Copyright© 2002 to 2005, Marlene R. Fedin; no reprint or reuse, on or offline,

without express permission of the author

IF YOU'RE WONDERING ABOUT THAT BREATHLESS IN-FLIGHT FEELING...

Now there's another compelling reason to focus on the amount of oxygen in a cabin, and it has nothing to do with disease transmission.

It's About Oxygen Levels, Not (Just) the Air Quality
An Irish study (Anaesthesia, May, 2005: "The effect of high altitude commercial air travel on oxygen saturation") of flyers of all ages on long- and short-haul flights found that blood oxygen levels in over half (54 percent) of participants dropped by an average of 4 percent at cruising altitudes. That brought the recorded in-flight levels to an average of 93 percent. To understand the significance of the numbers, know this: If you were on the ground and hospitalized, that level (anything below 94 percent) would prompt some physicians to administer supplemental oxygen. (We can already hear the objections from the airlines' defenders. Yes, we know it's apples and oranges, but it is relevant.)

The dip in oxygen levels might not even be noticeable to healthy folks, but it can lead to life-threatening problems in individuals who have heart or lung disease (folks who may already have lower levels of blood oxygen). However, researchers are concerned that the combination of lowered oxygen levels and common cabin conditions such as low humidity and passengers' decreased mobility and dehydration, could be factors in in-flight and post-flight illnesses for all flyers.(!)

"We have always known (that) oxygen levels fall when a plane is flying."

—UK Civil Aviation Authority spokesperson

Of course, concern about oxygen levels is not new to flight attendants (and travelers who've been on the road long enough to remember when the amount of pure oxygen pumped into cabins was much higher than current levels). They're all too familiar with the dizziness, headaches, nausea, fatigue, clamminess, and impaired mental performance (think "brain fog") that are a byproducts of low oxygen levels. Of greater concern, the study researchers point out, is how low oxygen levels contribute to DVT (deep vein thrombosis), a potentially life-threatening condition that is of increasing concern to all flyers.

Unsurprisingly, the researchers are advocating that airlines up the amount of oxygen in the cabins. Given the costs associated with such an increase (more oxygen = increased operating costs), we're not likely to see a voluntary change anytime soon.

NOTE:  Airlines do not routinely carry supplemental oxygen for passengers' use. If you will need oxygen in-flight, you'll have to request it from an air carrier well in advance of your flight. (FYI: You can't just carry your own supply onboard. See Healthy Resources below for info on how to arrange for supplemental oxygen.)

In the perfect world, airlines would be required to stock supplemental oxygen for use, on-demand, as needed. In the real world, where there's no such thing as one-size-fits-all oxygen fixes and where there are legitimate medical and liability issues, the only way to secure oxygen in-flight is to make special arrangements with a carrier, well in advance of a flight.

The Bottom Line: The lowered oxygen levels should pose no risk to the generally healthy. However, depending on the length and number of the flights and the state of your own health at the time you are flying (think debilitating cold or respiratory infection or extreme fatigue; of if you're recovering from the flu or pneumonia), you may want to consult a physician in advance of travel even if you have not been diagnosed with a cardiac or pulmonary condition.

Special Circumstances: If you're a senior, a smoker, or if you have been diagnosed with a chronic or transient cardiac or pulmonary condition, you should definitely consult a physician who is conversant with the problems associated with air travel. You may want to get a prescription for supplemental oxygen, even if you won't  need to use it for every flight.

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THE ULTIMATE TRAVEL WORRY? MEDICAL EMERGENCIES

Think on-time flights and comfortable lodgings are a road warrior's biggest concerns? Think again. Travelers, it seems, worry about more than delayed or cancelled flights and the odd airport-security snafu. More than 70 percent of the people who responded to a January survey cited a medical emergency while traveling as their top concern. Of the 1,585 Americans surveyed nationwide by Impulse Research, concern about encountering a medical emergency (73.5 percent) far outweighed being mugged (30.7 percent), injured in a terrorist attack (23.4 percent) and being kidnapped (7.2 percent) or sexually assaulted (7.6 percent). Experiencing a serious injury concerned the majority (55.3 percent) while about a third (32.5 percent) feared being felled by a serious illness.

