Tag: air travel

Categories : Respiratory DiseasesTags :

Aircraft and Hospital Air Is Cleaner than You Might Think

On By ModernMedia

First study to use worn face masks as a passive tool to monitor indoor air

Photo by Daniel Eledut on Unsplash

According to a new Northwestern University study, the ambient air on aeroplanes and in hospitals mostly contains harmless microbes typically associated with human skin.

In the first study of its kind, scientists used an unexpected sampling tool – used face masks and an aircraft air filter – to uncover the invisible world of microbes floating in our shared air. Their results revealed that the same types of harmless, human-associated bacteria dominate both aeroplane and hospital air.

Across all samples, the team detected 407 distinct microbial species, including common skin bacteria and environmental microbes. While a few potentially pathogenic microbes did appear, they were in extremely low abundance and without signs of active infection.

Not only does the study help illuminate what microbes exist in shared air, but it also demonstrates that face masks and air filters can be repurposed as non-invasive, cost-effective tools to monitor confined, high-traffic environments.

“We realized that we could use face masks as a cheap, easy air-sampling device for personal exposures and general exposures,” said Northwestern’s Erica M. Hartmann, who led the study. “We extracted DNA from those masks and examined the types of bacteria found there. Somewhat unsurprisingly, the bacteria were the types that we would typically associate with indoor air. Indoor air looks like indoor air, which also looks like human skin.”

An expert on indoor microbiomes, Hartmann is an associate professor of civil and environmental engineering at Northwestern’s McCormick School of Engineering.

A second life for used face masks

Hartmann and her team conceived the project in January 2022, amid the COVID-19 pandemic. At the time, travellers became increasingly concerned with how well aircraft cabins filtered and circulated air. Hartmann received a grant to collect aircraft cabin filters to look for evidence of pathogens.

Although Hartmann did procure an aircraft’s high-efficiency particulate air (HEPA) filter, which had been used for more than 8000 flight hours, she quickly realised the project might be impractical.

“At the time, there was a serious concern about Covid transmission on planes,” Hartmann said. “HEPA filters on planes filter the air with incredibly high efficiency, so we thought it would be a great way to capture everything in the air. But these filters are not like the filters in our cars or homes. They cost thousands of dollars and, in order to remove them, workers have to pull the airplane out of service for maintenance. This obviously costs an incredible amount of money, and that was eye opening.”

Searching for another method that passively traps microbes, Hartmann and her team pivoted to a much cheaper and much less disruptive tool: face masks. For the study, volunteers wore face masks on both domestic and international flights. After landing, they put the masks into sterile bags and sent them to Hartmann’s lab. For comparison, Hartmann also collected face masks that volunteers took on flights but never wore.

To understand how indoor environments differ, Hartmann and her team wanted to examine another high-traffic, enclosed environment with heavily filtered air. The team selected hospitals as the second testbed. After wearing a face mask during a shift, hospital workers submitted their masks to Hartmann’s lab.

“As a comparison group, we thought about another population of people who were likely wearing masks anyway,” Hartmann said. “We landed on health care providers.”

The sky is clear

After receiving masks from travellers and health care workers, Hartmann’s team collected DNA from the outsides of masks. They found the air in hospitals and in aircraft contains a diverse but mostly harmless mix of microbes, with only minimal traces of potentially pathogenic species.

In both environments, common human-associated bacteria – especially those found on skin and in indoor air – dominated the samples. Although the abundance of each microbe present was slightly different, the microbial communities from hospitals and aeroplanes were highly similar. The overlap suggests that people themselves – rather than the specific environment – are the main source of airborne microbes in both settings. And those microbes floating around indoor air come from people’s skin, not from illness.

Hartmann’s team also identified a handful of antibiotic resistance genes, linked to major classes of antibiotics. While these genes do not indicate the presence of dangerous microbes in the air, they highlight how widespread antibiotic resistance has become.

Although indoor air might not be as harmful as some people may have feared, Hartmann emphasises that airborne spread is just one way infections can travel. For many common illnesses, other routes – such as direct contact with an infected individual or interacting with high-touch surfaces – are far more important.

