Fliers' Survival Guide for Airports, Planes

Taking some simple precautions can help ensure a safe and healthy arrival.

From the WebMD Archives

'Tis the season for spending time with family and friends, and that can involve air travel.

The travel season kicks off with Thanksgiving and continues through the New Year. This means security hassles, including possible health risks from the new full-body scanners, as well as the not-all-that-remote possibility of catching a cold or flu while flying the friendly skies.

Fear not. Here are expert tips for healthy flying, starting at the airport.

Scanners and Pat-Downs

There have been many changes to the airport and airline security process since the Sept. 11, 2001 terrorist attacks. Although these measures are for our own protection, some people worry that they bring a new element of risk into the equation.

Full-body back scatter X-ray scanners are generating a lot of controversy because of the radiation that they emit. The Transportation Security Administration and Department of Homeland Security maintain that these scanners emit safe levels of radiation, but others are not so sure there is a such thing -- especially for frequent fliers.

"If you travel a lot, you may not want to go through them and may want to opt for pat-down instead," says Brenda Powell, MD, a travel medicine expert at the Cleveland Clinic in Ohio. The alternative to these so-called "strip-search" screenings is known as an "enhanced" pat-down.

No-Shoes Zone

Another safeguard was born after "shoe bomber" Richard Reid attempted to hide explosives in his shoes on a U.S.-bound plane in December 2001.

Now, fliers must take off their shoes at security in U.S. airports and send them through the X-ray machine to be screened. That's a lot of shoeless feet right where you're about to tread.

"Make sure you wear socks," says Michael Zimring, MD, director of the Center for Wilderness and Travel Medicine at Mercy Medical Center in Baltimore.

"If your feet are sweaty, you can get a bacterial or fungal infection," Zimring says. "The floor is dirty and people are walking all over it. Who knows what is on there?"

It's Germy Up There

The holidays coincide with the yearly cold and flu season, and a widely quoted study in the Journal of Environmental Health Research suggests you may be up to 100 times more likely to catch a cold on a plane than you are in your normal day-to-day-life.

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To lower your risk, don't touch the doorknob on the airplane bathroom. "Take a paper towel, and grab the door knob to get out," he says. Also avoid grabbing onto seats when walking through the plane. If you must take hold to steady yourself, use hand sanitizer as soon as you return to your seat.

"On the airplane, we are constantly touching stuff that hundreds of other people are touching, and a cold virus can live on an inanimate object for quite a while," Powell says.

Transmission can occur quickly and innocently by touching a faucet in the bathroom, and then touching your mouth or eyes. If you are the sick passenger, cough into your elbow just like they teach schoolchildren to do. "You don’t want the virus on your hand," Powell says.

Boost Your Defenses

Holiday flights are often packed, so switching seats is not always an option. This means if your neighbor has a cold or flu, you may be out of luck. "If someone is coughing and sneezing within three seats in any direction, you may get infected," Powell says.

So does that mean you are definitely going to catch it? Not necessarily. The best offense is always a good defense, Powell says.

Use saline nasal spray before and after the flight. "The plane air is so dry and that dries out your mucus membranes, which reduces your resistance to infection, but keeping these membranes moist with saline spray may help."

A Neti pot -- a ceramic pot that uses a salt water solution to flush out the nasal cavity -- can also rinse out viruses and pollen after a flight. Supplements of vitamin C may boost your immune system.

Seeing another passenger wearing a face mask may cause some alarm, but in other countries, people have no qualms about wearing a mask in public. "This can offer some protection for other passengers if you are sick, or for you if other passengers are ill."

BYOP (Bring Your Own Pillow)

Gone are the days when airlines would give weary travelers blankets and pillows for free.

That is a good thing as far as germs are concerned. Instead of buying a blanket or pillow on the plane, bring your own and the same holds for headphones, Zimring says. This eliminates the yuck factor.

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Stay Hydrated

The air on the plane is very dry, so it is important to stay hydrated by drinking a lot of water. The benefits are exponential. "This also will assure that you get up and pee," Zimring says.



