We are a mobile society, and air travel allows us to visit friends, business associates, and family members around the globe. I feel fortunate to live in a era where such accessibility to others is possible. Flying has become a commonplace occurrence for many of us. What I’d like to discuss in this week’s Insight are some of the more common health hazards of flying and what we as passengers can do to minimize or avoid flight-itis.
The air inside a plane is a contained system. . .recycled continuously during the flight. As a result, it is neither fresh nor germ-free. We are the captive audience of the coughers and sneezers around us. . .and the longer the flights, the more likely we are to get a whiff of somebody else’s germs. Additionally, there may be odors of perfumes, hydraulic fuel and other scents either noxious or at least unpleasant. Some frequent flyers have resorted to wearing masks of various kinds to protect themselves from communal germs. Not everyone has a comfort level for such conspicuous avoidance. Taking high doses of Vitamin C and Echinacea concentrate for several days may help. Nevertheless, I do hear fairly regularly about colds, sinus infections, and general sniffles from patients when they return from extended air travel trips.
While on the subject of “personal space”, I feel compelled to discuss the phenomena of crowding, herding, and mandatory confinement which are standard in modern air travel. We spend hours waiting in lines, at gates, and sometimes on runways in preparation for soaring. We are jostled and pushed, squeezed through gates and metal detectors, and then wedged between strangers for hours in-flight. Noises range from repetitious loudspeaker announcements to airplane engines to crying babies. The emotional trauma of such experiences varies from person to person. Unfortunately rage reactions are becoming more common throughout the world. My own coping strategy has become one of “expect the worst scenario and then be happy when anything less worrisome occurs”. Take a variety of compact amusements with you to the airport. Written material, music and electronic companions will help to allay frustration. Additionally, headphones can provide extra insulation for people who require more personal space. . .though occasionally, the cheerful banter of an adjacent passenger may be therapeutic for individuals who have a real phobia of flying.
Unfortunately, Fear of Flying is an overwhelming problem for many people. The scope of this problem ranges from mild anxiety to major phobia. There are desensitization programs, relaxation techniques, and for those flyers who cannot handle the reality of captivity five miles above the earth, there are drugs. If you are one of the many people who agonize over various aspects of flying. . .do not suffer silently. There are satisfied customers who now fly with relative mental comfort thanks to desensitization programs. Most physicians are sympathetic to the plight of fearful flyers and will not be reluctant to prescribe small amounts of short-acting tranquilizers to help a patient relax during air travel.
Low air pressure and low humidity can both create physical problems and symptoms with air travel. . .especially prolonged air travel. Most airplanes have a relative humidity considerably less than 10% (for comparison, some deserts have relative humidity in the 20–25% range and optimal comfort for most folks is approximately 50% relative humidity). As a result of the low humidity, skin, eyes, and noses dry out, and we become relatively dehydrated overall. . .especially on the longer flights. Low air pressure results in a tendency for swelling of ankles and feet. Regular water drinking before, during and after flights is the best way to avoid and/or prevent overall dehydration from flying. Avoid caffeine and alcohol because they act as diuretics and tend to pull more moisture from your body. Water spritzers for facial skin and eyes can be helpful on long flights. And, remember to use a non-irritating moisturizer in your nose. Regular movement by alternately flexing and relaxing muscles (esp those of feet, ankles and legs) along with periodic aisle-walking can help to minimize the foot and ankle swelling. The regular movement massages the muscles and improves overall circulation with a subsequent decrease in the pooling of blood in legs and feet.
Finally, no article on flight-itis would be complete without a few words on jet lag. Jet lag affects the flyer in physical, mental, and emotional ways. We all have diurnal rhythms (internal clocks), and when these rhythms are disrupted by altered sleep/wake patterns, marked changes in time zones, and different climates, we can react with unpleasant changes in bowel regularity, mood, libido, energy level, and even in ability to think and remember. Because of sleep disturbances that may result, the fatigue can be enhanced and even our ability to fight infections may be impaired. The factors described in previous paragraphs further aggravate jet lag. . .and basically, jet lagged flyers are “one big mess” until equilibrium is restored.
Make an effort to regularize your schedule as soon as you can; sleep on local time and be sure to exercise. . .especially outside and in natural sunlight if at all possible. Remember to rehydrate your whole body. By using some of the above information and suggestions, I hope you’ll be able to minimize your own flight-itis. There are some unavoidable stressors and circumstances, but preparation and appropriate actions can lessen the impact on our minds and bodies. As I sit in the Houston airport amidst a crowd of weary travelers waiting for our delayed plane to arrive, I am drinking water and glad to have my laptop for company. I know tomorrow I’ll be tired. . .but hopefully not plane puny.
Stephen L. Hines, M.D.
June 2000
