Health tips

General health information

Air travel in commercial aircraft is fast, convenient, and safe with the vast majority of passengers reaching near and distant destinations safely and without deleterious health effects. However, the aircraft environment and travel related factors can cause certain stresses on the traveller, and several tips can make travel more enjoyable. This page has been prepared by the Aerospace Medical Association to provide passengers with general health information and useful air travel tips.

Before your flight:

  • Be sure your immunizations are current.
  • Delay your trip if you are not well.
  • Reserve a seat by the wing if you are prone to air sickness.
  • Seek the advice of your physician if there is any question.
  • Allow ample time to check in and reach your departure gate.
  • Carry your medication with you.
  • Wear loose, comfortable clothing and comfortable shoes that have been worn previously.

During the flight:

  • Eat lightly.
  • Drink water and fruit juices.
  • Do not place anything under the seat in front of you so you can stretch and exercise your legs.
  • Stand and walk about the cabin periodically.
  • Relax and enjoy your flight.

The Aerospace Medical Association’s Web Site offers useful tips for airline travel.

Visit Anaphylaxis Canada for information on how to travel safely with allergies.


Effects of altitude

Although aircraft cabins are pressurized, that pressure (called barometric pressure) is less than that on the ground. For most flights the cabin pressure is the same as that at 5,000-8,000 feet above sea level. In other words, when you are flying, the atmosphere within the aircraft is like that on the 5,000-8,000 feet peak of a small mountain. This has two effects: there is less oxygen available because the pressure of oxygen becomes lower; and, gas within our body cavities expands. Both of these phenomena are usually well tolerated by healthy passengers.

Oxygen: There is less oxygen absorbed into the blood and circulated throughout the body during flight as compared to ground level due to a decrease in oxygen with an increased cabin altitude. As long as you are in reasonably good health, your body has physiological mechanisms that compensate for this decreased quantity of oxygen. On the other hand, passengers with significant heart, lung, and blood diseases may not well tolerate lower amounts of oxygen. Therefore, they should consult their physician before air travel to evaluate their capability to travel and to determine if there is a need for medical oxygen or other special assistance. Medical oxygen can be arranged with most airlines and it is important to check with your carrier several days in advance of the flight. Furthermore, the combination of low oxygen, alcohol, inactivity and sleep can generate unpleasant side effects like dizziness and/or fainting if one stands up too fast after awakening. Arm and leg exercises before standing up will usually prevent this.

Gas Expansion: The body contains air in the middle ear (inside of the ear drum) and sinuses. As the aircraft ascends, the air in these cavities will expand to the outside via tubes connecting them to the nose. On descent the reverse occurs with air flowing from outside to these cavities via the same tubes. This is well tolerated as long as the air can flow into and out of these cavities freely. To facilitate the free flow of air, particularly on descent, it is helpful to periodically swallow, chew, or yawn. (This is why it is important that passengers stay awake during descent.) Give something to drink to young children or a pacifier to infants. Individuals with ear, nose and sinus infections should avoid flying because the congestion prevents the air from flowing freely in and out of these cavities which could result in pain, bleeding, and possibly a ruptured ear drum. Also, avoid gas forming foods or liquids before flight.

Alcohol consumption: Research has shown that the effect of alcohol is accelerated at higher altitude in a pressurized environment. Consequently, you should consume alcohol in moderation while on board an aircraft. Please note that you may not consume alcohol that has not been supplied by Air Canada.

Any customer who is suspected of being impaired by alcohol will be denied boarding. Flight attendants are prohibited from serving alcohol to anyone who is or appears to be intoxicated.

Cabin environment

Air quality: In all modern pressurized aircraft, half the cabin air is fresh air drawn in via the engines with the other half recirculated from the cabin. The recirculated air is ducted through an air filter before being reintroduced into the cabin. There is a total air change (filtered recirculated plus outside air) every 2 - 3 minutes or 20 to 30 exchanges per hour. This is far more than for any home or office building and easily maintains cabin contaminants to low levels. Several studies of the past l0 - 15 years have confirmed that the levels of volatile organic compounds (solvents), airborne particulates, carbon monoxide, carbon dioxide, ozone and microbials were well within acceptable health levels of our regulatory agencies. This does not mean the air is  'allergy-safe' by any means.

