Healthy Flying

A little preparation can make a big difference to your travel experience. Get to the airport in plenty of time and you're already set up for a calmer journey. You'll be less likely to forget something, too.

The Aerospace Medical Association has this advice for travel planning:

• Make sure you have any immunisation needed for your trip.
• If you aren't well, delay your trip.
• Prone to air sickness? Reserve a seat by the wing.
• Wear loose, comfortable clothing and worn-in shoes.
• Carry any necessary medication with you.

If you do need medication, check beforehand that you're allowed to take it into your destination country, and obtain a doctor's letter if necessary (get more information from NHS Direct). If you've any health worries, such as heart or lung complaints, please consult your doctor before you travel. You may wish to obtain a Medical Information Form (MEDIF) from your airline.

Not everyone loves flying, and a few people dread it. Symptoms range from anxiety at take-off to all-out fear of even boarding an aircraft. Strange noises, claustrophobia, perceived loss of control or panic attacks can all ruin sufferers' peace of mind.

If you're affected, there's no need to suffer in silence. Let the cabin crew know you're worried and they can keep an eye on you – that can be reassuring by itself.

If you don't like turbulence, reserve a seat near the centre of the aircraft where it's felt less strongly.

To keep calm, try to occupy your mind – even a good book can help. Play calming music through your headphones, or try deep breathing exercises.

Courses designed to help beat fear of flying are also available, often run in conjunction with airlines. For example: Flying with Confidence course (in conjunction with British Airways).

Some people suffer from motion sickness on moving vehicles. It's caused by conflicting messages from the eyes and the motion sensors of the inner ear – your body says you're moving but your eyes say you're sitting still. For those affected by this condition, symptoms can include:

• Nausea
• Dizziness
• Fatigue
• Vomiting
• Cold sweats
• Headache.

Anxiety or odours can worsen the condition, and children aged two to 12 are more susceptible. If you're prone to motion sickness, these tips from the Aerospace Medical Association may help:

• Ask for a seat over the wings, where the ride should be smoother.
• If possible, travel on larger aircraft.
• Ask for a window seat.
• Avoid alcohol for 24 hours before flying (and in-flight).
• Keep your seatbelt fastened.
• Ask your doctor about suitable medication.

It's also a good idea to avoid bulky or greasy foods before flying.

The cabin air on board a plane is much drier than on the ground. Dehydration can case headaches and tiredness, and is bad for your skin, kidneys, liver, joints and muscles. Drink plenty of water and fruit juice, and avoid alcohol or drinks containing caffeine. It may also help to use a mist sprayer or moisturise your skin.

DVT is a blood clot in the deep veins of the body, usually in the legs. If part of the clot breaks off and travels to the lungs, it can cause collapsed lungs and heart failure. It has been linked with long-distance travel (journeys of four hours or more) on any form of transport. Experts agree that immobility is a main factor.

During the flight, try to move around (when it's safe to do so) – walk up and down the cabin regularly and do in-flight exercises. This will also help you avoid cramp. 

Avoid taking sleeping pills, because they'll leave you immobile for a long time. Wear loose clothing to aid circulation.

Elastic flight stockings improve circulation and can further help lower the risk of DVT. You can buy them at pharmacies or shops in the departure lounge.

Certain groups may be more at risk of DVT than others. For further information see the NHS information site for DVT.

For most flights, the air pressure in the cabin at cruising altitude is similar to that on a mountain top. This means there's less oxygen available, and it also causes gas within our bodies to expand.

• Most reasonably fit passengers can easily cope with decreased oxygen.
• Inactivity, sleep and alcohol can cause dizziness if you stand up too fast – try doing arm and leg exercises first.
• Anyone with serious heart, lung or blood disease should consult a doctor before making their travel plans.
• If you go Scuba diving, you should wait 24 hours before flying to minimise the risk of decompression sickness.

Some people suffer from ear pain or even temporary hearing loss as the aircraft descends. Air pressure in your middle ear is controlled by the Eustachian tubes, which open in the back of the throat. If the tubes become blocked, rising cabin pressure pushes on the ear drums and causes discomfort.

