an ever increasing number of people using air travel,
airports around the world are becoming ever more crowded,
the check-in queues are getting longer and flight delays are
on the increase.
Nevertheless, the cost of flying has dropped in relative terms
over recent years and air
travel has also made the more remote regions of the
world a lot more accessible to ordinary individuals. Flying
is also statistically "the safest way to travel".
restrictions on flying
Many airlines will not allow passengers to fly with
certain conditions. Regulations may vary so if in doubt seek
advice from the medical department of the airline concerned.
Conditions that might cause problems include:-
beyond 36 weeks.
born babies during the first few days after birth.
or current middle ear infections or sinusitis.
psychiatric illness or epilepsy.
myocardial infarction or moderate/severe heart failure.
chest, intra-cranial or abdominal surgery.
pnuemothorax or moderate to severe hypoxic pulmonary
presence of a communicable disease.
record of causing disruption during flights.
Class Syndrome (Deep Vein Thrombosis DVT)
about this condition has been reported recently in the media.
Deep Vein Thrombosis (DVT) is a condition in which a clot,
or thrombus, typically forms in a deep vein in a leg. People
with a DVT may notice pain and swelling in the leg where the
clot has formed, though smaller clots may not cause any symptoms.
The major problem occurs when a part of the clot breaks off
and flows to the lungs. This condition, called a Pulmonary
Embolus, can cause severe injury or death.
still for long periods of time in cramped conditions can lead
to swollen ankles and occasionally DVT. This of course is
not unique to air travel but the cramped conditions often
found in economy class seats especially on long haul flights
has given rise to the name "Economy Class Syndrome".
Recent research, however, has found that passengers in any
seating class of the aircraft may develop a DVT. Research
indicates that any situation where one's activity is limited
for long periods - a long automobile drive or train ride,
for instance - may contribute to a DVT. For this reason, the
term Traveler's Thrombosis is more appropriate.
can often put travellers at higher risk. The circulating air
in aircraft cabins is kept dry and this can lead to passengers
becoming significantly dehydrated. Consumption of alcohol
before or during the flight will worsen this. Some passengers
may be flying from areas that have a hot and arid climate
and may be dehydrated on boarding the plane. Others may be
dehydrated as a result of contracting a bout of travellers
risk factors include; age (over 60), previous DVT, varicose
veins, recent surgery or injury, pregnancy, oral contraception,
hormone replacement medication, cardio-respiratory disease
and other chronic illnesses including malignancy.
persons with three or more of the above risk factors should
discuss additional protective measures with their doctors.
measures against DVT include:-
stretching and mobility exercises and if possible
walking around the cabin during the flight.
sufficient fluids to keep the urine pale.
a low dose aspirin tablet (75mg) for its anti-adhesive
effects on blood platelets.
use of graded compression stockings. These are available
at most pharmacies and are marketed specifically for
use during long haul flights.
clothing may be beneficial in avoiding constriction
recommend taking short naps, instead of long ones,
to avoid prolonged inactivity
has been known to doctors for many years. Until recently it
was beleived it only affected people of advanced years. It
is now known it can strike at any age irrespective of physical
fitness. Complications may arise that prove fatal. Anyone
who sits in cramped conditions on a long-distance aircraft,
coach, train or car is particularly at risk.
Preventative measures include wearing TRAVEL SOCKS. If properly
fitted, compression socks can reduce the potential risk of
D.V.T. These are available on line from:-
it is possible to travel to distant parts of the globe in
a matter of hours. This can result in the traveller ending
up in a part of the world where time is out of sync. With
his or her own "body clock" or Circadian Rhythms which regulate
our sleep patterns.
If we travel east or west by more than four time zones (hours)
then we will usually be affected. This means that travellers
from the UK will be affected when travelling to Asia, Australia,
New Zealand, The Pacific Islands, North and South America
but will not normally be affected when travelling to Europe,
Africa and The Middle East.
the past when people travelled by sea there was ample time
for the body to adjust to the local time but with the advent
of modern high speed aircraft the body does not have time
to adjust. Hence the term "Jet Lag". It normally takes one
day per time zone (hour) for the body to adjust to its new
effects of jet lag are usually tiredness & insomnia but
can also include: poor concentration, nausea, vomiting, constipation
and general malaise. The effects are made worse by alcohol
travel is usually tolerated better than Eastward. Stop-overs
on long haul flights may be helpful. Avoiding heavy commitments
on the first day after arrival is recommended. When travelling
away on vacation the effects may not be so noticeable but
on returning home to a normal routine they will be.
