(eTN) – Travel has always been perilous. Over the decades we have come to worry about hijackings, terrorists, sleeping pilots, and worn-out engine parts. The current OMG is germs! The critters are all over the place: on our airline seats and tray tables; in bathrooms – on toilet seats, faucet handles, and door knobs; in hotel rooms and on bed linen; on TV remote controls and on drinking glasses.
Bacteria. Sky High
The Lancet (2005) found that an airplane cabin provides the smallest volume of available air per person in any public space. On the website for The Centers for Disease Control and Prevention, the heads-up warning finds that, “…as with other close contact environments, cramped aircraft quarters may facilitate the transmission of influenza virus from person to person or through contact with contaminated surfaces.”
Hidden in Food
Almost no one has kind words for airline food, and some passengers have become ill from eating spoiled, contaminated cuisine on domestic and international flights. Getting sick from food should not be a surprise since many parts of the world continue to lack clean water for growing and cleaning produce, for feeding animals, and for providing sanitary food production facilities. The entire food chain is ripe for food-borne illnesses. Adding to this reality is the questionable sanitation practices among airline personnel. Even the World Health Organization Guide (WHO) in its review of Hygiene and Sanitation in Aviation (1977), the study finds that the “Galleys are extremely difficult to clean satisfactorily… and have many almost inaccessible areas in which foods and beverages…can penetrate. The WHO also found that notification that a sick passenger had been onboard may take days to reach airport health authoritie and, therefore, recommends the continuous use of bactericide be included in the daily cleaning routine.
The Terrible Toilet
Studies of airlines have found that the germs congregate on sinks because they’re small and used by lots of people, says Charles Gerba, Ph.D., of the University of Arizona. Gerba found E. coli on faucets and door handles in the dozens of samples from airborne restrooms.
The year is 2003 and a Chinese doctor infected with SARS (from his patients) boarded a plane and infected other passengers. Diseases do not come cheap and SARS cost the Canadians $519 million in 2003 and $722 million between 2003 and 2006. The country also lost 662,000 occupied room nights just in the month of April 2003 which translates to an estimated $92 million in lost revenue. The labor force was also impacted and job losses were estimated at 5,300 for 2003 and 7,350 for 2003-2006. China lost an estimated $2.2 billion in economic output while Vietnam incurred a loss of $15 million. All told, an estimated economic loss was likely to exceed $10 billion in 2003.
Currently, international public health and security agencies concentrate efforts on the threat of avian and pandemic influenza, although tuberculosis reemerged in 2007 as a perceived health hazard to the general public. Another disease waiting in the wings is whooping cough. Although most Americans receive the vaccination as children, it was recently discovered that the immunization wears off by the time people reach their teens or early twenties. Whooping cough presents as an aggravated cold or bronchitis and may not arouse the attention of airline or medical personnel as to its true nature.
A World Bank (East Asia and Pacific Region) study (2005) determined that there was a lack of studies to determine the actual costs of a flu pandemic; however, a 1999 study of the United States calculated that it could lead to 1,000,000 – 2,000,000 deaths in the US, plus 7,000,000 or more hospitalizations, and up to 40 million out-patient visits to 50 million additional illnesses. The present value of the economic losses was estimated between $100 and $200 billion for the US alone (2004 dollars). If this estimate was extrapolated to all high-income countries, there could be a present value loss of $550 billion.
According to Mary Schiavo, a noted attorney and former Inspector General of the US Department of Transportation (1990-1996), “Airlines ignore the germ issue, [which are unfortunately]…very dirty environments. There are no federal regulations that require an airline to clean or disinfect its plane, seats, tray tables, service/gallery areas, pillows, blankets, or floors, so mostly they don’t – ever.”
Schiavo commented that, “A private study done by a media outlet found the seats, tray tables, pillows, and blankets to be covered with staph, strep, the germs that cause pinkeye.” The study also found bodily waste materials and pesticides on seats, tables, and bathroom doors. According to Schiavo: “The cabin air is not disinfected as it is constantly recirculated. Some carriers claim their plane air is cleaned by hospital grade filters. It is not. The newest planes offer a filtration system, but your odds of getting such a plane are slim.”
If the airlines are not providing a sanitary environment, what is the passenger to do? Schiavo suggests: “The best advice is to carry an ample supply of disinfecting wipes and wipe off your hands once you get to your seat and then clean off your tray table and latch, arm rests (if the guy next to you slopped over in your seat has not hogged them) and carry your own inflatable neck pillow. Avoid the blankets unless you are on carriers which have freshly laundered and sealed blankets. Sadly most of those carriers are foreign or only on overseas flights in first and business class.”
Schivao is concerned with passengers with compromised immune systems and recommends traveling with a disposable face mask which she uses during her travels “…if the person next to me is coughing, I put it on and arrive healthier and happier.”
Doing Nothing or Doing Something
According to Veda Shook, Association of Flight Attendants International President, there are no sanitation standards in the passenger cabin. “In fact, OSHA has been kept out of the aircraft cabin and flight attendants and passengers are subject to an environment absent sanitation standards, temperature standards, and proper procedures for cleanup of biohazards,” she said.
A recent study by the Association of Perioperative Registered Nurses found that that 57 percent of men and 46 percent of women do not wash their hands after using the toilet; therefore, all public washrooms should install the Sanidoor, a hands-free, germ-free way to open public restroom doors. Facilities equipped with the Sanidoor system open with a simple hand wave, much like touch-free faucets and towel dispensers.
Alexandra Harrington, Esq., in her discussion of germs on a plane (2009) suggests the creation of an international public health do-not-fly list as a “stop-gap measure.” This intervention would stop people with infectious diseases (or exposed to an infectious disease) from flying until it was medically established to safely travel.
Bugs Be Gone
Airlines have opportunities to provide a heightened sanitary environment for passengers. Simple gestures, like providing disposable paper seat covers (think toilet seat covers – but larger) upon boarding the aircraft, offering hand wipes to passengers prior to serving food, requiring face masks to people who are coughing (and their neighbors), and introducing air sanitizers, touch-free water faucets and paper dispensers in toilets would suggest that the airline was at least cognizant of sanitation issues.
Sadly, at this time, it is caveat emptor! At a time when carry-on space is at a premium, passengers have to carry their own supply of paper seat covers, hand sanitizers, disposable gloves/face masks, food, and water. The only responsibility of the airline appears to be fly passengers from one place to the other. For all other services, we are all on our own.