by Dr. Rajiv Narula
Do an Internet search on ‘Economy Class Syndrome’ and you are likely to come up with a long list of articles/ links. The death of a 28 year old woman, after a 20 hour flight from Australia to England, from a blood clot in her lungs ,has been a popular news item in Australia and the UK. The Australian government and a British Parliamentary committee are commissioning a study on Deep Vein Thrombosis or DVT and its relationship to air travel. The person who coined the term Economy Class Syndrome, perhaps spent a restless part of their trip in the dungeons of an airplane – the ‘economy’ section. This section usually has fares advertised in national newspapers and when you call, they are usually sold or not available due to one of those reasons listed at the bottom of the page.
Deep vein thrombosis usually presents as a warm, swollen, lower extremity. Risk factors include pregnancy, post operative after orthopedic and pelvic surgery, prolonged periods of immobility, having certain cancers, especially pancreatic cancer and women on oral contraceptive pills. Diagnosis can be made clinically, but is usually confirmed by an ultrasound study of the leg veins. Therapy consists of the use of blood thinners. These may need to be used for 6 months or longer, requiring frequent blood monitoring. A small percentage of these blood clots will travel to the heart and lung, where they may cause death. This is most likely the cause of death of that young woman who died when she reached the UK from Australia.
Air travel, especially when one is stuck in the back of the plane where leg space is minimal, could play a role in the formation of one of these deadly clots. Studies have shown that flights that are more than 8 hours in length can also play a role. People who try and pass time by drinking alcohol, are infact dehydrating themselves( alcohol inhibits the absorption of water), the one consolation in this is that they need to go to the bathroom on a regular basis, so they do do some stretching, unintentionally !
Possible strategies to reduce your chances of developing a blood clot from flying includemaking sure you are well hydrated before and during your flight, do some low level exercise/ stretching while in flight. Try to get an aisle seat so that you can get out without aggravating your fellow passengers. Research by Japanese researchers found that in an airplane environment , food and non alcoholic beverages improved oxygen levels in the body by 21% and by 48% in the brain. According to Dr. Makoto Matsumura, Assistant Professor of Cardiovascular Surgery at Saitama Medical School , Japan, “ after eating and drinking, blood volume may be increased.” This increase in blood volume, reduces the chances of clot formation in the veins of the lower legs.
Some airlines, like British Airways, Air New Zealand and some Australian airlines possibly sensing legal ramifications are giving passengers warning leaflets with their tickets. However, according to the news agency, Reuters, 800 Australians have signed up with a Melbourne law firm seeking damages from various airlines due to issues resulting from this.
Perhaps the airline industry should sponsor an unbiased study to look at this issue and come up with recommendations on how best to prevent them. Having wide seats in economy class with more leg room would make sense medically probably not financially.