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Stress can be faced before the flight along with any moment of our life.

Despite anecdotal evidences, which indicate that flight is a subjective preference, there are scarce studies that address the air travel stress.

Check-in line, necessity to arrive the airport 2 to 3 hours before the flight for the luggage and security check and subsequent process are regarded among most important causes of the pre-flight stress. Moreover, it is emphasized that media news, crowded airports, delays and cancellations play significant role in the air travel stress.

The studies show that the unique nature of air travel interestingly requires stress for a safe and valid air travel. Previous research emphasize that the perceived air travel stress may lead to strong emotional reactions, including anxiety and anger. Components of anxiety may include the anxious effect, concerns about future negative events and somatic reactions such as tachycardia.

On the other hand, when the pre-flight stress is evaluated as the sole factor, it is emphasized that the pre-flight processes have strong influence on the human affect. This may cause anger, anxiety and psychosocial stress. The term “psychosocial stress” means losing temper and acting accordingly after the plane takes off. You can watch flight preparation videos or follow the advices written in our articles to cope with the pre-flight stress. Thus, you can experience a pleasant and stress-free air travel.

Reports issued by aviation industry reveal out that the air rage is steadily increasing and it had reached serious figures over the time. This condition is primarily threatening the flight safety. We, hereby, recommend a stress-free life not only for daily routines, but also for your travel.

References:

  • Deheart, Roy L. "Health Issues of Air Travel." Annual Review Public Health, 7 Nov. 2002.
  • Jonathan B. Bricker "Development and Evaluation of the Air Travel Stress" Journal of Counseling Psychology, 2005, Vol. 52.

Although modern aircrafts are far comfortable than their ancestors, passengers may, at times, encounter physical or psychological challenges that are caused by the flight environment. Some of these challenges are addressed in investigations.

One of the most common challenges is hypoxia – oxygen deficiency. Partial oxygen pressure decreases by 20% relative to the sea level while flying at a certain altitude. This mild hypoxia does not cause a problem for health people. However, it is not the case for people with certain health problems, such as heart disease, chronic respiratory tract disorders and anemia.

It is known that the barometric pressure fluctuations in the cabin influence certain body parts, such as middle ear, paranasal sinuses and the bowel. While the plane is climbing, the cabin pressure decreases, resulting in up to 30% expansion of gases. This would not lead to serious problems, other than mild abdominal discomfort and blocked or clogged ears, under normal circumstances. People suffering from such problem may follow the techniques, such as Valsalva Maneuver, that are explained in detail in our pages nasal congestion and ear problems.

Motion sickness can be one of the physical effects exerted by the flight. A study on motion sickness while flying reported that 0.5% of passengers vomited and 8.4% felt nausea (upset stomach) during the flight. Motion sickness can be severe if exposed to turbulence in the flight. The predisposed people are recommended to take necessary measures before the flight.

Reference

  • Dowdall, Nigel. "Customer health: a new role for occupational physicians." In Depth Review, 3 Dec. 2002.

The studies on influence of the route of the destination on the performance generate conflicting results. Some data report that traveling to east is more hazardous for the performance. It is emphasized that the underlying factor is about the normally longer circadian rhythm longer – >24 hours or approximately 25 to 26 hours. In conclusion, it is reported that the body adapts more easily to the changes, which prolong the day rather than shortening it.

Many studies show that the eastward passengers experience more labile symptoms of jet lag, which require longer time for re-synchronization, as the body follows a quicker adaptation due to the phase latency. The studies conducted by Lemmer et al. report that symptoms of jet lag following westward flight are predominantly faced in the first three days and that the symptoms are more severe following eastward flight and they persist even 7 days after the arrival.

The jet-lag and these results related with adaptation should be taken into consideration by people, who have busy schedule and require more physical activity, and especially by athletes. Based on results of this study, business or sports schedule is a critical factor that influence the performance following the travel. In case of a disadvantageous travel schedule, it can be advantage to synchronize the body clock gradually before the flight. You can watch our videos to learn how to do this.

