Health concerns during air travel

Are there any restrictions for the elderly or the infirm traveling by air?
    No, there are no restrictions. With technological development, air travel has become increasingly comfortable and safe and should present minimal danger to elderly passengers or passengers with mild heart disease, high blood pressure, asthma or other conditions or to pregnant women. Because planes are fast, comfortable and stable; well-equipped; and have good environmental conditions for health, air travel is well suited for old, weak, sick and disabled passengers. But, it is best for passengers with health concerns to inform airlines in advance, so that the relevant department can take precautionary measures and provide them with appropriate services. For safety, passengers with a serious heart condition or cerebral infarction, and pregnant women close to their due date (pregnant for more than 8 months), etc. are recommended not to travel by plane. If they must travel, they must contact the airline in advance to arrange appropriate protective measures.

How to fight fatigue when traveling by plane
    AIt's natural to feel tired in both body and mind when traveling. Here are a few tips for taking care of yourself.
Avoiding jetlag: There is no evidence of increased ability to avoid the effects of jetlag by exercising or changing the diet. The best way to avoid jetlag is to adjust sleeping times before departure and try to have a meal and get to sleep on the plane according to the local time of destination city. If you cannot sleep, taking a nap can help to decrease jetlag. If you really have difficulty getting over jetlag, you may take some medication under a doctor’s guidance to help you sleep.

How to avoid a stiff neck: It is easy to get a stiff neck when sleeping on a plane. To prevent this, you can ask the airhostess for a U-shaped pillow or you may ask her for two small pillows, one of which can be placed to support the small of the back and the other can be placed to support your neck. This not only can help you sleep more comfortably but also can help avoid a stiff neck.

How to avoid dizziness: due to the insufficient air on the plane, it is easy for dizziness to occur. In this case, you can ask the airhostess for a small oxygen cylinder or ask to lie flat. The flight attendants will find a way to help you even if there are no extra seats available.

Ticketing
    Passengers are required to present valid personal travel certificates when purchasing tickets (including but not limited to ID cards, Passports, Visas, etc.). Passengers are required to fill in the Passenger Ticket Purchase List. Ill passengers must have medical certifications approving of travel by flight written by medical units authorized by China Eastern. Please refer to the Transportation Conditions for details regarding travel of ill passengers.

Beware of thrombosis when traveling by plane
    Medical statistics show that about 2-10% of passengers will experience thrombosis while traveling on a plane. Some medical experts believe that the probability will never reach 10% again, but even if 2% of passengers each year experience phlebothrombosis, the number is alarming. New Zealand researchers plan to conduct specialized research on the relationship between long-distance air travel and human thrombosis. The study will include research on 1000 tourists. The researchers collect blood samples from passengers who have spent more than four hours on plane and returned within six weeks and compare changes in thrombus before and after their trips. The purpose of the research is to know whether long-distance flights lead to increased risk of thrombus and how many passengers will suffer from increased risk of thrombus. The head of the research project, Dr. Rodney Sues said that the respondents of this research will no longer be taken solely from high-risk groups and will now include a wide range of people. This will help determine the impact of long-distance plane travel on the risk of thrombus in the general population. In addition, scientific researchers will conduct a physical examination on the passengers’ legs and lungs to further understand the distribution of thrombus in human body. If the passenger does not have thrombosis before travel, but a "positive" reaction occurs after returning, then this suggests that symptoms of thrombosis exist in the passenger’s body.

Three “Preventions” for passengers traveling by plane
    Because air travel is comfortable and fast, traveling by plane has become more and more popular in modern times. Therefore, having adequate disease prevention knowledge is increasingly important to the mental and physical health of those traveling by plane. Here are the Three “Preventions" for air passengers:

  1. Prevention of airsickness. Airsickness is caused by a disruption of the body’s balance sensory organs. If you know that you may experience motion sickness when on a plane, you should take the necessary medication 15 minutes before boarding the plane, remain calm and remove distractions while in flight and you will be fine.
  2. Prevention of aero-otitis media. Swallowing and keeping the mouth open are the most effective; while keeping the mouth closed and covering ears are the most taboo actions. It’s may be unsightly to keep the mouth perpetually open or to swallow continuously, even though they offer protection against aero-otitis media. So it is generally recommend chewing gum and candy, which keeps the auditory tube open and pressure reduced, during the flight. Therefore, chewing and eating food is an effective way to prevent aero-otitis media, and is easy and agreeable. If you feel that the symptoms will not go away, you may hold your nose with your thumb and index finger, close your mouth, and forcibly blow out so as to equalize pressure in the middle ear and to relieve the symptoms such as stuffy ears, diplacusis, earache, etc.
  3. To prevent the outbreak of an existing illness. Changes in altitude during taking off and landing, ascent, descent, change of direction, turbulence, as well as the rapid changes in brightness when the plane passes through the clouds may cause the onset of some conditions. Therefore, patients with brain conditions caused by thrombus or hemorrhaging are absolutely prohibited to travel by plane. Patients with severe concussions must be accompanied by a medical specialist and effective precautionary measures must be taken, if air travel is necessary. Patients with a slight concussion should carry pain-killers with them. Elderly passengers with vascular sclerosis may take a small amount of sedatives before boarding the plane. Patients with nasal conditions caused by a bad cold had best delay air travel because eustachian tube obstruction may raise the risk a ruptured ear drum.

What are the benefits of eating candy or snacks on the plane?
    During air travel, airline hostesses may give out candy and snacks to passengers. It not helps kill time, but also helps protect passengers.

