Thousands of Australians fleeing the southern hemisphere’s winter will hit the European summer tourist trail this year – and for most of us, that involves the unique and peculiar torture of spending hours on a plane.
Hurtling through the air at 35,000 feet during an ultra-long-haul flight (12-plus hours, according to Point Hacks) takes an enormous toll on your body – even if you’re up the pointy end of the aircraft.
Deborah Mills, medical director of Brisbane’s The Travel Doctor, said it was important to consider the potential health impacts of plane travel, without becoming paranoid.
“It’s a marvellous thing that we can get on planes and fling ourselves across the planet,” she said.
“The message is that you need to be aware of [the risks] and take precautions.”
Sonny Lau, medical director of The Travel Doctor – TMVC, Melbourne Clinic also urged travellers not to let health concerns overshadow their excitement about a much-anticipated trip.
“Commercial air travel is still, by and large, a very safe modality for people who are sensible and look after themselves,” he said.
What’s the latest on the health risks, and how do you guard against them?
Deep vein thrombosis
Most airlines use inflight guides, videos, or announcements, to educate passengers about the risks of deep vein thrombosis, those nasty blood clots that form in deep veins, usually in the lower legs.
Though they can cause significant discomfort on their own, the biggest concern associated with DVTs is the possibility that part of the clot will break off and travel to the lungs, causing a potentially life-threatening pulmonary embolism.
Venous thromboembolism (VTE), comprising DVT plus PE, is the third commonest vascular disorder in Caucasian populations, according to the Royal Australian College of General Practitioners.
Figures from 2021 estimate that more than 17,000 Australians every year will have an embolism, though not all of them arise from long-haul plane travel.
This condition typically hits the headlines when it kills healthy, young people.
For example, returning home after the Sydney Olympics in 2000, a 28-year-old woman collapsed and died at London’s Heathrow Airport after a 23-hour flight; in February this year, it claimed the life of 24-year-old Sydney woman just back from Japan.
Such cases, though rare, highlight that VTE can occur at any age. People in older age brackets, smokers, obese individuals, women taking the contraceptive pill, and people with other health conditions are among the groups most at risk.
Can you reduce your risk by forking out for a lie-flat bed?
Lau points out that although thromboembolism is sometimes dubbed “economy class syndrome”, this is something of a misnomer.
“[It] is mostly associated with excessive or prolonged duration of immobility,” he said.
Clots may still occur in premium economy, business class, and first class, he warned.
“But, of course, fewer people travel in business and first class, compared to economy,” Lau said.
Mills urged air travellers to walk around the plane as much as possible, drink lots of fluids, and avoid sleeping pills “because they make you more immobile”.
“Compression stockings [can] stop the blood pooling in your legs and decrease your risk of having a deep vein thrombosis,” she said.
Sudden drops in altitude
In May 2024, a Singapore Airlines flight hit sudden turbulence, injuring 79 people, and killing one.
Many of the injured were hospitalised, some with serious spinal cord, brain and skull injuries.
“The biggest worry for me on planes at the moment, really, is you take off your seatbelt, the plane drops 100 metres, and you smash your head against the ceiling,” Mills said.
The investigation into the incident by Singapore’s Transport Safety Investigation Bureau remains ongoing.
There have been several similar incidents in the year since, including injuries to up to a dozen people on board a Qatar Airways Doha to Dublin flight; a further 11 were injured during a Lufthansa flight from Buenos Aires to Frankfurt.
Some experts warn that severe turbulence is becoming more common due to climate change.
“That’s one of the reasons why people really need to get their seatbelts on,” Mills said.
Jet lag
Jet lag occurs when your circadian rhythm (sleep-wake cycle) is turned upside down by rapid travel across multiple time zones.
Turning up in a location that demands you be awake when you’d usually be asleep (or vice versa) and throw in expected sleep deprivation, and the unpleasant state of jet lag results.
Symptoms include fatigue, disturbed sleep, irritability, reduced performance, headache and even gastrointestinal upsets.
Mills said the worst could be avoided by getting as much sleep as possible on the plane, walking around in the sunshine upon reaching your destination, and having meals at local time – so no 4am room service dinners.
While jet lag is often no more than a nuisance, at its worst, it can be deadly.
This is largely because it causes your mental performance to decline sharply.
Research on aircrew involved in long-haul flights and flights across multiple time zones reveals poorer psychomotor, vigilance, and cognitive performance.
Published in the International Journal of Travel Medicine and Global Health, the research reveals that road accidents are the leading cause of death in international travellers.
So don’t stumble off an ultra-long-haul flight and into the airport’s car hire office.
“Don’t jump in a hire car or plan a busy day,” Mills said.
“Planning to be a human being and to be able to take a day or two to recover is a very important part of travel planning, which first-time travellers may not realise.”
Dehydration
In-cabin air is very drying, with humidity levels between 5-15 per cent.
Consume a few glasses of the proffered alcohol or coffee, and you’re likely to suffer some degree of dehydration, said Lau.
“Keeping up your water intake is important because dehydration makes life very difficult,” he said.
Some people, particularly those wedged into window seats on a row of three, may be reluctant to drink enough water because it means regularly climbing over their seat mates to get to the toilet.
“It’s a matter of trying to minimise inconvenience your fellow passengers, but on the other hand, you have to look after yourself, and people do understand that,” Lau said.
But the preventive measures don’t stop there.
Cabin air can also dry out your mucous membranes and cause your lips to crack, so consider the use of saline nasal sprays or lip balm to manage these symptoms.
Gastrointestinal issues
Dehydration plus stress can lead to a further problem – constipation.
“Now probably that’s not so much of an issue for a regular flight, but if you’re in an ultra-long-haul flight, it can make life very difficult,” Lau said.
Bloating is another potential pitfall, with Mills noting that boredom can lead to people overeating on the plane.
“But eating too much can make people feel uncomfortable,” she said.
Pairing your inflight meal with carbonated drinks amplifies the discomfort.
“The gas in the fizzy drinks expands when the plane ascends … so trying to avoid [them] is a good idea on planes,” Mills said.
Dental pain
Mills also recommends travellers get any necessary dental work at least six to eight weeks before a trip.
“Having dental work just before you fly can lead to pain … so having your dental work done well in advance is also a good idea,” she said.
The pain is caused by atmospheric pressure changes acting on certain dental conditions, such as small air pockets trapped inside fillings.
Research published in the British Dental Journal indicates that “dental tourists” who travel to an overseas destination to have work done must remain mindful of the risks of barotrauma (tissue injuries) and barodontalgia (toothache) caused by changes in air pressure.
Stress
Though travel is often sold as an experience that is exciting, fun, and possibly life-changing, it can also be highly stressful too.
“International commercial flights can be a challenge,” Lau said.
“You have to deal with a lot of issues, make sure you find the correct terminal and gates, and then you have to deal with all sorts of delays or cancellations.”
Often, too, flights arrive or depart at less than civilised hours.
Heightened emotions and all the inevitable frustrations associated with travel can lead to air rage, in which passengers become verbally or physically abusive.
According to the International Air Transport Association such incidents are surging, with one incident for every 395 flights in 2024 – up from one incident per 405 flights in 2023.
Unruly passengers can be turfed off a plane, so keeping your cool, even in the face of provocation, can be key to getting to your destination and enjoying your holiday.
This article first appeared in Cosmos. Read the original here
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