How Clean is the Air We Breathe in Airplane Cabins; Emergency Medical Centers Save Lives in the Air.
QUEST: Welcome back to "CNN BUSINESS TRAVELLER." When it comes to travel, the one part of the experience when we really feel out of control is when we're cooped up in the tin can better known as the plane. Think about it, hundreds of other people breathing, sneezing, coughing the same air. How dangerous is it? What can we catch? Luckily for us, Ayesha Durgahee has been sifting the myths from reality.</s>AYESHA DURGAHEE, BUSINESS TRAVELLER CORRESPONDENT (voice-over): Shoulder to shoulder, strangers confined in one space, in a stale and stuffy cabin. We no longer have to inhale other people's cigarette smoke. Instead, there's the perception of inhaling other people's germs.</s>JOE BIDEN, VICE PRESIDENT OF THE UNITED STATES: But you're in a confined aircraft, when one person sneezes, it goes all the way through the aircraft.</s>DURGAHEE: Air in the cabin doesn't actually move backwards or forwards. It enters from the top of the cabin and is drawn vertically to floor level, taking any germs lurking in the air with it. By the time the air re-enters the cabin, it has been filtered using high-efficiency particulate air, or HEPA filters, that reduces the risk of transmitting airborne diseases. (on camera): HEPA filters are the same ones used in hospital operating theaters. They're 99.9 percent efficient at removing bacteria and viruses so the air that we breathe onboard is actually cleaner than the air in your office. (voice-over): HEPA filters may do a good job of providing us with cleaner, fresher air, but what happens if you hear someone cough or sneeze?</s>DR. RICHARD DAWOOD, FLEET STREET CLINIC: If a person sneezed two rows behind you, you might be at risk from direct inhalation of some of those droplets, but what you wouldn't be at risk from is the idea that those droplets would be taken into the ventilation system and they would be blown out at you in the fresh air supply. Filtration of air within the aircraft cabin is highly efficient. And you can expect probably a full change of air within the cabin every three minutes or so.</s>DURGAHEE: Airlines aren't required to make public their cabin air data. And there are no rules for humidity, temperature or bacteria levels. There's very little information available. In fact, the last key findings were in 2001 where, in the U.S, an aircraft using only re-circulated air was compared with an aircraft using outside air. The study showed that 20 percent of passengers on both aircraft contracted a cold within a week of stepping off the plane. So just think that we are more susceptible to illness when we fly.</s>DAWOOD: We certainly know that there's an increased rate of respiratory infection in people who travel. There are certainly factors in the aircraft that could make it more likely. One of these is the general dryness of the cabin air. It's pumped in from the outside and that removes the -- an important layer of protection, the moisture film that lines the mouth, the nose, the throat, the respiratory passages. That acts as an important barrier. And when that's gone, it's certainly possible that bacteria and viruses can break through.</s>DURGAHEE: It's not just about the quality of the air we breathe on board that leaves our immune systems weakened. It's the combination of time zone changes, jet lag and the stress of the airport, all part and parcel of the travel process.</s>QUEST: Preparing for the worst is the stock in trade of airlines and airports, especially when it comes to medical emergencies. That's why there are companies like MedAire, with control rooms and large numbers of doctors ready to give advice if necessary. We now take you behind the scenes for a rare look at the MedAire control center in Arizona. When you're up in the air, it's these guys on the ground who are on the front line when it comes to your health.</s>UNIDENTIFIED FEMALE: We have a 78-year-old male passenger who is having some chest pain...</s>QUEST: It looks like a call center. It's actually MedAire's Global Emergency Response Center.</s>UNIDENTIFIED FEMALE: Monitor and give some fluids.</s>QUEST: The company was founded 20 years ago by former nurse Joan Sullivan Garrett to provide medical assistance to passengers and crew of airlines, yachts and commercial ships.</s>JOAN SULLIVAN GARRETT, CHAIRWOMAN & FOUNDER, MEDAIRE: Because it's 24 by seven, we're getting calls day and night. And these calls are from a variety of locations. We have calls coming from the gates. We have calls coming from Reservations. We have calls coming from the jet way before they even approach the cabin. And sometimes we even get calls from the runway. And then we have calls from -- in many cases, we're taking care of the airline crew because they're traveling, they're exposed to sick people and so they get sick. And so, again, that takes us well up to almost 100,000 calls from a variety of different sources.</s>QUEST: Last year, MedAire received more than 17,000 in-flight calls. Passengers fainting is the most common medical complaint. It's followed by nausea and vomiting. Heart attacks on board are thankfully relatively rare. The company's founder says, over the last few years, there has been an improvement in health care on board flights with a marked decline in fatalities and a reduced number of flight diversions.</s>GARRETT: If I were going to be able to plan a heart attack for myself, I would hope that I was on an airline because the time to defibrillation is less than two minutes. That's unheard of in most metropolitan areas. So I'm not recommending that if you have chest pains, get on a plane. But I am saying, if you are on a plane and you do have chest pain, put that hand up, ring the bell, or understand that they are very well trained to deal with that scenario.</s>QUEST: Since the outbreak of swine flu, MedAire has seen a significant rise in the number of calls like this one. It's 9:45 pacific time. A passenger on board an American carrier enroute to Kenner, Louisiana, is in trouble.</s>UNIDENTIFIED FEMALE: I do copy to zero, female passenger with flu- like symptoms. You can page (ph). Nausea, fever, diarrhea. Has she been vomiting, over? I copy that information. If you'll please stand by, I'll have you speak with a MedAire physician.</s>QUEST: Dr. Andrzej Dmowski is one of the 35 physicians on hand at the Banner Good Samaritan Medical Center.</s>DR. ANDREZEJ DMOWSKI: I understand you have a 50-year-old passenger with flu symptoms, nausea, fever, diarrhea and vomiting, is that correct? How many times has the passenger vomited? We can give one tablet Promethazine, which should help with the nausea. We can try to let that dissolve under the tongue with a little ice. Elevate the legs. Continue the oxygen. Possibly place a mask on the patient just because she has the -- had some flu-like symptoms. And we'll have medics meet you on arrival. This isn't a typical flu. There's many other things going on with the vomiting, the diarrhea...</s>GARRETT: We were very engaged and very engaged during SARS. And we were also extremely involved because a lot of crews were grounded all over the world when 9/11 happened. And so we had to deal with the anthrax and calls from all sorts of things. So today, it fits pretty much with what we're accustomed to.</s>DR. DAVID STREITWEISER, BANNER GOOD SAMARITAN HOSPITAL: One of the more interesting cases didn't involve a person. It involved a case of frozen eyeballs that one of our client airlines accidently transported to the wrong location. And they were going to be used for transplant purposes. Had to remain frozen to be usable. And they had to stay overnight now in a non-refrigerated environment. They couldn't get them to the correct location until the next day where they could be used. So the airline didn't know what to do with them. And we were able to use our resources at the hospital, talk to our transplant service and say, well, how would you preserve frozen eyeballs. And they gave us the precise instructions, how much dry ice to use. And it worked out great.</s>QUEST: Next time you're on a flight and the shout goes up, "Is there a doctor on board," you can be safe in the knowledge, whatever the problem, sound advice is just a call away. When we come back, practical tips for keeping traveling bugs and bacteria at bay.