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EDITIONS
Panorama Monday, 11 June, 2001, 10:19 GMT 11:19 UK
Your comments on Economy Class Syndrome
Economy Class Syndrome, Sunday 10 June 2001

The forum is now closed.


An excellent programme! I had a dvt back in 1990 so was at extra risk when flying, however when I returned from a holiday in the West Indies in 1998 I had the classic leg pain associated with dvt after a couple of day's this had not improved, so I phoned my GP. I was told if it bothers you go to a&e in a very casual manner by the receptionist. I did go to the a&e, I explained that I had been on a long haul flight (I must have read about the connection previously) however the doctors had no idea what I was talking about! Eventually they agreed to give me a heparin injection to be on the safe side. So if you succeed in getting the airlines to take responsibility perhaps you could start teaching gp's and a&e departments
Alison Richards
Worcester Park

I spent 10 years living in Dubai, U.A.E. Every year I would fly back to Scotland for this is where I originally come from. The flight from Dubai to London was 8 hours and I have been on over 50 flights in my life time. Although I flew these flights between the ages of 7 and 17 I cannot ever recall being advised to do exercise neither do I recall being told about DVT and the causes. I have never contracted DVT as far as I know. I put this down to the fact that I never stayed in one place while flying. I do like to move around a bit. What I would like to know is why Airlines won't inform passengers about the problem. I can understand that it isn't good for business but I don't see it causing any problems. Correct me if I'm wrong, but don't most of the public already know about DVT, or at least that medical problems can arise from long-haul flights? And therefore airlines warning people about the problem and how to prevent it should not affect business. And if airlines would start warning people they should be praised for it. Thus creating more business. Businesses want to make money.
Stephen Stooke
Dunfermline

Having suffered from DVT at the age of 24 as a consequence of unhealthy living and working dipping sheep the summer before, I undertook a long haul flight to Los Angeles in the summer of 1999, vaguely aware that there could be a problem if I was not careful. I drank plenty of water, took aspirin and walked up and down a lot - something that the flight attendants were loath to let me do. On the flight back, I had every intention of doing the same, but as a consequence of a hectic week of family reunion and some vodka I fell asleep for five hours. This was early July; by September, I had a leg ulcer in the same leg as the DVT of four years previous, from which I have not yet recovered. I'm going to China next year to teach English - thank God there's a train!
Adam Horovitz
Stroud

I am no Doctor and I'm also no Marketing Director but I do understand the Airlines' concerns regarding the commercial implications of such a potentially "revenue affecting" health scare like DVT. I have luckily had good health all my life but my girlfriend has survived one Pulmonary Embolism six years ago as a result of taking the contraceptive pill. Last month we spent three days in accident and emergency with what doctors thought may be a second PE but "luckily" turned out to be a small bronchial infection. This was my first exposure to the dangers of clotting and also the first time I realised just how fatal this condition can be. I am nothing short of disgusted to find out how so many major airlines can have pasted over this type of condition for so long. It is obvious that clinical trials and conclusions can not be reached overnight but why oh why can people not at least be made aware of the problems that may be encountered. Do the likes of Lufthansa think that they will lose so much custom as to outweigh the future legal costs of people who quite rightly take them to court for not informing them of the facts in advance. This smacks of the tobacco industry and it makes me sick.
Neil Thompson
Northwich, Cheshire

In October 2000 I travelled to Sri Lanka on holiday on a long haul flight - to cut a long story short, I developed 3 DVTs in my leg and groin and spent 2 weeks in hospital there. I now have the joys of taking warfarin every day for the rest of my life. I am 28. I had previously had a suspected Pulmonary Embolism but no information was ever given about the risks involved in flying. Airlines are blasť about the risks to their passengers health and their recent changes to in-flight brochures prove that it unfortunately takes tragedies & adverse publicity to make them act at all. If they are so sure flying is so safe then why not allow the studies?
Kirstin Smith
Johnstone

