An Australian woman has shared the shocking reality of what it's like to fly with an airborne allergy as she calls on passengers to stop supporting the sale of nut products on flights.
Em Lee posted photos of what she believed was a reaction to nut residue left on a plane seat or tray table that she possibly touched or inhaled during a domestic flight on the weekend.
Ms Lee said her children were "terrified" she would die during her episode, though she deemed it to be only a "minor" reaction, reports news.com.au.
But she used her frightening experience to remind all plane passengers that nut products, which have long been popular snacks on flights, had the potential for much worse.
"Having a life-threatening airborne allergy is like boarding a plane and enduring the whole flight with a person holding a loaded gun to your head. It is horrible," Ms Lee said.
"This also affects my children emotionally in a huge way. They were so traumatised thinking I would die on last night's plane, despite me calmly reassuring them the whole time. They are terrified."
Almost three in 100 Australian children have a peanut allergy, and only 20 per cent of children outgrow the allergy, according to Allergy & Anaphylaxis Australia.
Allergies to tree nuts, which include almonds, walnuts, macadamias, pine nuts and many others, are also prevalent in Australia, which has among the highest rate of food allergies in the world.
And for those with airborne allergies, it's not enough to avoid eating or touching a particular product — the reaction happens when sufferers breathe in the allergen, which can be extremely difficult to avoid.
Ms Lee said while the number of people who had potentially life-threatening airborne allergies was very small, she wanted to see fewer airborne allergens served in confined spaces, like plane cabins.
"Long-haul flights are the worst, where I need to carry my own tracheostomy kit in case I need to perform my own surgical airway," she said.
"There aren't too many airborne allergens that are this severe/life-threatening, and also common. I wish there was a way to avoid it to at least some degree.
"Of course I can and do avoid environments where nuts are present, and there are usually hospitals and paramedics with appropriate medication if required available. Being in the air is a completely different ball game."
She said it appeared important "people aren't being withheld from their rights to be served nuts on planes … a super important snack they couldn't possibly go without".
"Thanks society for pushing for your rights to be served nuts on aeroplanes, and thank you to the airlines who insist that they will never reconsider this snack option due to high demand," she said.
While airlines continued to serve nut products on planes — which are difficult for people with airborne allergies to avoid — other passengers could do their part to help, Ms Lee said.
"Please avoid bringing nuts on planes, or purchasing them," she said, pointing out supply equals demand.
"If demand stops, they may be more receptive to taking them off the menu.
"Be supportive of those living with this. It truly is an insanely traumatic thing to live with!"
In the meantime, Ms Lee used her post on Facebook to share flying tips for people with potentially life-threatening airborne allergies — and the list is exhausting.
She said: "Take antihistamines before and during flights. Pack at least 3 EpiPens. Advise airline in advance — twice — and document who you spoke to. Ask flight crew to request that passengers avoid eating nuts during the flight. Ask crew not to serve nuts on plane. Wipe down seat and tray with disposable antibacterial wipes (or get a partner or crew member to do this if possible). Pack a dust/gas mask. Pack an emergency kit for the plane to hold for you (they don't allow it on normally due to liquid and sharps restrictions). Kit should include at least 5x 1mg ampoules of adrenaline, hydrocortisone, ventolin, intramuscular needles, cannula, glucagon (for those on beta blockers), sodium chloride (fluids), and a full tracheostomy kit. Then hope there's a doctor on board who can perform all of this in under 20 minutes!"
She also said people with airborne allergies should get a letter from their GP explaining the need for all that equipment on board.
"The emergency kit can be in the care of flight crew at all times to maximise safety for other passengers," she said.
Airlines have been criticised for what some passengers believe to be poor handling of their allergies.
In May, a brother and sister, both with severe nut allergies, claimed Emirates flight crew told them to spend the seven-and-a-half hour flight in the plane's bathroom if they wanted to avoid nuts being served in the cabin.
Shannen, 24, and Sundeep Sahota, 33, said they told Emirates staff three times of their potentially life-threatening allergy but 40 minutes into the flight, the pair were "panic-stricken" when they learned the chicken main course contained cashews.
They feared they would be exposed to nut residue that could be carried through air vents. Emirates apologised for the incident but said it "cannot guarantee completely nut-free flights".
In March, a mother slammed American Airlines after her son, 10, nearly died after eating a cashew on a flight from Aruba to the United States.
Francine Ingrassia said flight crew were not equipped to deal with her son's medical emergency.
"If it was not for the quick-thinking stewardess on the plane, the nurse who administered the EpiPen and cared for him the entire trip and passengers who gave us their EpiPens, this would have been fatal," she said.
In a case that was recently heard by a British coroner, the daughter of a millionaire businessman died after a flight from eating a sandwich she had bought at Heathrow Airport.
Natasha Ednan-Laperouse, 15, collapsed on a flight from London to Nice after eating the artichoke, olive and tapenade baguette, which contained sesame seeds.
Despite being given two doses of drugs and an EpiPen, Natasha died in hospital in France.
Her parents are now campaigning for changes in the UK's food labelling laws.