Epidemiology of Medical Events on a Commercial African National Airline Carrier Between 2009 and 2011

Document Type: Original Article

Authors

1 Division of Medicine, Faculty of Medicine, University of Cape Town, South Africa

2 Department of Public Health Medicine, University of KwaZulu Natal, Durban, South Africa

Abstract

Introduction: An estimated 3.8 billion passengers traveled on commercial aircraft in 2016, of whom close to 1.5 billion crossed international boundaries. Modern commercial aircrafts can carry up to 800 passengers and can fly more than 18 hours. Although not very common, in-flight medical incidents can result in flight diversions that are costly and extremely inconvenient. The aim of the current study was to review in-flight medical incidents on a commercial African carrier between 2009 and 2011.
Methods: A secondary analysis of data collected by air stewards during in-flight medical events that were recorded in a register were retrieved for the 3-year period 2009-2011. All medical documented data was evaluated.
Results: A total of 3306 medical events equating to an average of 155 cases per million passengers per year were documented over the 3-year study period, of which 3279 were specified into medical categories. Cardiovascular cases (1124; 34.0%) gastrointestinal (727; 22.0%), muscular-skeletal (302; 9%), and respiratory (202; 6%) were the most common cases. Most incidents (74%) were managed by the cabin crew. Five of the medical incidents led to diversions. There were 9 deaths on board over the 3-year period.
Conclusion: In-flight medical incidents are rare events. Comparisons with other airlines is difficult due to the non-standardization of recording methods. A global uniform reporting format across all airlines is necessary. Further research is required to determine the factors associated with medical incidents so that pre-emergency preparedness plans can be strengthened.

Keywords


  1. International Air Transport Association (IATA). Annual Review 2017. Cancun: IATA; 2017.
  2. Silverman D, Gendreau M. Medical issues associated with commercial flights. Lancet. 2009;373(9680):2067-2077. doi:10.1016/S0140-6736(09)60209-9.
  3. Kesapli M, Akyol C, Gungor F, Akyol AJ, Guven DS, Kaya G. Inflight Emergencies During Eurasian Flights. J Travel Med. 2015;22(6):361-367. doi:10.1111/jtm.12230.
  4. Hinkelbein J, Neuhaus C, Bohm L, Kalina S, Braunecker S. In-flight medical emergencies during airline operations: a survey of physicians on the incidence, nature, and available medical equipment. Open Access Emerg Med. 2017;9:31-35. doi:10.2147/OAEM.S129250.
  5. 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.
  6. Tonks A. Cabin fever. BMJ. 2008;336(7644):584-586. doi:10.1136/bmj.39511.444618.AD.
  7. Sand M, Morrosch S, Sand D, Altmeyer P, Bechara FG. Medical emergencies on board commercial airlines: is documentation as expected? Crit Care. 2012;16(2):R42. doi:10.1186/cc11238.
  8. Cocks R, Liew M. Commercial aviation in-flight emergencies and the physician. Emerg Med Australas. 2007;19(1):1-8. doi:10.1111/j.1742-6723.2006.00928.x.
  9. Mahony PH, Myers JA, Larsen PD, Powell DM, Griffiths RF. Symptom-based categorization of in-flight passenger medical incidents. Aviat Space Environ Med. 2011;82(12):1131-1137. doi:10.3357/ASEM.3099.2011.
  10. Cupa M. [Air transport, aeronautic medicine, health]. Bull Acad Natl Med. 2009;193(7):1619-1630; discussion 1630-1611.
  11. Delaune EF 3rd, Lucas RH, Illig P. In-flight medical events and aircraft diversions: one airline’s experience. Aviat Space Environ Med. 2003;74(1):62-68.
  12. 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.