Not Just Economy-Class Syndrome

Until last October few airline passengers worried about blood clots forming during flights. Then a 28-year-old Englishwoman stepped off a plane at London’s Heathrow Airport after a 12,000-mile journey from Australia and collapsed and died. An autopsy attributed her death to a pulmonary embolism resulting from deep vein thrombosis--in other words, a blood clot that had lodged in a lung. The likely cause of the clot was the passenger’s restricted movement in a cramped seating space during the long trip.

Since then what quickly came to be called economy-class syndrome has drawn a lot of attention. Last week a hospital near Heathrow reported that at least 30 people had died over the last three years after debarking at the airport following long flights. That’s at just one hospital near one airport. Since symptoms of a clot, which can include swelling and cramping, vary and are often mistaken for something else, precise numbers are unavailable.

It’s not a problem just for air passengers. The syndrome is the fourth most common cause of death in the United States, according to Dr, Robert McBane, a thrombosis expert at the Mayo Clinic. It occurs as well in people who sit at desks or in theater seats too long and in patients immobilized during surgery. McBane and others, according to news reports, also believe it is related to a genetic propensity to clot more quickly that is present in up to 5% of people.

Although business-class and first-class airline passengers too can be afflicted, the misery of long-distance flights in cramped economy class made a vivid link for many people. The idea that more legroom would help prevent a dangerous medical problem caught on quickly. More room, of course, would make it easier to stretch out one’s legs, which doctors recommend as a preventive. For reasons of comfort and competition, some airlines are already removing a row or two of seats to add legroom.

Doctors also recommend sitting on the aisle or near a bulkhead to allow for more bodily movement, drinking plenty of water and avoiding alcohol on flights to stave off dehydration in a plane’s dry air. Walking around once an hour, or at least doing foot and leg stretches, may help as well. Of course, there are a limited number of the roomier aisle and bulkhead seats, and strolling around crowded airplanes whose narrow aisles are often clogged with food and beverage carts is not so much an option as a challenge.

Among those who survived thrombosis during or after flights, lawsuits are being threatened. Some airlines now provide written warnings to passengers or show videos that encourage stretching. And even if it’s no magic bullet for preventing thrombosis, that extra inch or two of leg space is still a goal devoutly wished in economy class.