Health hazards of air travel

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A number of possible health hazards of air travel have been investigated.

Contents

Infection

On an airplane, people sit in a confined space for extended periods of time, which increases the risk of transmission of airborne infections. [1] [2] For this reason, airlines place restrictions on the travel of passengers with known airborne contagious diseases (e.g. tuberculosis). During the severe acute respiratory syndrome (SARS) epidemic of 2003, awareness of the possibility of acquisition of infection on a commercial aircraft reached its zenith when on one flight from Hong Kong to Beijing, 16 of 120 people on the flight developed proven SARS from a single index case. [3]

There is very limited research done on contagious diseases on aircraft. The two most common respiratory pathogens to which air passengers are exposed are parainfluenza and influenza. [4] In one study, the flight ban imposed following the attacks of September 11, 2001 was found to have restricted the global spread of seasonal influenza, resulting in a much milder influenza season that year, [5] and the ability of influenza to spread on aircraft has been well documented. [1] There is no data on the relative contributions of large droplets, small particles, close contact, surface contamination, and no data on the relative importance of any of these methods of transmission for specific diseases, and therefore very little information on how to control the risk of infection. There is no standardisation of air handling by aircraft, installation of HEPA filters or of hand washing by air crew, and no published information on the relative efficacy of any of these interventions in reducing the spread of infection. [6]

Air travel, like other forms of travel, radically increases the speed at which infections spread around the world, as viruses rapidly spread to large numbers of people living across the world. Human and cargo traffic greatly facilitates the spread of pathogens across the world, [7] [8] for example during the COVID-19 pandemic.

Deep vein thrombosis

Deep vein thrombosis (DVT) is the third most common vascular disease next to stroke and heart attack. It is estimated that DVT affects one in 5,000 travellers on long flights. [9] [10] Risk increases with exposure to more flights within a short time frame and with increasing duration of flights. [10] According to a health expert in Canada, even though the risk of a blood clot is low, given the number of people who fly, it is a public health risk. [9] It is reported in 2016 that the average distance between seat rows has declined to 79 centimetres (31 in), from over 89 centimetres (35 in), while the average seat size has shrunk to 43 centimetres (17 in) from 46 centimetres (18 in) in the previous two decades. [9]

Radiation exposure

Flying 12 km (39,000 ft) high, passengers and crews of jet airliners are exposed to at least 10 times the cosmic ray dose that people at sea level receive. Every few years, a geomagnetic storm permits a solar particle event to penetrate down to jetliner altitudes. Aircraft flying polar routes near the geomagnetic poles are at particular risk. [11] [12] [13] There is also increased radiation from space. [14]

Other possible health hazards

Other possible hazards of air travel that have been investigated include airsickness and chemical contamination of cabin air.

In pregnancy

In low risk pregnancies, most health care providers approve flying until about 36 weeks of gestational age. [15] Most airlines allow pregnant women to fly short distances at less than 36 weeks, and long distances at less than 32 weeks. [16] Many airlines require a doctor's note that approves flying, specially at over 28 weeks. [16]

See also

Related Research Articles

<span class="mw-page-title-main">Common cold</span> Common viral infection of the upper respiratory tract

The common cold or the cold is a viral infectious disease of the upper respiratory tract that primarily affects the respiratory mucosa of the nose, throat, sinuses, and larynx. Signs and symptoms may appear in as little as two days after exposure to the virus. These may include coughing, sore throat, runny nose, sneezing, headache, and fever. People usually recover in seven to ten days, but some symptoms may last up to three weeks. Occasionally, those with other health problems may develop pneumonia.

<span class="mw-page-title-main">Asymptomatic carrier</span> Organism which has become infected with a pathogen but displays no symptoms

An asymptomatic carrier is a person or other organism that has become infected with a pathogen, but shows no signs or symptoms.

