Economy Class Syndrome
  Flying can lead to leg blood clots
  By THE PEOPLE'S PHARMACY Joe and Teresa Graedon
Until Sept. 11 most people took air travel pretty much for granted. That casual approach has changed forever.

New security measures will make air travel safer, but there is also new and important research to keep people healthy on long flights. On Sept. 13, the New England Journal of Medicine published a report on the dangers of long-distance flying.
Traveling for more than 3,000 miles is associated with a higher risk of blood clots lodged in the lungs. Double that distance to 6,000 miles, say a trip to Australia or China, and the incidence more than triples. This research focused on people arriving at Charles De Gaulle International Airport in Paris.

Other researchers speculate that such pulmonary embolisms are only the tip of the iceberg. Blood clots that form deep in the legs can travel not only to the lungs, but also to the heart or brain, causing heart attacks or strokes.
Prior research showed that up to one person in 10 on an airplane for five hours or more might develop blood clots in the legs. While most of these go undetected because they don't cause symptoms and will eventually disappear, some lead to severe disability and even death.

Called "economy class syndrome" for the lack of legroom in coach, deep vein thrombosis (DVT) seems to result when people are confined to one position for long periods of time.
To prevent blood clots, passengers should avoid dehydration by skipping caffeine and alcohol and drinking lots of water (which has the added benefit of getting people to stand up and walk to the bathroom). The investigators also encourage people to stretch their legs frequently during a long flight or do exercises and avoid crossing their legs.
Clothing is even more important. Elastic support stockings have been found to prevent blood clot formation. In one study, none of the travelers wearing compression hose on a long flight developed blood clots, while 12 in 116 experiencd DVT while wearing regular socks or stockings.

This special hosiery is frequently prescribed for people with varicose veins or leg ulcers because it keeps blood circulating back to the heart. Surgeons, operating-room nurses, hair cutters and others who have to stand for long periods of time often find compression socks essential to combat leg fatigue.
Another tactic to prevent blood clots might be the lowly aspirin. A small dose (81 mg) might be all that is necessary to protect flyers from DVT. Such research has not yet been done, but aspirin continues to demonstrate its amazing ability to prevent cardiovascular complications.

It's always prudent to check with a physician before taking aspirin, since it can interact with many prescription medications. For an overview of dangerous combinations, you might wish to consult our Guide to Key Aspirin Information. It is available for $1 to cover printing and handling. Anyone who would like a copy, please include a long (No. 10), stamped, self-addressed envelope and send to Graedons' Peoples' Pharmacy, No. A-12, P.O. Box 52027, Durham, NC 27717-2027.

Next time you have a long flight, pay attention to security requirements, dress comfortably and protect yourself from deep vein thrombosis.

Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert. To suggest questions, write to The People's Pharmacy, The Press-Enterprise, PO Box 792, Riverside, CA 92502-0792; fax to (909) 782-7613 or email to



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