Almost 13 percent feared having a stroke or heart attack on the go. Active and adventure vacations—26 percent of those surveyed said they skied, 14 percent climbed mountains, and almost 20 percent claimed to be involved in "other potentially dangerous activities"—could account for reported hospitalizations (almost 13 percent) and trips that were curtailed for medical reasons (more than 15 percent). Unsurprisingly, almost 93 percent said they wanted to transfer to a U.S. or an advanced medical facility if they had a medical emergency while out of the country. Although 60 percent said they prepared for foreign travel by getting vaccinations and packing medications, their preparation fell short in a key area: More than two-thirds (69 percent) did not even check the State Department's travel warnings. And only 10 percent cancelled a trip based on a government warning.

BUT...THAT CONCERN DOESN'T TRANSLATE INTO ACTION, AKA PRE-TRIP PLANNING

Despite their alleged concern about health and safety, many travelers often spend more time on the details of air and ground transport and planning local shopping, sightseeing, and dining options than they do in prepping for possible health concerns. A December, 2004, survey conducted by ASTA (the American Society of Travel Agents) and GlaxoSmithKline found that although 69 percent of participating travelers believed that safety and health are major considerations when choosing an international travel destination, only 19 percent sought travel-health advice from a medical professional while planning their trips.

Unsurprisingly, a large percentage of those surveyed had no idea what disease risks were associated with the various destinations they were considering. (40 percent were uncertain where malaria was a risk while 52 percent and 51 percent, respectively, were not sure where hepatitis A and hepatitis B could pose problems.) But more importantly, many were unaware that such serious diseases as malaria and hepatitis could even be contracted in popular venues. (The World Health Organization has deemed malaria one of the most serious threats to global travelers, yet less than 9 percent of those who had journeyed to areas with malaria outbreaks had taken anti-malarial meds.)

Equally disturbing: 66 percent of those who had visited countries with a risk of vaccine-preventable hepatitis A and 58 percent of those visiting areas with a hepatitis B risk had never received vaccinations (FYI: These diseases can seriously damage the liver and can disable or even kill those who contract them.)

The lesson? Ignorance of the risks and/or a lack of careful preparation can not only mess up your trip, but result in serious and chronic health problems, some with potentially life-threatening consequences.

TIP: Before you go, check the CDC Travelers' Health site and World Health Organization (WHO) Disease Outbreak information.

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IF TRAVELERS ARE AT RISK, WHY DO THE FEDS AND AIRLINES HESITATE?
Delta Air Lines will provide electronic passenger lists to the Centers for Disease Control (CDC) on a test basis in an attempt to curb the transmission of infectious diseases such as SARS, avian influenza, and dengue fever, as well as exposure to biological agents by international air travelers. The CDC currently collects data by hand from multiple sources, including flight manifests, but immediate electronic access to an airline's passenger data could greatly reduce the turnaround time in identifying and notifying at-risk flyers.

Delta's participation is voluntary and it's currently the only domestic carrier involved in the test although the CDC is reportedly chatting up other airlines and industry groups. The test is also limited to providing data only from flights originating in an area with an outbreak or for flights on which a passenger later identified as being infected had flown. The disclosure of Delta's participation follows the early April House aviation subcommittee hearing on disease transmission via the international air system.

At the hearing, the CDC stressed the importance of the airlines' cooperation. As always, the airlines say they want to help but cite a host of reasons—privacy and technical issues top the list—why they can't. Given the genuine threat posed by increasingly virulent infectious diseases, the volume of air travel and the risks posed by in-flight exposure, the CDC shouldn't have to beg for cooperation. And if the government really believes that we're at risk, then it should take a "proactive posture" as suggested by subcommittee chairman John Mica (R-FL) and mandate that the airlines provide the information, on demand as needed.

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· Quiznos Subs: Two units are set to open in May in the new A/B complex food court; one in Concourse D.