Business travel can pose health risks

ACOEM offers air travel checklist

Every day, millions of Americans travel via air for business or pleasure, but few are aware of the health risks that can be caused by flying, from the merely uncomfortable (dry eyes) to the life-threatening (cardiac events), especially for those with underlying health conditions.

Because air travel is such an important part of American business, the American College of Occupational and Environmental Medicine (ACOEM), which issues a checklist each Labor Day on a health topic that affects worker health and workplace safety, has created a list of pre-flight planning tips and recommendations for traveling. (See tips.)

"This list addresses the most common health and medical issues that impact air passengers during their flight," reports Thomas B. Faulkner, MD, MHA, FACOEM, a member of the ACOEM board of directors who also serves as medical director for Atlanta-based Delta Airlines. Faulkner assisted in developing the Medical Tips for Air Travel checklist.

Frequent travelers should know that taking some precautions before flying can make travel not only more comfortable, but can ward off adverse health complications.

Uncomfortable effects of cabin pressure such as dry eyes and skin are unavoidable, but they can be minimized. For example, contact lens wearers might consider using moisturizing eye drops or wearing glasses instead, to lessen the effects of dry air. Moisturizers and lip balm can relieve dry skin.

Faulkner say air on commercial airlines "is very, very clean air," but when the person in the next seat has a cold and cough, germs can be unavoidable.

Travelers might avoid unwanted bacteria in drinking water by requesting water in sealed bottles; according to ACOEM, a recent environmental Protection Agency (EPA) study found bacteria in the water on both domestic and international aircraft. Ice, usually purchased from vendors who are required to meet strict hygiene standards, generally is safe on domestic flights.

Travelers with certain health conditions should take additional precautions before flying. Anyone with heart or lung conditions should check with
a physician before flying, as pressurized cabins cause lower oxygen saturation in the body.

"You do feel fatigued when you fly, and that's because when you're at altitude, you desaturate; the oxygen in your blood may go down from 98% to 92%. It's like going from sea level to an 8,000-foot mountaintop," Faulkner explains. Certain cardiac and respiratory conditions can cause more serious desaturation.

Pregnant women, too, should get clearance from their physicians before flying; diabetics may need physician input on adjusting their medications if they fly across multiple time zones.

Recent surgery may be a contraindication to flying. Again, the passenger should check with his or her physician to ensure there is no increased risk of deep vein thrombosis (DVT), but Faulkner stresses that evidence indicates it's not air travel that increases the risk of DVT, but the long periods of immobility.

"It's important to stretch, flex your arms, and get up and walk around if possible," says Faulkner.

If health conditions require air travel be postponed or canceled, airlines may refund airfare if the passenger provides a note from his or her physician.

If the flight is unavoidable, the traveler should contact his or her physician to ask about what precautions to take. Frequent travelers who have health conditions that might affect travel should find out ahead of time what the airline's policy is on traveling while ill and traveling when medical assistance is needed; some airlines require physician documentation for ailing patients before they fly.

The Labor Day checklist for 2005, and for all years since 1996, is available on-line at