I found the programme most informative and positive about bringing the airlines into question. My sister-in-law Tracey Dunn was in the Press after clotting on her honeymoon. 2 1/2 years later, despite me knowing the dangers and taking aspirin, exercising on the plane and drinking water, I ended up in hospital for 2 weeks with a DVT in my leg. Both Tracey and myself, despite the uncanny coincidence, were the lucky ones in that we didn't die from the DVTs we got on the plane but are still suffering from the life changing effects of having a DVT. I want as many people to be aware of how easy it is to clot - especially young people and not just the elderly. I am only 29 years old and didn't think it could happen to me! How wrong I was! I am at the hospital every week having my blood checked, some 5 months later. I have to inject myself if I fly again and wear special stockings on long journeys. I fully support the work being done into this important issue. This is too important for the matter to now lie low - public awareness on this should be continually on the agenda - I wouldn't want anyone to suffer the way I have. Thank you for a wonderful programme - I hope people sit up and listen.
Lisa Dunn
London

I have just completed a doctoral thesis on the causes of deep vein thrombosis and would like to comment on the excellent Panorama programme recently shown on the subject. My findings suggest that DVT is caused by a lack of oxygen which causes the platelets (a blood cell involved in coagulation) to become activated and to provide phospholipids which are essential for clotting to take place. This is happening more frequently in airliners because the companies have reduced the concentrations of oxygen in recirculated air partly to save money and partly to induce drowsiness in passengers. This is accentuated on long haul flights. The result is that the passengers become more relaxed, often sleeping for long periods, and their breathing becomes shallower. Combined with already low levels of oxygen this means there are low concentrations of oxygen in the blood and the clots form. In most people this would not necessarily matter, but in people with factor V Leiden, which is a genetic mutation of factor V and not a deficiency, or people with prothrombin gene mutation or other anticoagulant deficiencies like Protein C or antithrombin III deficiency they are unable to stop the clot growing. The fact that they have these 'Thrombophilias' does not mean they are more likely to get a DVT just that they are less able to fight one if it does occur. To counter this problem I suggest that airlines increase the levels of circulating oxygen in the cabin and that passengers regularly do deep breathing exercises to maximise their blood oxygen levels.
Warwick Davis
Eastbourne

As a chronic deep vein thrombosis sufferer I would like to make one or two points in relation to your programme last night on deep vein thrombosis. It is not only long aeroplane flights that precipitate the condition; when I was first admitted to hospital with a dvt I was asked if I had been on any long journeys, including car and coach journeys, during which my legs had been immobile. I therefore find it odd that you could blame the airlines so vehemently and exclusively for the lack of information on the subject, particularly when the B.A. representative explained that there was a statement in their literature to the effect that circulatory problems could arise from prolonged immobility. In my experience it is never clear cut what the exact cause is, in fact the physician who dealt with me when I started to suffer said that in only 10% of cases was the real cause ever discovered. It may seem obvious that a long-haul flight has caused the condition to develop in a passenger on such a flight, but there are other factors that can have an adverse effect on the circulation. For example, on Sunday night you showed an extract from a video which showed Emma Christofferson parachuting out of an aeroplane; I have been told quite specifically not to indulge in such activity because altitude can have an adverse effect on the circulation. Obviously from a personal point of view I appreciate the fact that the debate about the causes of dvt has been brought into the open but I for one do not blame the airlines for my condition. If we are to look for someone to blame we must first establish definitively what the causes are, otherwise we should be blaming the car and coach manufacturers and goodness knows whoelse for not giving health warnings with their products.
Philip L. McClellan
Leeds

We are all placing our natural health, if not our lives, at risk by taking a long flight in economy class. With the absurd price difference of economy, against business or first, few passengers - if they want to travel at all that is, have any choice in the matter. Buses - making a much shorter journey in a local area, offer better comfort, seating and leg room than international airlines. Isn't that rather incredible in itself?
Philip Turner
Amsterdam

