Health and Environment|

Window Seats Increase DVT Risk

View of Plane Seats and WindowAccording to doctors, the risk of deep vein thrombosis (DVT), where blood clots typically form in the legs, is increased when travellers sit in the window seat of a plane. This is more dangerous for people who are already at a higher risk of serious blood cots and choose to sit by the window on flights longer than four hours. Some of these people include those who have cancer, limited mobility, are severely obese, recently had surgery and are over the age of 70.

The American College of Chest Physicians, however, says that healthy women who are pregnant or on the pill should be careful where they sit on a plane as well. The group, which represents over 18,000 physicians who specialise in critical care and lung disease, has examined existing evidence, finding that the risk of DVT is strongest on aircraft journeys more than eight hours long. However, it noted that passengers on flights more than four hours can also increase their risk due to immobility during the flight and sitting by the window – particularly for obese travellers.

Blood in the body’s calves and thighs is kept pumping by muscular contractions to force it back towards the heart. The blood can gather in deep veins when people are immobile for long periods of time. Then a clot can form, partially or completely blocking the vein, and when part of it breaks off, it can move into a blood vessel that serves a lung – which is called pulmonary embolism (PE). Big clots can cause a person to suddenly collapse or even die, as their body is starved for oxygenated blood.

The American College of Chest Physicians says that the risk of developing DVT or PE because of a long flight is very small. Chairman Dr Gordon Guyatt says that the risk for most passengers is extremely low and nothing to be worried about. A symptomatic venous thromboembolism (VTE), the combination of DVT and PE, is experienced by one out of 4,600 within a month of a four-hour or longer flight, and only a minority of these are serious.

McMaster University’s Dr Mark Crowther says that a person’s risk is increased when they remain immobile for a long time. Travellers sitting in a window seat for a long time tend to have less mobility, which is why their risk for DVT is greater, and this risk rises when other factors are taken into account. McGill University professor Dr Susan Kahn says that the average risk for DVT is about 1 in 1,000 every year, and healthy travellers should be assured they are unlikely to develop a clot, despite long-haul travel doubling the risk.

The American College of Chest Physicians has now published new guidelines to recommend all long-haul passengers get up regularly during their flights to walk around, as well as stretch their calf muscles while they sit or stand. They also advise that higher DVT risk travellers should wear below-the-knee compression stockings – including pregnant women and the elderly. Although having an alcoholic drink on board won’t increase the risk, the doctors advise against the use of aspirin and other anti-coagulants to prevent a problem. Only more powerful anti-thrombotic medications should be considered on an individual basis, as the adverse effects could outweigh the benefits.

Dr Guyatt says the health care system has made a significant push to administer DVT prevention for all patients, no matter what their risk is. Because of this, many people are getting unnecessary therapies that don’t really provide a good benefit and could have adverse effects, he added.

 

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