whilst flying may help to reduce the symptoms of jet lag but
long periods of immobility aboard the aircraft can make the
traveller more susceptible to DVT.
travellers find taking melatonin helpful. It may help the
body to adjust its circadian rhythms but its effects are scientifically
unproven. It is not readily available in the UK but can be
obtained in some countries such as USA and Hong Kong.
relaxed flight is important.
travelling when you are already tired and take rest
the actual travelling time will usually be at least
twice the actual time spent in the air since it will
include travelling to and from and hanging around
heavy commitments on the first day. Be prepared for
tiredness in the evenings and early waking which can
last up to 5 or more days.
tablets will help you to sleep and be correspondingly
alert during the next day but they do not speed up
adjustment to the new time zone.
is no evidence that re-circulation of the air in aircraft
cabins increases the risk of spreading infections amongst
the passengers since very effective filters are used to remove
bacteria and viruses.
However, sitting for long periods in close proximity to passengers
who are suffering from common colds or influenza may increase
the chances of another passenger becoming infected. This is
why most airlines discourage passengers with infectious conditions
is increasing world-wide and there is a small but real risk
of catching the disease during air flights. Transmission has
only been recorded in flights lasting over eight hours. The
risk is greater when many of the passengers on board are from
countries with a high incidence of the disease.
The risk of transmission of TB on a commercial aircraft is
low and there is no reason to suspect that the risk of transmission
on aircraft is greater than in any other confined space including
other forms of public transportation if the duration is the
head lice and other skin parasites may be passed on through
contact with aircraft seats where previous passengers have
been infested. It must be stated though, that most airlines
carry out thorough cleaning of the cabin and other facilities
International flights to some countries (including the UK)
require the spraying of the aircraft passenger compartment
with insecticide when departing from certain locations while
the passengers are present, or require periodic applications
of a residual insecticide. This practice, called disinsection,
is used to prevent the importation of insects such as mosquitoes
but this will also have an effect on any other insect parasites
sickness on arrival
healthy people who travel rapidly to 3500m above sea level
may develop symptoms of acute mountain sickness (AMS) after
arrival. People with respiratory or cardiac problems may experience
symptoms at even lower levels. A few airports in the Andes
and Himalayas are actually sited above this altitude which
can result in symptoms occurring soon after disembarking.
awareness of the symptoms of AMS would be helpful. Dehydration
exacerbated by the dry aircraft cabin atmosphere may worsen
symptoms. Acclimatisation and rest after arrival is recommended
since strenuous activity may worsen symptoms.. Further ascent
should be avoided until any symptoms have disappeared.
persons with pre-existing hypoxic respiratory disease should
seek medical advice prior to departure.
estimated nine million people in the UK suffer anxiety about
flying and may miss out on professional and personal opportunities
as a result. Fear may develop from a bad experience - a rough
flight, or after a news report of a high jacking or crash.
Panic attacks are common and the sensation is often so frightening
that the sufferer may refuse to fly from then on.
Advice for travellers who are afraid of flying
that flying is safer than road or rail travel in most developed
- Try distraction
by talking with other passengers, watching in-flight films,
eating or reading.
the cabin crew. Reassurance about strange sounds etc. can
your doctor prior to travel to assess your general fitness
for air travel.
taking a tranquilliser before flying but remember, these
drugs do not mix well with alcohol.
term describes the psychological or physical violence occurring
within an aircraft during flight. It is of particular concern
because of the cramped conditions inside an aircraft and the
inevitable involvement of cabin crew and other passengers.
There have been several instances where aircraft have had
to land prematurely to offload disruptive passengers and taken
legal action against those involved.
rage may be caused by a combination of events, including delayed
flights, exhaustion due to lack of sleep, excessive use of
alcohol and the behaviour of fellow passengers. It has recently
been recognised that a common cause of air rage is nicotine
withdrawal in heavy smokers on long-distance 'no smoking'
flights which have now been introduced by many airlines.
should avoid excessive alcohol consumption and discourage
their travelling companions from heavy drinking. Airlines
have the right to refuse to carry those who are intoxicated
or who have previously caused disruption on a flight.