In medicine, public health, and biology, transmission is the passing of a pathogen causing communicable disease from an infected host individual or group to a particular individual or group, regardless of whether the other individual was previously infected. The term strictly refers to the transmission of microorganisms directly from one individual to another by one or more of the following means:

<span class="mw-page-title-main">Basic reproduction number</span> Metric in epidemiology

In epidemiology, the basic reproduction number, or basic reproductive number, denoted , of an infection is the expected number of cases directly generated by one case in a population where all individuals are susceptible to infection. The definition assumes that no other individuals are infected or immunized. Some definitions, such as that of the Australian Department of Health, add the absence of "any deliberate intervention in disease transmission". The basic reproduction number is not necessarily the same as the effective reproduction number , which is the number of cases generated in the current state of a population, which does not have to be the uninfected state. is a dimensionless number and not a time rate, which would have units of time−1, or units of time like doubling time.

<span class="mw-page-title-main">Oseltamivir</span> Antiviral medication used against influenza A and influenza B

Oseltamivir, sold under the brand name Tamiflu, is an antiviral medication used to treat and prevent influenza A and influenza B, viruses that cause the flu. Many medical organizations recommend it in people who have complications or are at high risk of complications within 48 hours of first symptoms of infection. They recommend it to prevent infection in those at high risk, but not the general population. The Centers for Disease Control and Prevention (CDC) recommends that clinicians use their discretion to treat those at lower risk who present within 48 hours of first symptoms of infection. It is taken by mouth, either as a pill or liquid.

<span class="mw-page-title-main">Influenza A virus subtype H5N1</span> Subtype of influenza A virus

Influenza A virus subtype H5N1 (A/H5N1) is a subtype of the influenza A virus, which causes influenza (flu), predominantly in birds. It is enzootic in many bird populations, and also panzootic. A/H5N1 virus can also infect mammals that have been exposed to infected birds; in these cases, symptoms are frequently severe or fatal.

<span class="mw-page-title-main">Flu season</span> Recurring periods of influenza

Flu season is an annually recurring time period characterized by the prevalence of an outbreak of influenza (flu). The season occurs during the cold half of the year in each hemisphere. It takes approximately two days to show symptoms. Influenza activity can sometimes be predicted and even tracked geographically. While the beginning of major flu activity in each season varies by location, in any specific location these minor epidemics usually take about three weeks to reach its pinnacle, and another three weeks to significantly diminish.

An emergent virus is a virus that is either newly appeared, notably increasing in incidence/geographic range or has the potential to increase in the near future. Emergent viruses are a leading cause of emerging infectious diseases and raise public health challenges globally, given their potential to cause outbreaks of disease which can lead to epidemics and pandemics. As well as causing disease, emergent viruses can also have severe economic implications. Recent examples include the SARS-related coronaviruses, which have caused the 2002–2004 outbreak of SARS (SARS-CoV-1) and the 2019–2023 pandemic of COVID-19 (SARS-CoV-2). Other examples include the human immunodeficiency virus, which causes HIV/AIDS; the viruses responsible for Ebola; the H5N1 influenza virus responsible for avian influenza; and H1N1/09, which caused the 2009 swine flu pandemic. Viral emergence in humans is often a consequence of zoonosis, which involves a cross-species jump of a viral disease into humans from other animals. As zoonotic viruses exist in animal reservoirs, they are much more difficult to eradicate and can therefore establish persistent infections in human populations.

<span class="mw-page-title-main">Immunization during pregnancy</span>

Immunization during pregnancy is the administration of a vaccine to a pregnant individual. This may be done either to protect the individual from disease or to induce an antibody response, such that the antibodies cross the placenta and provide passive immunity to the infant after birth. In many countries, including the US, Canada, UK, Australia and New Zealand, vaccination against influenza, COVID-19 and whooping cough is routinely offered during pregnancy.

<span class="mw-page-title-main">Influenza</span> Infectious disease

Influenza, commonly known as the flu, is an infectious disease caused by influenza viruses. Symptoms range from mild to severe and often include fever, runny nose, sore throat, muscle pain, headache, coughing, and fatigue. These symptoms begin one to four days after exposure to the virus and last for about two to eight days. Diarrhea and vomiting can occur, particularly in children. Influenza may progress to pneumonia from the virus or a subsequent bacterial infection. Other complications include acute respiratory distress syndrome, meningitis, encephalitis, and worsening of pre-existing health problems such as asthma and cardiovascular disease.

