Dangerous Seats?

This hasn't been a great year for the airline industry--or for the millions of travelers who have been delayed, stranded and otherwise mistreated. But the latest airline-travel woe hits passengers right where they sit: in those notoriously cramped seats. Not only are modern airline-seating arrangements woefully lacking in legroom, some believe they also may even be deadly in certain circumstances. Three passengers are suspected of having succumbed in the past month to complications stemming from sitting too long in cramped airline seats.

Headline writers are calling it "the economy-class syndrome," underscoring the striking difference between the legroom in first- and business-class cabins and that in the rest of the plane. In a widely reported case last week, an apparently healthy British woman in her late 20s took a 20-hr. flight from Australia to London and collapsed at Heathrow Airport 10 minutes after arrival. She died within hours. An autopsy showed that she had developed deep venous thrombosis--a blood clot in her leg--that lodged in one of her lungs.

The airline industry, however, disputes the link between cramped seats and dvt, and got support last week from a report in the British medical journal The Lancet by Dutch and Italian researchers, which found no added risk from air travel--or long journeys by any other mode of transportation.

While the airlines may take comfort in that report, doctors generally agree that some people are at greater risk for DVT than others when they sit for long periods of time--in the air or on the ground. The folks who have the most reason to be concerned are those with a history of stroke or heart conditions; people older than 65; cancer patients; and anyone with elevated estrogen levels, such as pregnant women or patients taking estrogen supplements. There are also several circulatory disorders that can make the blood more susceptible to clotting. None of these necessarily means you can't fly; but you should be more careful if you do.

For years, doctors have warned passengers who travel long distances not to stay seated for the entire flight. A known risk factor for blood clots in the leg is remaining sedentary for long periods of time--three hours or more. One of the easiest ways to counteract this risk on an airplane is to get up occasionally for a couple of minutes and walk the length of the plane. If the flight attendants are in the middle of service, just stand next to your seat and do a series of toe raises--lift yourself up on your toes for a couple of seconds, relax, then do it again. Three sets of 10 or 15 are enough to generate forceful leg-muscle contractions that will pump the blood up your veins and prevent it from pooling and possibly creating a clot.

Another precaution is to drink adequate amounts of nonalcoholic fluids before and during the flight. Dehydration can affect certain factors in the blood, making it thicker and more likely to clot. Travelers should be alert for leg pain, swelling and feelings of heaviness. When in doubt, it never hurts to get up and stretch. But only after the captain has turned off the FASTEN SEAT BELTS SIGN.

Dr. Ian appears on WNBC-TV in New York City. If you would like to reach him, e-mail him at ianmedical@aol.com