Q:

9/17/2012
I have a 14 year old with a tree nut allergy. Is it safe to bake at home with tree nuts in bread recipes as long as the windows are open and he's in school? I wasn't sure if baking with nuts is risky for him. Up until now, I haven't done so. Thank you.

A:

Thank you for your inquiry.

Unfortunately I cannot personally give you a definitive answer to your question regarding the baking of tree nuts. It is quite clear that allergic reactions including asthma, rhinitis, and anaphylaxis have occurred due to the inhalation of fumes generated by cooking food. Such allergic reactions have occurred to, for example, milk, fish/shellfish, and green beans. In addition, reactions to the inhalation of tree nuts (particles dispensed in the air as packages are opened) have been reported during airplane flights.

However, I have not found any literature reports of allergic reactions to tree nuts during the baking of bread.

There is a recent excellent and comprehensive review of inhalation reactions to foods which is available online free of charge. I have copied the title and the link to this article below. As you can see, the senior author of this was Dr. Sami Bahna who is a known expert in food allergy.

Food hypersensitivity by inhalation
Daniel A Ramirez† and Sami L Bahna*†Clinical and Molecular Allergy 2009, 7:4.

Since I could not personally give you a definitive answer, I am going to ask Dr. Bahna to share his thoughts with us regarding your inquiry. When I receive his response, I will forward it to you.

Thank you again for your inquiry.

Sincerely,
Phil Lieberman, M.D.

We received a response from Dr. Sami Bahna. Thank you again for your inquiry and we hope this response is helpful to you.

Sincerely,
Phil Lieberman, M.D.

Response from Dr. Sami Bahna:
Thank you for sharing with me this question, which is not specifically addressed in the literature, as you mentioned.

Unless this child has severe systemic reactions or breathing difficulty from touching or smelling the offending nuts, most probably he will not be affected by exposure to baking with nuts, particularly if he is not around. Another guiding factor can be his degree of reactivity to allergy skin testing or serum testing.

Best regards.
Sami Bahna, MD, DrPH

AAAAI - American Academy of Allergy Asthma & Immunology