Kalamaoo County

Health and Community Services Department

INTERNATIONAL TRAVEL CLINIC

In-flight Problems

Dehydration
The circulating air in aircraft cabins is dry since there is very little moisture in the air taken from outside the cabin to replenish supplies when the planes are at high altitude. Skin moisturizers can help alleviate dry skin and lips and if contact lenses irritate they should be removed and spectacles used instead if necessary.

There is no evidence that the dry air results in significant internal dehydration in those otherwise fit and well. Alcohol (especially spirits) and caffeine containing drinks can however cause dehydration especially when inadequate clear fluids are drunk - passengers should try and drink sufficient to keep the urine its normal pale color.

Poor circulation and venous thrombosis
Sitting still for long periods in the inevitably cramped positions in aircraft frequently leads to swollen ankles and sometimes muscle cramps. Venous thrombosis in the legs and occasionally pulmonary emboli can occur but this is not unique to air travel and can occur whenever people are immobile for prolonged periods. Preventive measures should include general advice to all passengers. Regular stretching and mobility exercises should be encouraged as well as walking around the cabin and while waiting in airports.

Those with risk factors such as being over 60 years of age, having had previous deep vein thrombosis, recent surgery or injury, being pregnant or less than 2 months post-natal, having malignancy, cardio-respiratory disease, varicose veins or other chronic illnesses, being on estrogen medication (contraceptive and hormone replacement) or having thrombophilia should discuss additional protective measures with their doctors.

Advice for those at special risk may include the use of graded compression stockings or rarely a single injection of low molecular weight heparin, given shortly before departure and for the period of risk, which should be only used under the guidance of a doctor. Aspirin is no longer considered helpful and it may cause indigestion or stomach bleeding. Similar advice is appropriate for travelers by bus or train who spend many hours immobile in cramped conditions.

Respiratory tract infections
There is no evidence that re-circulation of air in aircraft cabins increases the risk of transmitting infections since very effective filters are used to remove bacteria and viruses. However sitting in close proximity for long periods next to passengers who are suffering, for example, from common colds or influenza clearly may increase the chances of a passenger becoming infected. This is why airlines discourage passengers from traveling while unwell with infectious conditions.

Skin Parasite infections
Occasionally head lice and other skin parasites have been passed through contact with aircraft seats when a previous passenger has been infested. This is more likely in countries where these problems are common.




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