I should like to thank you for drawing attention to the problem of travel-related DVT. Anything that contributes to informing the public about this issue should be welcomed; however, I wish to point out that responsibility for such information does not lie solely with the airlines, as your programme implies. The medical profession needs to become more involved. The programme rightly draws attention to the fact that risks increase dramatically in the presence of two other factors : a) oral contraception or HRT and b) genetic blood clotting abnormality. I strongly feel that the general public is not adequately informed about such risks by the medical profession. In my experience, oral contraception and HRT are usually prescribed without any special precautions being taken or information being given. Panorama states that the 7-fold risk increase (Factor V) may apply to as much as 5% of the population. Doctors I spoke to a few years ago led me to believe that the figures were much lower, and they used this argument to justify the fact that they considered routine screening for Factor V deficiency among women on the pill was not an option - too costly, I was told, in relation to the number of persons who might benefit.
F. Filon
Brussels

I am 25 and I suffered a DVT two years ago after getting off a 12 hour overnight sleeper train journey not a flight. I was taking the pill and had been immobile for basically 12 hours with tight blankets around me. I felt unwell, short of breath, pains in my calves etc. Since then I have been on one long haul return flight ensuring I walked around every hour drank plenty of water also making sure I had an aisle seat. I am reasonably happy about flying but am glad I know the facts, however my situation can prove that even immobility on a train boat aeroplane or anywhere really may cause DVT. I now take blood thinners for the rest of my life.
Mrs Heather Poole
Inverness, Scotland

Awareness of the risk factors for DVT are important. However whilst concentrating on the exercise issue, factors like free-flowing alcohol surely must be considered when looking at long haul flights. I have travelled to Australia twice in recent years and have been aware of risk of DVT, yet the only information often given hidden within flight magazines is to exercise and drink plenty of water. Perhaps we need to look at exercise, food and drink with relation to DVT and other potential health risks involved with long haul flights. A suggestion could be that when plane tickets are issued (for any flight length) and leaflet is attached outing health issues and preventative measures. This could be supported by in-flight information as well, as it often takes more than one source of information for an impact to be made...
Pat Simcock
Guildford

My husband suffered a DVT in 1998 as a result of a 3 hour flight preceded by a week of lots of car travel for work. Fortunately he survived due, we were told, by his relatively young age, then 39, and a strong heart, plus the DVT had caused several small thrombosis that had 'peppered' his lungs rather than having one large clot. Following tests we found that he is one of the 1 in 20 people who suffer from a depletion of Factor 5 Leiden in his blood. We have two young children who will now be tested for this deficiency when they reach puberty. Perhaps screening for this blood disorder should be available for everyone seeing it is a factor which significantly predisposes one to blood clots, and, as highlighted in your programme, increases significantly the risk of getting DVT. Thank God we were lucky to find out about it, albeit after my husband's DVT, but hopefully we can try to minimise the potential risk of flying for our children.
Helen Martin
Banchory, Scotland

I have suffered DVT in both legs, a full PE and several bouts of Phlebitis one of which lead to the PE. All these events occurred as a result of long haul flights between the UK and the East Coast USA. My problem is that my protein C and S levels are low and this causes by blood to clot more readily than normal.
Mark Henderson
Bracknell

We would like to draw your attention to our website www.travelwithcare.co.uk. We on behalf of Tyco, the market leaders and No 1 supplier to the Medical profession of Anti-embolism stockings can supply via Practice Nurses or direct from our secure website shop ResT.E.D. below knee graduated compression stockings. These are clinically proven to reduce DVT in convalescing patients and will therefore address the same risk in travellers. They must be correctly sized by calf girth and leg length to be effective and not shoe size. Please contact me for further details. Excellent programme.
Ann Danby - Director of Homeway
Amesbury