As the plane goes higher, the air becomes thinner and the atmospheric pressure drops rapidly. In such cases, you may feel as if your ears are\ blocked, and some people might experience temporary hearing loss and earache. Such symptoms are related to the auditory canal. This canal is a curved and narrow channel linking the middle ear to nasopharynx. The auditory canal is usually closed and temporarily opens when swallowing, yawning, chewing or sneezing. This helps maintain the pressure balance between the middle ear cavity and the atmosphere. The change of air pressure caused by the ascent or descent of the airplane will result in negative air pressure inside middle ear tympanic cavity, which pressurizing the auditory tube and blocks the passage of air into the middle ear. In this case, symptoms such as a blocked ear, tinnitus, fural fullness and hearing loss may happen.

Therefore, if you chew on food, gum or candy while the plane is taking off or landing, the continuous action of chewing and swallowing will cause the auditory tube to open and close continuously. This allows air to freely enter the middle ear cavity, which helps balance the pressure between the middle ear and the ambient atmospheric pressure. In this case, ear discomfort will be alleviated or prevented.

Avoiding airsickness on board
    Human vestibular organs will constantly suffer from pessimal stimulation caused by sudden change in motion during the flight. This will cause the body to react abnormally (including pale skin, fatigue, cold sweat, nausea, sickness, dizziness, and headache) due mainly to vestibular vegetative nerve function disturbance. This is called airsickness.
    The occurrence of this condition is determined by three main factors: acceleration; duration of stimulus to the vestibular organs; endurance capacity of the vestibular organs. Additionally, airsickness can be caused or even worsened by cold, fatigue, insomnia, overeating, an empty stomach, excessive drinking and smoking, gastrointestinal conditions, nervous system dysfunction, emotional distress, long flight times and poor air quality

Prevention and treatment of airsickness:
    Severe airsickness is not common amongst flight crews, but can affect up to 11% of passengers. The key to preventing this condition is to eliminate contributing factors, to improve endurance of vestibular organs and to treat symptoms.

  1. Flight crews will try to ensure a smooth flight by avoiding sudden and rapid acceleration and deceleration.
  2. While in flight, passengers should not be nervous, travel on an empty stomach or overeat, and should not drink or smoke excessively.
  3. The passenger cabin should be kept clean and tidy, and any bad odors should be eliminated.
  4. Sick passengers or those with a tendency to get carsick, should not read or engage in other activities during turbulence or when the plane is inclined, turning, swinging widely, taking off, or landing. It is best to lie on one side in the seat with eyes gently closed to reduce stimulation, to avoid feeling ill or to relieve symptoms.
  5. Passenger with a history of carsickness, seasickness or airsickness, can take 1-2 tablets of dimenhydrinate 30 minutes before take off.
  6. Passengers should get regular exercise, in order to build fitness and to improve the endurance of vestibular organs.
  7. Once airsickness occurs, appropriate medicine should be taken or treatments started to help ease the patient’s discomfort.

Three diet “Don’ts” before boarding
    Some passengers may experience symptoms like dizziness, nausea, heaviness in the chest, flatulence and even sickness during the flight. In fact, these symptoms are most commonly caused by the poor eating habits of passengers, with the exception of a minority of people born with a tendency for “airsickness”. In the majority, their symptoms will disappear by following three “Don'ts” before boarding.

First, do not overeat before boarding or travel on an empty stomach. After the plane reaches a high altitude, gastrointestinal blood supply will be relatively reduced, which will reduce gastric secretion and weaken gastrointestinal peristalsis. This is bad for the digestion of food. Therefore, if you overeat before boarding, the burden on the heart will be increased due to an increased air in stomach. Conversely, it is inappropriate to have an empty stomach because this can induce a hypoglycemic reaction that increases blood sugar consumption, and symptoms like dizziness, nausea and sickness will follow. Further, an empty stomach may worsen true symptoms of “airsickness”. Therefore, before boarding, it is necessary to eat something, but be careful not to overeat.

Second, do not eat too much meat or food that is high in protein. Foods high in fat and protein will stay in the stomach for a long time because they are not easily digested. Generally speaking, these foods need 4 to 5 hours to leave the stomach. Additionally, gastrointestinal digestive function will become weak because the secretion of digestive juices is reduced at a high altitude. Thus, adverse reactions like gastrointestinal dilation, abdomen discomfort, flatulence and hiccups may occur. Therefore, it is better to eat a light meal before boarding.

Third, do not eat food high in insoluble fiber. Under normal circumstances, the human gastrointestinal tract contains 1000 ml of gas; 800 ml of which is swallowed and 200 ml generated upon the digestion of food. As the plane ascends, the atmospheric pressure will decrease, so the gas in the gastrointestinal tract will expand. It has been shown that the volume of gas in the gastrointestinal tract will increase 2 to 4 times at an altitude of 5000 m compared with that on the ground. But today, with the cruising altitude of modern large aircraft typically above 8000m, you can expect even greater expansion of gas in the gastrointestinal tract. Discomfort at high altitudes is likely if passengers consume foods, like beer, soft drinks and radishes that may induce gas before boarding.

Common in-flight ailments
It is common to experience minor ailments when flying. The degree of discomfort can be minimized and your feeling of well being after getting off the plane maximized if you are well prepared. Common in-flight ailments are:

  1. Otalgia and tinnitus: It is likely that most people have experienced these conditions. Try to chew gum or swallow forcibly. If it doesn’t work, try to plug ears with two moist cotton balls, or subsequently try to cover the ears with two cups. In this way, otalgia can be greatly relieved.
  2. Sore throat: Try to drink as much water as possible. In addition, loquat leaf extract, mint and throat-soothing candies should be brought on board. Here is the recipe for a home remedy: Drink boiled water mixed with several drops of white flower oil. This is an effective cure for a sore throat.
  3. Airsickness: Generally speaking, it helps to take motion sickness pills, or to eat prunes and acidic ginger. This is similar to the treatment of carsickness and seasickness. Airsickness often occurs soon after taking off and should disappear after a short while or after the plane reaches a certain altitude. Tips to prevent airsickness: do not eat too much after leaving home or two hours before boarding.
  4. Sore hips and an aching back: Inevitably, soreness will occur in the hips and the feet will become numb if you remain seated with your legs bent for more than ten hours. Relieve these symptoms by regularly standing up to stretch muscles and joints or leaving your seat to walk around.

