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    'Economy Class Syndrome' Back in the News


    A famous recent episode occurred in 1994 when former Vice President Dan Quayle developed a leg clot that traveled to his lung soon after a series of airplane trips. And researchers from the Hospital Pasteur in Nice, France, have reported that travelers who sit for more than five hours on planes are more than four times as likely to develop blood clots in their leg than nontravelers

    In London, at least 30 people have died of blood clots in the past three years after arriving from lengthy flights at London's Heathrow Airport, according to a study conducted at Ashford Hospital in southeast England. Just this past October, newspapers reported that a 28-year-old women flying from Sydney to London developed DVT and collapsed and died after reaching Heathrow.

    "In patients prone to circulatory problems, when they lie still for extended periods of time, [long-haul flights] don't help, but there is no reason for the average person to be concerned about this," says Louis D. Fiore, MD, an assistant professor at Boston University School of Medicine and School of Public Health and the chief of oncology at the VA Boston Health Care System.

    People at high risk for DVT include people with varicose veins or cancer, smokers, individuals with history of leg clots, leg or pelvic surgery or a leg injury, pregnant women, women taking birth control pills and hormone-replacement therapy, overweight individuals, elderly people, and very tall people.

    Warning signs include a warm or hardened area in the lower extremity, aching legs, pins-and-needles sensations, and problems bearing weight on the legs. If the clot moves to the lungs, chest pain is often a sign, as is shortness of breath.

    Ways to prevent DVT while flying include:

    • Your blood becomes thicker when you are dehydrated, increasing risk of clots. So try to drink an 8-ounce glass of water every two hours when flying and avoid alcohol and coffee, as they are dehydrating.
    • Try compression hose. They are available over the counter at surgical supply stores and cost about $15 per pair. Even better are tailor-made support hose, made based on a person's leg measurements. Such support hose work by keeping blood flowing and preventing pooling of stagnant blood.
    • Book a seat in an exit row, a bulkhead seat, or an aisle seat.
    • Walk up and down the aisle about once an hour.
    • Wear loose-fitting clothing.
    • Don't smoke.
    • While in your seat, contract your calf muscles from time to time by clenching your toes. Another exercise, suggested by British Airways: Bend your foot upward, spread your toes, and hold for three seconds -- then point your foot down, clench your toes, and hold for three seconds.
    • People at high risk of blood clots should ask their doctors whether to take aspirin before flying to inhibit blood clotting.
    • Don't cross your legs or sit on the edge of your seat, since these positions can reduce blood flow in your legs.

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