Our company has recently begun to supply a magnetic pad to sit on whilst flying. The magnets will increase circulation in the top leg/hip area. It has proved to be of great benefit to people who are in the high risk area from DVT. The pad can then be used on arrival to help get over jet-lag by placing it under the pillow case of your pillow. If we can help call us for a consultation to see if you are one of the low percentage of people who may be susceptible to DVT - 01225 314 096. The pad costs £33.00 and lasts 15 years. We supply specialist shops and clinics, and everyone here is a fully accredited therapist. Note: It is crucial to drink water on all flights long and short.
Iain Gay
Burbage

In the Panorama programme, and in subsequent comments, the connection has been made between the health of passengers, their immobility, the quality of cabin air and seat space. I agree with those who say that we must all use our common sense on our travels, but equally would appreciate some common sense from the airlines, which among other things insist on that curious practice of organising mass sleep, by dimming lights and drawing curtains. Filled with food and/or alcohol and fast asleep, moving around is unlikely. Again, I am all in favour of readily available and affordable flights, but not so much in favour that I would object to better scrutiny of reports of noxious fumes entering cabin ventilation systems, and of air quality being compromised in order to conserve fuel. After all, when you have set off as fit as a flea, heeded all the available advice, and arrived in an inexplicable and frightening state of ill-health at the other end, you are bound to seek some reassurances.
Rita Freeman
Bath

I fell on a skiing holiday in Canada. I was in a wheelchair after my visit to hospital out there. Long coach trip/internal flight/transatlantic flight/coach from airport=DVT!! NO-ONE mentioned it. Airline not just at fault but also hospital in Canada. Sent away at first by A+E in Wales admitted 2 days later... 6 months of Warferin but glad to be still alive! ALL SERVICES NEED TO BE EDUCATED. My problem was just waiting to happen.
Jeff Davies
Cardiff

Medichecks.com offer a Deep Vein Thrombosis Risk Test - see website. Anyone with the risks named in your programme should ensure that their risks are assessed in order that they can seek medical advice and reduce their risk factors before travelling. Those with Factor V Leiden, Factor II mutation and anticardiolipin antibodies in particular - and have the risk factors mentioned on the programme should have this test. The above factors are genetic and these need to be known to individuals - and especially if they are i.e. taking hormone therapy in which case they may have their risk increased x 30. Visit the website to see how this test is now available nationally.
Alistair Hall
Nottingham

My Mother sadly and tragically died after a long haul flight to Dallas Dec 1999. Her death certificate records pulmonary throbomboli, (known as DVT). My mother was a healthy 55 year old woman, this we know as she had only just had a thorough medical. I am totally sickened by the apathy of the airlines not to give out preventative information earlier as I KNOW my mother would still be here today and would be able to enjoy her grandchildren and them her. She is desperately missed forever.
Deborah Bellamy
Northampton

We, like you, have been encouraging the airlines and tour operators with little success to provide pre-flight information relating, amongst other things, to DVT at the point of sale and when airline tickets are despatched. You can see our video of exercises to alleviate the risk of DVT at http://www.medicdirect.co.uk/mpegs/AirThromb-384.mpg In addition you may be interested in our assessment of passengers most at risk at http://www.medicdirect.co.uk/merchant.ihtml?pid=1064&step=4#Link%203
Peter Morgan
Leighton Buzzard

My husband had a DVT after an overnight flight from London to Uganda. We diagnosed it quickly and started him on treatment so fortunately, the clot did not embolise. He had taken aspirin and the swollen leg was painless. He contacted the airline manager in Kampala who claimed to know nothing of this problem. Apart from the gradual reduction in legroom, I believe that the oxygen saturation of the recirculated air has been reduced over the years. This reduces fuel consumption and therefore cost. Such a reduction would also increase the risk of clots. Getting alcohol on a flight is usually no problem, but getting more than a thimble-full of water is. If the airline does not expect people to sleep on overnight flights, why do they distribute blankets and pillows, turn down the oxygen and the lights? Asleep of course, we are much less trouble.
Dr D Morgan
London