What can be done for otalgia on the plane?
    As a plane lands, the atmospheric pressure will go up, and may cause severe ear pain. Below are tips to clear plugged ears while on the plane. A cup, a piece of napkin paper and some hot boiled water are needed.

  1. Go to find some paraffin-coated cups and stack them. Get two paper napkins and stuff them into the bottom of the top cup.
  2. Ask an attendant to add hot water and immediately pour out all the water, allowing steam to rise from the cups.
  3. Tilt your head to one side placing your ear near the mouth of the cup. It is important that you do not let hot water fill the ear. Once the water vapors enter the ear, the eustachian tube will open and the pain will be gone.
    Be sure to take care of your ears if you must travel on a plane when you have a cold.

Eating habits on the plane should be scientific
    “Food is the primary necessity of the people.” A healthy diet is the material basis of human survival and reproduction from perspective of human development history. Along with improvement of people’s living standards and continuing nutrition research, people’s concept of a good diet has changed greatly. People are no longer satisfied with adequate amounts of tasty food. Health and nutrition have gradually become the most important values concerning food consumption. In other words priorities have shifted from “what should I eat” to “I should eat well”.

For most people, eating healthy at home is no longer enough. Following a well-balanced diet during all daily activities, including during air travel, is important. Airline meals are provided to passengers and the flight crew. Limited space means that passengers cannot always leave their seat when they wish, and the schedule and content of meals must be fixed by the airline. Scheduled meals include dinner and other meals, snacks, or fruits. There are few food choices provided. Generally, airlines will provide rice or noodles along with meat or fish. Airline meals are served as a combination of separately wrapped portions. These portions may consist of cold cuts, salad, hot dishes, desserts and fruits. Hot meals are basically combination of a staple food and a meat and vegetable dish.

The flight crew must maintain a high level of awareness at all times during the flight. However, they may also be affected by environmental and operational conditions such as acceleration, altitude hypoxia, rapid ascent and descent, and abnormal postures in a high altitude and high speed environment. Likewise, passengers may not have a good appetite when confined to such a small cabin, may dislike the in-flight food choices or may simply have no appetite at all. Therefore, airline meals must meet certain requirements in order to satisfy members of flight crew and passengers. The problem is how an airline meal should be prepared in order to provide the flight crew with sufficient nourishment, to protect their health in the long term, and to help ensure flight safety. It is also important that airline meals be prepared to satisfy passengers and to help relieve their fatigue in cabin. Satisfying the needs of various people is one of the biggest problems in designing airline meals.The flight crew must maintain a high level of awareness at all times during the flight. However, they may also be affected by environmental and operational conditions such as acceleration, altitude hypoxia, rapid ascent and descent, and abnormal postures in a high altitude and high speed environment. Likewise, passengers may not have a good appetite when confined to such a small cabin, may dislike the in-flight food choices or may simply have no appetite at all. Therefore, airline meals must meet certain requirements in order to satisfy members of flight crew and passengers. The problem is how an airline meal should be prepared in order to provide the flight crew with sufficient nourishment, to protect their health in the long term, and to help ensure flight safety. It is also important that airline meals be prepared to satisfy passengers and to help relieve their fatigue in cabin. Satisfying the needs of various people is one of the biggest problems in designing airline meals.

To solve such problems, while presenting new products, all major airline meal companies try to make airline meals more nutritious. They want to innovate and change old concepts, in order to make airline meal more suitable for passengers. Currently, the most common practice is to pair meats and vegetables with foods that are high in protein, and low in fat and cholesterol. Meals are gradually more likely to include coarse cereals, wowotou (steamed corn bread) and corn on the cob. According to the feedback of flight crew and passengers, these meal changes have been successful. However, such changes were simply based on past experience. Creating airline meals according to nutritional principles, to determine the appropriate quantity, adequate weight, reasonable collocation, and overall nutritional value remains a challenge.

Assembling nutritious airline meals requires knowledge from various subjects, including nutriology, nutritional physiology, food chemistry, food technology, food hygiology, etc. Many factors from various areas will be taken into account even in the design stage of nutritious meals. Such considerations will include the quantity and quality of food required by human body, the nutritive value of food, as well as the requisite amount of nutrients and food supply for people of different ages, health, weight activity level, and so on. Taking air personnel as an example, according to a study of the calorie consumption of flight crewmembers, each member of the crew should be supplied with an average of 13020-15120 kJ every day. When not flying, meals should consist of 56% carbohydrates, 30% fat, and 14% protein. When flying the proportion of calories should be adjusted to contain 60%-70% carbohydrates, 20%-25% fat and 12%-14% protein. This adjustment will help mitigate harmful effects of being at high altitudes and will promote endurance of the human body. Moreover, at high altitudes, people should not eat foods rich in fiber that easily generate gas. Airline meal providers must comprehensively take the requirements of the human body and characteristics of specific foods into account when designing a meal. They should pay attention to both the proportion of nutrients, the types of food that satisfy consumers, and the impact of the environment on food consumption needs.

Simply put, the development of nutritious airline meals is focused on proper proportion of calories and nutrients contained in the meal and the choice of ingredients. In the meantime, we should know that the development and design of nutritious airline meals is a long and difficult process that will require significant input of materials, manpower, and money. The effects of this investment will be seen gradually but certain. Many passengers have the impression that airline meals are simply scraped together by some cook. We have reason to believe that the introduction of concepts of nutrition into airline meals will completely freshen previous passenger impressions of airline meals. People will then genuinely appreciate airline meals.

