The gift of long distance travel brings with it some health and wellness considerations. It makes sense that being confined to a small space with limited movement and a very artificial environment is bound to have some impact on our health if we are constantly exposed.
Let’s explore the risks associated with frequent, prolonged air travel and what proactive steps you can take to make sure you are looking after your body in the best possible way…
The contributors to flying risk are mostly related to changes in pressure, prolonged sitting and potential dehydration. We can ameliorate the prolonged sitting and dehydration and we can be sensible about the pressure effects.
Let’s look at the increased risk of clotting especially. A deep vein thrombosis can form in a vein in the leg when a person is not engaging their calf muscles frequently enough. Venous blood moves as a consequence of muscle contraction and movement, whereas arterial blood has a more active muscular dynamism implicit in arteries. This means that in order to keep your venous blood flowing well, you need to MOVE, often and consistently. We even do this naturally in our sleep.
The same risk applies to long distance truck drivers or people who sit in front of the telly for hours on end without moving. We were designed to move and so we should!
There are other risk factors that can contribute to clotting risk, including obesity, taking oral estrogen in the form of the contraceptive pill or hormone replacement therapy, or a pre-existing clotting disorder.
If a person is dehydrated, the blood is less diluted and has a high viscosity and this, compounded by a lack of movement, will increase risk, too. Smoking cigarettes also increases the viscosity of a person’s blood and this is another risk compounder.
Tips for Moving on a Flight
- Every 1 – 2 hours: Most guidelines (e.g. by the World Health Organisation, the British Thoracic Society, and the American College of Chest Physicians) recommend standing up and walking the aisle at least every 1 – 2 hours during long flights (> 4 – 6 hours).
- In-seat movement every 30 – 60 minutes: Even if you can’t stand (e.g. if there are sleeping passengers around you), do ankle circles, calf contractions, and foot pumps regularly to keep blood moving.
What is the impact of sleeping pills?
Most of the regulatory societies recommend against using sedatives on long-haul flights because of the hypothetical increased risk if you are knocked out cold, which would naturally impact your movement. They instead suggest shorter acting benzodiazepines if you are anxious about not getting any sleep.
Will compression stockings help reduce the risk of a clot?
Below-knee stockings (15 – 20 mm Hg) significantly reduce DVT risk – by nearly 19-fold in at-risk flyers. These can be purchased from pharmacies and must be fitted properly to be comfortable.
Am I at risk of catching an infection on a long-haul flight?
While airplanes are often perceived as high-risk environments for infection, modern aircraft ventilation systems significantly reduce the actual risk of airborne transmission.
Most respiratory viruses spread primarily through close contact, so passengers sitting within 1 – 2 rows of an infected person are at highest risk, particularly on long flights.
However, cabin air is typically completely exchanged every 2 – 3 minutes; about 20 – 30 air changes per hour — and passes through HEPA filters that remove 99.97% of particles ≥ 0.3 microns, including bacteria and viruses. In addition, air flows vertically from ceiling to floor, limiting front-to-back spread along the cabin. As a result, while prolonged proximity to an infectious passenger increases exposure risk, the frequent air exchange and high-efficiency filtration make long-range airborne transmission relatively low.
Does putting an antibiotic ointment on your nostrils actually reduce your risk of picking up a bug?
There is no evidence for this practice! Most infections picked up in cosy environments are viruses, and this practice has no impact on your risk so spare yourself a shiny nose.
What impact does the change in pressure have on my oxygen levels?
During commercial flights, cabin pressure is typically maintained at the equivalent of 1,800 – 2,400 metres (6,000 – 8,000 feet) above sea level, which lowers the partial pressure of oxygen in the air. As a result, healthy adults usually experience a mild drop in blood oxygen saturation from around 97 –99% at sea level to approximately 90 – 95% in flight. Most people will not experience this perceptually.
People with severe lung disease, anaemia, or chronic heart conditions may experience larger drops, sometimes to 85% or lower, which can cause shortness of breath, fatigue, or dizziness. While these changes are generally well tolerated by healthy travellers, supplemental oxygen or pre-flight assessment may be necessary for those with significant cardiopulmonary disease.