Mr John Scurr said that Factor V Leiden deficiency predisposes to DVT. It is actually the PRESENCE of Factor V Leiden that is the culprit - not the deficiency of it. Ask any Haematologist. Your reporter was even worse, talking about Factor V deficiency. In any case this is just one of about 10 hereditary factors that predispose to thrombosis. Ten percent of the population have some such abnormality, so it is very misleading to single out only ONE of them. And this from an eminent surgeon...
Dr Mihaly Saary
London

I am a concerned economy class passenger and am in no way connected to the airline industry. I found your programme superficial and lacking in analytical rigour. My main concern is that there are obviously many occasions when people sit for long periods i.e. coach, train and at work. You made no attempt to discover if there were incidences of DVT in such instances. Also, you implied that DVT began with the introduction of the Comet, but you did not say why. The Comet, being a jet airliner obviously reduced travelling times so if DVT is caused by long periods of air travel, the introduction of the Comet should have reduced incidences of DVT. On the other hand, the introduction of the Comet increased the altitude of the flights, but again you didn't conclude that this was a factor in increased incidences of DVT. I think you should have made more progress towards understanding the true cause of DVT by being more analytical and less sensational. In this way you might have been able to allow people to more fully understand the threat of DVT and what precautions they should take. In particular, I think you should have investigated medical research which linked DVT with travelling in pressurized aircraft environments. For instance, your programme doesn't allow me to decide whether I should travel by train in preference to plane. However, I am sure the programme has been useful in bringing more awareness to the problem of DVT and perhaps you could follow this up with a deeper investigation, now that you have had your fun bashing the airlines.
B Richards
Isle of Man

It is with great interest that I watch this debate on DVT and air travel progress. My company is in the process of bringing a Natural Herbal supplement to market to prevent and treat DVT. Our clinical studies that we performed in China on 2000 passengers travelling by train confirmed most of the statistics that are readily accepted today regarding the occurrence of DVT through immobility. Other studies relating to DVT mention hip operations and leg injuries that require immobilisation as major causes of DVT. The programme does a good job of blaming the airlines which is fairly easy when you consider the target. The mere fact that the industry has such an incredible safety record compared with the number of people they carry indicates their priority is aircraft safety and as a result passenger safety. I am sure they are applying the same conservative and methodical principles to dealing with the DVT issue also. I fail to see how deliberately killing paying passengers as you seem to insinuate makes good economic or marketing sense. However Panorama is to congratulated in raising peoples awareness on the subject and hopefully your programme has saved some lives through knowledge and education of the many viewers watching the story.
Desmond Delaney
Vancouver, Canada

I suffered a DVT last year whilst on honeymoon in Nice, France. I was mis-diagnosed for two weeks before a particularly alert GP suspected a pulmonary embolism. I was rushed to hospital for emergency treatment and was told I was very lucky to survive. It was later confirmed that because I was 40, was on the pill (for only 2 months to cover the honeymoon holiday) and had taken a flight (even though it was short haul), it was enough to bring on a DVT. I am very interested in setting up a forum for people who have suffered a DVT, so that we may gain force and get something done. Anyone interested should email me at: carole@rdpconsultancy.com
Carole Stewart
Romsey

I wish to inform viewers of the existence of Victims of Air Related DVT Association (VARDA) which I chair. At present we are collating data on DVT episodes and deaths and would like to hear from the public on this issue. Please send us the following information: Name, Address, Telephone Number, Airline, Flight duration, Class and Health Status. This information will greatly help our public awareness campaign. Our email address is feedback@aviation-health.org
Ruth Christoffersen
Newport