Be cautious of altitude hypoxia during flight
    The atmosphere in which the plane travels is a three thousand kilometer thick layer of air that surrounds the earth surface. For humans, the most important content of air is oxygen, which is essential for normal physiological function and metabolism. A human may live for 5 weeks without food or for 5 days without water, but can only survive for 5 minutes without air. So oxygen is of great importance to the human body.
    Atmospheric pressure, which is the pressure caused by the weight (caused by attraction of gravity) of air, drops as altitude increases. Along with dropping atmospheric pressure, the partial pressure of oxygen also drops. The decrease in atmospheric pressure at high altitudes can cause altitude decompression sickness, while the drop in the partial pressure of oxygen (PO2) can cause altitude anoxia. Altitude hypoxia is one of the main conditions suffered in a high-altitude environment. The so-called altitude anoxia (also called altitude sickness) results from organ malfunction during high-altitude flights as the organs become hypoxic. The drop in air density causes altitude hypoxia rather than the decreasing proportion of oxygen in the air. As the air thins at higher altitudes, the drop in air density and the drop in atmospheric pressure cause the drop in the partial pressure of oxygen, which, in turn, causes a reduction in the amount of oxygen the body takes in addition to hypoxia.

Ⅰ. Impacts on organism functions and symptoms by altitude hypoxia

When the organism suffers from hypoxia, the first system to be affected is the central nervous system; and the second is the cardiovascular system, with corresponding symptoms of lack of energy, apathy, dizziness, nausea, drowsiness, lack of concentration, palpitations, chest tightness, yawning, decreased blood pressure and so on. Altitude hypoxia may be harmful to both the flight crew and passengers.

Ⅱ. Prevention of altitude anoxia

At present, aircrafts used in civil aviation mostly are sealed-body aircraft. Equipment that supplies oxygen to the cabin are the most effective way to prevent and overcome altitude anoxia. However, the prevention of hypoxia problems during flight cannot be guaranteed. Exceptional situations, such as damage to cabin seals, mechanical failure, and failure or malfunction of oxygen supply equipment, may force passengers to deal with problems of hypoxia.

  1. Before taking off and after landing, maintenance personnel should check the onboard oxygen supply equipment and closed pressurization system to make sure they function normally and efficiently. The purity of the oxygen supply should also be checked.
  2. The pilot should know well the various altitudes that may cause hypoxia, the main symptoms of anoxia, how to properly use oxygenating equipment, and methods for dealing with sudden or emergent occurrences of altitude hypoxia.
  3. Increase your level of physical fitness in order to increase your anoxia tolerance. People who remain fit will have a good endurance in oxygen-deficient environment, while those who are unfit will have less endurance. People should avoid factors that may weaken anoxia tolerance, such as smoking, drinking alcohol, being fatigued, insomnia, obesity and so on.
  4. During the flight, passengers should not keep an empty stomach, overeat, or drink alcohol, and should reduce stress. If you experience any discomfort during the flight, remain calm, avoid frequent activity and do not smoke as each of these actions may reduce oxygen consumption.
  5. During the flight, attendants should pay attention to passengers’ expressions and mannerism, especially looking for passengers who may be in distress.

High-altitude radiation and air travel
    Perhaps in the near future, airlines will ask passengers to check the possible radiation levels they may be exposed to during the flight in advance. Professor Robert Parish, the founder of In-flight Radiation Protection Service Co., Ltd., warned that passengers should delay trips when radiation levels increased sharply. Professor Parish pointed out that in general, radiation from the sun won’t cause much harm to people living on the earth, but may be harmful to people traveling by plane in the event of solar storms. Therefore, he advised passengers to check solar activities before deciding on the date of departure.

    Professor Parish asserts that solar storm outbreaks are irregular and estimates that the frequency of outbreaks will reach its peak this year. Radiation levels during solar storms are equivalent to the radiation levels 100-200 times that of a one-hour X-ray fluoroscopy. Such radiation may endanger the health of airplane passengers, especially pregnant women. As for frequent flyers and crew who are regularly exposed to radiation, it could be bad for their health.

    Professor Parish advocates installing radiation monitors on the plane so as to monitor radiation levels during the flight. Perhaps in the near future, more and more people will be aware of the harmful effects of high-altitude radiation.

Regulations for air passengers traveling with infectious disease
    Passengers with infectious disease must go through the following formalities before they taking a commercial flight:
    Passengers with a category A fulminating infectious disease (including plague, cholera and paracholera, and smallpox) are prohibited by the State from taking a civil aviation flight.
    As proscribed by the states, passengers with a category B acute infectious disease (including: relapsing fever, epidemic encephalitis B, typhoid, paratyphoid, scarlatina, epidemic cerebrospinal meningitis, virus hepatitis, anterior poliomyelotis, typhus, anthrax, diphtheria, influenza, tick-borne encephalitis, hydrophobia, measles, pertussis, dysentery, kala-azar, Japanese river fever, hemorrhagic fever, leptospirosis, brucellosis) must possess a certificate issued by a medical institution and apply to the Bureau of Civil Aviation for approval to fly. With the approval of the head of the Bureau of Civil Aviation and in the case of medical or other emergency, the infected passenger may buy their tickets and board the aircraft.
    Passengers with infectious disease must be transported by a chartered cabin or airplane, and the check-in procedures are the same as those of general passengers.

Eight notices for healthy passengers traveling by plane
    Traveling by plane is different from traveling by ship. Besides knowledge that air passengers with health conditions readily impacted by altitude hypoxia, low pressure, rapid acceleration, etc. are not fit to travel; there are also a few concerns for healthy passengers. You can have a more comfortable and enjoyable trip if you have pay attention to and address these issues.

