DVT guidance

House of Lords Air Travel & Health Report

The Scientific Committee of the House of Lords reported on 15th November 2000 on the long awaited report which is some 94 pages long including 5 pages of recommendations.

It begins by stating that

  • "safety is paramount within the airline industry and nobody would wish otherwise."
  • "Our concern is not that health is secondary to safety but that it has been woefully neglected". (1.8)
  • "We have not found substance in the extreme claims about health risks from air travel but a significant minority have some real fear for their health when flying." (1.3)

The main areas that report addresses are:

  • Regulatory arrangements
  • Elements of healthy cabin air
  • Providing a healthy cabin environment
  • DVT, seating & stress
  • Other medical concerns including in-flight emergencies
  • Wider Issues including information prior to flying , media interest & reporting

Report summary

Over the last few years the media has reported on numerous health scares as a consequence of air travel. The report outlines that the claims that fuel such scares are often not substantiated and it encourages those viewing the report to consider all the facts present. However, the report does not dismiss the fact that there are those in the minority for whom air travel is a difficult experience and it seeks to address those needs.

In our present political climate the report acknowledges that our first priority has always been air safety, and so the area of health has often been neglected in recommendations and rulings. It sees the need for health to take a more prominent role in future recommendations as travel by air continues to grow.  The report recommends that the traveller be better informed of the risks related to flying. This comes together with a call for the airlines to better prepare its passengers for taking to the skies.

Key highlights

  • The first recommendation of the report was for "a higher profile for health", and for the airlines to take more responsibility for the health of both the crew and its travelling public. It seeks for the government to take a leading role in enforcing this recommendation.
  • The report wants to see more information is available to travellers relating to fitness to fly and it recommends the updating of various Department of Health publications and other travel health-related documents.
  • With regards to recent publicity surrounding deep vein thrombosis (DVT), the report recommends that the public are made aware that the term "Economy Class Syndrome" is misleading. This is because the condition can easily affect anyone, including those travelling first class, if certain risk factors are present.

It recommends that more research be completed into the condition and its relation to flying. It recommends the term "flight-related DVT or thrombosis".

  • The report recommends research into seating and the allocated measurements on planes, taking into account larger passengers and the need for comfort on long flights, and less ambiguous criteria than currently exist.
  • As far as air quality is concerned, the report recommends that airlines begin to perform random air sampling from the cabin as a way of reassuring customers regarding the quality of air on the plane.
  • Infection control is an ongoing issue related to flying and the report recommends that airlines make more effort to stop those who are infectious from flying.
  • The report recommends that passengers be provided with earplugs to enable sleep on long flights.
  • The report recognises the need to reduce stress on long flights and recommends that airlines review food and drink times to allow passengers time to sleep.  This would reduce stress and help those who experience jet lag.

DVTs

The report has almost seven pages on this subject, and its findings are summarised as "interim precautionary and preventative advise concerning air travel related DVT".
 
Those with no known predisposing factors should:

  • Move around in seat and cabin as much as possible
  • Exercise calf muscles whilst seated and do half hourly flexing and rotating of ankles for a few minutes
  • Avoid excess of alcohol and caffeine-containing drinks both before and during the flight
  • Drink only water or non-caffeinated soft drinks or juices when thirsty or feeling dry
  • Observe and act on information given in in-flight media

Those at minor risk (meeting one or more of the following conditions) are:

  • Aged 40 or over
  • Very tall , very short, or obese
  • Previous or current leg swelling for any cause
  • Recent minor leg injury or minor body surgery
  • Extensive varicose veins

They should follow advice as per those with no predisposing factors, plus the following:

  • Avoid leg discomfort whist seated
  • Avoid alcohol and caffeine-containing drinks both before and during the flight
  • Take only short periods of sleep, unless normal sleeping position can be attained.
  • Do not take sleeping pills
  • Consider the need to wear support stockings

Those at moderate risks meet one or more of the following conditions:

  • recent heart disease
  • pregnant or on any hormone medication particularly the contraceptive pill and HRT
  • recent major leg injury or leg surgery
  • family history of DVT

They should follow all of the above advice plus:

  • take professional medical advice about the risks involved
  • take pre-flight low dose aspirin (providing person has no contraindications)
  • take professional advice about the need to wear compression stockings

Those at substantial risk meet one or more of the following conditions:

  • previous or current DVT
  • known clotting tendency
  • recent major surgery or stroke
  • current malignant disease or chemotherapy
  • paralysed lower limb(s)

They should consider avoiding or postponing the flight, taking medical advice if unsure. If travelling, they should follow all of the above advice but have low molecular weight heparin prescribed instead of aspirin.

Persons sensitive to Aspirin products or with known respiratory problems MUST seek medical guidance before following any of the above information

  • The above guidance is from the Select Committee report and it is issued until substantial research gives other guidance, which the report calls for.
  • Any practitioner concerned about flight-related DVT should seek advise from a suitably qualified doctor.

Disclaimer: The IFNA issues this information in good faith, it cannot be held responsible for any health related problem from the guidance above. This information is designed to compliment rather than replace proper medical advice from a GP or other suitable qualified health professional.
 
Page Modified: 05 March 2007