Of all patients with a known peanut allergy, 60% will have an accidental peanut exposure within 5 years.20,53,54 In contrast to children, food reactions in adults more commonly occur in restaurants, followed by home, workplace, or school.55,56 Specifically for nuts, commercial catering is an additional risk factor, accounting for 68% of reactions.57 Anaphylaxis to inhaled food allergens has been reported, mostly for seafood, when vapors during cooking become carriers for airborne protein allowing physical contact of protein with mucous membranes. Peanut has also been reported to cause allergic reactions via inhalation, though most studies are based on self-reported symptoms and have not been positively confirmed with inhalation challenge.58 In fact, casual contact of peanut butter has been studied in peanut-sensitized children and neither intact skin exposure nor inhalation was shown to elicit systemic or respiratory reactions.59 This point becomes important when counseling patients and parents about potential exposures such as the school lunchroom or on airplanes.