  1. 24 hours before boarding passengers should get adequate rest and avoid overworking and stress. This is especially important for long-distance passengers.
  2. Passengers should pay attention to their food consumption before boarding. It’s best to eat high-calorie foods or beverages such as noodles, rice, dessert, lean meat, fish, etc. that are non-greasy and do not generate excessive gas. It’s best not to eat foods high in fat, grease and cellulose and not to drink alcoholic or carbonated beverages. Also, passengers should not eat too much nor should they eat nothing at all.
  3. Don’t smoke after boarding the plane. Passengers are allowed to bring their own beverages on they plane, but they must be checked before boarding the plane (please note that the aircraft is adequately supplied with beverage to satisfy passenger needs).
  4. Don’t sit for too long! Passengers, especially those on long trips should frequently move their legs to prevent the formation of thrombosis.
  5. It is simple to fasten your safety belt. To ensure your safety during the flight, you should take care to fasten your safety belt, especially during the summer and autumn rainy seasons.
  6. Passengers should pay attention to broadcast instructions during takeoff and landing. When the plane is about to land, passengers should eat candy, drink fluids, or regularly perform a swallowing action to avoid aero-otitis media.
  7. Patients with chronic conditions should take medicine that alleviates symptoms. Passengers above middle age are recommended to take nitroglycerine or nifedipine tablets.
  8. People experiencing physical discomfort are not fit to travel by plane for business, even if they don’t have a fever. People diagnosed with a common cold should only travel after they have recovered. In the spring, infectious diseases are more common, and people with a fever should be more vigilant and go to a health clinic for diagnosis and treatment as soon as possible.

On board health of passengers
    The passengers shall assist the flight attendant in keeping the passenger cabin clean.
    The passenger cabin is the main place for air passengers to rest. The passenger cabin must be kept pristine, comfortable and clean, free of harmful gases, foul smells, electromagnetic radiation, loud noises or intolerable mechanical vibrations. Additionally, the passenger cabin is equipped with survival equipment for rapid escape in the event of emergency and adequate supplies of first aid medicine and equipment. The sanitation and hygiene of the cabin is very important, therefore passenger waste and litter must not be thrown about at random, but be disposed of by the flight attendants in a timely manner.
    In order to take appropriate preventative measures, the captain and chief flight attendant must immediately contact ground personnel at the destination airport if a critical illness occurs on board or if a passenger is found to have an infectious disease.
    In order to ensure the passenger safety and improve the quality of service, severely sick and wounded passengers that must travel must go through check-in procedures in accordance with relevant Civil Aviation Administration regulations.

1. Sick and wounded persons for whom an emergency airlift is absolutely necessary must contact with Civil Aviation Administration in advance. A chartered airplane or air ambulance can be arranged for them, and they must be accompanied by first-aid equipment and medical care personnel.

2. People who have an injury/illness described below are not considered fit for air travel:

  • (1) Conditions that may cause people to harm themselves or others; Patients in critical condition (articulo mortis).
    Infectious diseases and dermatosis that may cause discomfort to others;
    Women who are over 36 weeks pregnant;
    Psychotic patients with behavioral disorders.
  • Diseases easily influenced by altitude hypoxia:
    Severe anemia;
    Myocardial infarction, congestive heart failure, cor pulmonale;
    Severe hypertension, intracranial hypertension, patients who have had cerebrovascular accident;
    Epilepsy that is difficult to control, severe asthma and bronchiectasis, acute pulmonary edema.
  • (3) Diseases easily leading to distension of body cavity due to decreased air pressure; People who have had
    gastrointestinal operation and thoracic surgery less than 20 days prior.
    Cavernous pulmonary tuberculosis;
    Patients with bleeding peptic ulcers;
    Intestinal obstruction;
    Patients with serious tympanitis and paranasal sinusitis.
  • The relevant personnel of civil aviation are entitled to refuse to carry patients with critical illnesses that they judge not fit to travel by plane.

    What factors should passengers consider when eating before boarding the plane?

    Don’t eat and drink too much. Because this may not only cause indigestion and aggravate the stomach, but may also cause nausea and sickness since the food may generate a lot of intestinal gas in a low pressure environment.

    Avoid eating greasy foods and foods that contain too much animal protein, such as fatty meat. These foods may cause flatulence at high altitudes, aggravating indigestion.Foods that contain too much cellulose and easily generate intestinal gas should be avoided. Examples include soybeans, peas, radishes, chives, and celery. Carbonated beverages should also be avoided so as to not aggravate feelings of tension in the chest and abdominal distention.

    The following foods are advised to be eaten before boarding the plane: bread, noodles, yoghurt, green vegetables, lean meat, sweets, chocolate, fruit, honey, fruit powder, etc.

Travel health tips
    Traveling through mountains and along rivers, and sea and land tours can cause tremendous fatigue. This, coupled with an irregular diet, persistent exposure to the sun and wind while outdoors, can harm human health—especially the skin. So it is necessary to take necessary precautions to properly protect the skin while traveling.

  • Ⅰ. Drink plenty of water during the trip. Water not only helps the skin maintain moisture, but also supplies essential nutrients to the skin. It is often difficult to eat regular meals while traveling; as a result, the skin may suffer from insufficient nutrition in addition to weather damage. Generally speaking, eating more fruit is helpful and convenient. There are all kinds of fruits that can be found in orchards like peaches, apricots, and plums. Wild fruits are generally more nutritious than those bought in the supermarket.
  • Ⅱ. Massage your face frequently during your trip. While a passenger in a car or during short breaks, you may close your eyes to get some rest and you can use this time to gently massage your face with your hands. In this way, blood flow to your face will be accelerated and the supply of nutrients will be increased; both of which will help restore elasticity and a healthy appearance.
  • Ⅲ. Wash your face with mountain spring water during the trip. Places with mountain springs can often be found while traveling. Crystal-clear mountain water is natural mineral water, which can supplement the bottled drinking water you carry. Mountain water, because it is less polluted and contains many minerals, can beautify your skin if you wash your face with it. In addition, mountain water can help protect skin from wrinkles and chapping while keeping it soft and clear. Keep in mind that in order to avoid skin discoloration due to the deposit of pigments, you should not use perfume when you go out in the sun.
  • Ⅳ. Avoid dermatitis. Skin is always exposed to the elements while traveling; as a result, sunshine, cold, heat, moisture and insects may irritate the skin. The skin, needing some time to adapt to new surroundings, may often become inflamed. It may be helpful to take a shower several times a day, especially on relatively hot days. Use soap when showering and take care to clean the skin—pay special to skin creases and underneath fingernails and toenails. Gently dry yourself and put on clothes that are dry and clean. In addition, some kinds of skin conditions (acne, oral herpes, leg ulcers, rosacea etc.) will get worse at the beginning of the trip, while others like psoriasis will get better due to exposure to the sun. It is important to be aware that other skin conditions, like contact eczema, may be caused by contact with some forms of vegetation and untreated wood (mahogany, ebony, teak, etc. ) used to make jewelry or other items.
  • Ⅴ. Wash your hands frequently, and do not touch wild, stray, or unfamiliar animals. This is the key to prevent the spread of infections that may cause intestinal problems. Be especially careful not approach wild or stray animals, or even household pets in endemic areas where rabies and parasitic diseases such as echinococcosis are known to exist.

