnosis.
Psychophysiological entity
I concede the last statement. Very difficult to get a level analytical playing field over long periods of time.
I'm not really able to understand the 'memory system' of immune cells. I just phoned my son for a briefing, (stress and the immune system is one of his focus subjects.) but he was driving, so I'll have to wait for that.
What does seem strange to the layman, is the level of 'learning' within the cells themselves. So, it takes me away from a direct control of some misguided processing in the brain - as so much is going on at cell level. However, I still think there is a high likelihood there is some sort of master control that becomes confused. It so often seems to be linked to factors like stress.
I claimed at the time I felt wholewheat bread made me ache. It seemed to be 100% hit rate. I went on to enjoy years of eating such bread.
It was the period all those years ago that prompted me to try not eating wheat this time around - with almost total success. (the soap thing blurs the certainty.)
Another issue is the products they use on the wheat. A Uni professor neighbor can't touch the stuff, but she can eat bread again when she's in a different state (of the US). Clearly that slews any results from hit and miss self help.
I'll try to get a clearer picture, then steer back to the OP's point of sudden and disabling reactions.
I'm not really able to understand the 'memory system' of immune cells. I just phoned my son for a briefing, (stress and the immune system is one of his focus subjects.) but he was driving, so I'll have to wait for that.
What does seem strange to the layman, is the level of 'learning' within the cells themselves. So, it takes me away from a direct control of some misguided processing in the brain - as so much is going on at cell level. However, I still think there is a high likelihood there is some sort of master control that becomes confused. It so often seems to be linked to factors like stress.
I claimed at the time I felt wholewheat bread made me ache. It seemed to be 100% hit rate. I went on to enjoy years of eating such bread.
It was the period all those years ago that prompted me to try not eating wheat this time around - with almost total success. (the soap thing blurs the certainty.)
Another issue is the products they use on the wheat. A Uni professor neighbor can't touch the stuff, but she can eat bread again when she's in a different state (of the US). Clearly that slews any results from hit and miss self help.
I'll try to get a clearer picture, then steer back to the OP's point of sudden and disabling reactions.
Peanut Alergies and Flying
Hello all,
I am posting this on behalf of a young friend who would like to pursue a career in Aviation, but has a severe allergy to Peanuts. He says the allergy is severe enough for it to be fatal, and he carries an EpiPen in case of accidental ingestion. Whilst specific to Peanuts, his GP has advised he stay away from all nut types.
I have looked about on here, and did the usual Google searches but cannot find any specific information as to if he is likely to be able to fly professionally in a commercial environment. I believe he has enquired with the UK RAF and the answer was (not surprisingly) a flat “absolutely no chance”.
I have held a Class 1 medical previously, but for all the medical scenarios I have read about I have absolutely no idea what the potential limitations could be in this instance. My gut instinct is that it won’t be good news.
Appreciate any pointers,
Kind Regards.
T
I am posting this on behalf of a young friend who would like to pursue a career in Aviation, but has a severe allergy to Peanuts. He says the allergy is severe enough for it to be fatal, and he carries an EpiPen in case of accidental ingestion. Whilst specific to Peanuts, his GP has advised he stay away from all nut types.
I have looked about on here, and did the usual Google searches but cannot find any specific information as to if he is likely to be able to fly professionally in a commercial environment. I believe he has enquired with the UK RAF and the answer was (not surprisingly) a flat “absolutely no chance”.
I have held a Class 1 medical previously, but for all the medical scenarios I have read about I have absolutely no idea what the potential limitations could be in this instance. My gut instinct is that it won’t be good news.
Appreciate any pointers,
Kind Regards.
T
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My gut instinct would be 'no'. But there is always the possibility (at least in the UK/Europe) that your friend could argue he is being discriminated against under the Human Rights Act and Discrimination From Disabilities Act.
My reason for my gut instinct being no is that even if the airline introduced a total 'no nuts' policy in their on-board food and snacks, it would be extremely difficult to enforce what every passenger brings on with them.
I don't think the allergy itself would prevent him from getting the required medical certifying him for flight, more it would be the airlines concern with his allergy on board.
Do keep us updated on this, I would be curious to know the outcome.
My reason for my gut instinct being no is that even if the airline introduced a total 'no nuts' policy in their on-board food and snacks, it would be extremely difficult to enforce what every passenger brings on with them.
I don't think the allergy itself would prevent him from getting the required medical certifying him for flight, more it would be the airlines concern with his allergy on board.