“For this study, we solely looked at what’s in the air,” Hartmann said. “Hand hygiene remains an effective way to prevent diseases transmission from surfaces. We were interested in what people are exposed to via air, even if they are washing their hands.”

The study, published in the journal Microbiome, was supported by the Walder Foundation.

Source: Northwestern University

Categories : Emergency MedicineTags :

Is There a Doctor on Board? New Research Reveals the Frequency of In-Flight Medical Emergencies

On By ModernMedia

The study is the largest global analysis of in-flight medical events

Photo by Daniel Eledut on Unsplash

 With nearly five billion people flying each year, medical emergencies in the air may be more common than most realise and they can be deadly.

A new study led by Duke Health researchers analysed more than 77, 00 in-flight medical events reported to the world’s busiest airline medical support centre. The findings show that while most incidents are minor, thousands of passengers required hospital care after landing, and hundreds died or triggered aircraft diversions.

The study, published in JAMA Network Open, was conducted in partnership with MedAire, an aviation and maritime health and safety solutions company, which also provided the data for analysis. The paper offers a rare look into how airlines respond to medical crises and why some flights are forced to divert.

“This is the largest and most comprehensive study of in-flight medical emergencies ever conducted,” said Alexandre Rotta, MD, senior and corresponding author of the paper and chief of the Division of Pediatric Critical Care Medicine with the Department of Pediatrics at Duke University School of Medicine.

“It gives us a real-world snapshot of what happens when someone gets sick in the sky and how starkly the options differ from those in a hospital,” Rotta said.

Researchers reviewed medical calls from 84 airlines across six continents, covering over 3.1 billion passenger boardings between January 2022 and December 2023.

They found that one in every 212 flights involved a medical emergency. Of those flights, about 8% of passengers were taken to the hospital after landing, and 1.7% of the total medical events were so serious they caused the plane to divert.

The most common reasons for diversion were suspected strokes, seizures, chest pain, and altered mental status. Cardiac arrest occurred in 293 cases, with survival rates far lower than on land.

Medical volunteers (often physicians) assisted in nearly one-third of emergencies. Their involvement was linked to a higher likelihood of diversion, likely because they were called upon during more serious events.

“It’s humbling to practice medicine in the air,” said Rotta, who became interested in the topic after being called upon as medical volunteer during several flights. “You’re working with limited equipment, no lab tests and no backup. Even minor issues can become major challenges.”

Rotta emphasised that airlines are generally well-prepared, especially in the US, where regulations require defibrillators and basic medical kits. However, he noted that not all airlines partner with ground-based medical support centres, an approach he believes is essential.

“Airplanes aren’t hospitals, and we shouldn’t expect them to be,” he said. “But having expert guidance from the ground can make all the difference when someone’s life is at risk.”

The findings could help shape airline policies, improve crew training and inform passengers with chronic conditions about how to prepare for travel.

Source: Duke University

Categories : Environmental EffectsTags :

People Near Airports Likely to Suffer from Shorter Sleep

On By ModernMedia
Photo by Daniel Eledut on Unsplash

A new study published in the journal Environmental Health Perspectives has found that people who were exposed to even moderate levels of aircraft noise were less likely to receive the minimum recommended amount of sleep each night, and this risk increased among people living near a major cargo airport, or near a large water body, and among people with no hearing loss.

A new analysis by Boston University School of Public Health (BUSPH) and Oregon State University has found that exposure to even moderate levels of airplane noise may disrupt sleep, building upon a growing body of research on the adverse health effects of environmental noise.

The study found that people who were exposed to airplane noise at levels as low as 45dB were more likely to sleep less than 7 hours per night. For comparison, the sound of a whisper is 30dB, a library setting is 40dB, and a typical conversation at home is 50dB.

Sleep is essential to overall health and well-being, including daily physical and mental functioning, and a lack of adequate sleep can lead to increased risks of cardiovascular disease, depression, diabetes, cancer, and numerous other health conditions. Health experts state that most adults need seven to nine hours of sleep each night for healthy functioning.

