Air Travel

When you travel by air you should be aware of an increased risk of thrombosis. The condition has been dubbed Economy Class Syndrome, as cramped seats suffered by economy passengers on long-haul flights make it difficult for blood in the legs to flow properly. It is a misleading phrase because people travelling first class, and even pilots have been affected.

Risk Factors

Three members of the British Olympic team suffered from blood clots when flying to Australia for the Sydney Olympics. It follows that even strong, fit and healthy people can be susceptible to thrombosis when travelling by air. However, some factors can increase the risk of thrombosis:

• Thrombophilia - an underlying tendency to get blood clots
• Age - elderly passengers are more at risk
• Diet - overweight passengers are more at risk
• Aircraft - some aren't so good - dry, recirculated air may be a factor
• Money - economy class passengers are more at risk due to cramped seating
• Height - leg room is very limited for tall people reducing in-seat mobility

To Reduce The Risk

There are a number of things that you can do to reduce the risk of thrombosis when travelling by air:

• Book A Better Seat - space to kick your feet around is healthy so try to get a good position in the cabin. Seats that are positioned next to an exit have lots of space and can sometimes be reserved for only a small fee.
• Wear Support Stockings - these help to prevent the blood from pooling in the lower leg and increase circulation. If you have recently undergone surgery or have suffered from deep vein thrombosis they are highly recommended.
• Avoid Excessive Amounts Of Alcohol - drinking alcoholic drinks causes dehydration.
• Drink Plenty Of Water - keeps you properly hydrated and if you do this you might have a simple excuse for our next tip…
• Go Walkabout - stretch your legs with a walk up and down the plane every hour or so, perhaps a trip to empty your bladder (it’s not healthy to have a full bladder). In your seat you can increase circulation by exercising your feet (like clutch pedal control in a car - lift your toes up and down).
• Watch For Symptoms - when you get off the plane any clots that have formed may start to circulate and move to the lungs causing breathing difficulties. And if you have painful and swollen calves after a flight, even several days after, it would be advisable to see a doctor.

What Is Being Done

Air passengers should get more information about the health risks of flying.

• A Japanese doctor, Dr Toshiro Makino, says 25 people have died at Tokyo airport over eight years due to blood clots caused by cramped airline seating. A study by the Nippon Medical School clinic at Tokyo’s Narita airport found 100 to 150 passengers a year were treated at the clinic for the problem after arriving on long-distance flights. Of these cases, 50 to 60 were regarded as serious.
• John Belstead, an accident and emergency consultant at Ashford Hospital in Middlesex (Heathrow’s nearest hospital), said his department had dealt with 30 passenger deaths in the last three years. Heathrow handles around one million people on long haul flights each month.
• A problem in tracing the extent of the condition is that not all hospitals record whether blood clot patients have been on a plane.
• A study of 100 passengers has revealed 10% developed clotting as a result of flying. The report’s author, John Scurr, said the study was specifically designed to trace blood clots caused by flying.
• Dr Patrick Kesteven, consultant haematologist, said a research team in London has started work to find biochemical markers to find thrombosis before overt symptoms became evident.
• The UK House of Lords Science and Technology Committee has called for urgent research into the causes of DVT and asked the Civil Aviation Authority to lay down a standard for seat dimensions, so passengers would know what to expect.
• An inter-departmental group with members from the Department of Environment, Transport and the Regions, the Department of Health, the Civil Aviation Authority and the Health and Safety Executive, was being created to work with airline companies.
• Qantas and British Airways are among several major airlines that have pledged to distribute information about the risks of DVT to travellers.

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