Do keep us updated on this, I would be curious to know the outcome.
Hey, jackieofalltrades,
Appreciate the reply. Many thanks.
You raise a couple of interesting points - maybe ok to achieve the Class 1- based on current criteria, but individual (read probably all) operators may have the issue where by they cannot achieve 100% guaranteed containment, as you say they cannot dictate what pax bring on-board. I guess from a risk perspective there is the dual crew scenario, but that would remove any chance of single Pilot ops, what if a 2 crew jet had 2 pilots with the same allergy?
Interesting, will get him to ring the SRG at Gatwick and see if he can get some clarity on this. (he is still a teen and not aware of what the system has or how it works)
I will keep you up to speed on the outcome, and thanks again for asking.
Kind Regards.
T
Appreciate the reply. Many thanks.
You raise a couple of interesting points - maybe ok to achieve the Class 1- based on current criteria, but individual (read probably all) operators may have the issue where by they cannot achieve 100% guaranteed containment, as you say they cannot dictate what pax bring on-board. I guess from a risk perspective there is the dual crew scenario, but that would remove any chance of single Pilot ops, what if a 2 crew jet had 2 pilots with the same allergy?
Interesting, will get him to ring the SRG at Gatwick and see if he can get some clarity on this. (he is still a teen and not aware of what the system has or how it works)
I will keep you up to speed on the outcome, and thanks again for asking.
Kind Regards.
T
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EASA Class 1 and peanut allergy?
I've looked all over the place for an answer to this, but so far it's been 
, so hope someone on here might be able to cast some light. I'm aware that other posters already working as pilots have asked about suspected allergies and renewal of medical certificates etc. but this enquiry refers specifically to submitting to the medical for the first time, with awareness of this particular condition. Can you even be considered for a Class 1 certificate with it, or would you face immediate rejection?
Brief background - my son's been talking for some time about a career as a commercial pilot and is just about to embark on GCSE options etc.
He's done some research and already has a few ideas in mind for achieving his ambition. However, the fly in the ointment is that some years ago he was diagnosed with peanut allergy. The fact that it hasn't even occurred to him that he might not pass the medical shows how it's become part of his routine...he manages simply by avoiding certain foods and carrying an Epipen. So far he hasn't had a severe reaction or needed to use the Epipen (touch wood!!!), but of course the condition can be potentially serious in the event that the allergy is triggered. Since EASA Class 1 is required from the outset in order even to apply for training (and, presumably, for any flying-related activities in the meantime), is his allergy likely to make this particular ambition a non-starter? The condition already excludes him from any type of military career in the future, though joining the Air Cadets is still a possibility (we think!).
I'm aware that entry to the profession is extremely competitive anyway, and I hate to crush ambition, but would rather do it sooner rather than later if this particular medical barrier really is insurmountable! Any ideas greatly appreciated.
, so hope someone on here might be able to cast some light. I'm aware that other posters already working as pilots have asked about suspected allergies and renewal of medical certificates etc. but this enquiry refers specifically to submitting to the medical for the first time, with awareness of this particular condition. Can you even be considered for a Class 1 certificate with it, or would you face immediate rejection?Brief background - my son's been talking for some time about a career as a commercial pilot and is just about to embark on GCSE options etc.
He's done some research and already has a few ideas in mind for achieving his ambition. However, the fly in the ointment is that some years ago he was diagnosed with peanut allergy. The fact that it hasn't even occurred to him that he might not pass the medical shows how it's become part of his routine...he manages simply by avoiding certain foods and carrying an Epipen. So far he hasn't had a severe reaction or needed to use the Epipen (touch wood!!!), but of course the condition can be potentially serious in the event that the allergy is triggered. Since EASA Class 1 is required from the outset in order even to apply for training (and, presumably, for any flying-related activities in the meantime), is his allergy likely to make this particular ambition a non-starter? The condition already excludes him from any type of military career in the future, though joining the Air Cadets is still a possibility (we think!).
I'm aware that entry to the profession is extremely competitive anyway, and I hate to crush ambition, but would rather do it sooner rather than later if this particular medical barrier really is insurmountable! Any ideas greatly appreciated.
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However, the fly in the ointment is that some years ago he was diagnosed with peanut allergy
How certain is the diagnosis ? Some I have known in the past have been very uncertain to say the least. The great majority of nut allergies produce much less dramatic effects. It's those tiny number of really serious ones which occasionally hit the headlines !
