Some reassuring advice to travellers carrying insulin through airport security checkpoints and on aircraft.

People with diabetes who use insulin and travel on passenger aircraft will be familiar with the new security precautions relating to syringes and needles when moving through airports and travelling on aeroplanes.  Medical supplies such as needles, syringes, injection pens, etc. are now classified as ‘weapons’, and even those who use insulin pumps are sometimes confronted by new requirements in air travel security.

While we all probably understand the proper concerns of officials about items such as insulin syringes, which in the wrong hands can become weapons, the issue remains a sensitive one for legitimate users.  The guidelines developed by Diabetes Australia with various security bodies are mostly working well when practised by security staff.

However, there is another concern being expressed by some members of Diabetes Australia.  Queries have been raised about the potential risk to the effectiveness of insulin exposed to X-rays in security devices at airports.  It is important to always take precautions to minimise the exposure of insulin to a wide range of ambient temperature extremes, by users carrying the insulin on themselves, rather than placing it in the checked-in baggage-hold luggage.  But what happens to insulin when it is exposed to the X-rays that are an integral part of the security equipment used at airports?

Diabetes Australia approached the two largest suppliers of insulin in Australia, Novo Nordisk and Eli Lilly, to establish what scientific analysis has been done to identify the risks of X-rays on the insulins they supply.

Novo Nordisk have exposed a representative range of its insulins to both X-rays and cosmic rays.  The latter are a form of radiation from space that reaches Earth and is in greater concentrations at higher altitudes.  These were conducted at Copenhagen Airport in Denmark and on a return flight between Copenhagen and Tokyo.  The airport X-ray test involved taking the insulin through security equipment 30times, corresponding to an approximate radiation of 21 uSievert (a scientific measure used in such tests).  The in-flight cosmic ray test was equivalent to an irradiation level of 100 uSievert.

Novo Nordisk informed Diabetes Australia that their investigations ’…did not reveal any changes in the quality of the insulin products with respect to insulin degradation and formation of aggregates’.  The company concluded that ‘the quality of the insulin preparations carried by a person is neither affected by the X-ray radiation exposed at the security control in the airport nor by the cosmic radiation during the flight’.

While Eli Lilly  have not mentioned any scientific analysis, they provided the following statement: ‘Under normal conditions, insulin is stable when passing through X-ray machines encountered at airport terminals during travel.  However, if the insulin remains in the path of the X-ray irradiation for longer then normal or if a vial were to be repeatedly exposed under normal conditions, the stability may be impaired.  For this reason, insulin should not be exposed to X-rays during travel; it should be inspected manually as needed’.

This statement by Eli Lilly, in the apparent absence of scientific analysis, can be read as erring on the side of caution and advocates that people carrying insulin ask for it to be inspected manually by airport security staff.

Under regulations administered by the Department of Transport and Regional Services, responsible for airport security, any traveller passing through a screening point may request a physical search of themselves and their property.  Upon such a request, staff must then oblige.

Incidentally, it should also be remembered that under the same set of regulations people with certain medical conditions (such as diabetes) are  permitted, subject to screening, to carry their medical supplies with them within the secure areas of airports and  on board aircraft. 

Any risk to the viability of insulin exposed to X-rays would seem to be at most, minimal.  In any event, individuals can exercise the right to submit to a physical rather than technological search at the airport.