Economy Class Syndrome

Posted on May 7, 2008
Filed Under People |

50 years ago that the venous thrombosis was first linked with air travel. In recent years, and to the extent that the flights are widespread and people traveling heavily in them, have been reported many cases of this health problem.

Several clinical studies have shown an association between air travel and the risk of venous thrombosis. Some other studies have gone further and conclude that this relationship is dose-response, ie the risk of pulmonary embolism in people traveling by air has increased as a function of distance traveled. Other studies, however, have shown controversial results. Two recent studies have presented an increased risk of developing venous thrombosis 2 and 4 times in people who had traveled by plane, especially in the first two weeks after the flight.

This study
Concludes that the risk of venous thrombosis doubled in travelers and is a function of immobility. Therefore affects not only the aircraft but to other means of transport that hinder mobility.

Available evidence to date suggests, therefore, that the overall risk of suffering a venous thrombosis is moderately increased after air travel. However, there are still many unanswered questions. For example, know the exact underlying mechanism and it is not clear whether the risk increases only after air travel or after a long trip in general.

To try to clarify these issues this study was designed to investigate risk factors, both genetic and environmental, of suffering a venous thrombosis. For the 750 participating patients were asked about the trips made to suffer just before the venous thrombosis.

The results of this study showed that long journeys increased 2-fold risk of developing venous thrombosis. Air travel increased the risk to the same extent that travel by car, bus or train. The risk was higher in the first week after the trip.

The authors note that venous thrombosis is a condition in which many interacting factors, genetic and acquired, and they found groups of people with additional risk factors in which the risk was even higher. In particular, they note the case of people with Factor V Leiden (a blood clotting factor), obese people, people high or low, and women taking contraceptives. Some of these synergistic effects were more apparent in air travel.

As a possible mechanism for generating a higher risk in people who travel by air indicate an effect of hypobaric hypoxia (reduced oxygen concentration by a decrease in atmospheric pressure in the cabin of the aircraft) on blood coagulation. In their study found an increased risk in all types of travel, which suggests that the excess risk of developing venous thrombosis in people flying is caused mainly by immobilization. Additionally, the risk increases more in people high or low because they experience greater restraint and greater understanding of their veins as the other passengers.

The researchers conclude that the risk of venous thrombosis increased 2 times for all travelers and to the same extent for all modes of transportation. In people who take oral contraceptives, are carriers of the Factor V Leiden mutation, or are particularly high, low or obese that risk is considerably higher to the point of proposing we look to assess the efficacy of prophylactic measures on them.

We already knew that travel was by itself a risk factor. We now know that it is a risk factor for venous thrombosis, or worse, pulmonary embolism.

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