I found the programme on DVT very interesting, especially as my uncle died of PE at the age of 48. Although he wasn't a victim of so called 'Economy Class Syndrome', I have been aware of the risks of flying for some years. I fit into several risk categories mentioned in the programme as I am on the pill and smoke. I believe that height is also a risk factor, as being over 6 foot tall, I don't have room to sit still in the average plane seat, let alone exercise! I can understand that increasing leg room is not financially viable, but why can't there be better accommodation for people with longer legs? Getting a seat that I can move in is a lottery, and many airlines do very little to help.
Alison Drew
Ipswich

Great programme, a real eye opener. As a regular flyer I was aware of the possible effects of flying, or rather "being forced to sit still for a long time. " Being 6ft4, airplane seats are uncomfortable, but there is always room, to either exercise your feet/ankle/calf or just to walk around a bit. Tip - Drink more water than normal. This is not only healthy, it will make you go to the toilet more often, so more movement in the legs, less chance of developing DVT. The Aviation Industry, has to focus more on Passenger sitting comfort, i.e. more leg room.
RMW
Bristol

Why doesn't the British government make it compulsory for ALL British Aviation companies etc. to show a video to all their customers around the same time as the Safety Instructions are read / showed. A small video / instructions explaining to passenger the risks and the actions they should take (i.e. Moving Regularly)
Shane Andrews (Age 13)
Cardiff

I thought the programme did a good job of highlighting the problem. I had a suspected embolism 2 weeks after a flight from Sydney to London. I was left to sleep the whole way from Bangkok to London - 12 or 13 hours (club class). However, I'm not convinced that the airlines can carry out or necessarily assist research. From my own experience and from what I've read, the problem most often does not occur on the plane or at the airport - and for example, I never got round to notifying the airline after the event. Surely if it's as big a problem as potentially affecting one in ten long haul travellers, there must be a significant increase of dvt patients being treated in hospital. Is there not a responsibility on the medical establishment to confirm or deny the existence of such an apparently common syndrome. In the meantime, next time I fly long haul I'm going jogging round the cabin in any case!
Douglas Odam
Glasgow

My husband has recently suffered a DVT following a short flight of around two hours. Surely the airlines could spend a little of their money on devices to prevent the occurrence of DVT, such as foot pads that have recently been mentioned in the press, or on stockings. But perhaps they prefer to spend millions painting tail fins!
Daniela English
Shepperton

I believe the airlines should make more provision for disabled travellers on long haul flights. I am disabled and have great difficulty in getting correctly seated in any aircraft where, through reasons of aviation safety, I have been allocated a seat with very little leg room because the other areas have to be available for able-bodied passengers in case of emergency. I frequently travel to Australia to visit relations (1 trip a year) and the leg room available to me is unreasonably limited. I have problems bending my legs and although some airlines take this into account, there are several that don't. They just want to get the best deal and most money for the flight. I was fortunate to have been allocated a seat in Raffles class on Singapore airlines last year and it made all the difference - 2 - 3 feet extra leg room and a foot rest was also available.
Steve
Warrington, Cheshire

Excellent programme but very difficult for me to watch and impossible for my wife Ruth. I suffered flight-related DVT with multiple pulmonary embolisms two days after returning from a holiday in Goa in January this year. I collapsed twice with breathless attacks and but for rapid diagnosis, treatment and a high standard of care in Stafford's hospital, might well not be here today. I am now in contact with my MP, David Kidney, who hopes to raise a Bill on this issue early in the new Parliament. Anything that can help raise public awareness and hopefully lead to regulatory requirements on airlines must be welcomed. So thank you for this programme
Nick Balmforth
Stafford

A good programme but I think that too much emphasis is on long haul flights. You can also get DVT's from coaches, trains or even being immobile in bed. I am 18 years old, certainly not over weight, do not smoke or drink, take plenty of exercise and have never been on a long haul flight in my life. But I was still diagnosed with having a DVT in March this year and have been on warfarin ever since. I think that the programme should now make people aware of the signs and symptoms of DVT's are not only associated with long haul flights but is simply to do with immobilitlty wherever you are.
Jennie Patterson
London