Humidity: Aircraft cabin relative humidity is usually less than 20%, which is fairly dry. Although these low levels may be a source of mild discomfort (dry skin and eyes), there is little risk to your health.

Minimize discomfort from dryness by

  • Drinking reasonable amounts of water and juices.
  • Limiting consumption of alcohol, tea, coffee, and caffeinated drinks because they cause you to lose fluids.
  • Wearing glasses instead of contact lenses.
  • Applying a skin moisturizer.

Motion sickness: For those susceptible to motion sickness

  • Request a seat over the wings.
  • Schedule flights on larger airplanes.
  • Request a window seat.
  • Avoid alcohol for the 24 hours prior to flight and in flight.
  • Keep seat belts fastened while seated.
  • Consult your physician about motion sickness medication if necessary.

Space: Because of crowding in some aircraft, passengers are frequently uncomfortable and unable to stretch or easily leave their seats. In susceptible individuals, prolonged periods of immobility, can increase the risk for blood clots to form in the legs. This can occur in a train, car, bus, or aircraft. Consequently, it is called travellers thrombosis. There is no epidemiological evidence of a particular link with air travel itself.

Travellers' thrombosis can cause pain and/or swelling of the legs during travel or even several days or weeks afterwards. Clots in the legs are not serious in themselves, but occasionally they break off and travel to the lungs causing what is called pulmonary embolism. This is not a common occurrence but when it does happen, it can be life threatening.

Nevertheless, a few simple tips might decrease the risk:

  • Wear loose clothing and avoid tight, restrictive garments.
  • Place nothing under the seat in front of you so you can stretch and periodically exercise your feet and ankles.
  • Drink mainly juices and water while minimizing alcohol and caffeinated beverages.
  • Walk about the cabin periodically (every 60 - 90 minutes).
  • Consult your physician if you have underlying illness such as coronary artery disease, cancer, or blood clotting disorder.

Customers with allergies

If you have severe allergies, you should always carry one or more EpiPens as you would under any other circumstances. If you have a severe allergy to cats, you should carry your asthma inhaler, hand sanitizer and wet wipes to clean surrounding areas.

We invite you to view our Policy regarding customers with allergies, and to visit Anaphylaxis Canada for more information on how to travel safely with allergies.

Aircraft disinsection

Aircraft disinsection is the spraying of an aircraft to prevent the importation of insects (i.e. mosquitoes) potentially carrying disease(s), such as malaria or dengue fever.

Disinsection of Air Canada aircraft is done in compliance with the requirements of the World Health Organization (WHO) and the International Civic Aviation Organization. Transport Canada also requires all Canadian air carriers to comply with the disinsection requirements of all countries to which they fly.

Failure to carry out disinsection may result in disembarkation being refused and remedial disinsection treatment being undertaken on the ground by local health authorities.

Spraying is carried out on the following routes, and with the noted exceptions. These are also subject to change, and may change seasonally:

Destination Airport Method
Australia On arrival method:
This method takes place before passengers have disembarked and the doors have been opened. Crew walk through the cabins discharging approved single-shot aerosols in the prescribed dosage.
Product Used: Callington Haven Aircraft Cabin Spray Insecticide
Aruba, Barbados, Cuba, Jamaica Top of descent method:
This method is similar to the "On arrival method", except that it is carried out at the top of the aircraft's descent, just before it starts preparations for landing.
Product Used: PSA Aircraft Insecticide™
Puerto Rico, St-Lucia Spraying only required if flight transits at another destination before arrival

Top of descent method:
This method is similar to the "On arrival method", except that it is carried out at the top of the aircraft's descent, just before it starts preparations for landing.
Product Used: PSA Aircraft Insecticide™
Santiago (Chile)
Buenos Aires (Argentina)
Spraying is required YYZ - SCL before landing at Santiago, Chile, and SCL - EZE before the aircraft arrives at Buenos Aires.
Spraying is required EZE - SCL before arriving in Santiago, Chile


Top of descent method:
This method is similar to the "On arrival method", except that it is carried out at the top of the aircraft's descent, just before it starts preparations for landing.
Product Used: PSA Aircraft Insecticide™

Disinsection is carried out year round, and passengers are notified of the procedure via an on-board announcement prior to spraying of the cabin. This gives passengers the opportunity to cover their eyes and noses if they wish. The spray dissipates from the cabin and aircraft in a few minutes.

