Air

Practicalities Getting There Air Health Issues 

Flying is not a particularly healthy activity so you might like to think about some relevant issues as listed.

In addition all parents should bear in mind that airlines will not carry children with infectious diseases, severe cases of middle ear infection, or sinusitis.

Ear Problems

Apparently around a quarter of travellers have suffered ear pain or discomfort when flying. Children are considered more at risk of this kind of pain and solutions may be difficult as many children have "a dysfunction of the Eustachian tube". Ideally you should avoid a child travelling with a heavy cold, severe hay fever, or any form of ear infection or sinusitis. All conditions mean that changes in air pressure are likely to cause pain from unequal pressure on either side of the eardrum. This is caused by mucus blocking the Eustachian tubes from the throat to middle ear, where air normally moves to equalise pressure.

Measures to Alleviate:

• Swallowing, breast or bottle-feeding babies - best offering during takeoff (don't start too soon as the plane may spend some time standing on the runway) - or for older children chewing gum, and yawning.



• Passing air from the back of the nose to the middle ear via the Eustachian tube to equalise pressure. Techniques include auto-inflating the ears by pinching the nostrils closed and puffing out the cheeks. A more fun alternative is to take a balloon for the child to blow up as it also helps blow air into the middle ear. More jaded parents envisage subsequent problems from flying balloons with this last.



• Painkillers and/or nasal decongestants.



• Ear plugs designed to help equalise the pressure in the ear. Cirrus Health Care offers a product called Earplane. These come in adult and child sizes. A silicone ear plug provides a seal with the ear canal and ceramic pressure regulation.



• Crying will help so it is a good idea to allow it.



• Two paper cups filled with paper napkins soaked in hot water to put over the ears. The warmth relieves the pressure. If you are particularly worried you could take your own thermos of hot water, handkerchiefs and cups.

Dehyration

While water vapour in the atmosphere in general is 70-80%, and levels of 30-60% are considered comfortable, on most flights it may be 10-20% and sometimes lower. The dehydration is worsened by the fact that cutting ventilation rates mean savings on the airline's fuel bill. Passengers are themselves an important source of water vapour - on their breath - so the fewer there are, the drier the air will be.

In order to encourage sleep, the temperature on most long-haul flights is increased after the meal has been served. This can be helpful, but levels rise above generally recommended room temperatures and encourage further dehydration.

Most of the advice which applies to adults can also be applied to children: drink lots of liquids both before and on board, without caffeine (so less cola and chocolate). Avoid also diuretics such as tea and coffee. If at all possible aim to sit at the front of the cabin where the air should be fresher.

Although children's skin is usually supple enough to cope, particularly if your child suffers any kind of skin problem you might like to take along a moisturising cream to make them more comfortable. Lip balm might also be a good idea and a water spray might be nice if they can be trusted not to run riot with it.

Drinking enough is particularly important if breastfeeding but is increasingly vital the longer the flight. You should therefore drink more than the standard recommendation of 200ml of water per hour in the air. Occasionally aircraft run out of mineral water so if you can bear to, it is worth carrying on your own.

Toxic Fumes

Apparently aircraft cabins may be contaminated by a cocktail of toxic chemicals, principally organophosphates. Small quantities of the chemicals are used in engine oil to minimise wear and if the oil leaks past seals into a jet engine (reported always a possibility) the chemicals are vaporised and sucked into the cabin by the air conditioning system.

Other pollutants such as kerosene are likely to be at higher levels if the aircraft has been standing on the tarmac for any length of time with engines running.

Infections in the Air

Recycling air rather than drawing in fresh saves airlines up to 6% on fuel bills and there are further savings to be made on reducing the ventilation rate. This means most airlines mix fresh air with 50% recycled. The recycled air contains less oxygen, encouraging the transmission of bacteria and viruses, as do the low levels of humidity, which apparently encourage the survival of airborne viruses.

According to Professor Martin Hocking, who has published a book on the subject with the Aviation Health Institute, airline air filtration systems do not completely remove viruses. Not surprisingly, a plane can become very infectious.

The book states that; "Viral infections such as the common cold, influenza, measles, mumps and chicken pox are easily spread. More worryingly, there have been well documented cases of TB transmission, a significant risk to air travellers when it is realised that this disease is endemic in many parts of the world, and that single or multi-drug resistant varieties have shown up in increasing frequency in recent years."

This of course explains why airlines will not take any passengers who are clearly suffering from ailments such as those mentioned.

In addition, the carbon dioxide caused by breathing will build up and cause stuffiness and according to the professor the low oxygen levels may lead to fainting.

Best option is to try to sit at the front and ideally in business or first. This is because the air is not delivered per passenger but simply by space. (By law the cockpit is supplied with 10 times more air than the passenger cabin.) You could consider a preventive such as vitamin C prior and during the flight and, again, it's worth drinking lots of water. Another tip is periodically to hold a damp cloth over nose and mouth to moisten the air you breathe, and helping counter the drying out of the mucous layers in mouth, nose and ears.

Plaster Casts

Given that the body swells when in the air it is not a good idea to travel with a limb in plaster as this can stop the blood flow. If you child is in plaster you will have to discuss this with your doctor.

Babies

Babies should not fly in their first 48 hours of life because their heart and lungs can't cope with the reduced levels of oxygen.

In 1998 there was a report that flying, particularly long-haul might have been connected with cot death. The theory was that even in a pressurised aircraft cabin the lower levels of oxygen than at sea level might have been at least a contributory cause. An equivalent low level of oxygen was provided for babies of around three months under test conditions and their breathing monitored. It was found that in some children the amount of oxygen in the blood fell. However subsequent research has thrown this concern into doubt and flying is currently reported safe for babies.