Fifteen Travel “Don’ts”
    Along with improving living standards, people have begun to pay more attention to enjoying life, as a result, leisure traveling is increasingly popular. But among those who travel on holiday, some do not enjoy the experience due to insufficient trip preparation. So, what kinds of things should be paid attention to while traveling?

  1. Do not rush while on tour. The purpose of a vacation is to find pleasure in both body and mind and to expand your awareness. So, the significance of travel will be lost if you do not enjoy the local environment of each place you visit.
  2. Do not over pack. Taking too much luggage is meaningless and is a burden while traveling. It is neither convenient to take them with you on daily excursions, nor is it safe to leave them in the hotel. Therefore, a big pack with essentials will be enough.
  3. Do not cause trouble. Your destinations are not on your “turf”, so it is best to restrain yourself, the use of force and your arrogance.
  4. Do not go out alone. It’s best not to go out alone, especially if you are traveling with a group of people. Try to always have at least two or three companions.
  5. Do not lose track of your money. Take care by always keeping an eye on it or leaving it in a secure place.
  6. Do not take children. Children must be looked after all the times, which will prevent adults from completely enjoying the pleasure that comes along with travel. Therefore, it may be best not bring children along.
  7. Do not remain unfamiliar with your surroundings. Please buy a map as you reach each destination. You can either keep it for use in an emergency, when lost or as a memento.
  8. Do not travel alone. It is best to travel with friends, especially when traveling long distances Traveling with friends will not only be more fun, but you can also take care of each other.
  9. Do not travel without a purpose. Some people have neither a destination nor plan in mind and may be content to stop at a random destination they reach along the way. This kind of travel with money and without purpose is a waste of both time and energy, and may impact the health of body and mind.
  10. Do not rush to take cars and boats. Away from home, safety must be the top priority.
  11. Do not eat and drink too much. Some travelers do not eat properly while traveling. They may eat too much delicious food while not eating any foods that are not to their liking. Such behavior is not advisable. At the same time, pay attention to food hygiene in order to prevent intestinal discomfort and diarrhea during the trip.
  12. Do not scratch, write, paint or otherwise mark on any scenic spots. Graffiti both damages historic sites and is uncivilized. Please refrain from defacing any landmarks.
  13. Do not use bad language. Civilized and polite behaviors are required constantly while on travel. Never use bad language or argue with someone else. This will help maintain a pleasant relationship between you and your companions.
  14. Do not make friends too readily. Be cautious with strangers to avoid being cheated.
  15. Do not carry important documents or valuable items. Beware of the serious consequences caused by handing over official documents and having things stolen.

What kinds of passengers are unfit for air travel?
    Along with economic development, the frequency of international air travel of Chinese citizens is gradually increasing each year. However, some people may worry that they are not physically fit enough for air travel. So which passengers are unfit for air travel? According to medical recommendations, pregnant women, old people and children are unfit for air travel. But, experts point out that woman less than 36 weeks pregnant may travel by plane as long as they have been examined and cleared by a doctor. It is also recommended that leg exercise be done throughout the flight in order to maintain good blood circulation. Also, they should always keep their seatbelts fastened.

    As for the elderly, they may, by all means, travel by plane if they do not suffer from cardiovascular diseases such as hypertension and heart disease. Medical experts state that elderly passengers with these diseases are fit for air travel if they can comfortably climb a flight of stairs. However, a medical examination is still recommended. Meanwhile, ask the doctor how to best handle time difference problems when taking medicines.

    In addition, passengers who have recently undergone surgery, on areas such as the eye, or have a hemorrhagic gastric ulcer and/or tympanitis are also unfit for air travel. Experts point out that because the rates of recovery after surgery vary significantly, it is best to avoid flying out of caution. Tympanitis patients are also unfit for travel because they are more likely to suffer from airsickness. A medical assessment by a doctor is necessary for patients who wish to travel by air after surgery.

    High-altitude low-oxygen environments are not suitable for infants. Many airlines require that an infant not be permitted to board a plane before they are 14 days old because their lungs may be unable to adapt to the conditions. Also, the middle ears and Eustachian tubes of toddlers may be quite sensitive. Toddlers who are less sensitive may have some ear discomfort while those who are more sensitive may easily get airsick. To ease their child’s discomfort, parents should help their toddler to try to blow out or swallow while holding their nose and mouth closed.

Are you fit for air travel?
Special groups

Pregnant women: women less than 36 weeks pregnant may travel by plane after receiving a check up from their doctor. During the flight, pregnant women should do regular leg exercises in order to promote blood circulation. Meanwhile, keeping the safety belt fastened (around the lower abdomen) is recommended in order to avoid placental abruption caused by turbulence.

Women who are more than 36 weeks pregnant when traveling by air are more likely to suffer premature labor due to pressure changes and turbulence. Moreover, suitable conditions for delivering a baby do not exist on the plane. In order to ensure the safety of the mother and baby, the majority of airlines now prohibit women who are more than 36 weeks pregnant to board the aircraft.

