Singapore Airlines has tightened seatbelt rules on its flights after one passenger died and more than 100 were injured when one of its planes hit severe turbulence.

Passengers and crew onboard flight SQ321 suffered skull, brain and spine injuries when they were thrown violently around the cabin during Tuesday’s terrifying high-altitude ordeal. Some passengers said the turbulence happened so fast there was no time to fasten their seatbelts.

The London to Singapore flight carrying 211 passengers and 18 crew was forced to make an emergency landing in Bangkok, where at least 48 people are still being treated in hospital.

In response, Singapore Airlines said it had introduced a “more cautious approach” to turbulence.

“In addition to the suspension of hot beverage service when the seatbelt sign is on, the meal service will also be suspended,” the carrier said in a statement to AFP. “SIA will continue to review our processes as the safety of our passengers and crew is of utmost importance.”

Investigators from Singapore and the US have travelled to Thailand to look into the causes of Tuesday’s incident.

Air safety experts have told AFP that passengers are often too casual about wearing seatbelts, leaving them at risk if the plane hits unexpected turbulence. Scientists also say that so-called clear air turbulence, which is invisible to radar, is getting worse because of the climate crisis.

The director of Bangkok’s Samitivej Srinakarin hospital, where most of the injured were taken, said his staff had never before treated such severe injuries caused by turbulence.

Keith Davis, an Australian passenger, described the ordeal, which left his wife, Kerry, with a severe spinal injury and no feeling below the waist.

“It was absolute carnage, instantly. It was absolutely surreal. You know, there’s no warning,” he told the Australian broadcaster Channel 9. “Before we knew it we were on the ceiling. And then bang, we’re on the ground. And you don’t know what is going on.”

Davis said his wife hit the doors of the overhead luggage lockers before falling to the floor of the aisle, and was unable to move for the rest of the flight.

On landing at Bangkok’s Suvarnabhumi airport, the plane was met by emergency responders who used gurneys to ferry the injured passengers to waiting ambulances.

Photos taken inside the plane after it landed in Bangkok show the cabin in chaos, strewn with food, drinks and luggage, and with oxygen masks dangling from the ceiling.

The chief executive of Singapore Airlines, Goh Choon Phong, has apologised for the “traumatic experience” and expressed condolences to the family of Geoffrey Kitchen, 73, the British man who died.

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