In-flight health Dr Rob Hicks Whether you're off on holiday or making a business trip, there are preventive measures you can take to avoid the health risks associated with plane journeys.

In this article

Causes of in-flight problems Minor medical problems

Preventing problems Enjoy your flight

Travel preparations plus long waits at the airport, customs and baggage handling often mean people making plane journeys become stressed easily. Add to this existing medical conditions and it's a recipe for potential health problems.

Fortunately, in-flight medical emergencies are uncommon, although about one in every 20,000 passengers does experience something serious. Heart and lung problems account for 25 per cent of these problems.

• Dehydration
• Immobility
• Reduced oxygen availability
• Air expansion

The amount of oxygen available within the cabin may be slightly less than normal air. Although this difference will be tolerated well by most people, those who already have heart or lung problems may find it triggers symptoms.

People with angina, for example, may find they experience chest pains because the heart isn't getting enough oxygen. Those with asthma or chronic obstructive pulmonary disease may find their breathing becomes a little harder or wheezy.

Too much coffee or alcohol can cause an irregular heart rhythm or palpitations

Too much coffee or alcohol can cause an irregular heart rhythm or palpitations to develop, especially if this has happened before.

Blood clots in the legs or lungs tend to make themselves known once the flight is over. Prolonged immobility and dehydration during the flight make these more likely.

Although not life-threatening, these can spoil the beginning or the end of a holiday.

At aircraft cabin pressure, the air in body cavities expands. Favourite places for this to happen are the ears, sinuses and teeth, if tooth decay has caused erosion. This can result in severe pain.

In general, the air quality in planes isn't as good as the air outside, and air filters aren't always fully effective. This allows bacteria and viruses to spread easily from one person to another, which is why many people come home from their holiday with a cough or cold.

Also, the air isn't humidified, which contributes to the body becoming dehydrated. This and the drying out of the protective mucosa of the mouth and nose, which normally acts as a barrier to bacteria and viruses, increases susceptibility to infection.

Travelling by plane when you have a cold can cause permanent ear or sinus damage. Ideally, you should wait until your condition improves, particularly if you have a high fever and/or ear/sinus pain. Consult your doctor about whether it's safe for you to travel - they may be able to prescribe antibiotics or decongestants.

Changes in air pressure when an aircraft is ascending or descending may cause discomfort for travellers with a head cold or ear condition. Pinch the nose and, with the mouth shut, blow gently. Swallowing, chewing gum or sucking sweets can also help.

If you've recently been treated for an ear condition, you should wait at least two weeks before travelling by air.

Travellers with a history of motion sickness can attempt to avoid the symptoms by taking anti-motion sickness pills before departure. As with any medication, consult your GP for specific advice.

Allow plenty of time to get to the airport and through check-in. Things do go wrong, so plan for this. Make use of luggage trolleys and ask for help from the airport staff if you're having difficulty. It's better to share a load than to end up with strained muscles.

Drink plenty of water during the flight. One or two glasses an hour is a good guide. It's best to avoid alcohol and caffeinated drinks, as they contribute to dehydration.

Every hour get out of your seat and move around for about ten minutes

Swollen feet, aching joints and muscles, indigestion and wind all result from immobility. Every hour get out of your seat and move around for about ten minutes. Have a good stretch too.

While you're seated, jiggle your legs up and down as if you're pedalling a bicycle and try not to sit with your legs crossed. Wearing a pair of elastic support stockings helps to maintain good blood flow.

During the flight, particularly while taking off and landing, suck sweets, swallow, or hold your nose, close you mouth and try to blow. This will equalise the pressure and help avoid ear and sinus pain.

Keep any medicines you need, such as angina sprays or asthma inhalers, in your hand luggage. They're no use to you packed away in your suitcase. Keep a written list of your medical problems and the medicines you take handy so if you need assistance those helping you are aware of your situation.

• Plan and be prepared
• Drink plenty of water
• Avoid alcohol and caffeinated drinks
• Move around the cabin
• Have essential medicines with you
• Take a list of illnesses/medicines

There's no guarantee that you won’t pick up an infection such as a cough or cold, but you can lessen your chances of becoming a victim of these. Keep your immune system strong by getting enough sleep and relaxation, eat a healthy diet that’s rich in fruit and vegetables, exercise regularly, and don’t smoke. Wash your hands regularly during the flight as you may come into contact with contaminated surfaces whilst moving around the cabin - if this isn’t easy then use a travel hand-sanitizer. Encourage those who are coughing and sneezing to cover their mouth and nose when doing so with a disposable tissue

This article was last medically reviewed by Dr Rob Hicks in August 2007.
First published in May 2001.