Infants: Many airlines prohibit an infant less than 14 days old from boarding a plane. This practice helps avoid health problems to any tissues and organs that are unable to adapt to pressure changes. It is recommended that infants older than 14 days old suck on a bottle or pacifier during landing in order to keep its eustachium open and prevent tympana barotrauma. Parents can guide their toddler to try to blow out or swallow while holding the nose and mouth closed in order to relieve any ear discomfort.

The elderly: Before boarding a plane, it is necessary for elderly persons (especially if sick) to undergo a physical examination, and to consult with the doctor on how to prevent accidental injury during the flight. According to general standards, a patient with heart problems may travel by plane as long as he/she does not feel uncomfortable after climbing a flight of stairs. In any case, all medicines should be prepared in advance and taken as scheduled. In the event of an accident, an elderly person should prepare a letter in advance and carry it with them at all times. The letter should make note of any physical conditions, necessary medicines and contact information for family members. It is more difficult for old people to adapt to time differences, so they should be sure to get sufficient rest in order to better adapt to new rhythms. During the flight, elderly passengers should do as much physical exercise as much as possible in order to avoid edema or thrombosis of the lower extremities. But, the exercises should be done slowly in order to avoid postural hypotension and consequently cause syncope.

All passengers

Mental stress: Some passengers may grow stressed on their first flight. How to prevent such stress? Psychologists suggest: First, relax in a comfortable position by leaning the chair back, putting your hands on the armrests, relaxing your eyes, clearing your mind, breathing slowly and relaxing your muscles; second, reduce the degree of anxiety by shifting your attention by talking with other passengers, reading, listening to music, watching videos and observing people and things around you etc. In this way, mental stress will be alleviated as the amount of anxiety is reduced.

Other discomforts: Healthy air passengers may also experience physical discomfort such as thirst, dehydrated skin, swelling of the legs and feet, dry eyes, gastrointestinal discomfort, ear pain, and airsickness. Here, methods to cope with such discomfort are listed:
During a long flight, it is advised that passengers drink plenty of water, do leg exercises and do not wear contact lenses. Before boarding, passengers should eat a light snack that will not cause flatulence. To relieve ear discomfort caused by pressure changes during the flight, passengers can hold their nose and mouth closed while trying to blow out, swallowing, chewing gum or other methods. Passengers should stretch at regular intervals if safety conditions allow, or should take medicine to prevent airsickness. In the event that you begin to feel dizzy, you should not turn your head. Instead, you should lower your seat back and close your eyes to rest for a while.

People with the following diseases are not considered fit for air travel:

    Patients suffering from a cardiovascular disease, such as severe heart failure, myocarditis with the past month, myocardial infarction within the past six weeks, recent angina pectoris, acute arrhythmia cordis, hypertension with acute complications, pulmonary heart disease, and acute valvular heart disease.

Patients with respiratory diseases, such as acute asthma, open pulmonary tuberculosis, pulmonary emphysema, or pneumonia, and patients who have had thoracic surgery within the past three weeks.

Patients with gastrointestinal diseases, such as bleeding peptic ulcers, varices of esophagus or acute gastroenteritis, and patients who have had an abdominal operation within the past two weeks.

Patients with diseases of the sensory organs, such as acute otitis media with obstruction of auditory tube, and acute nasosinusitis with ventilatory disorder of nasal cavity, as well as patients who have had an ophthalmologic operation or otorhinolaryngological operation within the past two weeks.

Patients with diseases of hematopoietic system, such as severe anemia.

Patients suffering from brain conditions, nervous disorders or psychoses, such as coma or abnormal respiration due to craniocerebral injury, encephalitis, intracranial tumors, manic psychosis, and frequent or recent epileptic seizures; and patients who have had cerebrovascular injury within the past two weeks and an intracranial operation within the past three weeks.

Patients with obstetric conditions, such as pre-eclampsia, and a known possibility of miscarriage.

Others: Patients with severe diabetes, required to be under quarantine, and symptoms of hemoptysis, hematemesis and suffer symptoms of moaning.

Travel beauty tips for long-haul flights.

    Staying in the cabin for three to four hours is not problematic. Remaining in-flight for longer than ten hours may be less comfortable.

To maintain a healthy appearance after getting off the plane, it is recommended to take extra care of your body and skin.

  1. Make sure you get enough sleep the night before departure. It is incorrect to think that staying up late the night before a flight and sleeping during the flight will help you adjust to any time difference. There are more effective ways to use time, so there is no need to subject yourself to such a routine.
  2. Only wear light make-up as the light in the cabin is dim and no one will notice your heavy make-up. Moreover, it is not good to wear a thick coat of makeup on your face for longer than ten hours.
  3. Before boarding, it’s best to clean your skin thoroughly.
  4. Carry with you basic cosmetics, such as eyebrow pencil, face powder, and lipstick in order to touch-up your makeup before getting off the plane. Doing so will adequately enhance your appearance after getting off the plane.
  5. Travel with an eye cover and eye drops. The eye cover can help your sleep on the plane by keeping the light from disturbing you. The eye drops will help relieve eyes that are bloodshot due to lack of sleep.
  6. Keep your skin moisturized. This can be achieved by drinking plenty of water and by using skin care products that have a water replenishing effect.

Carry comfortable clothes

1. Wearing trousers is more practical than wearing a skirt. Due to the limited space available on the plane, nearly everything, with the exception of the lavatory, will be done in your seat. Because you cannot be constantly aware of how you appear to other passengers, especially when asleep, wearing trousers will help prevent embarrassment.

