Staying healthy in flight

With the busiest travel season of the year nearly upon us, medical professionals are offering advice about how holiday travelers can minimize health risks when flying. Some are common sense while others, though less intuitive, are equally important and helpful.

Combing through some recent emails on the topic, I noted two basic categories: maintaining one’s general health, and reducing the risk of more serious medical problems while in flight.


Prior to taking two back-to-back ultra-long-haul flights earlier this year I consulted my own physician about potential health risks and how to minimize them.

“The most common problem on long flights is exposure to other persons’ illness that may be contagious such as the flu or colds,” so good hand washing is always recommended, my doctor recommended.

Another simple recommendation: drink water.

Drink water to Stay hydrated while in flight
Stay hydrated while in flight

“Staying hydrated is essential, especially on long flights,” Dr. Raymond Bertino, Clinical Professor of Radiology and Surgery at the University of Illinois College of Medicine, explained. Dr. Bertino admitted that he experienced a medical event himself while traveling because he neglected to follow that simple advice.

Some sources I have seen recommend drinking an 8-ounce glass of water every hour, and more if you are also consuming alcohol because alcohol dehydrates; the body uses water as it metabolizes the alcohol that has been consumed.

Yet another simple bit of advice is to get up and move.

Whether on an ultra-long-haul flight or a short hop, may airlines have cards in the seat back pockets, warning about the possibility of deep-vein thrombosis, or DVT, which can occur when a person remains sedentary for prolonged periods of time.

In 2003, NBC reporter David Bloom was cramped in a Humvee for hours and days on end while embedded with U.S. troops fighting the war in Iraq and was taken out not by enemy fire or an IED, but by a pulmonary embolism that was the result of a DVT. That holiday travelers may be sitting in a comfortable seat aboard a Boeing (NYSE:BA) or Airbus jetliner does not mean there is zero risk.

“DVTs are actually pretty rare but there is an increased risk with flying, and the longer the flight the higher the risk,” my doctor advised. Getting up once an hour to walk down the aisles will reduce your risk of a DVT, she noted.


Frequently, more serious medical issues arise while in the air.

Every year, an estimated 44,000 in-flight medical events occur worldwide on commercial airliners according to data published in the New England Journal of Medicine. On average, that works out to slightly more than 120 events per day. Some events were unpredictable and were not preventable but many might have been.

A number of such events were precipitated because people who had a specific medical condition failed to check with their own physician before traveling. Many conditions are exacerbated by air travel for reasons ranging from the added stress of negotiating the airport and security, to the thinner air in the aircraft cabin.

Although modern airliners are pressurized, the “cabin altitude” in most commercial aircraft can be as high as the equivalent of 8,000 feet above sea level. The Boeing Dreamliner is an exception; its cabin altitude is pressurized to the equivalent of 6,000 feet above sea level.

Again, the advice is simple.

“If you have a serious illness, check with your doctor to be sure air travel does not pose an increased risk,” Bertino recommends.


Additional tips may help further reduce travelers’ risk of experiencing medical problems in flight or shortly after arriving at their destination.

Pack any medications in your carry-on, making sure they are clearly labeled and ideally in their original prescription containers. If traveling to another country, it is a good idea to obtain a letter from your doctor stating that you are their patient, naming the medications, and including a statement that the meds are necessary. That is particularly important if any of the medications are narcotic or psychotropic.

Try to be well rested before traveling; don’t assume you’ll be able to catch up on your sleep in flight. And while we’re on the topic of rest,

Don’t take a sleep aid like Ambien for the first time when you are traveling, as it may have exactly the opposite of the intended effect and leave you awake and jittery for eight hours. Do not take sleep medications at all if you are also consuming alcohol. Finally,

Stay calm and don’t let travel delays or other problems stress you out, Bertino advises.


If a medical event does occur, initial emergency evaluation and medical care are often provided by a physician volunteer on the flight. Now, physicians who volunteer to help a sick traveler can use an app called airRx to access 23 scenarios of the most common medical emergencies, with concise treatment algorithms and quick reference information to help evaluate and treat the patient.

Dr. Bertino led a team of experts in aerospace medicine, emergency medicine and ground support to develop airRx.

Screen of airRx app

Medical schools do not provide formal physician training for handling in-flight events, and many doctors work in areas where they do not commonly deal with emergent events. airRx is designed to bridge the knowledge gap, providing a real-time checklist and quick reference handbook to improve the way that emergent medical situations in the air are addressed.

airRx can be downloaded from either the Apple App Store or Android Google Play for a modest fee and is fully functional in Airplane mode after being downloaded.

Visit my main page at for more news, reviews, and personal observations on the world of upmarket travel.

Photo by Carl Dombek
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