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The UK postgraduate curriculum for GPs should include a basic overview of aviation medicine and the effects on health of flying, recommends a report from the House of Lords Science and Technology Committee.
At present training for GPs in aviation medicine is not mandatory. In evidence to the committee Michael Bagshaw, professor of aviation medicine at King’s College London, said, “My experience with lecturing to GPs . . . is that there is an amazing ignorance among the medical profession about the health effects of flying.”
The update to the committee’shighly influential report Air Travel and Health, published in 2000, also calls for various specialties such as cardiology, orthopaedics, and psychiatry to follow the lead of the British Thoracic Society in producing guidelines on fitness to fly for GPs and other health professionals.
Committee member Baroness Finlay of Llandaff said, “We are aware that GPs are in a difficult position when deciding on a patient’s fitness to fly, as there is not a single place to access all the relevant information.” The update calls for information that is already available, such as that from the British Thoracic Society, the BMA, and the World Health Organization, to be pooled in a single publication for ease of reference.
It also criticises the inconsistent health advice available from airlines and on the internet, particularly on the use of aspirin to prevent deep vein thrombosis. Committee spokesman Lord Patel said he had been alarmed to discover that 20% of passengers on long haul flights had taken or planned to take aspirin before, during or after their long haul flight. “For most passengers taking aspirin may do more harm than good,” he said.
Although taking aspirin may reduce the risk of arterial thrombosis it has no effect on venous thrombosis, says the committee’s report. About 24000 people have to be treated to prevent one thrombosis, whereas the number needed to treat for harm to result from taking aspirin is in the region of one in 17000, it says.
The new report emphasises that the risk of cross infection in an aircraft cabin is the same as that in any enclosed space such as an office building. In fact, disease is more likely to be spread by skin contact than through ventilation systems. It says that passengers should be encouraged to wash their hands before eating on board to reduce the risk of transmission of an infection during a flight.
The committee received a large number of submissions from pilots and cabin crew on the subject of contaminated air events and ill health. Such events occur when engine oil or hydraulic fluid from the engines enters the cabin air because of a faulty oil seal. Extreme temperatures cause decomposition into a range of substances, including volatile organic compounds. The committee found that evidence is insufficient to prove a link between contaminated air events and long term ill health but called for more research into the area.
Air Travel and Health: An Update is available at www.parliament.uk/hlscience.