Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: TUESDAY, June 29, 1993                   TAG: 9310080346
SECTION: EXTRA                    PAGE: 6   EDITION: METRO 
SOURCE: Jane Brody
DATELINE:                                 LENGTH: Long

DON'T LET AIR TRAVEL GET YOU DOWN

While no systematic study has been done on the incidence of flight-related health problems, complaints from passengers have ranged from headache, nausea and backaches to colds, pneumonia and blood clots in the lungs. Airlines have also greatly reduced the influx of fresh air on planes to save money, worsening health problems.

No less an authority than Alfred Kahn, a chairman of the former Civil Aeronautics Board and father of deregulation, reports that within a five-year stretch six of eight long-distance flights he took resulted in attacks of bronchitis or pneumonia, one of which landed him in a hospital for five days.

Difficulties in documenting the extent of flight-related health problems start with the fact that passengers quickly disperse to many distant points. Also, it is often hard to separate the effects of forced contact with airborne infectious organisms from the immune-suppressing effects of travel-related stress, which leaves people more vulnerable to infection.

But in 1979, influenza struck 72 percent of passengers on a flight to Kodiak, Alaska, after the plane had been held at its landing gate for four hours. The common source of their infection, hours of breathing contaminated air in the plane, was nailed down only because nearly all the sick passengers visited the same doctor in Kodiak. Although correction of such problems lies in the hands of the airlines, there are many steps passengers can take to minimize their chances of arriving ill or achy at their destinations: first, get comfortable and move around occasionally; second, avoid dehydration by consuming eight ounces of water or other plain beverage for each hour of the flight; third, protect your ears by using a decongestant and, yes, that old standby, chewing gum; and, finally, choose good food to limit the stress of travel.

The combination of cramped seats that forbid much movement and the pressure of seat cushions on the back of the thighs impairs circulation in the legs, often resulting in swollen ankles and feet and sometimes in dangerous blood clots in the lower leg that can, days later, break loose and lodge in the lungs. In 1988, doctors in New York and Britain described three cases of flight- related pulmonary embolisms in otherwise healthy middle-age adults.

To reduce such risk, they suggested that passengers on long flights sit in aisle seats - or, if necessary, climb over seat mates - and take hourly walks in flight. Other helpful measures include not smoking (smoking, still permitted on many international flights, thickens the blood), wearing nonconstricting clothing, not crossing your legs, wearing elastic or support hose, taking off your shoes and elevating your feet by resting them on luggage or a stack of magazines or blankets.

Dehydration, which also thickens the blood, can result in general discomfort, digestive problems, undue fatigue and worsened jet lag. With the humidity level typically about 10 percent, the atmosphere on planes is drier than the Sahara. Eyes become sore and red and upper respiratory passages dry out, increasing their susceptibility to infection.

Many beverages commonly consumed in flight actually add to dehydration. These include drinks with caffeine (including soft drinks), alcoholic beverages and salty drinks like tomato juice. The effects are often compounded by salty peanuts and pretzels.

Use saline eye drops before, during and after the flight. This is especially important for people with contact lenses, who may be better off wearing glasses in flight.

Skin, too, suffers from dehydration on flights. Apply a good moisturizer bodywide before leaving for the airport, and carry some with you. Use a spritzer bottle of water to revive your facial skin and hair.

Ears are a common source of in-flight health problems. While most people know they should not fly with a cold or upper respiratory congestion, postponing a scheduled trip is rarely a choice. As the plane descends, the Eustachian tube in the middle ear tends to collapse as the outside pressure builds. The middle ear becomes filled with fluid and blood, and may even rupture.

The risk can be reduced by taking a decongestant before the flight and again an hour before the descent; if the flight is more than about four hours, also use a nasal spray 30 to 60 minutes before landing and again in the descent.

Chewing gum or, for infants, sucking on a bottle or breast is helpful.

When ears fail to open by themselves, try the Valsalva maneuver: close your mouth, pinch your nose and force air up from your lungs into your ears; you should hear the middle ear click open, at least temporarily. Repeat the maneuver often in the descent to equalize pressure.

For more information about healthier and safer air travel, Diana Fairechild offers 200 tips in her book ``Jet Smart,'' (Flyana Rhyme Inc., $12.95). It is available through bookstores, or it can be ordered by mail directly from Fairechild for an additional $2 postal charge at P.O. Box 300, Makawao, Hawaii, 96768; phone (808) 572-5252.

Jane Brody writes about health issues for The New York Times.