"Moving your legs by walking to and from the bathroom can help prevent 'economy class syndrome,' also known as deep venous thrombosis (DVT) or blood clots in your legs that develop after long flights," says Zimring, who wrote Healthy Travel: Don't Travel Without It. Remember to buy the water after you pass through security or risk confiscation.

Drinking water can help prevent DVT, but if you are at high risk for these blood clots, other precautions are needed.

"If you are over 60, obese, pregnant, have a history of heart disease, have had surgery on a lower extremity within the last several weeks, have varicose veins, or a history of these blood clots, see your doctor or a travel doctor, especially if the flight is longer than two hours," Zimring says.

Compression hose may help reduce your risk of DVT while you fly. "Exercises, such as keeping your feet flat on the ground and bringing your heel up and down, can also improve circulation," Zimring says.

You should also skip the mile-high happy hour. It's best to avoid excessive alcohol and caffeine while flying. "Alcohol is dehydrating and so is caffeine and so is the air on the plane," Zimring says. "You are better off drinking plain water."

Manage Motion Sickness

Motion sickness can happen, and most planes still provide air-sickness bags in seat pockets. Some over-the-counter motion sickness products can help, Powell says. Ginger supplements or ginger ale may also help prevent nausea.

"Take these before you start feeling sick," Powell says. "Don't eat a heavy or spicy meal before you fly."

The more turbulent the flight, the greater your risk of feeling ill. Motion sickness occurs when there is a disconnect between what your body is feeling and what your eyes are seeing. Keeping your eyes on the horizon may help.

Most planes no longer provide free meals, but many do offer snacks. "Pick up a plain turkey or vegetable sandwich," Zimring says. "This way you know you will have a decent meal instead of the junk they serve you or you can buy." Healthy eating also helps prevent motion sickness.

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Chew Gum

The uncomfortable feeling of clogged or popping ears when flying occurs because of changes in air pressure and altitude that cause a swelling of your Eustachian tubes.

"Try yawning, chewing gum, or gently holding your nose and blowing," Powell says.

Using over-the-counter decongestants, whether pills or nasal sprays, before a flight can also help unclog your ears.

Reset Your Internal Clock ASAP

Jet lag can ruin an otherwise happy holiday vacation. "When you arrive, get right on the new time zone as quickly as you can," Powell says. "If it's bedtime, try to go to bed, and if it's daytime, try to stay awake."

Supplements of the hormone melatonin may help with jet lag by regulating sleep and wake cycles. "Take it before bed," Powell says.



High Anxiety

All of the focus on terrorist attacks has increased anxiety about flying, says Tara Brass, MD, a psychiatrist in Manhattan and Scarsdale, N.Y. "People's level of anxiety has increased since Sept, 11, and this is largely a result of media attention on airplane safety," she says.

If you are an anxious flyer, "fly with somebody you are comfortable with who doesn't share your anxiety," Brass says.

Tune out the background noise with music. "Normal plane noises such as the sound the engine makes after takeoff or before landing can be anxiety-provoking," Brass says. "Bring music to drown it out, listen to in-flight entertainment, or read a trashy magazine for distraction," she says.

If you are traveling alone, tell your neighbor that you are a nervous flier.

"Talk to people around you, and say ' I am afraid of flying, and I may grab your hand," Brass says. But not everyone is up for conversation or hand-holding on your flight, so be respectful of your seatmate's boundaries.

Other tips include always flying direct (to avoid multiple take-off and landings) and not booking early morning or red-eye flights. "Being tired can increase your risk of anxiety," Brass says.

If your fear of flying is paralyzing and interfering with your life, talk to a doctor about medication or a short course of cognitive-behavioral therapy to help change your thought process.

If you follow all of this advice, "you will definitely decrease your odds of getting sick, and increase your odds for a happy holiday visit," Zimring says.

WebMD Feature Reviewed by Laura J. Martin, MD on November 17, 2010

Sources

SOURCES:

Michael Zimring, MD, director, Center for Wilderness and Travel Medicine, Mercy Medical Center, Baltimore.

Brenda Powell, MD, travel medicine expert, Cleveland Clinic, Cleveland, Ohio.

Tara Brass, MD, psychiatrist, New York.

Hocking, M. Journal of Environmental Health Research, April 2004; vol 3.

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