Law Office Management

May 2, 2015

Health in Transit

Doctors and well-traveled lawyers dole out their go-to tactics to avoid getting sick while flying.

Brian Arbetter, a partner with Sheppard, Mullin, Richter & Hampton in Los Angeles and Chicago, learned the hard way how easy it is to fall ill when traveling around the clock.

"I had an unfortunate experience from too [many trips] in a row," says Arbetter, who typically flies about 150,000 miles each year for his international employment law practice.

He was hospitalized in 2010 for pancreatitis and had his gallbladder removed. Medical staff told Arbetter his "travel life" was at least partly to blame, so he gave his lifestyle a makeover. He tried to eat more healthfully, walk more, and reduce his alcohol consumption during trips. Even with healthier habits, though, Arbetter says he worries about viruses hitching a ride home with him, especially in the wake of outbreaks like Ebola.

"There's only so much you can do" as an airline passenger, he says. "You're in a contained vessel and you have a lot of people all around you."

Sometimes getting sick is unavoidable, but we spoke with experts about minimizing the risk. Here are seven tips for travelers, thanks in large part to Sarah Doernberg, an assistant professor of infectious diseases at UC San Francisco, and Neda Pakdaman, medical director of Stanford Concierge and Executive Medicine Clinics.

1. Mitigate germs.

According to the Centers for Disease Control and Prevention (CDC) and the World Health Organization, air circulation and quality on planes is actually so good that people are no more likely to catch a cold on an airplane than they are on a bus or at a crowded theater. But as airlines cut down on legroom, travelers are packed in closer than ever. That becomes a particular problem when nearby passengers sneeze, cough, or touch.

Flu viruses can live on surfaces for two to eight hours, according to the CDC. However, certain bacteria-including E. coli and drug-resistant Staphylococcus-can survive for days on airplane tray tables, armrests, seat pockets, window shades, and metal toilet handles, a 2014 study from Auburn University showed.

Pakdaman of Stanford suggests using antibacterial wipes to clean nonporous surfaces, such as tray tables and armrests. Also consider avoiding any pillows or blankets offered in-flight unless they're wrapped or sealed.

Both doctors suggest regularly washing your hands as the number one precaution against getting sick. Travelers who don't expect to have easy access to a sink can bring along hand sanitizer. Beyond that, avoid touching your mouth and nose so germs won't have an easy pathway to your mucous membranes, Pakdaman says.

2. Stay hydrated.

Aircraft cabins typically are very dry, with just 10 to 20 percent humidity, according to the CDC. Because dehydration of mucous membranes can lead to symptoms such as dry eyes, nasal irritation, and dry mouth, Pakdaman recommends drinking plenty of water. She says travelers also might consider using eye drops and limiting or avoiding diuretics such as caffeine.

And while a Bloody Mary might seem especially appealing at 30,000 feet, alcoholic drinks can exacerbate dehydration. Doernberg suggests drinking even more fluids if you plan to consume alcohol.

3. Eat wisely.

Sheppard Mullin's Arbetter pays close attention to his eating schedule, coordinating when he eats on the plane to match his mealtimes at his destination. Sometimes he skips eating in-flight food altogether.

Don't bother wasting cash on vitamin drinks or other over-the-counter "miracle" cures. Most products purporting to boost your immune system are not conclusively proven to prevent illness. "I don't think there's convincing enough evidence that they work," Pakdaman says of vitamin C-based cold-prevention products.

4. Keep moving.

Long-distance travelers over age 40 and those with other risk factors should be especially mindful of deep vein thrombosis, when blood clots form in the legs of passengers who sit still for long periods of time. Though not a communicable illness, these clots can wreak havoc by causing swelling or even breaking off and making their way to the lungs.

Anyone who is vulnerable to clots should talk to a physician before traveling. Risk factors include age, family medical history, recent surgery, and cancer. WHO recommends moving often, getting up to walk the plane aisles every two to three hours, wearing loose clothing, and stowing carry-on luggage so that it does not obstruct your legs.

5. Reduce stressors.

After Arbetter's hospitalization, he made it a priority to shorten business trips when possible and avoid stacking consecutive flights.

But Harumi Hata, a partner at Seyfarth Shaw in Los Angeles, knows she can't always control her schedule. So Hata, who practices corporate law, compensates by reducing other headaches. For example, she tries to carefully plan her route in an unfamiliar city and arrives early for meetings. Hata also takes power naps when she can.

6. Beat jet lag.

Constant jostling between time zones can lead to stomach problems, difficulty concentrating, and generally feeling ill.

Depending on when you arrive at your destination, it can help to immediately go for a walk outside. Sunlight plays a big role in governing our internal clock because it influences melatonin, which signals the body when it's time to sleep.

7. Take precautions early.

Your best weapon for fighting off germs is your immune system, so tune it up before you come in contact with them. That means getting enough sleep and incorporating exercise and other healthy lifestyle habits whenever possible.

Doernberg also suggests getting a yearly flu shot and keeping other vaccinations up to date (including the measles shot, especially in light of recent outbreaks). People with compromised immune systems should consult a physician before traveling.

And when you book your flight, keep in mind that even the seat you choose can make a difference. A notorious study by the CDC found that on a 2008 flight from Boston to Los Angeles during a norovirus outbreak, passengers sitting next to the aisle were more likely to have fallen ill. In a follow-up study, one microbiologist reportedly asserted that aisle-seat armrests in general tend to hold more germs than others because passengers touch them so often.

Emily Morris is an associate editor at California Lawyer

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Donna Mallard

Daily Journal Staff Writer

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