The content of the spray used by Air Canada is designated by the World Health Organization (WHO), and contains either 2% Permethrin or 2% d-Phenothrin. The remainder of the spray consists of HFA 134A as a propellant. The solvent and propellant currently in use are designed to be non-ozone depleting.

Note: A WHO expert committee on the safe use of pesticides has agreed there is no evidence that these insecticides present any toxic hazard to the passengers or crew, provided the correct procedures are followed. The Human Resources Development Canada Report “Comparative Toxicity of Permethrin and d-Phenothrin with Pyrethrum” found similar results.

You can learn more about the use of insecticides in passenger aircraft by visiting the U.S. Department of Transportation’s disinsection website.

Last updated: August 31, 2011

Complaints or information:

On board:
Please see the operating crew

Mail:
Customer Relations
P.O. Box 64239
5512-4th St. N.W.
Calgary, AB
T2K 6J0
Fax: 1-866-584-0380

On line:
Customer Relations
U.S. Department of Transportation’s disinsection website

Miscellaneous

Passengers requiring prescription medications should always carry them on board in their carry-on baggage. This is especially important if you are taking medication for heart disease, diabetes, or seizures. Passengers with severe allergies should carry one or more Epipens as they would under any other circumstances.

Although insulin does not generally require refrigeration, passengers wishing to keep their medication cold are asked to bring a small cooler, as the cabin crew is unable to look after medication on board. If available, extra ice may be provided as needed.

Jet lag is often associated with air travel especially when crossing multiple time zones. The symptoms of jet lag are multiple and vary with each individual, but result mainly from the internal body clock being out of phase with the daily schedule at the travel destination. Sleep is also often disrupted, leading to additional fatigue. Adjusting to jet lag is generally easier when travel is to the west, but most travellers adjust to the new time after a few days. Several tips may help diminish the effects.

  • Rest well before the flight.
  • Try to move 1-2 hours toward the destination time before flight, if your schedule permits.
  • Eat lightly before and during the flight.
  • Once departed, reset watches and other activities to the destination time.
  • Drink water and fruit juices in flight and minimize alcoholic beverages.
  • Consider using caffeinated beverages strategically during the day to mask fatigue but avoid use within 4-6 hours of bedtime when the effect may make sleep onset more difficult.
  • Wear loose, comfortable clothing.
  • Schedule outdoor activities on the first few days at the new destination.
  • After arrival, adjust to destination time as soon as possible.
  • Limit naps to a single nap of 30-40 minutes or less. Go to bed and awaken at the appropriate time for the new time zone.
  • Discuss with your physician if sleep medication could be beneficial.
  • For travellers who scuba dive, it is advisable to wait 24 hours after the last dive before taking to the skies so as to minimize the risk of developing decompression illness, such as the bends.

Conclusion

Air travel, whether for business or pleasure, whether short haul or long haul, is safe and should be enjoyable. Understanding the aircraft cabin environment and planning ahead can make your journey more comfortable for the healthy traveller as well as the traveller with medical conditions or special needs. If in doubt, check with your physician or your airline. The Aerospace Medical Association is pleased to provide these air travel tips and hopes that they will help you have a more pleasant trip.

The Aerospace Medical Association is pleased to have provided these air travel tips and hopes they will help you have a more pleasant trip. You can also obtain their 52-page publication entitled "Medical Guidelines for Airline Travel". It provides information for physicians to enable them to properly advise patients with pre-existing illness who plan to travel by air.
Copies can be obtained by telephone 703-739-2240 X 106 or 107 or email (gcarter@asma.org).
Cost - including shipping and handling - is $18.00.