Flying and health

While flying is a relatively safe (and perhaps one of the safest) mode of transportation per kilometre travelled, it can put pressure on the mind and body.

This article contains general advice, followed at the reader's own risk. None of it should be taken as medical advice. If you have health issues that might be complicated by flying, consult your doctor.

Common issues

The following issues and remedies are for those travelers with extra concerns about some conditions. Most people do just fine with a bottle of water, and perhaps a neck pillow and an eye mask for sleeping. For very long flights, extra measures may be useful...as noted below.

• At high altitude, cabin pressure is much lower than on the ground, often equivalent to 8,000 feet/2500 meters above sea level. This can generate great discomfort if ears or sinuses are clogged, e.g., by allergies or a cold. If congested, and if your doctor has no concern about complications, consider taking a decongestant (anti-histamine optional) an hour or so before departure. An extended-release form may be preferable for a long flight. (If you hope to sleep, note that such potions make some people restless.) See altitude sickness for prolonged low pressure.
  • As any flight descends, most people have some trouble with pressure in their eardrums. That's why babies/infants then often cry loudly, having been quiet during takeoff and throughout the rest of the flight. Pinching your nose, closing your lips and trying to exhale can relieve the pressure. Another remedy is a product called "EarPlanes," which are disposable earplugs available for $5-10 at drugstores. The plugs are specially designed to regulate the pressure in your ears and can make flying much easier for people who suffer ear pain when flying.
  • The reduced pressure during a flight can be dangerous if you have been diving within 12 to 48 hours before departure; see Scuba diving for details.
  • If you might be prone to breathing complications, avoid taking a flight with a destination much higher than your departure point; see Altitude sickness for details.
• Your nasal passages can dry out during multi-hour flights...rendering you uncomfortable and slightly more susceptible to airborne infections. Drink plenty of liquids (without alcohol or caffeine), perhaps use a moisturizing nasal spray (e.g., saline solution rather than topical anti-histamine). Consider using a face mask on long flights to conserve lung and sinus moisture. (Masks may otherwise offer only marginal protection against airborne disease; sterile cloth masks may work slightly better than formed, single-use paper ones.)
• Bring some food with you, even if you don't have diabetes, don't have food allergies, and don't tend to get miserable when hungry, unlike about 99% of us. It could be as simple and portable as a granola bar (aka flapjack or oat bar). The point is to have something just in case your plane is stuck on the tarmac for hours, while tempers rise and blood sugars drop.
• Cabin temperature can vary, and for window seats, the wall can be cool while airborne. Consider taking a coat, jacket or newspaper on board. Wear warm socks, and if in a window seat, put something between you and the wall...even a few layers of newspaper help considerably. On the other hand, if you get stuck on the ground on a hot day, you may quickly find yourself uncomfortably hot. Consider dressing in layers, so that you can adapt to the temperature that you encounter.
• Contact lenses. On multi-hour flights, you should use re-wetting drops frequently, or consider wearing prescription glasses instead...especially if you hope to sleep. The very low cabin humidity can cause dry contact lens complications for your eyes. (As for any long trip, take spare contact lenses and prescription glasses.)
• Sanitizing wipes can be essential on board and in airports to clean handles on overhead storage bins, hands, tray tables, arm rests, and key bathroom surfaces that have heavy use and unknown or (perhaps) neglected cleaning. Choose pre-wetted packets rather than bottled liquid for security-check convenience. Avoid those only for hands (often leave a residue of glycerine on hard surfaces); and (if possible) opt for those that contain sanitizing ingredients beyond alcohol for effectiveness.
• Fifty countries worldwide, including China, South Africa, Argentina, Australia and New Zealand require that insecticides (usually residual types) be used on planes. If the airline (e.g., Hawaiian Airlines) does not use residual insecticide, the plane may be sprayed in-flight before arrival in those countries. If you are sensitive to such chemicals, ask in advance what is used, so your doctor can determine if it will affect you.

Less common issues

• If you need oxygen en-route, check with the airline to see if the type you need is feasible; if so, have your doctor (through your travel agent or airline) arrange it or issue a "prescription" for it well in-advance. If you normally carry an O₂ source, ensure it can be carried on board and used there.
• If you have asthma or allergies, bring your asthma inhaler(s) and your allergy medications on board with you. Bring these even if you don't think you'll need them. Even if you carefully checked with the airline to make sure that you had booked a no-smoking flight on a peanut-free airline, your seatmate could still turn out to be a peanut salesman who was chain smoking cigarettes until just before the cabin doors were locked.
• If you are prone to motion sickness, consider taking appropriate medication. Vomiting is rare, but nausea is still unpleasant. Some, such as the scopolamine patch, need to be taken in advance of the flight. Also, consider booking the largest airplanes possible on your route, as the big behemoths are much less susceptible to turbulence and much less likely to trigger motion sickness than the bouncy little turbo-props.
• If anyone in your party is handicapped in other ways (e.g., mobility, vision), you'll want the airline to know in-advance, preferably as you book your flight. With notice, they can make appropriate seat assignments, arrange assistance in the terminal, and notify the cabin crew of your needs. Beware: not all airlines are equally accommodating.
• If ill (especially with anything that might be contagious), you really shouldn't fly. In the close quarters of a plane, perhaps for hours, with 200 or more people going eventually to countless places, you could start or spread misery, even an epidemic. You should defer travel until you have recovered. If an airline or airport personnel notice symptoms, you may be denied boarding. Good trip insurance can help with the expense of suddenly delayed travel.
• If you've had surgery or a plaster cast applied within the last 15 days or so, you'd best avoid flying. Low cabin pressure can cause extremely uncomfortable swelling. Consult your doctor.
• If pregnant, consult your doctor for your particular circumstances. Generally, if you're less than 28 weeks with a singleton or twins, and have no complications or history of premature labor, you may be able to travel without medical clearance; check with the airline.

