Sitting in a window seat of an aeroplane during long distance flights
can increase the risk of deep vein thrombosis (DVT), doctors say.
A window seat is one of the risk factors for DVT in long distance travellers
outlined in new guidelines by the American College of Chest Physicians (ACCP),
which say that a person's individual risk factors for blood clots should be
taken into account before being offered preventative medicines.
Other risk factors highlighted include being elderly, pregnant or taking oral
contraceptives.
The experts also say that so-called '"economy class syndrome" is a
myth, as the risk of developing a blood clot during a long haul flight is the
same for those travelling in first or business class.
Deep vein thromboses are blood clots which usually develop in the legs. If a
clot breaks away, it can cause a potentially fatal blockage in the lungs known
as a pulmonary embolism.
The new guidance, published in the journal Chest, says the risk of developing a
blood clot on a long distance flight is "very small" for most people,
but was strongest for flights taking longer than eight to ten hours,
particuarly in those with other risk factors.
Prolonged sitting, such as in a window seat of a plane, where someone is less likey to get up and
move around, can also increase the risk of DVT.
Guidelines co-author Dr Mark Crowther from McMaster University, Ontario, said:
"Travelling in economy class does not increase your risk for developing a
blood clot, even during long-distance travel.
"However, remaining immobile for long periods of time will. Long distance
travellers sitting in a window seat tend to have limited mobility, which
increases their risk for DVT. This risk increases as other factors are
present."
Smoking and obesity were also identified as risk factors, but the doctors said
they found no "definitive evidence" that either dehydration or
drinking alcohol boosted the risk of DVT.
Medical conditions which can put a person at increased risk include
having had recent surgery, a family history of blood clots and having heart
disease.
The guidelines recommend that all long-haul passengers should take preventative
measures such as getting out of their seats and walking around, and calf muscle
stretches.
In addition to this, people at higher risk of DVT should sit in an aisle seat
if possible and wear below-knee graduated compression stockings, they advised.
The doctors also advised against the use of aspirin or any other anti-coagulant
medication to prevent DVT in long-distance travellers.
Drugs which can prevent blood clotting should only be considered on an
individual basis for those at a higher risk of DVT as the "adverse effects
may outweigh the risks," they said.
Dr Gordon Guyatt, who chaired the panel of experts which drew up the
guidelines, said: "There has been a significant push in health care to
administer DVT prevention for every patient, regardless of risk.
"As a result, many patients are receiving unnecessary therapies that
provide little benefit and could have adverse effects."
"The decision to administer DVT prevention therapy should be based on the
patients' risk and the benefits of prevention or treatment."
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