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Friday, 30 November, 2001, 11:22 GMT
Travel blood clot warning issued
Interior of a plane
New research suggests a link between flying and DVT
Pregnant women and those on the Pill should seek medical advice about the health risks of long-distance air travel, says the government.

The guidelines from the Department of Health are in response to controversy about the risks of the potentially deadly blood clotting condition deep vein thombosis (DVT).

The advice, issued on Friday, covers all groups suspected of having an increased risk of DVT, which affects an estimated one in 2,000 people each year.

Mothers who have recently given birth, women taking hormone replacement therapy, and anyone who has recently had surgery or a stroke should also check before flying, or indeed any travelling which involves long periods seated, it recommends.

However, although these groups are thought to be at slightly higher risk, the overall risk is believed to be small.

Sitting still

Dr Pat Troop, the government's Deputy Chief Medical Officer, said that it was the "most up-to-date" information about the potential risks.

DVT: Who should seek advice?
Pregnant women
Women taking the Pill
Patients taking HRT
Mothers who have just given birth
Any patient with a history of DVT
Heart disease patients
Cancer patients
Patients who have recently had a stroke
Patients who have recently had major surgery
However, she stressed that it was not just air travel which carried a risk of DVT, although it has been dubbed "economy class syndrome", because sitting still for long periods increases the danger.

She said: "Blood clots can occur when people remain immobile and seated for long periods of time, and therefore could occur in a range of travel situations."

The new advice has been sent to airlines and will also be made available to the public through NHS Direct - the telephone information service.

Exercise advice

The guidance also encourages passengers to carry out "in-seat exercises" while flying, to increase blood flow to the lower legs, where clots are most likely to form.

Blood clots can occur when people remain immobile and seated for long periods

Dr Pat Troop, Deputy Chief Medical Officer
It also suggests that blood-thinning drugs or elastic stockings may be ways of reducing the risk in high-risk groups - although there is currently little evidence to support the effectiveness of the former.

Existing government guidelines already recommend that people with heart disease, cancer or who have recently had major surgery should seek medical advice before flying.


Clots develop in blood vessels deep in the legs when circulation slows, usually because people stay still for long periods.
Emma Christoffersen
Blood clot victim Emma Christoffersen

The clots can be fatal if they break off and are carried to the lungs, blocking the flow of blood - a condition called pulmonary embolism.

Publicity surrounding the condition was heightened by a number of high-profile cases.

Emma Christoffersen, 28, from Wales, died in October 2000, when she collapsed after a 20-hour flight from Australia.

Dr Patrick Kesteven, an expert in DVT from the Freeman Hospital in Newcastle, told the BBC that the government action was prompted by research in Holland, which suggested a stronger link between DVT, long haul flights and people in these high-risk groups.

I suspect the medical advice will be to work out what the risk is for that individual

Dr Patrick Kesteven
DVT expert

Dr Kesteven said women taking the contraceptive pill were three times more likely to be at risk.

He added: "There are various things you can do depending on the level of risk and I suspect the medical advice will be to work out what the risk is for that individual.

"I suspect some blood conditions can be disposed to thrombosis and a strong family history of thrombosis is a very high risk.


"The other factors are age, recent surgery, recent immobility, for example having a leg in plaster."
Interior of a plane
Airlines are proposing a comprehensive study

He suggested various action including exercise, wearing support stockings and, in extreme cases, taking medication when flying.

Recent research had been inconclusive about the dangers of long haul travel.

But a comprehensive study is being proposed by the airlines and the World Health Organisation - and the Department of Health has backed calls for further research.

British Airways said it welcomed the new Government guidelines and stressed that it had, for nearly a decade, provided its passengers with advice about well-being in the air.

Simon Evans, from the Air Transport Users Council, said he was "delighted" that the government was taking the issue seriously.

The BBC's Karen Allen
"Now there is detailed government advice"
Aviation medical consultant Dr Ian Perry
"Where is the evidence?"
Labour MP John Smith
leads the campaign for further research
See also:

08 Aug 01 | Asia-Pacific
'Economy class' deaths probe
23 Oct 00 | C-D
Deep vein thrombosis
23 Oct 00 | UK
The seats of discontent
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