References:

  • Lemmer B, Kern RI, Nold G, et al. Jet lag in athletes after eastward and westward time-zone transition. Chronobiol Int 2002;19:743-64.
  • Reilly T, Edwards B. Altered sleep-wake cycles and physical performance in 88 athletes. Physiol Behav 2007;90:274-84.
  • Loat CE, Rhodes EC. Jet-lag and human performance. Sports Med (Auckland, NZ) 1989;8:226-38.

Every year about 2 billion people make aircraft journeys, and the issue of jet lag has always been a point of discussion. Jet lag describes the temporary disruption to the circadian rhythm associated with long-haul flights which causes physical symptoms such as daytime fatigue, insomnia, loss of appetite, digestive complaints like constipation, lapses in psychomotor coordination and sluggish mental performance. 

Jet lag occurs as a result of a disturbance in the synchronization of your body's internal clock. According to the jet lag studies carried out by Dr. Waterhouse and colleagues published in 2007, this is a result of a discrepancy between the time zone in the suprachiasmatic nucleus of the hypothalamus and the new light-dark cycle, and the synchronization problems this causes in the brain. Jet lag is a manifestation of the difficulty the body has in adapting to the change in the light/dark cycle. 

In a simulation study carried out by Burgess and colleagues in 2003 and published in the Journal of Biologic Rhythms, in order to set the circadian rhythm appropriately, it was shown to be of benefit to go to bed 1 hour earlier and to be exposed to bright light upon waking up for 3 days before traveling east. It was also shown in the study that the more time you apply this phase therapy and plan your sleep before traveling, the more effective it will be. It has the potential to prevent jet lag altogether. 

References 

  • Waterhouse J, Reilly T, Atkinson G, Edwards B. Jet lag: trends and coping strategies. Lancet 2007; 369: 1117-29. 
  • Burgess HJ, Crowley SJ, Gazda CJ, Fogg LF, Eastman CI. Preflight adjustment to eastward travel: 3 days of advancing sleep with and without morning bright light. J Biol Rhythms 2003; 18: 318-28.

The cabin environment can affect passengers of different ages and conditions of health in different ways. Flight cabin pressure can directly affect the digestive system. Many people who fly fear that it is just them affected by gas and bloating, and embarrassed, they suffer in silence. 

Low cabin pressure leads to gas expanding. According to Boyle's law, gas expands by 35% when it is 8,000 feet above sea level. Even though the cabin pressure set on aircraft used by modern airlines endeavors to save passengers from the effects of the real pressure at cruising altitude, the change in pressure means it is still as if the body has instantly climbed a tall mountain. 

Despite the hypothesis that spaces in the body filled with air can be affected by pressure when flying, it is only really felt in the ears and as bloating. These spaces include the inner ear and sinuses, the intestines, the pleural spaces of the lungs, some dental fillings, and the skull. Because take-off and landing are quite gradual processes, the change in pressure is quite slow and so the effects on the body are limited. 

Several studies have been carried out on complaints of gas and bloating. In their study carried out in 1995, Enck and colleagues looked at the difference in indigestion complaints between ground staff and cabin crew. In 2000, Vejvoda and colleagues showed in their study that the rate of complaints of bloating was much higher in cabin crew working on long-haul flights compared with ground staff. The study published by Hinninghofen and colleges in 2006 underlined that what you eat while flying is directly related to gastric emptying time, and at an altitude of 2,500 m, gastric emptying time is negatively affected, thus increasing the chance of indigestion. The study also showed that gastric emptying time is extended by around 50 minutes, and this leads to more gas, bloating and nausea. 

So, studies show that these problems are common when flying, and that you are certainly not alone. 

