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New research characterizes pediatric injuries onboard commercial airline flights

October 24, 2016

CLEVELAND, Ohio - In a first-of-its-kind study, researchers at University Hospitals Rainbow Babies & Children's Hospital (UH Rainbow) found that lap infants may be at greater risk for injury on a commercial airline flight than older children traveling in their own seats or using in-flight restraints.

The study analyzed in-flight medical events (IFMEs) on flights worldwide between January 2009 and January 2014 and found 35 percent of all pediatric in-flight injuries occurred in passengers under the age of 2. The researchers found that the most common mechanism of injury was scalding burns from hot beverages or soups spilled on a child, followed by falls from the seat involving lap infants.

The study, conducted in partnership with Dr. Paulo Alves and Dr. Neil Nerwich of MedAire, an International SOS company, characterizes the incidence of IFMEs affecting children with specific focus on injury-related events.

Through an analysis of 114,222 IFMEs, more than 10 percent involved children (newborn to age 18) and more than three percent involved in-flight injuries. Passengers who sustained in-flight injuries were younger than those involved in other medical events.

"Pediatric medical events on commercial airlines are relatively infrequent given the amount of passenger traffic, however unrestrained children, especially lap infants, are more likely to sustain an in-flight injury particularly during meal service or turbulence," says Alexandre Rotta, MD, FCCM, Chief, Division of Pediatric Critical Care Medicine at UH Rainbow and the study's senior investigator. Dr. Rotta, who is also Professor of Pediatrics at Case Western Reserve University School of Medicine, says many pediatric in-flight injuries could potentially be prevented by using in-flight child restraints, avoiding aisle seats, and by having lap infants travel in their own designated seat.

"Our data originated from a pool of approximately 80 major airlines worldwide over a four year period - it provides a very significant sample," says Dr. Alves

More than 83 percent of in-flight injuries occurred on international flights covering distances of more than 3,500 miles and lasting longer than 6 hours. The most common types of in-flight injuries involved burns (39.3 percent), contusions (29.5 percent), lacerations (20.5 percent) and closed head injuries (8 percent).

"It is my hope the information we discovered will promote the development of preventative strategies and travel policies to protect the health of all pediatric airplane passengers, especially these most vulnerable infants," says Dr. Rotta.

The study, titled "In-flight Medical Events, Injuries and Deaths Affecting Children During Commercial Aviation Flights," will be presented during the 2016 American Academy of Pediatrics (AAP) National Conference & Exhibition on Monday, Oct. 24, at 6:15 p.m. ET as a platform oral presentation during the Council on Injury, Violence, and Poison Prevention Program.

The study follows the 2014 article "Fatalities Above 30,000 Feet: Characterizing Pediatric Deaths on Commercial Airline Flights Worldwide," published in the October 2014 issue of Pediatric Critical Care Medicine Journal, that identified a pattern indicating infants may be at greater risk for death on a commercial airline flight.

MedAire is the leader for in-flight medical advisory services, and as such delivers indispensable medical advice and assistance when medical situations arise in-flight.
About University Hospitals Rainbow Babies & Children's Hospital

Internationally renowned, UH Rainbow Babies & Children's Hospital is a full-service children's hospital and pediatric academic medical center with experts in 16 medical divisions and 11 surgical specialties who offer nationally ranked care not available at other institutions in the region, including a center dedicated to adolescent and young adult cancer treatment and Northeast Ohio's only single-site provider of advanced maternal fetal medicine and neonatology services. As an affiliate of Case Western Reserve University School of Medicine and the only Level I Pediatric Trauma Center in the region, UH Rainbow Babies & Children's Hospital offers access to novel therapies, advanced technologies and clinical discoveries long before they are available nationwide. Rainbow pediatric specialists - all of whom also serve on the faculty at the School of Medicine - are engaged in today's most advanced clinical research and are widely regarded as the best in the nation - and in some specialties, the best in the world. Learn more at

About MedAire

MedAire, an International SOS company, provides airlines with in-flight medical advice and support, at-destination crew support, aircraft medical kits, and train-the-trainer programmes for in-flight medical events. Since 1985, MedAire has been a trusted provider of 24/7 in-flight medical advice; 24/7 security advice, information and contingency planning; crisis management services for medical needs after accidents or serious incidents, medical and security support for crew while on duty travel; passenger fit-to-fly assessments; medical kits and equipment; crew medical training; and pre-travel medical review of MEDIF/MEDA. For more information visit

University Hospitals Cleveland Medical Center

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