This study is the first large-scale analysis of aircraft noise and sleep duration that accounts for the disruptive effects of multiple environmental exposures in communities, such as greenery and light at night (LAN).

Despite how common exposure to noise from aircraft is for many people, little is known about the health effects of aircraft noise, particularly in the U.S., according to study lead author Matthew Bozigar, assistant professor of epidemiology at OSU, and study senior author Junenette Peters, associate professor of environmental health at BUSPH.

“This study helps us understand the potential health pathways by which aircraft noise may act, such as through disrupted sleep,” Peters says.

For the study, Dr. Peters, Dr. Bozigar and colleagues from BUSPH, Brigham and Women’s Hospital, Harvard Medical School, and Harvard T.H. Chan School of Public Health examined airplane noise exposure and self-reported sleep disturbance among more than 35 000 participants living around 90 of the major US airports. The participants were selected from the Nurses’ Health Study (NHS), an ongoing, prospective study of US female nurses who have completed biennial questionnaires since 1976.

The team examined aircraft noise levels every five years from 1995 to 2015, focusing on two measurements: a nighttime estimate (Lnight) that captures airplane noise occurring when people sleep, and a day-night estimate (DNL) that captures the average noise level over a 24-hour period and applies a 10 dB adjustment for aircraft noise occurring at night, when background noise is low. The DNL is also the primary metric that the FAA uses for aircraft noise policies, and the threshold for significant noise impacts is above DNL 65 dB. The team linked these measures at multiple thresholds with the nurses’ geocoded residential addresses.

After accounting for a range of factors, including demographics, health behaviors, comorbidities, and environmental exposures such as greenery and light at night (LAN), the results showed that the odds of sleeping less than seven hours rose as airplane noise exposure increased.

Short sleep duration was also more likely among nurses who lived on the West Coast, near a major cargo airport or a large body of water, as well as among nurses who reported no hearing loss.

“We found surprisingly strong relationships for particular subgroups that we are still trying to understand,” Bozigar says. “For instance, there was a relatively strong signal between aircraft noise and both dimensions of disrupted sleep, short sleep duration and poor sleep quality, near major cargo airports. There is likely more going on to this story, as cargo operations tend to use larger, older, heavily laden, and therefore noisier aircraft that often fly through the nighttime hours. And the quantity of cargo shipped by air has been steadily increasing over the last couple of decades, possibly linked to more e-commerce. If the trends continue, it could mean more aircraft noise impacts to more groups of people.”

While the results suggested a clear link between airplane noise and sleep duration, the researchers observed no consistent association between aircraft noise and quality of sleep.

Source: Boston University School of Public Health

Categories : General Interest Medical IndustryTags :

Many Pilots Dodge Doctors to Keep Flying

On By ModernMedia
Photo by Daniel Eledut on Unsplash

A survey of military and paid civilian pilots has revealed that they may avoid seeking medical advice out of fear of losing certification to fly. Two-thirds of military and paid civilian pilots answered “yes” to at least one of four survey questions on reluctance to seek formal medical advice about health problems, reported William R. Hoffman, MD, who presented a poster at the American Academy of Neurology annual meeting.

Hoffman, a US Air Force employee, noted that both civilian and military pilots can be grounded if they have certain medical symptoms or diagnoses, with a range of negative repercussions for the pilot. As a result, pilots are disinclined to be truthful about their health if their employers or officials might find out.

In a previous survey of pilots led by Hoffman, more than three-quarters reported that they “felt worried about seeking medical care due to concern for their career or hobby.” The new survey probed this reluctance, with respondents asked whether they agreed or disagreed with the following:

  • Sought informal medical advice for fear of certificate loss
  • Flew despite experiencing a new symptom (physical or psychological) that warranted evaluation
  • Did not disclose prescription medication use
  • Misrepresented or withheld information on a written healthcare questionnaire for fear of certificate loss

Respondents to the web-based survey included 2383 nonprofessional civilian pilots, 1097 paid civilian pilots, and 261 military pilots.

Just over half of the unpaid civilian pilots denied ever hiding any of the four types of information. But that was true for only 33.6% of the paid civilian pilots and 32.2% of the military pilots.

