Epidemiology of Inflight Medical Events

Document Type : Mini Review


Aeronautical Expertise Department, Percy Military Hospital, French Military Health Service, Paris, France


Introduction: Since the 1950s, air travel has grown exponentially. In 2018, the number of international air passengers was estimated at 4.1 billion. Air travel exposes the passenger to a number of constraints (like physical constraints, stress) that can be correlated and lead to an inflight medical event, especially for passengers with chronic conditions or fragile health.
Methods: In June 2017, a mini review of the literature was conducted in order to summarize the data on inflight medical events and their frequency, types, and consequences.
Results: The most frequent inflight medical events are syncope and lipothymic discomfort, followed by digestive disorders, cardiorespiratory symptoms, neuropsychiatric disorders, and trauma. In almost two-thirds of all cases, these medical events are linked to a pre-existing pathology. There is no reliable register of inflight medical events, but their number is estimated to be between 120 to 350 each day throughout the world.
Conclusion: The definition of an inflight medical event deserves to be specified, and the collection of these events needs to be standardized. This will help bring about a better understanding of the issue and maybe raise awareness among passengers with chronic diseases or fragile health and their general practitioners.


The World Bank Group. Air transport, passengers carried. https://data.worldbank.org/indicator/is.air.psgr. Accessed January 14, 2018.
International Air Transport Association (IATA). Press release: Strong demand for air transport increases in 2014. https://www.iata.org/pressroom/pr/Documents/French-PR-2015-02-05-01.pdf. Accessed January 14, 2018.
International Air Transport Association (IATA). Traveler numbers reach new heighs. https://www.iata.org/pressroom/pr/ Pages/2018-09-06-01.aspx. Accessed January 14, 2018.
Air Journal. Air transport: 7.2 billion passengers worldwide in 2015. https://www.air-journal.fr/2016-09-11-transport-aerien-72-milliards-de-voyageurs-dans-le-monde-en-2015-5169203.html. Accessed January 14, 2018.
Air Journal. IATA: 8.2 billion international passengers in 2037! https://www.air-journal.fr/2018-10-25-iata-82-milliards-de-passagers-en-2037-5206389.html. Accessed January 14, 2018.
Peterson DC, Martin-Gill C, Guyette FX, et al. Outcomes of medical emergencies on commercial airline flights. N Engl J Med. 2013;368(22):2075-2083. doi:10.1056/NEJMoa1212052.
Sand M, Bechara FG, Sand D, Mann B. Surgical and medical emergencies on board European aircraft: a retrospective study of 10189 cases. Crit Care. 2009;13(1):R3. doi:10.1186/cc7690.
Cummins RO, Schubach JA. Frequency and types of medical emergencies among commercial air travelers. JAMA. 1989;261(9):1295-1299. doi:10.1001/jama.261.9.1295.
Szmajer M, Rodriguez P, Sauval P, Charetteur MP, Derossi A, Carli P. Medical assistance during commercial airline flights: analysis of 11 years experience of the Paris Emergency Medical Service (SAMU) between 1989 and 1999. Resuscitation. 2001;50(2):147- 151. doi:10.1016/S0300-9572(01)00347-1.
Rodenberg H. Medical emergencies aboard commercial aircraft. Ann Emerg Med. 1987;16(12):1373-1377. doi:10.1016/S0196-0644(87)80422-5.
Graf J, Stuben U, Pump S. In-flight medical emergencies. Dtsch Arztebl Int. 2012;109(37):591-601; quiz 602. doi:10.3238/arztebl.2012.0591.
Dowdall N. “Is there a doctor on the aircraft?” Top 10 in-flight medical emergencies. BMJ. 2000;321(7272):1336-1337. doi:10.1136/bmj.321.7272.1336.
Baker SP, Brady JE, Shanahan DF, Li G. Aviation-related injury morbidity and mortality: data from U.S. health information systems. Aviat Space Environ Med. 2009;80(12):1001-1005. doi:10.3357/ASEM.2575.2009.
Qureshi A, Porter KM. Emergencies in the air. Emerg Med J. 2005;22(9):658-659. doi:10.1136/emj.2005.024505.
Valani R, Cornacchia M, Kube D. Flight diversions due to onboard medical emergencies on an international commercial airline. Aviat Space Environ Med. 2010;81(11):1037-1040. doi:10.3357/ASEM.2789.2010.
O’Rourke MF, Donaldson E, Geddes JS. An airline cardiac arrest program. Circulation. 1997;96(9):2849-2853. doi:10.1161/01.cir.96.9.2849.
Brown AM, Rittenberger JC, Ammon CM, Harrington S, Guyette FX. In-flight automated external defibrillator use and consultation patterns. Prehosp Emerg Care. 2010;14(2):235-239. doi:10.3109/10903120903572319.
Nable JV, Tupe CL, Gehle BD, Brady WJ. In-Flight Medical Emergencies during Commercial Travel. N Engl J Med. 2015;373(10):939-945. doi:10.1056/NEJMra1409213.
Gendreau MA, DeJohn C. Responding to medical events during commercial airline flights. N Engl J Med. 2002;346(14):1067- 1073. doi:10.1056/NEJMra012774.
Select Committee on Science and Technology. Air travel and health: fifth report. London: United Kingdom House of Lords; 2000.
Bougouin W, Lamhaut L, Marijon E, et al. Incidence, characteristics and outcome of sudden cardiac death in France. Eur Heart J. 2013;34 Suppl 1:1743. doi:10.1093/eurheartj/eht308.1743.