Traveling by plane: what are the risks for my health?

Do you regularly have your head in the clouds and fear possible consequences for your health? We take stock with Dr. Emmanuel Pierantoni, pilot and aeronautical doctor.

In flight, the deleterious consequences of barometric depression are limited by the pressurization of the cabin: « artificially maintained altitudein the device is approximately equivalent to 2,500 meters« , emphasizes Dr. Pierantoni. The consequences of hypoxia (lower oxygen availability) are therefore minimal, but may be more marked in smokers or people with underlying heart or lung disease.

Pressure variations during takeoff or landing can sometimes cause pain in the sinuses or ears. « You go very quickly from the ground to 2,500 meters above sea level, or vice versa. This can generate constraints on the ear canal, in particular at the level of the Eustachian tube, which provides communication between the middle ear and the mouth », explains the aeronautical doctor. This is all the more easily blocked if one suffers from ENT infections ( colds, sinusitis, flu, etc.). Once clogged, it can no longer regulate the pressures, and the gases become sequestered inside the middle ear or the sinus cavities. « They end up dilating and, from fact, compress the eardrum causing pain in the ear“, he continues. clogged ear feeling is also systematic. The same process can concern the sinuses: when this cavity is clogged, the air expands and increases in volume inside, which causes sinus pain.

Several solutions can be used to remedy this phenomenon:

• swallow,
• yawn,
• to chew gum,
• force yourself to exhale by holding your nose (Valsalva maneuver).

Air pressure can also lead to increased production of digestive gases, causing discomfort and flatulence. In question, again, the dilation of the gases present in the digestive tract in connection with the depressurization of the cabin and the consumption of carbonated drinks and fermentable foods (pulses, dairy products, cabbage, peppers, etc.).

Air conditioning can also be a problem: « the humidity level is very low in the cabin. This is why we insist a lot on the hydration of the passengers », notes Dr Pierantoni. The air conditioning system can indeed be the cause of dehydration and give a feeling of dryness in the eyes, nose and mouth.

Sitting still for a long time increases the risk of blood circulation problems. “At a minimum, passengers can end up with ankles or slightly ‘swollen’ legs. But people who already suffer from venous insufficiency are at risk of developing trhomboembolic pathologies (linked to the formation of a clot), in particular phlebitis, or even a pulmonary embolism », warns the expert.

To prevent them, bet on compression stockings « very effective », and do not hesitate to stretch your legs when possible, or to mobilize your ankles and calves (contractions, massages, etc.).

It is better to choose glasses over contact lenses, especially if you are boarding a long-haul flight. Because ? Low humidity may cause corneal dryness and irritation. In addition, in case of dehydration, tearing decreases and contributes to dry eyes.

However, if you want to keep your lenses, remember to slip a little physiological serum in your hand luggage, to moisten your eyes and contact lenses.

« To my knowledge, there is no no contraindication to wearing a hearing aid on the plane« , says Dr. Pierantoni. These devices are even essential to not miss any information during the flight.

Don’t worry: cabin pressure won’t damage them, and they are « not likely to cause electrical interference ». However, to avoid the amplification of engine noise during takeoff and landing, you can adjust their volume, or turn them off while waiting for a return to normal.

Alcohol aggravates dehydration. « It even risks increasing the side effects of alcohol and intensifying the headache », warns the aeronautical doctor. Indeed, dehydration increases the amount of alcohol that enters our blood and therefore multiplies its effects. The feeling of drunkenness can also be accentuated by the lower quantity of oxygen available. A grim prospect for your fellow flight attendants.

« Contraindications are always relative, and require, on a case-by-case basis, the opinion of a health professional », insists Dr. Pierantoni. The World Health Organization identifies several potentially « at-risk » situations (source 1). It strongly advises against air travel for:

• the newborns less than a week (unless there is a compelling reason, after consulting a doctor);
• the pregnant women at four weeks of their term (eight weeks in the event of a multiple pregnancy);
• women who gave birth less than seven days previously
• and the people with severe respiratory problems (respiratory failure or pneumothorax, for example). « However, it is possible to travel with a suitable medical oxygen bottle, provided you have notified the company in advance », underlines the doctor.

Increased vigilance must also be provided:

• to people likely to present increased intracranial pressure (related to haemorrhage, trauma or infection);
• to people who have recently undergone certain surgical operationsparticularly in the digestive system, brain or eyes;
• people who have recently suffered from psychiatric disorders ;
• people with sickle cell disease.

To avoid a decompression sickness, divers are strongly advised not to fly within 24 hours of their last dive. When you scuba dive, the inhaled air, under pressure, forms small bubbles of gas in your body which will disappear on their own over time. If you climb in altitude without respecting a minimum time at low altitude, the bubbles not yet dissolved may increase in volume and expose you to the sudden risk of decompression sickness. « Diving in the morning and flying in the afternoon is potentially dangerous, This can cause a stroke, or even a heart attack“, warns Dr. Pierantoni.

In the end, the decision to disembark, or not, a passenger always rests with the captain. If he considers that the passenger is in a degraded physical or mental stateand which may compromise the safety or smooth running of the flight, he may, on his authority, take the decision to leave the person on the ground.

Could spending too much time in the air cause more health problems? “I am not aware of any data that show an increased risk of pathologies for passengers,” replies the specialist. And to continue: « I do not see any particular risk in flying often, except in case of serious health problemsdiscussed above.

The deleterious effects of Jet-lag should not be confused with the consequences of a short, medium or long-haul flight.

Fatigue, drowsiness, irritability, sleep or concentration disorders, digestive disorders, even delayed menstruation… These problems are not related to the flight itself, but to the change of time zone!

Impossible for you to set foot on a plane without worrying? Does the slightest jolt make you want to vomit? A past experience still haunts you and prevents you from taking the leap? You are not alone! According to the International Air Transport Association (IATA), almost 20% travellers feel a greater or lesser degree of anxiety and fear at the thought of boarding an aeroplane. Among them, 4% even say they have a specific phobia, which makes the idea of ​​flying unimaginable. Some passengers, completely calm when boarding, can also be overtaken by claustrophobia during the flight…

To overcome this fear of flying, some airlines have set up « flight familiarization » programs. Individuals can also call on the help of a therapist, virtual reality, hypnosis, or even sophrology and meditation to get rid of it.

Outdoor births and deaths usually make the headlines, but most incidents remain mild. According to Air France statistics, out of 1,500 medium and long-haul flights per day, only about thirty are diverted each year for medical reasons.

However, the question of diversion may arise on medium and long haul, when a passenger’s condition requires urgent and specific care. Depending on the patient’s condition and external data (weather, risk of landing at a particular aerodrome, possible treatment of the patient on site, etc.), it is always the captain who makes the decision (or no) to modify the trajectory.

Hostesses and stewards receive first aid training: they must hold a safety and rescue certificate. “In the event of traveler discomfort, they carry out an initial interrogation to assess the situation, explains Dr. Pierantoni. They also have the possibility of take advice from a doctor affiliated with the company’s medical service. Finally, they can seek medical help if needed or competent personnel on board the aircraft ».

First aid kits are also available on board each aircraft: a medicine kitusable by aircrew (containing bandages, disposable resuscitation kit, ‘basic’ medication for stomach aches, vomiting, diarrhoea, etc.) and an emergency medical kit (containing blood pressure monitor, stethoscope, syringes, tourniquets and prescription medications, such as vasodilators, antispasmodics, bronchial dilators, anticonvulsants, antihistamines, etc.). Please note: passenger doctors must produce proof of their medical skills.