When Cramped Planes Kill

In the interests of intrepid reporting, I'm writing this dispatch from seat 17E of a commercial aircraft, cruising at 36,000 feet somewhere above the Atlantic Ocean. I haven't moved from my seat since we passed Iceland almost four hours ago. Oh, and I'm drunk too.

My current location and behavior put me at risk of developing a potentially fatal deep vein thrombosis (DVT), or blood clot.

Otherwise known as economy-class syndrome or traveler's thrombosis, DVT is currently big news in Europe where it recently has been blamed for the deaths of several passengers following long-haul flights. Experts say clots often form in the legs because of cramped seating conditions and become fatal if they move to vital organs such as the heart, brain or lungs. Symptoms include shortness of breath, pain, swelling, and warmth.

As the number of daily aircraft flights rapidly increases, so does the prevalence of DVT. In the past eight years, doctors at Tokyo International airport have seen a total of 25 passengers die from blood clots and, each year, they treat almost 150 passengers for DVT symptoms. In a recent Reuters news report, an Australian surgeon estimated that as many as 400 airline passengers arrive annually at Sydney airport requiring treatment for DVTs and, currently, over 800 Australians are attempting to bring legal action against 20 global airlines for not informing them about the condition and how best to avoid it.

According to other reports, 70 percent of DVT cases are among economy-class passengers, 25 percent are in business-class travelers and only five percent are found in first-class passengers. But, despite attempts by the mainstream media to make DVTs a socio-political issue, by linking it to cheaper seats with less legroom, all passengers are at an equal risk of developing blood clots. The percentage breakdown of cases, showing fewer cases occurring in first-class than economy class, is more a reflection of the number of passengers in each section of the aircraft than a comment on the cause of DVT.

It's just more satisfying when someone from first-class bites the big one and sprays the ergonomically contoured upholstery of their seat with caviar and chilled Chardonnay, right comrades? But seriously.

Victims of DVT, so far, have included commercial and military pilots, Olympic athletes traveling to Australia for competition and even a Vice President, bumbling idiot Dan Quayle, who received treatment for blood clots in 1994.

Those most at risk include pregnant women, women taking birth-control pills or hormone-replacement therapy, individuals who have recently undergone leg or pelvic surgery, people with varicose veins or leg injuries, individuals with a genetic predisposition towards developing leg clots, cancer patients, tall people, elderly people, overweight people, and smokers.

In other words, probably you or someone you know.

And the risk of developing DVT also is dramatically increased with alcohol consumption, decreased mobility and dehydration caused by pressurized aircraft cabins. Researchers have found that sitting still for as little as four hours causes a significant amount of blood to pool in the legs, increasing the chances of developing a clot there.

In other words, absolutely everybody.

In a 1999 study published in the journal VASA, investigators looking at 19 cases of DVT found that almost all of the patients had been drinking alcohol and had not been actively moving their legs during their flights.

In another study, published in Aviation, Space & Environmental Medicine, researchers found that 33 of 134 patients treated for DVT had traveled non-stop by aircraft for four hours or more within 31 days prior to treatment. In other words, you're chances of developing a DVT and keeling over at the baggage carousel, sombrero tumbling poignantly to the floor, are much higher than your chances of contracting Mediterranean Spotted Fever or Von Hippel Lindau Disease.

In response to public concern, British Airways announced January 9, it would be providing information when issuing airline tickets to help passengers take precautions against DVT. Those traveling on long-haul flights should refrain from drinking, or sitting cross-legged during long-haul flights and should wear loose-fitting clothing and book an exit-row, bulkhead or aisle seat where possible. Passengers should also walk around the cabin once an hour to prevent pooling of blood in the deep veins of the legs. If this is not possible, leg exercises can be performed and DVT prevented by mimicking the action of depressing an accelerator pedal 20 times at one-hour intervals. Those particularly at risk should contact a doctor who might advise them to take an aspirin before flying to thin the blood a little and lessen the chances of clot formation. More recently, Thai airlines announced plans January 25, to provide free treatment to passengers suffering DVT if they agree to participate in a government study of the condition.

But as yet, airlines still have no plans to inform passengers of how to avoid Mediterranean Spotted Fever or Von Hippel Lindau Disease, which in my opinion, is just irresponsible. It's just another example of profiteering without a conscience, if you ask me. And if you've seen the damage a bout of Mediterranean Spotted Fever can do to a family you'll agree with me too.

Anyway, it's time for another round of my hourly exercises. But I might as well finish my drink first, I mean, there's no point wasting it, right?


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