In the airline industry, health-related issues concern most activities, including aircraft operations, passenger transport, and cargo. They cover matters as diverse as duty time limitation, transmission of communicable diseases, and disinfection.

IATA Medical Manual

The IATA Aviation Medical Manual is a complete guide that focuses on airline administration and operations from a medical point of view for passengers and crew.

IATA Travel Centre

The IATA Travel Centre is the most accurate information source for personalized passport, visa and travel health requirements advice depending on your nationality and destination.

Cabin Airflow Design

Aircraft cabins are designed to provide a clean and healthy environment. Multiple features help reduce the spread of airborne particles, including high rates of air renewal, advanced filtration, and cabin airflow design.

Why cabin air is different:

  • 20–30 air changes per hour – cabin air is refreshed far more frequently than in most office buildings.
  • 50% fresh air, 50% filtered air – the air supplied onboard is a mix of outside air and recirculated air passed through HEPA filters.
  • 99.9%+ filtration efficiency – HEPA filters remove the vast majority of airborne particles, including bacteria, viruses, and fungi.
  • Top-to-bottom airflow – air flows vertically through the cabin rather than along its length, helping to limit particle movement.

 

HEPA Filters

Most modern jet aircraft are equipped with High-Efficiency Particulate Air (HEPA) filters, similar to those used in hospital operating theatres and clean-room environments. These filters are highly effective at capturing microscopic airborne particles and contribute to the high quality of cabin air.

Rate of Air Renewal

The air in the aircraft cabin comprises of around 50% fresh air from outside the aircraft and 50% of HEPA filtered air. The air in the cabin is also renewed 20-30 times an hour or once every 2-3 minutes, which is a higher rate of air renewal than in other indoor facilities

 

Discover the main conclusions from cabin Air Studies (pdf)

Air Travel and Mask-Wearing

Health and safety requirements may vary by country, airline, and destination. Masks or other public health measures may be required on some flights. Always follow crew instructions, as non-compliance may result in penalties.

Even when masks are not required, passengers may choose to wear one for personal comfort or health reasons.

Here are some main conclusions from cabin air studies:

Harvard T.H. Chan School of Public Health
Researchers at the Harvard T.H. Chan School of Public Health found that the multiple layer of measures, including the wearing of face masks and more frequent disinfection, together with the aircraft airflow systems, results in a very low risk of COVID-19 transmission on aircraft.

 

US Transportation Command (Transcom), Department of Defense
Research by the US Transcom showed that aerosol particles were “rapidly diluted by the high air exchange rates” of a typical aircraft cabin. Aerosol particles remained detectable for a period of less than six minutes on average. Both aircraft models (B777 and B767) tested removed particulate matter 15 times faster than a typical home ventilation system and 5-6 times faster “than the recommended design specifications for modern hospital operating or patient isolation rooms.”

Mannequins with and without face masks sat in various seats on the aircraft while fluorescent tracer particles were released at intervals of two seconds to simulate breathing for a minute during ground and in-flight tests. Real-time fluorescent particle sensors were placed throughout the aircraft at the breathing zone of passengers to measure concentration over time.
View the US Transcom research

Airbus
Airbus used computational fluid dynamics (CFD) research to create a highly accurate simulation of the air in an A320 cabin, to see how droplets resulting from a cough move within the cabin airflow. The simulation calculated parameters such as air speed, direction and temperature at 50 million points in the cabin, up to 1,000 times per second. The same tools were used to model a non-aircraft environment, with several individuals keeping six feet (1.8 meters) distance between them. The result was that potential exposure was lower when seated side by side on a plane than when staying six feet apart in an environment such as an office, classroom or grocery store.
View the Airbus Presentation (pdf)

Boeing
Using CFD, Boeing researchers tracked how particles from coughing and breathing move around the airplane cabin. Various scenarios were studied including the coughing passenger with and without a mask, the coughing passenger located in various seats including the middle seat, and different variations of passengers’ individual overhead air vents (known as gaspers) on and off. The modeling determined the number of cough particles that entered the breathing space of the other passengers. Based on the airborne particle count, passengers sitting next to one another on an airplane is the same as standing more than seven feet (or two meters) apart in a typical building environment.
View the Boeing Presentation (pdf)

Embraer
Using CFD, cabin air flow and droplet dispersion models validated in full-scale cabin environment testing, Embraer analyzed the cabin environment considering a coughing passenger in several different seats and air flow conditions in our different aircraft to measure these variables and their effect. The research Embraer completed shows that risk of onboard transmission is extremely low, and the actual data on in-flight transmissions that may have occurred, supports these findings.
View the Embraer Presentation (pdf)

 

Passenger Medical Issues

Air Transport & Communicable Diseases

Communicable diseases and pandemics have important implications for airlines and their customers. On this page you will find resources for airlines and other travel professionals medical crews.

> Fact sheet: Public Health Emergency Preparedness (pdf)

COVID-19

In May 2023 WHO announced the end of the PHEIC (Public Health Emergency of International Concern) status of COVID-19 and a move to long-term approach to deal with the ongoing health challenges of COVID-19. IATA statement on the termination of the PHEIC.
> WHO info on COVID-19

Ebola, Marburg and other viral haemorrhagic fevers

There have been a number of outbreaks of viral haemorrhagic fevers in recent years, including Ebola in Uganda in 2022, and two simultaneous outbreaks of Marburg in Equatorial Guinea and Tanzania in early 2023. Lassa fever occurs regularly in parts of Nigeria and causes recurrent outbreaks. While there is potential for people with these diseases to travel by air, spread is generally only when they are highly unwell, and occurs through very close contact such as within households, during medical treatment, or at funeral rituals. Any cross-border spread is considered more likely to be through land borders. It is generally considered that these outbreaks should not need to impact international air travel. Current guidance in response to the 2026 epidemic of Ebola disease caused by the Bundibugyo virus (BVD) can be found below.

> Guidance on Ebola disease (pdf)

Emergency Response Guidelines

Based on experience with different outbreaks, the Emergency Response Plan & Action Checklist (pdf) is meant to be used by air carriers in the event of a public health emergency.​​

An important part of this plan involves a series of guidelines and best practices for airline staff: 

Universal Precaution Kit (2017) (pdf)

Crew health precautions in pandemic (2020) (pdf)

Maintenance Crew (2017) (pdf)

Cargo & Baggage Handlers (2017) (pdf)

Passenger Agents (2017) (pdf)

Passenger Locator Form

Hygiene for Prevention of Respiratory Infections (pdf)

Cabin Announcement Scripts (2017) (pdf)

Cabin Air Quality Brief (pdf)

Cabin Crew (2017) (pdf)

Cleaning Crew (2017) (pdf)

Bird Strike (2017) (pdf)

Ebola Disease – Bundibugyo Virus (BVD) (2026) (pdf)

Infectious Disease Issues

Food and Water on Board

Crew Medical Issues

Medical Emergencies Onboard