Health advice for aircrew on refugee flights

In order to assess measures taken by airlines to protect the health of crews on refugee flights, a survey was made of airlines involved in transporting Indochinese refugees from Southeast Asia. Five of the 20 airlines surveyed provided sufficient data for analysis. Combined, the five airlines transported approximately 2,500 refugees on more than 100 flights, involving at least one crew change per flight. Health measures varied considerably among airlines. Immunizations alone sufficed in some cases, whereas others required flight attendants to wear gloves and provided anti-malarials, even for crew which did not enter malarious areas. Where antimalarials were recommended, they were not protective against Southeast Asian strains of P. falciparum malaria. No airline noted an increase in illness among aircrew involved in refugee flights. Disinsection procedures were improperly performed in three airlines; one airline did not disinsect at all. Aircrew were generally overly immunized and, in some cases, overly protected in a setting where the probability of disease transmission was low.