The Agence France-Presse newswire notes: "British Airways, Britain's flagship carrier, late yesterday [January 14, 2001] accepted that DVT had been known about for some time, but insisted it was doing what it could to protect passengers . . . Most airlines accept there is a risk from DVT associated with flying, but argue it is negligible and travelling by car or train exposes people to the same risk."

Further evidence that the airline industry is covering up its knowledge of DVT is found in an Age article which briefly mentions that "an Australian airline made a secret but substantial payout to a passenger who nearly died six years ago [ie, 1995]."

British airlines are currently being sued by the relatives of many people who have died of flight-related DVT. An Australian law firm is considering launching a class-action suit against several airlines, bringing in at least 800 people who have either suffered from flight-related DVT or lost relatives because of the condition. Due to technical legal reasons, the class-action suit may not happen, but many individual suits will surely go forward.

In November 2000, a British parliamentary committee urged airlines to warn passengers about DVT. In a strongly worded report, it said that the health of passengers and crew was being "woefully neglected" by the airlines. The head of the inquiry said, "Passengers intending to fly are not told enough to enable them to make informed choices about their air travel."

Due to this pressure, British Airways has recently started including with each ticket a pamphlet telling passengers how to avoid DVT. Qantas, Air New Zealand, and Singapore Airlines are also among a small but growing number of airlines that inform passengers of DVT. The government of Thailand is currently studying the condition, offering to treat passengers for free if they show signs of DVT due to flights in or out of the country.

In early February 2001, executives, union representatives, doctors and others in the airline industry held a conference in Sydney to discuss flight-related DVT. The biggest airlines in Britain, Australia, and New Zealand were present, but quite tellingly, the Associated Press article fails to mention a single US-based airline in attendance.

US: The Sound of Silence

Most people living in the US have probably never heard of economy class syndrome or flight-related blood clots. For reasons that are obvious, the airlines would rather not have to discuss it, so we shouldn't expect them to raise the subject. Indeed, a look at their Web sites shows no information on DVT.

In contrast, the Web site of British Airways has information about how to prevent DVT three clicks in from the homepage. Qantas Airlines has DVT information--including an illustrated guide to exercises you can do in your seat--just two clicks into their site. You still have to make a special effort to look for this information; it's not displayed prominently, but at least it's there.

Perhaps even more frightening is the scant amount of attention the US authorities pay to this health risk. A search at the sprawling Web site of the Federal Aviation Administration (FAA) found only one document with information on DVT, a short article in the Winter 2000 issue of the Federal Air Surgeon's Medical Bulletin. I expanded the search to all Department of Transportation Web sites, but even that turned up no additional information. The FAA keeps track of every single injury caused by turbulence, yet it doesn't track even the deaths cause by blood clots formed during flights.

The silence of the media is likewise hard to explain. Of course, the mainstream press is controlled by corporations and is loathe to blow the whistle on industries, yet some dangers and potential dangers are covered. Most everybody has heard something about the risks of cell phones, breast implants, and Bridgestone/Firestone tires. Just why certain dangers are trumpeted while other are swept under the rug isn't immediately apparent.

But whatever the reasons, the American media are failing to warn us of the danger of flight-related DVT. The Washington Post and Wired News have recently run minor articles on the condition. The Associated Press has released a few articles on narrow aspects of the situation, but apparently very few newspapers ran those stories. Where are the front page headlines? Where is a 60 Minutes segment with Ed Bradley making the CEO of United Airlines squirm?

As the situations in Britain and Australia prove, the airline industry will do absolutely nothing about the situation until forced to by public outcry, which will only be generated by lots of media coverage. Pressure is being put on airlines in other countries to inform passengers, increase leg room in the cabin, and even have flight attendants lead passengers in leg-stretching exercises.

While the risk of flight-related DVT is admittedly small, it is still the most common cause of serious injury from flying. It's degrees of magnitude more likely than crashing or getting blown up, and it's even much more common than getting injured from air turbulence, which the airlines like to pretend is the greatest risk you face.

Thousands of deaths and tens of thousands of injuries could be avoided in the US each year if the public were made aware of what they can do to prevent blood clots from forming during flights.

Avoiding DVT

While it's true that other forms of travel can trigger DVT, the idea that the level of risk is the same as flying is highly questionable. First of all, who stays cramped in a car for 20 hours without stopping along the way? Yet flights between Britain and Australia take that long. Also, the pressurized, recirculated air in cabins may promote DVT by thickening the blood, according to an experiment published in The Lancet.

The major risk factor for flight-related DVT, of course, is simply staying still with your legs bent for long periods. Medical authorities suggest walking around the cabin, or at least standing up and stretching, once an hour. While seated, you should wiggle your toes, flex your ankles, and move your legs.

Smoking is another risk factor, so puffing (on flights that allow it) is a no-no. Taking sleeping pills is also verboten, since some doctors think it may contribute to the condition. In fact, it's a good idea not to sleep on flights at all, since that will immobilize you.

Drinking plenty of fluid, especially water, is also a good idea. Booze is contraindicated, since it dehydrates the body. Avoid tight clothing, especially knee socks. Some experts recommend taking aspirin for its anticoagulant properties, while others say that it won't work for this kind of clotting.

Above all, move your legs as much as possible before and during your flight!

References:

Airhealth.org Web site.
Good collection of information on flight-related DVT, with precautions you can take.

David Derbyshire. "Long flights 'cost 2,000 lives a year'." Telegraph (London). January 10, 2001.

Steve Dow. "Legal hitch in flight clot claims." The Age (Melbourne). January 14, 2001.

Lyall Johnson. "800 sue over air travel clot injuries." The Age (Melbourne). January 9, 2001.

Nicholas Lomangino, MD. "Venous thromboembolic disease: Risk for passengers and aircrew?" The Federal Air Surgeon's Medical Bulletin, Winter 2000.

Sally Squires. "Air travel: Is sitting hazardous to your health?" Washington Post, reprinted in Seattle Times. February 4, 2001.

John Sweeney. "Revealed: Air deaths cover-up." The Observer (London). January 14, 2001.

Stewart Taggart. "London-to-Sydney: Killer Flight?" Wired News. February 15, 2001.

Jonathan Ungoed-Thomas. "One in ten older flyers at risk from blood clots." Sunday Times (London). January 14, 2001.

unsigned. "Airlines 'neglect' passenger health." BBC News Online. November 22, 2000.

unsigned. "Airlines warned of DVT 30 years ago: paper." Agence France-Presse. January 15, 2001.

unsigned. "Doctor reckons 400 air blood clot cases a year at Sydney." Reuters. January 10, 2001.

unsigned. "Flights 'should carry health warnings'." BBC News Online. November 22, 2000.

unsigned. "Members of the airline industry to meet in Australia on ‘economy class syndrome'." Associated Press. February 4, 2001.

unsigned. "More evidence of flight risk." BBC News Online. November 10, 2000.

unsigned. "Olympic athletes suffered blood clots from flying." BBC News Online. January 11, 2001.

unsigned. "Thailand offers free treatment for 'economy class syndrome'." Associated Press. January 25, 2001.

unsigned. "The seats of discontent." BBC News Online. October 23, 2000.