These tips from NHS Direct may help if you suffer from this condition, which usually clears up after a short while:

• Your Eustachian tubes don't open properly while you're asleep, so try to be awake approximately an hour before landing.
• To open your Eustachian tubes, try yawning, sucking a boiled sweet or chewing gum.
• Keep swallowing – drinking water helps.
• Babies can suffer this condition – feeding during take-off and landing may help them.
• Colds can inflame your Eustachian tubes – ask your GP or pharmacist about decongestants.
• Don't wear soft earplugs during the descent.
• If you've had ear surgery, check with your doctor before booking a flight.

Half the air in a modern aircraft cabin is drawn in from outside and half is recirculated from the cabin. Recirculated air is filtered to remove contaminants. Many aircraft use the same system as hospital operating theatres, removing bacteria and some viruses too. So there's nothing intrinsically bad about cabin air quality, according to the Aerospace Medical Association.

Obviously the aircraft is a confined space, and germs can still be spread person-to-person. For this reason, anyone with a contagious illness should cancel or delay their flight until they're better.

The earth's atmosphere protects us against radiation from space. This shield is thinner at higher altitudes, and some people – particularly frequent flyers – worry that their risk of getting cancer might increase.

According to Cancer Research UK, flying on a commercial airliner is safe and unlikely to affect your risk of cancer, even for regular travellers and flight crew, because radiation levels are still below recognised health limits.

Some studies have suggested that pilots and cabin crew may face a slightly higher risk of skin cancer and breast cancer. However, the evidence is inconsistent and there might be other causes – for example, the amount of time spent in sunnier climates.

Read more on the Cancer Research UK website

Crossing time zones can disrupt your body's daily rhythm and lead to fatigue, clumsiness, loss of appetite, memory loss, digestive problems and flu-like symptoms.

Not everyone gets jet lag. People with strict daily routines tend to be worst affected, whilst children and babies rarely suffer. The problem is usually worse when travelling east than west, because the body can cope better with a longer day than with a shorter one. Recovery takes about a day for every time zone crossed.

Jet lag can be aggravated by dehydration, lack of oxygen, tiredness, alcohol and stress. Here are NHS Direct's recommendations for beating jet lag:

• Get plenty of sleep in the days before you travel.
• Start adjusting to the time at your destination as soon as you get on the plane – reset your watch, modify mealtimes and get some sleep, especially if you'll arrive in the daytime.
• Take light exercise during the flight. Don't overeat or drink alcohol.
• Try not to schedule important meetings for the first couple of days of your trip.
• When you arrive, get into a routine immediately.
• Drink plenty of water and take daily exercise.
• Be careful with caffeine – drink coffee in the afternoon, not first thing in the morning.
• Don't nap during the day – adjust to local time. But don't use sleeping tablets as they can make you drowsy the next day.

More on jet lag from NHS Direct

To help you sleep during a long flight, try using a sleeping mask, ear plugs and an inflatable travel pillow, all of which are available at shops in the departure lounge.

Air travel is generally safe for expectant mothers. Each airline has its own guidelines so you should check with yours to make sure you can travel. There's plenty of advice on pregnancy and travel on the Health Protection Scotland website. Here are a few key tips:

• Always get the all-clear from your doctor before you travel while pregnant.
• The most risky times to travel are in the first 12 to 15 weeks of pregnancy, and after 30 weeks.
• Check your airline's policy – many carriers won't accept passengers who are more than 28 weeks pregnant.
• Long flights can be very uncomfortable in late pregnancy.
• Think carefully before travelling to countries with poor medical facilities, or where there are major language or cultural differences from those you're used to.
• Discuss immunisation with your doctor. Some vaccines are best avoided during pregnancy, but travelling without protection may be risky.
• Illness during pregnancy can be more severe, so avoid contaminated food and water, and insect and animal bites.
• If possible, take written medical records (including blood group details) with you.
• Ensure your travel insurance covers pregnancy (but remember, your policy is only as good as the facilities available).