Almost 25 million Americans have some sort of flying-related fear, from nerves and anxiety to full-on aviophobia.

And now, recent news of what we now know was the tragic demise of Air France Flight 447 on Sunday night over the Atlantic Ocean has awakened a fear in many people who might not usually dwell on it.

I’m sure, to some extent, most of us feel some level of anxiety or vulnerability as our flight turns the final corner on the runway before accelerating and finally taking off. For some people, it’s nothing a sedative or a pre-flight cocktail can’t quell.

But for those people with a real fear of flying, just the thought of that pivotal moment in their trip can be enough to bring on the sweaty palms and racing heart. And for some, that fear is enough to keep them permanently grounded.

Now, we all know that probability-wise, the risks associated with driving a car are significantly higher than those associated with air travel — with research showing that the latter has actually gotten safer over the last couple of decades.

In fact, statistically speaking, the lifetime odds of dying in an air travel accident are 1-in-20,000 compared with 1-in-100 for an auto accident. And according to the NTSB, highway fatalities account for more than 94 percent of all transportation deaths — airplanes included.

But even though we understand that logically and statistically speaking, our chances of getting in a car accident are much greater than anything happening when we fly, it’s often the fact that we relinquish all control over our own well-being — for however long it takes us to get from point A to point B — to the pilot and his crew.

And for people prone to anxiety or obsessive compulsive disorders, this loss of control and the vulnerability we feel can become overwhelming, triggering a panic attack or worse. So it’s important for people suffering from these disorders to make sure they always carry their medication with them while they are traveling.

Other common phobias that can contribute to a fear of flying include claustrophobia (fear of enclosed spaces) and acrophobia (fear of heights).

Fortunately, today there are places to get help with your fears. Support groups and therapy are two options that have been around for a long time. But more recently, airlines have started to offer classes with flight simulators to help would-be passengers confront their anxieties and become more comfortable with the experience.

So while it may seem like there has been a lot of aviation incidents between the news coverage of the “Miracle on the Hudson” in January, and the fatal crash involving Continental Connection Flight 3407 in Clarence, NY just a month later — considering the fact that there are more than 87,000 flights in the skies over the U.S. on any given day — flying is still one of the safest way to travel.

Perhaps what leaves so many people feeling unsettled and fearful after this most recent accident is the mystery behind it. After a horrible tragedy, part of the healing process is to come to terms with what happened and try to make sense of it all. But as the days pass and the world looks on as investigators try to piece together the clues, it seems in the end, there will be more questions than answers as to the final moments of Flight 447.

Just yesterday I was traveling back from Seattle from the annual meeting of the American College of Allergy, Asthma and Immunology.  Quite a coincidence I, the “allergist,” was seated next to a young woman who was recently hospitalized and admitted to the ICU for severe anaphylaxis to peanuts.

It was very relevant and timely, as the snack service provided by the airline included the serving of peanuts and peanut crackers to passengers.  My physician assistant and I immediately got involved and requested a “peanut-free zone” be extended around the food allergic passenger’s seat.  The flight attendants worked smoothly and professionally to make this happen and to avert a potentially serious health issue for the passenger who has a life threatening food allergy to peanut and nuts. 

Take home message: Don’t be afraid to speak up when traveling on a plane! Many airlines will likely try and accommodate you if they are aware of this type of condition.  It’s not a bad idea to alert the airline when you are making your reservation so the “on plane” staff is also aware of your allergies and can easily help assist you if peanut products are served aboard the aircraft. Some airlines have already moved to peanut free snack foods. Check with your airline to learn if they are peanut/nut free! For travelers with the severest allergies, it is best to bring food from home just to ensure freedom from allergy-causing ingredients.

Let’s review food allergy avoidance and management while away from home.

• First, if your provider has given you an epinephrine auto-injector (i.e. Twinject, Epi-Pen) make sure you have this medication with you at all times when traveling in case of anaphylaxis (food allergy and anaphylaxis plan should be in place). 
• Also remember to have a note from your provider indicating the need for you to carry the “auto-injector” on the plane. 

The Food Allergy and Anaphylaxis Network is a great resource for food allergy safety tips while traveling if you or a family member has a food allergy.  One strategy mentioned is to choose the first flight available in the morning. Airplanes are sometimes cleaned at the end of each day and flying early in the morning may decrease the chance that the seats will contain food crumbs or residue.

Go to http://www.foodallergy.org/Advocacy/airlines.html for more information. It’s important to remember that more than 3 million Americans have food allergies to peanuts and nuts.

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine.  He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology.  No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.