Flying scared

As millions head off on their summer holidays, fears about flying have taken off.

Statistically, flying is the safest method of transport. According to the Civil Aviation Authority (CAA), between 1989 and 1998 UK airlines carried about 700million passengers – and fatal accidents claimed the lives of 56 people. That translates as a one in 12.5million chance of being killed on a UK airline – which compares favourably to the one in 10million chance of being struck and killed by lightning (1).

The safety of flying hasn’t stopped a constant stream of scare stories, which have been heightened by the events of 9/11. The fact that passengers are trapped thousands of feet in the air with complete strangers perhaps gives panics about planes some resonance.

Passengers are seen as being at risk from fellow passengers (terrorism, air rage), blood clots (DVT), or the in-flight environment (low oxygen, radiation, airline food and water). But when you begin to look at the figures, the fears should melt into thin air.

Air rage has been a long-running worry. Back in 1999, it was reported that air rage had increased by 400 percent over the previous five years (2). In that year, a plane had to be diverted after 12 passengers allegedly got involved in a brawl 35,000 feet above the sea. In January 2002, psychologist Dr Graham Lucas called for alcohol to be banned in-flight, because by reducing self-control it might increase the risk of air rage. He claimed that the cabin was a stressful environment where problems could be exacerbated by things like neighbours fiddling with light switches or a child kicking your seat (3).

But air rage is very rare. During the 12-month period 2002-2003, UK airlines operated about 1.2million passenger flights and carried about 118milion passengers. A total of 6482 incidents were reported in this period – but most of these involved things like verbal abuse to passengers or staff, or smoking in the toilets. Only 35 serious incidents were reported – which means that only one in every three million passengers was the cause of a serious disruptive incident (4). And nobody has ever died as a result of air rage.

DVT became a concern after 28-year-old UK resident Emma Christoffersen tragically collapsed and died after a 20-hour flight from Australia in October 2000. Since then it has become accepted media wisdom that ‘one in 10’ people is at risk of DVT. By January 2001, research found that, of people who make long-haul flights, 89 percent said they were aware of the issue of DVT, and 38 percent said that they were ‘concerned’ and had ‘already taken precautions’.

But the jury is still out on whether there is any connection between flying and DVT. If there is a link, then it is a very small increased risk that mainly affects those who are predisposed to develop DVT – such as people who have blood clotting disorders, or pregnant women. And the ‘one in 10’ figure is full of holes: it was taken from a study that was severely criticised for having major flaws in its method. Even then, the one in 10 people who developed DVT in the study developed tiny asymptotic clots, which posed no risk to their health (see Anatomy of a panic, by Josie Appleton).

The combined effects of 9/11 and the attempt by ‘shoe-bomber’ Richard Reid to blow up a plane mid-Atlantic have made terrorism a prime concern. Many people avoided flying after 11 September, and airlines have been making substantial cutbacks in their flights and staff. Security procedures have become more elaborate – with passengers being asked to take off their shoes, hand in their nail files, and wait on the runway while security checks clear passengers’ names. There have been calls for all airlines to carry air marshals, as Israel’s El Al does at present.

While a new breed of terrorist has changed the landscape of hijacking, thankfully these incidents are still very rare. Indeed, the 9/11 attack appears to have been a one-off ‘spectacular’ – certainly nothing remotely like it has happened since. And it is debatable to what extent the nitpicking kind of airline security introduced after 9/11 – where passengers have been treated suspiciously and have had their scissors, tennis rackets and other items removed – manages to reduce any risk of hijacking further. Millions of nail files have been confiscated in vain.

Dangers are also associated with the in-flight environment. Jet Smarter, a book about the dangers of flying by Diana Fairechild, claims that on some flights passengers will be involuntarily gassed with insecticides, as these are sprayed on the seats, luggage and sometimes on passengers. She claims that radiation for frequent flyers equals that of atomic energy workers, and that a flight across the Atlantic has the equivalent radiation of a chest x-ray. She also notes that there are no binding rules for the purity of drinking water on aircraft – and advises that it is safer to bring your own supply (5).

Not content with helping to all but ban smoking on flights (which has surely led to more than a few instances of ‘air rage’), the Action on Smoking and Health (ASH) website warns passengers that ‘airline food can be very unhealthy. Many contain far more fat and calories and sodium than the worst fast-food restaurant meals’ (6). So perhaps you’d better take sandwiches, too.

And then there are concerns about catching diseases such as SARS from your fellow passengers, or of feeling ill from low oxygen and air pressure. ‘Flying is definitely not for the faint of heart – that’s for sure’, concludes the Fair Air Coalition (7).

But while in-flight meals and drinks sometimes leave much to be desired, there is no evidence that airlines are poisoning their passengers or making them ill. And although the in-flight radiation levels are high in comparison to the ground, this does not mean they are dangerous – after all, atomic energy workers have to be protected from unsafe levels of radiation.

A sure sign that these worries are bogus comes from the fact that the causation arrows go in all directions – it is not clear which factors increase which risks, and which preventative measures could be taken. The results of a scare themselves become risk factors. So fear of flying has been blamed for causing DVT (8). But for those who want to drink alcohol to reduce anxiety, think again – this has also been claimed to be a DVT risk factor (9).

Dr Graham Lucas has argued that fear of terrorism combined with alcohol increases the risk of vigilantism – as passengers may mistake alcohol-induced air rage for terrorism, and take the law into their own hands. Similarly, it has been claimed that efforts to reduce the risk of terrorism by installing air marshals would actually increase the risks, as this would mean that there was a gun on board the plane.

The best advice might be to escape from this web of entrapment, and head up and away.

Read on:

spiked-issue: Sun, sea and scaremongering

(1) Flying still the safest form of travel, BBC News, 8 May 2000

(2) Airs and disgraces, Guardian, 6 February 1999

(3) Time to consider air drinks ban, says psychologist, Guardian, 22 January 2002

(4) Figures from Disruptive behaviour on board UK aircraft, Department for Transport, March 2003

(5) Jet Smarter review, on flyana website

(6) Dangers of Airline Food on the Action on Smoking and Health website

(7) Fair Air Coalition

(8) Travellers’ fear of flying may cause deadly DVT, Daily Telegraph, 24 January 2002

(9) DVT study calls for an end to in-flight alcohol, The Times, 16 May 2002