"Economy class syndrome" could be widespread killer

Will the threat of a multi-million dollar lawsuit convince the airlines to change?

By: Lanny Boutin

  For years the airlines industry has dismissed any connection between deep vein thromboses (DVT's) or blood clots and long flights. But a class action suit against 20 international airlines, including Air Canada, just might get their attention.
  The suit brought by Australian law firm Slater & Gordon alleges their more than 800 clients, including ten Air Canada passengers, were stricken by DVT's, a condition dubbed economy class syndrome (ECS). It alleges that immobility and cramped conditions on long flights have killed at least 35 people and left many others with permanent health problems.
  There are 650,000 to 700,000 serious cases of DVT's in the US each year. A recent French study, in the medical journal Chest, noted that almost 25 percent of participants, with DVT's, had travelled recently for more than four hours.
  Another study conducted at the Tripler Army Medical Centre in Hawaii found that 50 percent of those admitted to the hospital with DVT's in the preceding four years, had travelled for at least four hours, in the last month.
  Farrol Kahn, the director of the Aviation Health Institute, a non-profit organisation in Britain, has been quoted as saying 30,000 people in the United Kingdom have suffered from DVT's directly attributed to air travel.
  The author of several books including Arrive in Better Shape, Kahn stresses that unlike other industries "airlines are subject to little or no regulation on the health of their customers" He goes on to stress "that passengers must be responsible for their own health."

But Does Economy Class Syndrome Really Exists?
  As the Britain's House of Lords, Sciences and Technology Committee noted, there are few concrete studies on economy class syndrome.
  Warren Everson the vice president of Policy and Strategic Planning, at the Air Transport Association of Canada, the umbrella group for Canada's airlines, agrees. "As an industry we don't want to dismiss ECS, notes Everson, "but I have not been able to nail down any reliable, specific data on the syndrome yet."
  Much of the data is anecdotal, gathered after the fact and doesn't always specify the mode of transport, making some wonder if it shouldn't be called travelers thromboses. Others say there could be other factors, not just immobility, at work in the air.
  Dr. Jack Hirsch director of the Hamilton Civic Hospital Research Centre is proposing a study on the effects of air travel on clotting. A recent Gairdner Foundation Award Winner and member of the Canadian Medical Hall of Fame, Hirsch wants to test the blood chemistry of subjects before and after long flights, and is hoping the airlines will donate seats for the study.

What is Economy Class Syndrome?
  First diagnosed among people crammed into bomb shelters, in World War II Britain, economy class syndrome gets it's name from the cramped quarters in economy class sections of commercial airlines.
  Sitting immobile, for long periods, forces your heart to fight gravity to keep the blood circulating properly. Moving more slowly though the veins the blood can form small clots, which can break away and travel though the blood stream to other parts of the body. If they reach the heart, lungs or brain they can be fatal.
  DVTs can cause sharp localized pain in the arm or leg, chest pains, shortness of breath, dizziness, vertigo, sudden blindness or severe leg cramps. But often DVTs give no warning.

What Can you Do?
  Dr. Russell Rayman the executive director The American Aerospace Medical Association which published, "Useful Tips For Air Travelers" offers these suggestions for lowering your risk of DVTs while flying:

• Walk around every hour or hour and a half.
• Exercise your ankles every 20 minutes.
• Keep hydrated. Watch the alcohol, it's a diuretic.
• Keep the area under the seat in front of you empty.
• If pain, stiffness or swelling persist, contact your doctor.
• If you have a history of blood-clotting disorders, talk to your doctor before traveling.

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