Safeguarding public health at UK airports: an examination of current health security practices

In response to the H1N1 influenza outbreak and the role of air travel in facilitating the virus’s rapid spread around the world, this paper contributes to debates concerning the governance of infectious disease by examining the role of the Port Health Regulations and associated health security practices that are enacted at UK airports. While airports have been at the forefront of measures to prevent the importation of ‘foreign’ infectious diseases since the early 1930s, the present scale of international aeromobility combined with heightened awareness of the role air travel plays in the global spread of human pathogens, the epidemiological obsolescence of many early aeronautical sanitary regulations, and a dearth of academic studies on health security at airports, provide compelling reasons to examine the development, content, and implications of the existing Port Health Regulations and associated health security practices that are performed at UK airports. Drawing on extensive archival research and fieldwork interviews with key stakeholders in the aviation and health care sectors (including airport managers, ‘front line’ customer-facing airline personnel, and medical practitioners), we chart the development of sanitary regulations at UK airports and explore the current practices of health security that are performed at individual sites. We then identify the main challenges involved in safeguarding global public health against the dissemination of ‘foreign’ infectious diseases by air through UK airports and conclude by offering recommendations for improved practice.