Pressure changes

Air pressure is much lower at high altitude, and while a commercial aircraft cabin holds much of the pressure, in-flight cabin pressure is still significantly lower than at sea level.

Air pressure can cause discomfort in the inner ear, especially for passengers with nasal congestion. This most often occurs during descent, and can be quickly remedied by closing mouth, pinching nostrils and trying to exhale...perhaps several times until landing.

Restrictions and advice for some of these conditions can vary by airline, flight distances/times, total times to your destination(s), and availability of quality care at each stop and destination.

The air pressure changes are dangerous for people who have recently been scuba diving. On a diving holiday, it is advisable to plan on doing something else—perhaps shopping or relaxing in a beach-side bar—during the last day or two. See Scuba_diving#Preventing dive-related illness for discussion.

Deep vein thrombosis

Note: The following discussion should not be taken as medical advice. Consult a doctor if you think you might have or be at risk for DVT during planned travel.

Passengers on long flights may be prone to deep vein thrombosis (DVT), which is essentially blood clots forming in the veins, most often in the legs. It actually affects anyone who remains seated for long periods, e.g., train or car passengers. The elderly tend to have greater risk than the young. You can take precautions to avoid it:

• Stretch and/or walk at least every 2 hours or so. Even a trip to the washroom and back is better than nothing.
• Do in-seat exercises, e.g., flexing legs and torso, rotating/flexing feet.
• When booking the flight, ask for an aisle seat...to let you more easily get up and move around.
• Stay hydrated by drinking water, or other non-alcoholic, caffeine-free beverages.
• Consult your doctor to see if certain preventative measures are needed for you. They may include compression hose (ask about the right kinds and compression rates), perhaps taking a blood-thinner (e.g., low-dose aspirin) shortly before your flight.

Be aware of the early symptoms (e.g., pain or swelling in the legs) which you may notice during flight or later. If suspected, seek medical treatment promptly. If neglected, the condition can become serious, even fatal.

See a more comprehensive article at w:Deep vein thrombosis.

Nicotine

See also: Tobacco

As practically all commercial flights are non-smoking, and airports except designated areas, habitual tobacco consumers might face withdrawal symptoms during a long flight. Smokeless tobacco or nicotine gum might be used for substitute.

Jet lag

See also: Jet lag

While jet lag is not caused by flying itself, it occurs when travellers need to transfer between time zones.

Medications

See also: Medications, Flight baggage

IATA guidelines apply the 3-1-1 limits (in metric equivalents) to all international flights. They impose 100ml (3.4oz) limits on all liquids, gels and pastes in cabin baggage, including aerosols, toothpaste, deodorant/antiperspirant sticks, and drinks including water. All containers for those liquids must fit in a single clear bag/pouch smaller than 20cm x 20cm or 1 quart. Each container inside must meet the 100ml/3.4oz limit. Some exceptions are possible, e.g., for medical necessities or baby care items.

Have documentation that all medications belong to you, e.g., labeled bottles, copy of the doctor's prescription...for some countries, even more. Take no more meds than will be needed on your trip...plus a few extra of each type for possible multi-day delays. Make sure that no substance is not illegal in any transit country. For some countries, you'll need the country's written permission to carry the meds anywhere within its borders. Consult your homeland's "State Department" web site, e.g., .

• Some countries (e.g., Japan) may have unexpected restrictions on entering with basic medications...even at-home over-the-counter items, e.g., anti-histamines. They will be confiscated if discovered.
• The consequences in a few countries for some medications can be severe, e.g., immediate confiscation, fine, arrest, possible prison.

As possible, place all medications and the transparent bag of 3-1-1 liquids where they can be easily seen at security check. If you need more capacity, place all Rx liquids and injectables separately in as few transparent bags as possible. Ensure all medications are kept in original containers/bottles clearly labeled by the issuing pharmacist. (For international travel, wait to sort medications into daily/weekly dose containers at your destination if so desired. If presorted before travel, customs officials seeing this will have no proof of the contents and may declare all as contraband.) Place all other liquids not meeting the 3-1-1 Rule in your checked luggage. You may be required to demonstrate the harmlessness of any liquid you're carrying on request by security officials.

Insurance

One rule of thumb says "only insure what could ruin you". The rationale...why bother to get a policy protecting you on a twenty Euro flight with a no frills carrier? (And chances are, no company would offer such coverage just for that, for anything close to an acceptable rate.) Conversely, be sure you fully understand what could ruin you, e.g., per the discussion in Travel insurance. During travel a long way from home, the costs for an accident or medical emergency (e.g., for treatment, perhaps medical evacuation) really could ruin you. Other unexpected/unforeseen types of events noted in the article could also have serious costs...many times that for a quality policy.

Without your doctor's consultation, even good travel insurance may not cover you if you fail to notify the insurer and airline about health issues. The insurer may levy a surcharge for special coverage, or may not cover complications, e.g., that require unusual medical evacuation. The insurer and some airlines may also require written assurance from your doctor.

See also

• Physical fitness
• Senior travel