This year, an estimated 1.5 billion passengers worldwide are expected to pack their bags, grab their passports and hop on a plane to travel overseas, either for business or pleasure. But, rather than having the holiday of a lifetime or a productive business trip, an increasing number are falling sick as a direct result of flying.
Though it is usually air disasters that make headlines, alarmingly, an equal number of passengers who may reach their destination die (500 to 1,000 every year) as a direct result of flying. Studies are beginning to show that poor air quality, low oxygen levels and cramped seating are to blame, triggering heart attacks and deep vein thrombosis (blood clots), or causing sometimes life-threatening contagious diseases.
Flying has, since the late 1960s, been known to exacerbate medical conditions such as angina and other cardio-related diseases. Medical studies have consistently demonstrated a direct link between air travel and blood clots. In addition, there have been increasing reports of contagious diseases being spread by cabin air-conditioning, including gastroenteritis and even, frighteningly, tuberculosis.
Such statistics are of special interest to the British-based Aviation Health Institute, the world's first medical research centre to promote the health and well-being of passengers worldwide. The institute was established in 1997 by director Farrol Kahn, a former oil executive and a frequent flyer. "I found that, despite trying to sleep on planes or trying different remedies, I could never arrive at my destination in better shape," Kahn says. The institute, a registered charity, has the backing of several corporations and is working to encourage airlines to join its health-friendly airline programme.
This year Kahn presented a paper to Britain's House of Lords, calling for an inquiry into the aircraft cabin environment and detailing an alarming number of potentially harmful factors associated with flying.
Says Kahn: "Little is made of the link between air travel and health because symptoms usually do not occur while flying but several days later. For example, it can take a blood clot four to five days to appear while flu and colds may not appear for three days after flying." Perhaps the most common curse of the frequent flyer is the frequent respiratory infection. It's long been known that the flu virus spreads along major air routes, bringing to Hong Kong such unwelcome visitors as the Sydney and Beijing flu viruses last year. As the airline industry faces pressures to cut costs, air quality is the first to suffer. In the past, 100 per cent fresh air was pumped into cabins every two to three minutes. Today, this is more likely to be half fresh air, half recycled air, every 12 minutes. With this higher proportion of recirculated air being used, increased levels of pathogenic micro-organisms are being spread.
"This means bacteria and viruses are staying in the air longer," says Kahn. Another problem he points out is that air-conditioning units blow air from top to bottom.
"Hot air rises. So if someone sneezes germs get carried further than if the air-con was working from bottom to top."
A computer model developed by Pall Aerospace and Boeing shows just one cough can disperse 100,000 bacteria-carrying particles over 20 rows. Even talking or yawning can spread infections. Bacteria can also be spread through dust particles and skin scales lodged in seats and carpets. Hardly an appetising thought as you contemplate your "beef or fish" and standard bread roll.
Even if you don't catch a cold or flu, often long-haul flights can leave you feeling drained and exhausted with inflamed eyes, dry and cracked skin, and headaches and fatigue. The Aviation Health Institute blames this on the fact that, despite ever increasing numbers of passengers flying including a reported 10 per cent who are medically not fit to fly, airlines are placing their emphasis on safety and performance and not on the cabin environment.
Low cabin pressure gives rise to numerous problems. Cabin altitude is set at 2,400 metres, a level decided in the 1930s and arrived at because Andean communities were known to be able to live at this altitude. However, medical experts point out these communities have become acclimatised to such altitudes. The body of an average passenger, however, will find it hard to respond to sudden lower oxygen levels and increased air pressure. With more research being conducted on hypoxia (oxygen lack) some medical professionals have become increasingly alarmed by the levels of oxygen in aircraft cabins. It has been found that there can be a 25 per cent lack of oxygen experienced at 2,400 metres cabin altitude, putting extra strain on the heart and placing certain people at risk. The medical profession has recommended cabin altitude be reduced to 900-1,500 metres. Recent studies have even demonstrated that oxygen levels in the blood of passengers can fall to below 85 per cent, a condition that would be cause for concern in a hospital.
More alarmingly, Kahn claims that to cut costs when facing high fuel prices, airlines turn off oxygen packs and air-con units mid-flight. "What they will do is usually turn off the packs after a meal when a passenger might put drowsiness down to a full stomach and not a decreased level of oxygen in the air." He adds his organisation has several memos from airline chiefs of operations informing pilots to turn off oxygen packs and air-cons to save money. Kahn adds that on the new fleet of Boeing 777s there is a device that will turn oxygen packs off automatically if the flight is half full.
The Aviation Health Institute is working to try to implement measures to protect passengers. First, it would like to see warnings printed on all tickets informing passengers of the health risks involved with flying. "At least then the passenger can make an informed decision," says Kahn.
Secondly, through its airline programme it is hoping to encourage airlines to make positive changes. Aviation regulations set the standard amount of fresh air at the amount of 10 cubic feet per minute (cfm) per passenger but the institute would like to see airlines increase that amount. Lufthansa has joined the programme, having committed itself to providing 20 cfm of fresh air to its passengers and also to increasing the proportion of fresh air to recycled air from 50 per cent to 60 per cent.
Kahn adds: "We want to work with airlines to help them become more health-friendly." According to Katherine Wang, corporate communications manager for Cathay Pacific, Hong Kong's carrier has cabin air quality that exceeds Federal Aviation Authority (FAA) standards, set at 10 cfm and recirculated every two to three minutes, or 20 to 30 cabin changes per hour. Wang adds that while the airline has seven 777s on its fleet, oxygen packs are never turned off during flights. "In order to maintain a warm cabin temperature at cruising altitudes some air-conditioners are automatically turned off to maintain a cabin temperature of 24 degrees." Cathay Pacific also reports its Boeing 747 fleet has a seat pitch of 34 inches, three inches larger than the minimum required to prevent blood clots in the legs.
Asked to comment on the Aviation Health Institute's paper and whether Cathay Pacific might join the health-friendly airline programme, Wang said: "It is perhaps too premature to comment on this as there is still a lot of work to be done in this area. But of course Cathay Pacific will monitor this very closely."
If the public becomes more aware of the situation, Kahn says the Aviation Health Institute will feel it is making progress. "Prevention is better than cure," he says.
SCMP Hong Kong

And to think some Vit E and Vit C can prevent these and a lot of other illnesses like virus infections, flus, heart attacks, on and on.

The least airlines could do is improve air quality for the pax in front cabins. This would give people at least some choice as to what air they breathe and how high level of a risk they expose their health to.

So, get the conga going on the flight.

Oct 23, 2000

A 28-year-old British woman has collapsed and died from a blood clot after a long haul flight from Australia.

The condition, known medically as deep vein thrombosis (DVT), is believed to have been triggered when Emma Christopherson sat for long periods during the 20-hour Qantas flight from Sydney to London Heathrow.

Ms Christopherson, from Newport, South Wales, is one of the youngest people to become a victim of DVT, which has a history of affecting airline passengers.

She was taken ill in the Arrivals area at Heathrow and died on the way to hospital.

The travelers most prone to DVT are usually people who are elderly or middle-aged.

It is brought about by sitting for long periods in cramped conditions and raises questions over the amount of leg room available to airline passengers traveling coach class on long flights.

Health experts advise people to walk about and move their legs on extended flights.

Qantas spokeswoman Sally Martin, the airline's general manager for the UK and Ireland said: "Our sincere sympathies are with Emma's family. The safety of our passengers is always of paramount importance and we do refer to the possible effects of flying in our in-flight magazine."