Airport Security Versus Patient Security: The “Sickurity” Problem

Document Type : Perspective


Head of Department, Travel Medicine Chair, Internal Medicine Faculty, Debrecen Medical School, Hungary


The massive restrain security measurements at the airports very much impress the health status of the healthy and sick passengers alike. The security check is undisputedly a harassment – the confiscation of fluids, the limited movement on the airplane results in a stressful situation and put a harmful effect on healthy traveler and an even more harmful one on the sick. This kind of problem could be called “sickurity” problem. The aim of this article is to estimate the effects of safety measurements on the patients during their medical repatriation by commercial flight. Due to the high level of anti-terrorism measurements, the medical repatriation of a sick traveler has become more difficult than ever. The main issues of the problem are the following: entering with a patient on a stretcher into the security restricted area; taking the medical equipment, tools and drugs of the escorting professionals on the plane; ensuring appropriate oxygenisation in the safety zone, etc. While the safety measurements and restrictions could interfere with the patient’s treatment before and during the fly, the same is true for the medical escort, who need to treat and care the patient before and during the trip. Unfortunately, majority of airports are not prepared to solve this problem. Moreover, the security rules are vary by countries. Eventually the patient security and airport security are not mutually exclusive ideas. The traveller – both healthy and sick – has a right for appropriate care and treatment even at the airport. Therefore uniformised, satisfactory regulations are badly needed in order to remedy this urgent problem – a protocol, which meet the security and the health-care requirements both alike. Hopefully the authorities (IATA, ASMA, local transport authorities) whom may concerned in the topic will realise and soon create a solution to the “sickurity” problem.


  1. Shampo MA, Kyle RA. Jean Francois Pilatre de Rozier. JAMA. 1983;249(16):2203. doi:10.1001/jama.249.16.2203
  2. FitzGerald GF. The Development of the authentic trilingual text of the Convention on International Civil Aviation. Am J Int Law. 1970;64(2):364-371.
  3. The Convention on International Civil Aviation. Security: Safeguarding International Civil Aviation Against Acts of Unlawful Interference, Annex 17. Published July 2006.
  4. Jenkins BM, Johnson J. International Terrorism: A Chronology, 1968-1974. DTIC Document; 1975.
  5. Mueller O, ed. New ways of explosive booby traps at the international terroristic actions. Security Technology, 1993 Security Technology, Proceedings Institute of Electrical and Electronics Engineers 1993 International Carnahan Conference on; 1993: IEEE.
  6. Bramham G. ICAO eight-point plan adopted in 1989 has strengthened aviation security. ICAO J. 1998;53(10):4-6.
  7. Goodrich JN. September 11, 2001 attack on America: a record of the immediate impacts and reactions in the USA travel and tourism industry. Tourism Manag. 2002;23(6):573-580. doi:10.1016/S0261-5177(02)00029-8
  8. Levine S. Intrusive airport searches: screeners authorized to “pat down” private parts. US News and World Report; 2004.
  9. Treaty on European Union. Official Journal C 191, 29 July 1992.
  10. Hauser C. US eases rules on carry-on luggage. The New York Times. August 13, 2006.
  11. Commission Regulation (EU) No. 185/2010 of 4 March 2010 laying down detailed measures for the implementation of the common basic standards on aviation security (Official Journal L 055, 05/03/2010 P. 0001–0055). 2010.
  12. Regulation EC No. 1107/2006 on the rights of disabled persons and persons with reduced mobility when travelling by air. Published 2006.
  13. Chris R. Recreational Tourism: A Social Science Perspective. London: Routiedge; 1991.
  14. Felkai P, Gorove L. Repatriation of the traveler, falling ill abroad (A külföldön megbetegedettek hazaszállítása). Orv Hetil. 2009;150:1669-1676.
  15. Wang H, Weaver M, Abo B, Kaliappan R, Fairbanks RJ. Ambulance stretcher adverse events. Qual Saf Health Care. 2009;18(3):213-216. doi:10.1136/qshc.2007.024562
  16. Knapik JJ, Harper W, Crowell HP. Physiological factors in stretcher carriage performance. Eur J Appl Physiol Occup Physiol. 1999;79(5):409-413. doi:10.1007/s004210050530
  17. Knapik J, Harper W, Crowell H, Leiter K, Mull B. Standard and alternative methods of stretcher carriage: performance, human factors, and cardiorespiratory responses. Ergonomics. 2000;43(5):639-652. doi:10.1080/001401300184305
  18. Sagawa K, Inooka H. Ride quality evaluation of an activelycontrolled stretcher for an ambulance. Proc Inst Mech Eng H. 2002;216(4):247-256. doi:10.1243/09544110260138736
  19. Felkai P. Airport security check of medical substances used during patient repatriation. [A beteg hazaszállítása alatt használt orvosi anyagok repülőtéri biztonsági vizsgálatának lehetőségei]. Orv Hetil. 2012;153(37):1469-1474. doi:10.1556/OH.2012.29433.
  20. Basic consideration on the security checking of sick travelers at airports. [A beteg utazók repülőtéri biztonsági vizsgálatának alapelvei] Orv Hetil. 2012;153(35):1380-4. doi: 10.1556/OH.2012.29437.
  21. Bristow A, Toff NJ. A report–recommended standards for UK fixed wing medical air transport systems and for patient management during transfer by fixed wing aircraft. J R Soc Med. 1992;85(12):767.
  22. Commission Regulation (EU) No. 185/2010 of 4 March 2010. Laying down detailed measures for the implementation of common basic standards on aviation security, Annex 1, point Published 2010.
  23. Felkai P. Are the flight security measures good for the patients? The “sickurity” problem (Repülőtéri biztonság kontra betegbiztonság? a “sickurity” problémája). Orv Hetil. 2010;151(41):1702-1707. doi:10.1556/OH.2010.28973.
  24. Rodriquez D Jr, Blakeman TC, Dorlac W, Johannigman JA, Branson RD. Maximizing oxygen delivery during mechanical ventilation with a portable oxygen concentrator. J Trauma. 2010;69(1):S87-S93. doi:10.1097/TA.0b013e3181e44b27.
  25. 25. Akerø A, Edvardsen A, Christensen CC, Owe JO, Ryg M, Skjønsberg OH. COPD and air travel: oxygen equipment and preflight titration of supplemental oxygen. Chest. 2011;140(1):84-90. doi:10.1378/chest.10-0965.
  26. 26. Brunette GW, Kozarsky P, Magill AJ, Shlim DR. CDC Health Information For International Travel 2010. Edinburgh: Mosby; 2009.