2. Clothing and accessories should be simple and not overly ornate. Don’t wear too much jewelry that will attract a thief’s attention and distract and make trouble for you at the same time. Don’t wear revealing clothes that are cut too low or too high and expose the midriff and back. Not only could this cause you to catch a cold, but it may also attract unwanted attention. Clothes made of cotton are better than clothes made of fabrics, like silk, which wrinkle easily. Additionally, a loose sweater and pants will make you feel more comfortable. Finally, carry a pair of slippers or comfortable sandals to wear on the plane.

Simple ways to prevent airborne diseases

Thanks to the expansion and development of the airline industry, international travel and tourism are increasingly convenient. More and more people enjoy quick and comfortable transportation that begins in the morning and is completed by evening. How can you protect your health, cope with unexpected situations and make your journey more comfortable and safe when you are in a small cabin more than ten thousand meters above the ground? Here is some advice from the experts:

To protect passenger safety and health, it is most important to understand the factors influencing air safety and passenger health. First, we’ll consider factors that impact the inflight environment. The layer of air surrounding the earth is called the atmosphere, and is generally referred to as “air”. The atmosphere satisfies the physiological requirements of humans and other creatures, by helping to protect and support life.

The atypical air conditions within at the cabin can affect passenger safety and health. For example, lower atmospheric pressure and partial pressure of oxygen when in-flight can cause anoxia, flatulence, aeremia, ebullism, rapid depressurization, barotraumas etc.

Barotrauma is an injury caused by pressure changes during ascent or descent and is the most common disease among passengers traveling by plane. Aero-otitis media (otitic barotrauma), mainly caused by excessive take off and landing speeds or by restriction or obstruction of the eustachian tube accompanying upper respiratory infections, are of particular concern. To prevent barotrauma, learn the following two methods for clearing the eustachian tubes. 1. The Valsalva method can be used when the plane is descending. Close your mouth and use your thumb and forefinger to hold your nose closed while trying to force air out of your nasal, laryngeal and pharyngeal cavities. This process increases the air pressure inside these cavities and helps open the eustachian tubes. 2. The Politzer method is to swallow saliva or chew on a piece of gum or candy. 3. Passengers who have a cold or who suffer from an acute upper respiratory infection should go to a hospital and receive treatment without delay. It is best to travel by plane after the symptoms have been resolved.

Aerosinusitis (also called barosinusitis, sinus squeeze or sinus barotrauma): During descent, when the sinus cavity is under negative pressure; an embolus can easily obstruct the paranasal sinus cavities, causing an imbalance of pressure inside and outside pressure the cavity causing a barotrauma. The passenger will feel a cutting or stabbing pain in the frontal sinus cavities and may suffer symptoms like swelling of the eyes, teary eyes, and bloody mucus from the nasal cavity. To prevent this condition, passengers should: 1. Apply Naphazoline to the nose. 2. Massage the head or temples and Hegu acupoint between the thumb and forefinger.

Aerodontalgia is a rare condition. Acute inflammation can cause a sharp stabbing pain in the teeth that may last for several seconds. Chronic inflammation can cause a dull pain that can last for longer periods of time. As the plane is descending or after landing, such pain should disappear. Prevention methods include: taking anodyne and Saridon for patients with odontopathy and acupuncture or massage of the Hegu, Chia Ch'e, or pain points to relieve the toothache.

Pregnant women traveling by plane should be careful.
The main factors affecting a pregnant women’s health inflight include low atmospheric pressure, hypoxia, the small and narrow space inside cabin, etc. Normally, there is no limit placed on healthy pregnant women who wish to fly during the first eight months of pregnancy. However, in the interest of prudence, airline personnel and travel agents generally inquire as to the expected due date when selling plane tickets to pregnant women. Except in special circumstances, plane tickets will not be sold to pregnant women who are more than eight months pregnant. In such circumstances, if a woman more than eight months pregnant must travel by air, a certificate of examination signed by the doctor and sealed by the medical institution must be submitted for verification, in duplicate, within 72 hours of boarding. Such certificates must include the name and age of the mother, the approximate dates of conception and birth, permissible flying distances and dates, as well as a description of the mother’s fitness for air travel and any special accommodations required, etc. Additionally, the Special Passenger Request for Carriage-Handling Advice form must be filled out in duplicate. The pregnant woman may then buy her ticket and board the plane with the carrier’s consent.

Sun-block is important particularly on flight
The inflight air pressure, dryness and strong ultraviolet light are harmful to your skin. If you take time during your flight to care for your skin and to get sufficient rest, you can help preserve the health of your skin.

The overnight packs provided in the first and business class cabins usually contain some basic skin care products, such as lotion, moisturizing toner, lip balms, etc. that are suitable for most people. Of course, the brand and scent of the provided are not likely to satisfy everyone. Only those skin care products capable of fighting the effects of low air pressure at more than ten thousand meters, low humidity and ultraviolet light, can be qualified as the beauty shield during flight.

During flight, skin often feels dry because of the low humidity in the cabin. This is also why we often feel thirsty when traveling by plane. You can clean your face in plane lavatory and also clear your mind. A moisturizing toner can keep your skin cool and moist, and is a suitable item to carry onboard.

Another important part of skin care on a flight is to relieve the effects of low air pressure. There is an Australian skin care product made from refined ginger that is said to have a particular soothing effect. Just a little of such a product applied to the temples or arteries can relieve the effects of low air pressure at high altitudes.

Sunblock is an important part of in-flight skin care. Without the protection of a cloud layer and the terrain, ultraviolet light at such an altitude is more dangerous than that on the ground. Therefore, it is necessary to bring a protective face cream, eye cream and lip balm with UV-resistant ingredients and Vitamin E.

It is advised that you wash your face as soon as you board the plane, blend a sunscreen and moisturizer together and apply the mixture to your face. Just before getting off the plane, you should use a sponge to first apply a bit of firming lotion to your face and then apply a layer of day cream.

During flight, make sure your hand luggage does not contain any dangerous cosmetics, such as bottled perfume sealed by a plug, nail polish, etc.