Must admit that I can't see any reference on the CAA medical website to allergies. So, it's the usual advice that's given on here so often : phone or e-mail the CAA medical department, and ask what the current position is. I, for one, would be very interested to hear their answer, and I'm sure lots of others would be too.
Last edited by Ulster; 9th Jan 2014 at 11:57. Reason: punctuation
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The possible scenario is :- No peanut ingestion = 101% fit and well ; whereas, possibly even a tiny trace of peanuts in an otherwise innocuous crew meal might = major, life-threatening, anaphylactic reaction at any time at all !
In the meantime I'll follow your advice and contact the CAA medical department for their opinion. I've seen one of their forms which asks about allergies but nothing to indicate "what happens if...". I'll certainly let you know what they say.
The good news is the local Air Cadets officer got back to me this morning and said that there is nothing stopping my son joining up if he wants to as long as he knows how to use his medication. So not all bad news.
It'd be interesting to know exactly how allergic your son is to peanuts. Given that he carries an epipen then presumably he is suspected of anaphylaxis but if he's never had a serious reaction then it may not be as bad as that.
Also, has he ever considered hyposensitisation treatment?
But as always, get in touch with the CAA and get the word 'straight from the horse's mouth' as it were, like Ulster says, it'd be interesting to hear what they have to say on the matter!
Also, has he ever considered hyposensitisation treatment?
But as always, get in touch with the CAA and get the word 'straight from the horse's mouth' as it were, like Ulster says, it'd be interesting to hear what they have to say on the matter!
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Whilst not directly related to aviation certification, this site
Peanut and Tree Nut Allergy - Allergy UK
seems to have some common-sense information and advice about the fairly low incidence of life-threatening anaphylaxis, and about causative foods etc, and about avoidance measures. Definitely worth a look !
Peanut and Tree Nut Allergy - Allergy UK
seems to have some common-sense information and advice about the fairly low incidence of life-threatening anaphylaxis, and about causative foods etc, and about avoidance measures. Definitely worth a look !
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I submitted a detailed response in reply to Ulster’s first post (or at least I thought I did) but it’s disappeared – must have pressed the wrong button 
– so will try and reproduce the gist…
Many thanks for responses so far! The diagnosis is definite, I'm afraid - he attended a clinic some years ago and tested positive for peanuts, cashews and (to a very small extent) Brazil nuts, but OK for all other nuts and other common allergens. Even though his symptoms had been relatively mild he was sent along for testing with his sister who had suffered a serious reaction requiring hospitalisation, so if not for her then he might never have been diagnosed in the first place. (Apparently a sibling of an allergy sufferer has a higher chance of developing the same allergy). There must be many people walking around with this condition who never have it diagnosed, or are at least aware they have a problem but are not prescribed Epipens – these are the cases you tend to hear about in the news. Something like 1 school-aged child in 70 now has a peanut allergy, so it's a bit of a time bomb being stored up for the future.
Anyway I'm going to ask the GP to refer our son for retesting, as there’s a chance he might grow out of it. We’ve considered desensitisation treatment but I don’t think this is available on the NHS locally so will probably have to look into going down the private route.
I’ve followed your sage advice and have e-mailed the CAA to ask them about this, and will let you know what they say when I hear back.
– so will try and reproduce the gist…Many thanks for responses so far! The diagnosis is definite, I'm afraid - he attended a clinic some years ago and tested positive for peanuts, cashews and (to a very small extent) Brazil nuts, but OK for all other nuts and other common allergens. Even though his symptoms had been relatively mild he was sent along for testing with his sister who had suffered a serious reaction requiring hospitalisation, so if not for her then he might never have been diagnosed in the first place. (Apparently a sibling of an allergy sufferer has a higher chance of developing the same allergy). There must be many people walking around with this condition who never have it diagnosed, or are at least aware they have a problem but are not prescribed Epipens – these are the cases you tend to hear about in the news. Something like 1 school-aged child in 70 now has a peanut allergy, so it's a bit of a time bomb being stored up for the future.
Anyway I'm going to ask the GP to refer our son for retesting, as there’s a chance he might grow out of it. We’ve considered desensitisation treatment but I don’t think this is available on the NHS locally so will probably have to look into going down the private route.
I’ve followed your sage advice and have e-mailed the CAA to ask them about this, and will let you know what they say when I hear back.
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I submitted a detailed response in reply to Ulster’s first post (or at least I thought I did) but it’s disappeared
Looking forward to hearing what response you get from the CAA medics !