It’s not enough to just worry about traffic to the airport, wait times at security, and flight delays, but some travelers have to worry about flying with an injury or illness that might get worse in the air.
For those passengers, it’s important to know the risks of flying with an injury and illness, and why it can get worse in the air.
One reason, and the simplest explanation, is that the cramped conditions, with 200 or so people sharing the same cabin regardless of class, making it much easier for germs to spread. And those germs make it much easier for those with an already compromised immune system to get even sicker. Not to mention that those people who are already sick who choose to fly tend to do a good job of spreading the germs around.
“I tell people to wipe things down to reduce the risk of transmission,” said Lori Calavan, a practicing surgical critical care physicians assistant at St. Francis Hospital and Medical Center, and a senior medical consultant to Allianz Global Assistance. She added, though, “there’s not a lot you can do if you have people that are that close to you.”
Calavan said, aside from not getting on a plane if you feel that you are actively infectious, there’s not much passengers can do about the risk. But she recommends all passengers use proper hand-washing, and wipe any surface area around the seat clean before sitting down.
According to a 2015 study called “Airline Hygiene Exposed,” from Travelmath, which measured germs in a fecal coliform test, some of the dirtiest places on airplanes are the flush button in the bathroom, the seatbelt buckle, and the overhead air vent. But the study found that the tray table was, by far, the dirtiest place on the airplane, with a measurement of 2,155 colony forming units (CFU)/square inch. The flush button, by comparison, was measured at 265 CFU/square inch, while the overhead air vent was measured at 285 CFU/square inch.
“I think it’s a combination. You can get sick in a crowded area. You are in a limited space, it’s crowded. When people are flying and they have a compromised system, they are not well. It’s the same thing when you have toddlers in an infant room. You always run that risk no matter where you are,” she said.
For those who are injured, as opposed to sick, the reason it’s dangerous to fly with an injury is trapped air. Anyone with injuries where air has been trapped, because of the basic laws of physics and, more specifically, Boyle’s Law, Calavan said, is at a higher risk of pain and injury inflight than others.
“The biggest issue are those conditions that occur that have the possibility of trapped air. When we travel at altitude, the gases in the body can expand 1.5 to 2 pounds from sea level volume,” Calavan said.
Boyle’s Law says gases expand as air pressure decreases, which is precisely what happens when a plane climbs higher in altitude. That air expansion can cause discomfort and pain and, sometimes, injury.
“When you get at altitude, when you’re flying, there’s a different mix of gases than at sea level, but there’s less pressure, and less oxygen gets into the blood at a higher altitude,” she added.
That air pressure change can be minimally impactful. It’s the reason behind “jet bloat,” a common swelling and bloating that some travelers experience during flights. But it can also be the cause of some serious problems. According to the Mayo Clinic, most injuries are fine to fly with, but some, including those that might put people at a higher risk of blood clots, could be dangerous. According to Calavan, those types of patients need to check with their doctor before traveling.
“If you have someone who has a partially or a complete collapsed lung,” for instance, she said, “when you put them at altitude, the gas is going to expand and that collapsed lung is going to get worse. Patients can die if they completely collapse their lung.”
Medical travel insurance is important
For those who are injured or become sick while traveling, travel insurance companies like Allianz offer plans that provide coverage for emergency medical expenses. Having that coverage will allow travelers to not put themselves, or other passengers, at risk when flying, and allows them to get home safe and without an anvil-sized medical bill waiting for them.
“If someone is acutely ill on vacation, you want them to seek medical attention where they are. Usually it’s a combination of decisions. We always work together and ensure that a patient is never in harm’s way or at risk,” Calavan said.
Allianz, for instance, can get a traveler home with a medical or air ambulance — the equivalent of a mobile ICU — or even place an injured passenger in first class with a nurse or medical escort that can make sure the return back home occurs without incident.
“We’ve had big trauma patients with surgeries and wound and pain control, but once they are stable and their oxygen is stable, we can have them travel with a nurse or a doctor in a commercial plane first class, because they are going to be so much more comfortable than in an air ambulance,” she said.