|
 With
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 increased in
relative terms over recent years due to
high fuel costs 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".
Airline
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:-
 Pregnancy
beyond 36 weeks.
- New
born babies during the first
few days after birth.
- Recent
or current middle ear infections
or sinusitis.
- Unstable
psychiatric illness or epilepsy.
- Recent
myocardial infarction or moderate/severe
heart failure.
- Recent
chest, intra-cranial or abdominal
surgery.
- Recent
pnuemothorax or moderate to
severe hypoxic pulmonary disease.
- The
presence of a communicable
disease.
- Previous
record of causing disruption
during flights.
|
Economy
Class Syndrome (Deep Vein
Thrombosis DVT)
Much
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.
 Sitting
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.
 Dehydration
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 diarrhoea.
Other 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.
Those persons with three or more of
the above risk factors should discuss
additional protective measures with
their doctors.
 |
Preventative
measures against DVT include:-
- Regular
stretching and mobility exercises
and if possible walking around
the cabin during the flight.
- Drinking
sufficient fluids to keep
the urine pale.
- Taking
a low dose aspirin tablet
(75mg) for its anti-adhesive
effects on blood platelets.
|
- The
use of graded compression
stockings. These are available
at most pharmacies and are
marketed specifically for
use during long haul flights.
- Loose-fitting
clothing may be beneficial
in avoiding constriction of
veins.
- Some
recommend taking short naps,
instead of long ones, to avoid
prolonged inactivity
|
This
condition 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.
 Jet
Lag
Nowadays 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.
In 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 surroundings.
The 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 and
hangover.
 Westward
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.
Sleeping 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.
Some 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.
- A
relaxed flight is important.
- Avoid
travelling when you are already
tired and take rest before
departure.
- Remember
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 in airports.
- Avoid
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.
- Sleeping
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.
|
|
 Respiratory
Infections
There 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 from flying.
Tuberculosis 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 same.
Parasite Infestation
Occasionally 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 between flights.
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 present.
 Altitude
sickness on arrival
Most 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.
An 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.
Those persons with pre-existing hypoxic
respiratory disease should seek medical
advice prior to departure.
 Fear
of flying
An 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
- Emphasise
that flying is safer than road or
rail travel in most developed countries.
- Try
distraction by talking with other
passengers, watching in-flight films,
eating or reading.
- Tell
the cabin crew. Reassurance about
strange sounds etc. can help.
- Visit
your doctor prior to travel to assess
your general fitness for air travel.
- Consider
taking a tranquilliser before flying
but remember, these drugs do not mix
well with alcohol.
 Air
rage
This 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.
Air 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.
Passengers 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.
|
