Pre-existing medical conditions may be exacerbated by air travel, Lahey Clinic study shows

Release Date: 02/23/2009

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Pre-existing medical conditions may be exacerbated by air travel, Lahey Clinic study shows

BURLINGTON, MA—Writing in the current issue of Lancet, Lahey Clinic Vice Chair of Emergency Medicine Mark A. Gendreau, MD, and former medical student, Danielle Silverman, MD, conclude that in-flight medical events are occurring more frequently because a growing number of people with pre-existing medical conditions are flying. The Lahey study also suggests that extended flight times of more modern aircraft may be subjecting passengers to environmental and physiological changes associated with flight, impacting their health.

Passengers with pre-existing cardiac, pulmonary and blood conditions have a reduced arterial oxygen partial pressure, and the reduced cabin pressure that occurs during routine commercial flights further diminishes oxygen saturation in blood, exacerbating certain medical conditions. About 18 percent of passengers with COPD, or chronic obstructive pulmonary disease, for example, have at least mild respiratory distress during a flight, the Lahey study shows.

Cabin pressure at cruising altitude can cause gases in the body to expand by as much as 30 percent and can lead to abdominal cramping and other medical concerns for people with bowel obstructions, diverticulitis or recent surgery. On rare occasions, stitched surgical wounds have reopened in-flight because of this. Thus air travel should be delayed for at least two weeks after surgery, the authors recommend.

Dr. Gendreau suggests that individuals with acute exacerbation of asthma or COPD should postpone air travel until their respiratory condition is controlled. Individuals with fluid in their lungs, or uncontrolled heart rates, heart failure or pulmonary infections should also postpone air travel because they are at higher risk.

Passengers older than 70 years have the highest rates of in-flight medical events, but the mean age is 44 for men and 49 for women. Data show that there are about 85 recorded in-flight medical events every day on US air carriers, though airlines are not required to report these.

In-flight concerns about infectious diseases during air travel are real, says Dr. Gendreau, especially if fellow passengers in nearby seats are carrying highly contagious illnesses such as flu, measles, tuberculosis, or Norwalk viral enteritis, among others.

“In the modern travel era, clear understanding of the medical consequences of commercial flights has become increasingly important,” Dr. Gendreau said. “Individuals need to be aware of the possible medical complications of air travel, and physicians should identify people at potential risk from air travel and advise them of any necessary treatments to travel safely.”

Overall, US airlines are prepared for many medical emergencies with certain medical equipment available on-board and telemedicine capabilities with physicians on the ground.

About Lahey Clinic
Lahey Clinic, a physician-led, nonprofit group practice, is world-renowned for innovative technology, pioneering medical treatment, and leading-edge research. A teaching hospital of Tufts University School of Medicine, the Clinic provides quality health care in virtually every specialty and subspecialty, from primary care to cancer diagnosis and treatment to kidney and liver transplantation.