Fortunately, among all respondents, only 6.8% said they had not disclosed prescription drug use as required, and just 16.8% acknowledged that they had kept new symptoms secret. But 45.7% acknowledged seeking informal advice in place of seeing a professional, and 26.8% said they had withheld or overtly misrepresented information on written forms. A few (2.2%) admitted to all four types of avoidance.

Female pilots reported slightly more avoidance of disclosure (62.0% of all female respondents vs 55.4% of men; P not reported). Younger pilots were also less open, especially those aged 25–40 (69.1% vs 40.7% in those older than 60). Union membership and active-duty military status were linked to high rates of avoidance (70.1% and 75.8%, respectively, vs 51.8% among non-unionised civilian and military reservist pilots).

Hoffman suggested that neurologists recognise that pilots may be shy about revealing their true health condition. “This might be mitigated through developing rapport with the pilot, asking questions about concerns related to their flying status, and clear communication about documentation and clinic course.”

Additionally, he recommended, “it is good technique to order only the necessary tests for all patients, to include pilots to avoid false positives.”

Despite this, medical professionals have an obligation to communicate a pilot’s health concerns to those responsible for evaluating fitness to fly.

Source: MedPage Today

Categories : COVIDTags :

WHO Urges Equitable Travel Requirements

On By ModernMedia
Photo by Tim Gouw on Unsplash

The WHO has urged that as air travel is restored, vaccinations should not be a prerequisite for travellers, potentially locking out those in poorer regions, especially Africa.

In a virtual press briefing on Thursday, Dr Matshidiso Moeti, World Health Organization Regional Director for Africa said that the WHO believes that schemes to remove quarantine and entry restrictions for travellers that have been vaccinated, are discriminatory and could deepen already existing inequalities even further.

Meanwhile, she warned that Africa’s third wave, already underway in 12 countries, with cases rising in another 14, threatens to be the worst yet with 5.3 million cases across the continent. It is projected that in three weeks the third wave will surpass the previous wave’s peak.

Public fatigue and new variants are driving this surge across Africa, with Delta the variant  detected in 14 countries. She stated that Africa can “blunt this third wave” but “the window of opportunity is closing”.

The WHO aims to strengthen variant surveillance in Africa by reinforcing the regional laboratory hub have a 8 to 10 fold increase in next 6 months for genome sequencing

Though vaccination rates remain low in Africa, there is nevertheless a great demand for vaccines, with 18 countries having used over 80% of the vaccines received through COVAX. Fortunately only mild side effects from the vaccines have been seen in African communities, she said.

Mr Kamil Alawadi, Regional Vice President for Africa and Middle East, International Air Transport Association (IATA) said that inconsistent requirements added additional complications in travel, increasing cost for the passenger and the airline. For travellers, PCR testing can range from $100 up to $400 for a single, one direction trip.

The key requirement for the recovery of the airline industry is the lifting of restrictions, said Alwadi, citing a survey that showed that 84% of passengers will not fly if there were quarantines in place. However, demand still existed for air travel, as evidenced by travel bookings spiking as soon as governments relaxed their border restrictions.

Alawadi said that the IATA agreed with the WHO that only lifting quarantine requirements for vaccine individuals was inequitable, and that “a robust and flexible testing system” was needed in place of quarantine, using systematic testing at the point of departure such as rapid antigen tests which are cheaper, faster and more accessible.

Graphic from Skyscanner.net showing countries with major travel restrictions from South Africa (red, 83 countries), moderate (orange, 29) and low restrictions (green, 42)

The situation was urgent for the African aviation industry as it had lost USD7.8 billion in 2020, with eight airlines filing for bankruptcy, he noted. This was against a background of USD430 billion global loss for the industry, though he noted that some countries are seeing a rebound to 2019 numbers for domestic travel. However, it is projected that losses will only stop by 2023 and return to profit by 2024.

The IATA has developed protocols in concert with the  International Civil Aviation Organization (ICAO) and WHO that will be non-discriminatory not require vaccinations, said Alwadi. However the aviation industry is sinking very rapidly without governmental support.