References 

  • Hinninghofen, H., Musial, F., Kowalski, A., Enck, P., 2006. Gastric emptying effects of dietary fiber during 8 hours at two simulated cabin altitudes. Aviat. Space Environ. Med. 77 (2), 121-123.  
  • Vejvoda, M., Samel, A., Maas, H., Luks, N., Linke-Hommes, A., Schulze, M., Mawet, L., Hinninghofen, H., 2000. Study on strain, workload, and circadian rhythm in cabin crews during transmeridian flights. Research Report 2000-32. Deutsches Zentrum für Luft-und Raumfahrt (DLR), Cologne. 
  • Enck, P., Mueller-Sacks, E., Holtmann, G., Wegmann, H., 1995. Gastrointestinal problems in airline crew members. Z. Gastroenterol. 33, 513-516.

When flying, swelling of the feet can be a direct result of age, the health of vein walls, anatomical composition, pregnancy or varicose veins. The muscles which prevent fluid retention need to move in order to do their job. When sitting for long periods, blood flow stops as a result of reverse pressure, and fluid begins to gather in extremities. 

In 1996, Shuster and colleges first published their research on feet swelling during flight in the respected medical journal, The Lancet. A study was conducted which featured a simulated flight of 12 hours, with one group having a daytime flight, the other having a nighttime flight. 

The results of the research showed that water retention occurs more severely at night. The condition was seen most commonly in women over 30 and those with varicose veins. The study underlined the impact of in-flight ambient temperature and cabin pressure, and indicated that the condition is a natural result of these. 

Scientists also state that exercises and massage while flying can have a positive effect on the condition. It was also highlighted in the research that wearing tight socks before traveling makes the condition worse. People who suffer from feet swelling are advised to wear loose-fitting socks and to do exercises which work the ankle. 

References 

  • Shuster S. Jet flight leg and hypobaric pressure. Lancet. 1996 Oct 5;348(9032):970. PubMed PMID: 8843849. 
  • Shuster S. Jet flight leg. Lancet. 1996 Mar 23;347(9004):832-3. PubMed PMID: 8622363.

Human beings live in an environment with stable direction and magnitude of gravity force. Passengers may, directly or indirectly, perceive vibrations, motion and centrifugal forces during flight. In addition, the turbulence in a flight may create a linear movement on the vestibular (balance) system. Vertical or circular movements in the vestibular system are accompanied by particular complaints, such as nausea and dizziness. Balance problems may also lead to motion sickness.

The study titled “Airsickness and aircraft motion during short-haul flights” conducted by Turner et al. on 923 passengers in 38 flights revealed out that vomiting is reported by 0.5% of passengers and nausea is reported by 8.4%. The study found positive correlations between symptoms and low-frequency lateral and vertical motions. Moreover, it is reported that selection of seat or demographics of passenger are not directly correlated to those findings.

Studies on airsickness emphasize the importance of reducing exposure to vibration and seeing the horizon line. The Health Info articles on airsickness published by University of Maryland and Mayo Clinic recommend passengers to prefer seats over the wing or the front section.

The Flight Phobia video that is shot within scope of the Fly Good Feel Good project will guide you to cope with the airsickness. Moreover, our ginger teas may help preventing the nausea. Have a nice flight.

References 

  • Turner M, Griffin MJ, Holland I. Airsickness and aircraft motion during short-haul flights. Aviat Space Environ Med. 2000 Dec;71(12):1181-9.
  • Schmal F. Neuronal mechanisms and the treatment of motion sickness. Pharmacology. 2013; 91(3-4):229-41.

Have you ever felt in a long-haul flight that your contact lenses dried or even your eyes are irritated? The condition is caused by the environmental conditions of the cabin. Passengers with contact lenses may face such problems due to pressure alterations in the cabin.

Aircraft cabin exposes the passengers to low atmospheric pressure, oxygen and humidity as well as dry air. The underlying cause is the artificial low atmospheric pressure that is created to fly at an altitude of 35 thousand feet. Those conditions may cause ocular discomfort in passengers with contact lenses especially in flights lasting longer than 3 hours. Studies report that moisturizing eye drops approved to be used with contact lenses may help curb the dry eye during flight. As the dry eye causes irritation and infection, passengers who wear contact lenses are recommended to remove lenses aboard.

