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DVT: Preventing Airline Passengers’ Biggest Danger


Nov. 17, 2015 



Cramped – The way airlines have taken 130-seat airplanes and expanded them to 150 seats to squeeze out more revenue, results in higher DVT risks for passengers.
Last Wednesday, singer and dancer Tamar Braxton, 38, stunned fans when she announced that due to blood clots, allegedly caused by frequent flights, she will be leaving Dancing With The Stars.
It’s a reminder that DVT (deep vein thrombosis) can easily strike the young and fit.
We’ve known for a long time that passengers’ risk of DVT (also knows as economy class syndrome) is high on long-haul flights of over three hours. 
DVT is caused by immobility over a sustained period and claims the lives of a number of airline passengers each year.
People who fly four hours or more, the World Health Organization found, have three times the risk of developing clots compared with periods when they did not travel.
The blood clot is, in medical-speak, a deep vein thrombosis. If it stays in the leg it can cause stiffness and pain, but if it moves up the body it can cause real trouble. 
It can pass through the big vessels of the heart without much difficulty, but when it gets to the smaller vessels supplying the lungs it can cause a massive blockage, cutting off oxygen supply to the body: a pulmonary embolism, that may result in death.
About 300,000 people per year die of blood clots which some medical authorities consider to be as dangerous as high cholesterol for strokes and heart attacks.
Though most blood clots are usually not fatal, the fact is you can die if not treated as soon as signs manifest themselves.
Symptoms typically include unexplained pain, tenderness, redness and swelling, often in the leg. Once a clot has traveled to the lung, common symptoms include chest pain and breathing difficulties.
A Dutch research team found that one outof 4,500 people who fly will end up with a blood clot scenario within eight weeks after traveling. The risk increases with the duration of a flight and the number of flights in a short period.
Another study (see footnotes) found that over 5% of passengers developed DVT on transatlantic flights, even with exercise.
Shake A Leg
The primary preventive recommendation has been for airline passengers to exercise every half hour -now completely impractical with cramped space and narrow crowded aisles in nearly all classes. 
Some doctors now recommend taking pycnogenol (a pine bark extract) before and after long flights. Aspirin and anticoagulant medicine is not effective in preventing DVT, as it can cause uncontrolled bleeding.
The researches also warn against wearing commercial compression stockings and also provide a list of recommended exercises you can do to help prevent DVT.
The airline industry has known about the dangers of DVT for nearly 75 years. Airline company doctors have known about the risks of immobility since 1940 and the risks of immobility on long-haul flights since 1968.

Later in 1985, a group of doctors wrote a letter to the medical journal Lancet reporting that they had treated large numbers of airline passengers suffering blood clots. “We see a steady stream of illnesses which have developed in flight. The major manifestation of the illness may not occur until after disembarkation. We have seen several patients with thromboembolism presenting in this way, with a near fatal outcome in one case.”

The most obvious and long term solution involves the reorganisation of airline seating arrangements, as well as the provision of space and facilities for in-flight movement and exercise.

Flyersrights.org has filed a rulemaking petition with the FAA to increase seat size and stop further shrinkage, in order to mitigate against DVT as well as for safety and comfort reasons.  
This petition is now available and open for public comment by clicking here, or going to Regulations.gov and entering FAA-2015-4011-0001.  
Passengers can also sign a petition supporting larger seat size and passenger space on the Flyersrights.org web site by https://flyersrights.org/petitions/petition.php?id=8.
The FAA needs to hear from passengers or DVT is likely to increase further. 
End notes:  Health Revelations, vol. 4, no. 4 Sept. 2015; Cesarone MR et al, Prevention of venous thrombosis in long-haul with Flite Tabs, Angiology 2003 Sept. Oct. ; 54(5): 531-9; Belcaro G et al, Prevention of venous thrombosis in long-haul flights with pyconogenol, Clin Appl Thromb Hemost 10:373-7 2004. 

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