The Daily Telegraph - Saturday - Travel
Is flying a health risk? I had tests to find out
Having clocked up millions of miles in the air, John Arlidge checks in at three specialist clinics that help frequent fliers stay healthy
We all know that flying can be unpleasant. Changes in air pressure, dry air on board, cramped seats and poor food can leave us feeling tired, stiff and bloated. But what about the more hidden risks, especially to those who fly a lot?
Frequent fliers can suffer hearing loss due to constant changes in pressure. Exposure to radiation can increase the risk of cancer. Then there is the possibility of vein damage caused by blood clots – and even potentially fatal deep vein thrombosis.
With travellers more aware than ever of the issues linked to frequent flying, clinics now offer regular passengers checks to find out if their health has suffered. They also recommend safer ways to fly. As a business journalist who has travelled a few million miles in the air over four decades, I decided to try out a few of them.
THE TESTS
My first stop was a hearing test with Dr Rony Ganguly, director and audiologist at Pindrop Hearing which has several clinics across London. He explained that changes in air pressure during flights can cause eardrum pain and perforation, as well as vertigo and hearing loss. His colleague Shivanie Sachdev then looked into each ear and performed a series of hearing tests.
Next, it was time for a “vein MOT” with Prof Mark Whiteley, consultant venous surgeon at The Whiteley Clinic in London. Sitting still in a confined space for long periods of time means air travellers are more likely to develop a blood clot, which can damage veins – and prove fatal, if the clot reaches the lungs. His assistant performed a duplex ultrasound (to measure blood flow) on the veins in my legs.
My third appointment was with Prof Ramia Mokbel, consultant dermatologist at HCA Healthcare UK. I had no idea that, while aircraft windows block UVB rays, UVA radiation can get through and increase the risk of melanoma. She performed “mole mapping” – examining new moles or changes to existing moles which might indicate skin cancer.
Be warned, however. This is not a test for the easily embarrassed. It involves standing nearly naked and having lots of photographs taken of you and your moles, which are then displayed on a large screen for human and AI analysis.
THE RESULTS
Dr Ganguly told me that my ears were physically fine – or, in his words, that my “tympanic membranes and ear canals are intact and in good health.” The “pure tone audiogram” test showed “normal hearing on the right and a mild to moderate noise-induced sensorineural hearing loss on the left.”
He recommended that I see an ENT consultant to identify “why you have a difference in hearing between both ears.” Good advice.
It’s a decent start. What about my legs? Professor Whiteley examined my ultrasound and told me “your deep veins are clear – the valves are working well and there is no scar tissue indicating previous problems.”
This matters because deep veins “are the ones inside the muscle that take 90
One test involves standing nearly naked and having lots of photographs taken of you and your moles
per cent of the blood back to the heart.”
In the smaller veins leading to the deep veins, I have “the first couple of valves starting to fail, causing minor reflux (blood falling back down the vein with gravity rather than being pumped up the veins towards the heart).” That sounds bad, I said. “This is not significant at present,” he replied. Phew.
Meanwhile, there is “minor scarring on the inner surface of the small saphenous vein on both sides. This suggests that you have previously had superficial venous thrombosis – ‘clots’ or ‘thrombi’ in these veins. These have been removed by your body’s thrombolytic system but the inflammation has left scar tissue.” Could these have been caused by flying?
“It is usually associated with varicose veins,” he explained, “but it can be caused by flying.”
His recommendation? No need to worry or to have surgery but I should call him back if I develop “heavy aching or tired legs, tender varicose veins, swelling of ankles, red/brown stains at ankles.” Noted, Prof. Also, he advised me to do as much exercise as possible. “Veins love exercise.”
In the future when I fly, I should “keep moving as much as possible and keep hydrated. Choosing an aisle seat if travelling at the back of the bus makes it easier to stretch. And on flights of more than two hours, wear properly fitted, below-knee graduated compression stockings (grade 1 or grade 2).” He measured me up and gave me a pair. Not very fetching, but needs must.
My final appointment had been with Prof Ramia Mokbel. Her mole mapping “revealed a suspicious mole on the back and potentially an evolving basal cell carcinoma on the torso.” She told me she would use new artificial intelligence programmes “to decide whether we need to have them surgically excised and sent to the lab for histology biopsy.”
She didn’t seem that concerned but told me that I should do mole mapping once a year. “Skin cancer is one of the easiest [types] to spot early and to treat early,” she said.
My day of tests was over and I felt a bit stupid that I had travelled so many miles for so many years without using compression socks. However, I was also relieved that I now had a pair approved by Prof Whiteley, who told me that many over-the-counter socks do not compress the legs enough to be useful.
My father, Anthony, died of skin cancer last year, so I was pleased that Prof Mokbel had found nothing much of concern – but I will take her advice on the need for annual mole mapping. As for my ears, it seems that my slight hearing loss may be related to getting on a bit rather than to flying.
I will be back in the air this week – flying to Los Angeles, then back to London and on to Cannes – and I will continue to go on holiday with my family. But I will be drinking more water (and less wine) – and, of course, wearing those fetching socks.