You should also be careful not to fall asleep with contact lenses on your eyes during the flight. Contact lenses stiffen due to partially low oxygen and dry air, resulting in the risk of corneal abrasions. You are recommended to keep your contact lenses and irrigation solutions in your bag during flights. The 100 ml limit set for liquids aboard does not apply to lens solutions, but such solutions should be declared at the security check. You may also prefer travel type lens solutions or smaller packages. If you do not have small packaged lens solution, you may need to pour some of the solution to another container. This approach may go up in flames regarding infection.

Preferring eyeglasses rather than contact lenses especially in long-haul flights can be much healthier.

References 

  • Backman H, Haghighat F. Air quality and ocular discomfort aboard commercial aircraft. Optometry 2000; 71(10):653-6.
  • DeHart RL. Health issues of air travel. Annu Rev Public Health 2003; 24:133-51.

There are hundreds of studies conducted on nausea and vomiting that are among the most important symptoms of the motion sickness. The underlying causes of those symptoms include environmental factors that influence the vestibular (balance) system, such as vibration. It is known that vibration and vertical motions cause nausea in passengers in a flight.

Natural solutions can be used for nausea – a symptom of the motion sickness. Ginger has been used as a wide-spectrum antiemetic agent (that curbs the nausea) in traditional medicine for more than 2000 years. Various pre-clinical and clinical trials show that ginger poses antiemetic effects on various factors, which induce nausea. Although there are studies reporting that same effect does not apply to everyone, many research reports claim that ginger is a natural anti-emetic substance. A study conducted by Lien et al. in 2003 demonstrates that the ginger is efficacious in alleviating the nausea induced by circular vection. It is, therefore, reported that ginger can be a new agent in prevention and treatment of motion sickness.

Within scope of the Fly Good Feel Good project, detailed information about ginger teas is available at Special Teas page. You can try our special teas to cope with nausea during flight.

References 

  • Lien HC, Sun WM, Chen YH, Kim H, Hasler W, Owyang C. Effects of ginger on motion sickness and gastric slow-wave dysrhythmias induced by circular vection. Am J Physiol Gastrointest Liver Physiol. 2003; 284(3):G481-9.
  • Ernst E, Pittler MH. Efficacy of ginger for nausea and vomiting: a systematic review of randomized clinical trials. B J Anaesth. 2000;84(3):367-371

Airline travel is regarded among most common causes of the middle ear barotrauma (the airplane ear). Although the infants and children, nowadays, often travel by airlines, the literature on this issue is scarce. The studies on infants and children during a flight are usually limited to case reports and observational studies. 

While airplanes start climbing above the sea level, external pressure decreases and the middle ear starts absorbing air to balance the pressure difference. When the airplane starts descending, external pressure increases and the middle ear increases the pressure to reach a balance. However, when the pressure changes cannot be regulated due to a pathology, babies and infants may feel acute and severe ache. Since babies cannot specify nature and location of the complaint, they are more prone to this condition and the ache can cause onset of anxiety. 

When the pressure adaptation fails, the eardrum stretches and even it may, sometimes, cause local cracks. These conditions are common especially in the infants and children who have active upper respiratory tract infection and ear infection or are sleeping. Children are recommended to swallow or do “Valsalva Maneuver” that is instructed in the video content of the Fly Good Feel Good project in order to avoid barotrauma or the airplane ear that is caused by pressure fluctuations. 

Sucking hard candies and chewing gum are not recommended, because they may cause the risk of aspiration. The adverse weather conditions at flight altitudes may lead to instant altitude changes that can be felt while traveling by plane. A possible excitement during such an event may cause aspiration of the gum or the candy into the airway, resulting in blockage and choking. Studies show that fluid (water or soft drinks) consumption or breastfeeding is the best method to prevent barotraumas in infants and children in such circumstances. 

You may watch our video to learn about maneuvers to perform against barotrauma and to eliminate the stuffy ear. 