<span class="mw-page-title-main">Social distancing</span> Infection control technique by keeping a distance from each other

In public health, social distancing, also called physical distancing, is a set of non-pharmaceutical interventions or measures intended to prevent the spread of a contagious disease by maintaining a physical distance between people and reducing the number of times people come into close contact with each other. It usually involves keeping a certain distance from others and avoiding gathering together in large groups.

<span class="mw-page-title-main">Airborne transmission</span> Disease transmission by airborne particles

Airborne transmission or aerosol transmission is transmission of an infectious disease through small particles suspended in the air. Infectious diseases capable of airborne transmission include many of considerable importance both in human and veterinary medicine. The relevant infectious agent may be viruses, bacteria, or fungi, and they may be spread through breathing, talking, coughing, sneezing, raising of dust, spraying of liquids, flushing toilets, or any activities which generate aerosol particles or droplets.

Influenza prevention involves taking steps that one can use to decrease their chances of contracting flu viruses, such as the Pandemic H1N1/09 virus, responsible for the 2009 flu pandemic.

A fomite or fomes is any inanimate object that, when contaminated with or exposed to infectious agents, can transfer disease to a new host.

<span class="mw-page-title-main">Infection in childcare</span>

Infection in childcare is the spread of infection during childcare, typically because of contact among children in daycare or school. This happens when groups of children meet in a childcare environment, and there any individual with an infectious disease may spread it to the entire group. Commonly spread diseases include influenza-like illness and enteric illnesses, such as diarrhea among babies using diapers. It is uncertain how these diseases spread, but hand washing reduces some risk of transmission and increasing hygiene in other ways also reduces risk of infection.

A focus of infection is a place containing whatever epidemiological factors are needed for transmission of an infection. Any focus of infection will have a source of infection, and other common traits of such a place include a human community, a vector population, and environmental characteristics adequate for spreading infection.

<span class="mw-page-title-main">Air China Flight 112</span> Flight that carried a man infected with SARS

Air China Flight 112 was a scheduled international passenger flight on 15 March 2003 that carried a 72-year-old man infected with severe acute respiratory syndrome (SARS). This man would later become the index passenger for the infection of another 20 passengers and two aircraft crew, resulting in the dissemination of SARS north to inner Mongolia and south to Thailand. The incident demonstrated how a single person could spread disease via air travel and was one of a number of superspreading events in the global spread of SARS in 2003. The speed of air travel and the multidirectional routes taken by affected passengers accelerated the spread of SARS with a consequential response from the World Health Organization (WHO), the aviation industry and the public.

Allison Joan McGeer is a Canadian infectious disease specialist in the Sinai Health System, and a professor in the Department of Laboratory Medicine and Pathobiology at the University of Toronto. She also appointed at the Dalla Lana School of Public Health and a Senior Clinician Scientist at the Lunenfeld-Tanenbaum Research Institute, and is a partner of the National Collaborating Centre for Infectious Diseases. McGeer has led investigations into the severe acute respiratory syndrome outbreak in Toronto and worked alongside Donald Low. During the COVID-19 pandemic, McGeer has studied how SARS-CoV-2 survives in the air and has served on several provincial committees advising aspects of the Government of Ontario's pandemic response.

In epidemiology, a non-pharmaceutical intervention (NPI) is any method used to reduce the spread of an epidemic disease without requiring pharmaceutical drug treatments. Examples of non-pharmaceutical interventions that reduce the spread of infectious diseases include wearing a face mask and staying away from sick people.

<span class="mw-page-title-main">Transmission of COVID-19</span> Mechanisms that spread coronavirus disease 2019

The transmission of COVID-19 is the passing of coronavirus disease 2019 from person to person. COVID-19 is mainly transmitted when people breathe in air contaminated by droplets/aerosols and small airborne particles containing the virus. Infected people exhale those particles as they breathe, talk, cough, sneeze, or sing. Transmission is more likely the closer people are. However, infection can occur over longer distances, particularly indoors.

