A recent Southwest Farm Press article, "Oklahoma peanut industry hears good news," http://bit.ly/2opxjhx, quoted sources claiming that peanut allergies are not triggered by airborne protein, but must be ingested. A reader takes exception to that claim and also to a statement indicating that a large percentage of skin prick tests for peanut allergens come back as false positive.

Southwest Farm Press contacted the National Peanut Board (NPB) for clarification and an offer to correct any errors, as is our policy.

National Peanut Board registered dietitian nutritionist Sherry Coleman Collins, MS, RDN, responded:

 “I do not think any correction is necessary, but clarification might help. The article says that peanut protein is not airborne, which is not true. Although peanut protein can be airborne, it settles very quickly, which is one of the key reasons it likely doesn’t cause more serious reactions. There has never been clinical proof that airborne exposure causes anaphylaxis, but there have been lots of anecdotal claims.

“In clinical trials (as in the study by Simonte) and in clinical practice (as in the proximity studies by Dinikar), smelling peanut butter does not cause anaphylaxis or any significant reactions. Researchers have shown that protein is undetectable in the air after eating peanuts in almost every situation, except when shelling peanuts, but even then peanut proteins settle very quickly (Brough).

SKIN PRICK TESTS

“Food Allergy Research and Education (FARE) specifically has statements on their website that highlight the poor predictive value of skin prick tests alone:  https://www.foodallergy.org/diagnosis-and-testing/blood-tests?

“About 50 to 60 percent of all blood tests and skin prick tests will yield a ‘false positive’ result. This means that the test shows positive even though you are not really allergic to the food being tested. This is why they should only be used as part of the diagnostic process, yet are not diagnostic alone, as the NIAID guidelines specifically state: http://www.jacionline.org/article/S0091-6749%2810%2901566-6/fulltext#sec5.2.2.1.

Ryan Lepicier, NPB vice president for marketing and communications, adds: “The information on our site is vetted and based on science. The airborne issue is a delicate subject in the allergy community.”

He offers additional information from an allergy advocacy group’s website:

"Airborne exposure is a controversial subject. There is no evidence that peanut or tree nut particles or dust become airborne and can be inhaled, triggering a reaction. One study has shown that peanut butter vapors cannot trigger a reaction (no protein content) and two studies have shown that peanut dust is undetectable in the air. What likely happens is that the dust rapidly settles and persons unknowingly get the particles on their hands, which then come into contact with mucus membranes (e.g., finger-to-mouth contamination). There have been substantiated reports of fish/shellfish vapor containing protein and triggering a reaction." 

http://www.foodallergyawareness.org/foodallergy/anaphylaxis-2/