References: 

  • Samuels MP. The effects of flight and altitude. Arch Dis Child. 2004 Mar;19(5):448-55. Review. 
  • Rosenkvist L, Klokker M, Katholm M. Upper respiratory infec- tions and barotraumas in commercial pilots: a retrospective survey. Aviat Space Environ Med. 2008;79:960-3. 
  • Brown TP. Middle ear symptoms while flying. Ways to prevent a severe outcome. Postgrad Med. 1994;96:135.

It is known that airline companies have established facilities to treat the fear of flying of passengers by cooperating with private entrepreneurs or mental health experts. According to a review paper issued in 2000, while 43 out of 212 airline companies that could be contacted were actively working on this issue, only 15 companies provided passengers with detailed information and training, but the figure quickly reached 36 companies in 2004. The increase in number of training facilities might have originated from the increased demand to treatment by people with fear of flying or a factor that caused airline companies be more interested in rendering more services in this field. Nevertheless, sufficient knowledge was not available in the scientific and professional literature while such education programs were initiated. 

The studies report that the prevalence of the fear or phobia of flying ranges from 10% to 40%. The studies that discuss and address safety, health and comfort of passengers argue that the stress emerges on the way to the airport rather than during the flight. It is emphasized that arrival to airport, boarding on time, checking in with heavy luggage and even security control cause stress. If the fear of flying is added to those stresses, a considerable number of passengers gives up the flight. 

There has been a wide variety of methods and protocols used to date for the fear or phobia of flight. However, when these figures climbed, experts thought that the “best” major components of the fear of flying support educations should be standardized. Therefore, there are now gold standards that are commonly agreed and meet these requirements. If you have fear of flying or concerns about traveling by plane, you may watch our video prepared within the scope of our “Fly Good Feel Good” project and get professional support about golden standards from Turkish Airlines Flight Academy. 

References: 

  • Van Gerwen LJ, Diekstra RF, Arondeus JM, Wolfger R. Fear of flying treatment programs for passengers: an international update. Travel Med Infect Dis. 2004 Feb;20(1):27-35. 
  • Rayman RB. Passenger safety, health and comfort: a review. Aviat Space Environ Med 1997;68:432-440. 
  • Jones DR. Fear of flying--no longer a symptom without a disease. Aviat Space Environ Med. 2000 Apr;37(4):438-40.

Airline transportation has become a very popular form of travel as companies that offer affordable prices engaged in more competition. As the case for all other travel means, transportation has unique risks. Having a snack or eating on airplanes makes an important part of these air travels. However, passengers may face risks, such as food poisoning, as many companies prefer cheap options for catering services. 

Food-borne illnesses are extremely rate in modern airline transportation sector. However, you should consider this risk along with the price, while buying your ticket. What if all passengers are caught by a foodborne disease and the condition also involves the flight crew? The results of this picture in transatlantic flights may pose fatal risks that may not be as cheap as the ticket you bought. 

The studies show that prevalence of food poisoning ranges from 3% to 24% and it is observed that the prevalence is especially high in developing countries. Chicken, cream desserts and sea foods are the most common examples of in-flight catering that cause poisoning. When the risk analysis and etiological factors are reviewed, an infection that develops during the flight may be manifested after the travel and passengers may not recognize the condition. Therefore, it is necessary, as recommended by relevant research, to know how in-flight foods are prepared and cooked and to be aware of various food safety standards. 

Those studies briefly report that food preparation and storage should meet high standards to ensure quality and safety of in-flight catering. These standards are not only valid for airport kitchens, but also apply to vehicles that transfer foods from premises to the aircraft and to the airplane kitchens. Turkish Airlines fulfills such standards and offers fresh foods and snacks in homemade format. In-flight foods and snacks are prepared in line with high standards and they make the travel more pleasant and healthy. 

References: 

  • Lambiri M, Mavridou A, Papadakis JA. The application of hazard analysis critical control point [HACCP] in a flight- catering establishment improved the bacteriological quality of meals. J Roy Soc Health 1995;115:26-30. 
  • McMullan R, Edwards PJ, Kelly MJ, Millar BC, Rooney PJ, Moore JE. Food-poisoning and commercial air travel. Travel Med Infect Dis. 2007 Sep;17(5):276-86.