References

  1. 1 2 Mangili A, Gendreau MA (2005). "Transmission of infectious diseases during commercial air travel". Lancet. 365 (9463): 989–96. doi:10.1016/S0140-6736(05)71089-8. PMC   7134995 . PMID   15767002.
  2. ↑ Leder K, Newman D (2005). "Respiratory infections during air travel". Intern Med J. 35 (1): 50–55. doi:10.1111/j.1445-5994.2004.00696.x. PMC   7165774 . PMID   15667469.
  3. ↑ Olsen SJ, Chang HL, Cheung TY, et al. (2003). "Transmission of the severe acute respiratory syndrome on aircraft". N Engl J Med. 349 (25): 2416–22. doi: 10.1056/NEJMoa031349 . PMID   14681507.
  4. ↑ Luna LK, Panning M, Grywna K, Pfefferle S, Drosten C (2007). "Spectrum of viruses and atypical bacteria in intercontinental air travelers with symptoms of acute respiratory infection". J Infect Dis. 195 (5): 675–9. doi: 10.1086/511432 . PMC   7199876 . PMID   17262708.
  5. ↑ Brownstein JS, Wolfe CJ, Mandl KD (2006). "Empirical evidence for the effect of airline travel on inter-regional influenza spread in the United States". PLOS Med. 3 (10): 3401. doi: 10.1371/journal.pmed.0030401 . PMC   1564183 . PMID   16968115.
  6. ↑ Pavia, Andrew T. (2007). "Germs on a Plane: Aircraft, International Travel, and the Global Spread of Disease". Journal of Infectious Diseases. 195 (5): 621–22. doi:10.1086/511439. PMC   7109684 . PMID   17262701.
  7. ↑ Globalization and infectious diseases: A review of the linkagesLance Saker,1MSc MRCPKelley Lee,1MPA, MA, D.Phil.Barbara Cannito,1MScAnna Gilmore,2MBBS, DTM&H, MSc, MFPHMDiarmid Campbell-Lendrum,1D.Phil. "Globalization and infectious diseases: A review of the linkages" (PDF). World Health Organization.{{cite web}}: CS1 maint: multiple names: authors list (link) CS1 maint: numeric names: authors list (link)
  8. ↑ Aron, Joan (2003). Ecosystem Change and Public Health | Johns Hopkins University Press Books. jhupbooks.press.jhu.edu. doi:10.56021/9780801865817. ISBN   9780801874581 . Retrieved 2020-04-14.
  9. 1 2 3 Marchitelli, Rosa (30 May 2016). "Air Canada passenger suffers 'horrible pain' after being stuck in cramped seat". CBC. Retrieved 30 May 2016.
  10. 1 2 Kuipers S, Cannegieter SC, Middeldorp S, Robyn L, Büller HR, Rosendaal FR (2007). "The absolute risk of venous thrombosis after air travel: a cohort study of 8,755 employees of international organisations". PLOS Med. 4 (9): e290. doi: 10.1371/journal.pmed.0040290 . PMC   1989755 . PMID   17896862.
  11. ↑ "Evaluation of the Cosmic Ray Exposure of Aircraft Crew" (PDF). Archived from the original (PDF) on 2018-07-16. Retrieved 2020-10-19.
  12. ↑ Phillips, Tony (25 October 2013). "The Effects of Space Weather on Aviation". Science News. NASA. Archived from the original on 28 September 2019. Retrieved 19 October 2020.
  13. ↑ "NAIRAS Real-time radiation Dose". sol.spacenvironment.net. Archived from the original on 5 March 2016. Retrieved 1 June 2019.
  14. ↑ Protection of air crew from cosmic radiation: Guidance material
  15. ↑ Page 173 in: Genevieve Howland (2017). The Mama Natural Week-by-Week Guide to Pregnancy and Childbirth. Simon and Schuster. ISBN   9781501146688.
  16. 1 2 Page 57 in: Sarah Jarvis, Joanne Stone, Keith Eddleman, Mary Duenwald (2011). Pregnancy For Dummies. John Wiley & Sons. ISBN   9781119997061.{{cite book}}: CS1 maint: multiple names: authors list (link)
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