Intercontinental air travel: The cabin atmosphere and circadian realignment

doi:10.1016/j.tmaid.2009.01.004

Travel Medicine and Infectious Disease

Volume 7, Issue 2, March 2009, Pages 57-59

https://doi.org/10.1016/j.tmaid.2009.01.004 Get rights and content

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The cabin atmosphere

Potential effects of the cabin atmosphere on well being involve the relative hypoxia and the low humidity to which may be added the possibility that the quality of the cabin air supply could be inadequate. The relative hypoxia of the cabin environment is related to the need to limit the differential pressure across the wall of the cabin. Cabin altitudes up to 8000 feet (less than 2500 m) are permitted as at this altitude the reduced partial pressure of oxygen in the cabin air has a limited

The new time zone

As far as the management of jet-lag itself is concerned the goal for those that intend to remain in the new time zone for many days is to achieve circadian realignment in the most rapid and efficient way possible, and to minimize symptoms during the interim period.¹ However, there are limits to our knowledge and to what can be achieved. For instance, more information is required on the relationship between age and jet-lag, and frequent shifts to differing time zones, as with business

Emergence of chronobiotics?

The possibility that drugs could be developed that would accelerate resynchronization to a new time zone is a fascinating challenge to the clinical pharmacologist. As far as melatonin is concerned its sedative activity when endogenous levels are low is well documented, but clearly opinions differ as to its potential for chronobiotic activity.4, 5 After detailed deliberations, the United States Agency for Healthcare Research and Quality¹² concluded that there was no evidence to suggest that

The way ahead

What then can be gleaned from these reviews concerning the present and future management of the fatigue and malaise associated with intercontinental journeys? Improvements in the cabin environment will depend on the aircraft industry and so, for the while, the approach of the healthy traveller must be to adopt the behavioural advice offered by the reviewers. Exposure to the light–dark cycle of a new time zone is advocated, though prescribed regimes involving artificial light may not, at

Conflicts of interest

None.

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Jet lag and other sleep disorders relevant to the traveler
Travel Med Infect Dis
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The clinical management of jet lag: what can be proposed when performance is critical
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Some chronobiological and physiological problems associated with long-distance journeys
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The pathophysiology of jet lag
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Melatonin and its relevance to jet lag
Travel Med Infect Dis
(2009)
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Altitude exposures during aircraft flight. Flying higher
Chest
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There are more references available in the full text version of this article.

Cited by (5)

Occupational risk of organophosphates and other chemical and radiative exposure in the aircraft cabin: A systematic review
2021, Science of the Total Environment
Citation Excerpt :
Increasingly, the field has become more focused on low-dose chronic exposure. To quote Nicholson (2009), “ Sub-clinical long-term effects cannot be completely ruled out, and whether contaminants in the air supply could be a factor in the malaise experienced by passengers remains uncertain.” Howard (2017) describes axonal transport damage caused by repeated low-dose exposure to OPs.
Occupational exposure to oil fumes, organophosphates, halogenated flame retardants, and other volatile and semi-volatile contaminants is a concern within the aviation industry. There is no current consensus on the risk attributed to exposure to these chemical classes within the aircraft cabin. Contaminant concentrations rarely exceed conventional air quality guidelines, but concerns have been raised about these guidelines' applicability within the aircraft environment. This systematic review, the largest and most comprehensive completed to date on the subject matter, aims to synthesize the existing research related to chemical and other exposures inside the aircraft cabin to determine the occupational risk that may be attributed said exposure, as well as, determine knowledge gaps in source, pathway, and receptor that may exist. The Science Direct, Scopus, and Web of Science databases were queried with five search terms generating 138 manuscripts that met acceptance criteria and screening. Several potential areas requiring future examination were identified: Potable water on aircraft should be examined as a potential source of pollutant exposure, as should air conditioning expansion turbines. Historical exposure should also be more fully explored, and non-targeted analysis could provide valuable information to comprehend the aircraft cabin exposome. Occupational risk under typical flight scenarios appears to be limited for most healthy individuals. Contaminants of concern were demonstrated to be extant within the cabin, however the concentrations under normal circumstances do not appear to be individually responsible for the symptomologies that are present in impacted individuals. Questions remain regarding those that are more vulnerable or susceptible to exposure. Additionally, establishing the effects of chronic low dose exposure and exposure to contaminant mixtures has not been satisfied. The risk of acute exposure in mitigable fume events is substantial, and technological solutions or the replacement of compounds of concern for safer alternatives should be a priority.
Air travel: Effects of sleep deprivation and jet lag
2013, Chest
Citation Excerpt :
Travel conditions within the airplane may contribute to some of the distress experienced by travelers (both travel fatigue and jet lag symptoms).31 For example, expansion of gas within the GI system (due to lowered cabin pressure) may result in discomfort/bloating, lower inspired oxygen may affect patients with respiratory conditions, motion sickness may present itself, and low relative humidity may result in dehydration, although the degree of dehydration is likely minimal.32 The diagnostic criteria for JLD are as follows: (1) there is a complaint of insomnia or excessive daytime sleepiness associated with transmeridian jet travel across at least two time zones; (2) there is associated impairment of daytime function, general malaise, or somatic symptoms such as gastrointestinal disturbance within 1 to 2 days after travel; and (3) the sleep disturbance is not better explained by another current sleep disorder, medical or neurologic disorder, mental disorder, medication use, or substance use disorder.33
Air travel is a common mode of transportation in today's society, particularly for individuals traveling long distances. Sleep disturbances associated with air travel frequently result in cognitive and physiologic impairments that may be detrimental to the traveler's experience and intent. A primary consequence of air travel is the development of acute sleep deprivation, which may result in reduced attention/vigilance, alteration in mood states, diminished memory processing, and alteration in executive function. Along with and contributing to acute sleep deprivation, circadian rhythm misalignment resulting in jet lag disorder (JLD) is frequently encountered by air travelers traversing multiple time zones. JLD is characterized by insomnia or excessive daytime sleepiness associated with physical or mental impairment associated with travel. This review focuses on the neurocognitive manifestations of acute sleep deprivation and the pathophysiology and treatment of JLD to provide the practicing clinician a greater understanding of the sleep abnormalities manifest in air travelers. Treatment recommendations for the traveler, including the use of light/melatonin therapy, sleep scheduling, and pharmacologic aids for both sleep and alertness, are provided.
Spatial orientation and disorientation
2017, The Neurosciences and the Practice of Aviation Medicine
Jet lag: Use of melatonin and melatonergic drugs
2014, Melatonin and Melatonergic Drugs in Clinical Practice
Jet lag, circadian rhythm sleep disturbances, and depression: The role of melatonin and its analogs
2010, Advances in Therapy

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EditorialIntercontinental air travel: The cabin atmosphere and circadian realignment

Section snippets

The cabin atmosphere

The new time zone

Emergence of chronobiotics?

The way ahead

Conflicts of interest

Travel Med Infect Dis

Travel Med Infect Dis

Travel Med Infect Dis

Travel Med Infect Dis

Travel Med Infect Dis

Chest

Editorial
Intercontinental air travel: The cabin atmosphere and circadian realignment