I am delighted that at last DVT's are hitting the public's attention. In 1991 following a flight of over 14 hours to the Dominican Republic I had a DVT symptoms 6 days after we arrived, although I saw a Doctor on the Island 5 times, his only comment was that on my return to the UK I needed to urgently see a C.V. specialist. At no time was I told it was a suspected DVT and was prescribed aspirin. My rep who was aware of the problem and the doctors comments, did not at anytime warn me of the dangers of flying home and even arranged with the airline for me to have an extra leg room seat. At this stage I could not walk, my calf was swollen, red and very hot to the touch, the pain was amazing and I had also started to have a chest pains and was slightly breathless. Yet no-one was concerned about me doing the long flight home, in fact at the time it seemed as if they were just glad to get me off the island. I arrived back in the UK at 2pm was driven home, saw my doctor at 4:30pm and was admitted straight to hospital where I was told the clot had gone to my lungs. I was very lucky, and feel that not only do the airlines need to address the issue with (at the least) warnings, but also holiday reps should be made aware of the dangers of DVT's.
Penni Cragg
Wellingborough

Excellent programme. I suffered a DVT/PE a year or two ago after a long haul flight. Whilst I appreciate some may see any such programme as alarmist - particularly those who have a vested interest in maintaining commercial profit and/or warding off litigation - it is most important that the world at large is made aware of the issues in an open and transparent way. Hopefully the personal tragedies that you highlighted in your programme may be avoided as a result of your raising the level of awareness. Well done to all those involved in the production of this programme.
Peter Welburn
Winchester

If the airlines are convinced that there cannot possibly be any link between DVT and long-haul flights, then why are they so reluctant to give any help for research on the subject? Surely they should welcome this research which would vindicate them?
Michelle
London

I find it laughable that the same people who demand cheaper and cheaper air fares are now demanding that the airlines remove rows of seats to make them more comfortable. I have been flying for 18 years (my life) long haul - and have slowly seen the erosion of legroom in economy class. However, this is not to blame. People are at risk whatever seat they are travelling in - be it First, Club or Economy. I have a 6-hour train journey and a 7 hour flight next week - I will be getting up and walking around on both forms of transport.
Alastair Mackie
Bahrain, Arabian Gulf

I fly back to the UK every year to visit family and had never thought of a blood clot. But in March of this year my husband and I travelled to Arizona - a 1,400 mile trip. A day after arrival my calf felt like it was going to burst and obviously while we were there we did a lot of sightseeing. On our return home we had covered 2,800 miles in 7 days. By this time I was unable to put my foot on the ground, I then immediately went to the ER and they did a scan to find I had a blood clot, they told me it was in a vein but not DVT. I was told the travel had caused it and was advised in future when travelling for long distances to move around as much as possible, to wear anti-embolism stockings and to take a baby aspirin every day. I feel lucky that maybe I know to take precautions now to avoid this happening to me again. It should be more widely publicised.
Doreen Dowling
Rogers, AR, USA

Good programme on DVT. More publicity can only help. The big problem for passengers is the efficiency of aircraft design (wings and engines). This allows airlines to pack in the seats, all of which seem to get more uncomfortable as time goes on. I fly USA - Europe every month, and not only is bad seating highly stressful, the whole process is stressful, everything is over crowded, hub airports can't cope, and worse still they don't care.
Colin Reed
Rio de Janeiro

After viewing your programme this evening I realise just how lucky I am to be alive. I suffered a symptomless DVT at the end of November 1995 after a 14 hour flight from Hong Kong. I suffered increasing breathlessness throughout December but was only diagnosed as having a potentially fatal pulmonary embolism at the beginning of January 1996. Fortunately I was admitted to hospital and cured. I feel so terribly sorry for the families and friends of all those who were not so lucky. I had not read anything in the in-flight information booklets about the risk and what precautions passengers should take to help prevent the condition. On subsequent long-haul flights I do all the right things but I am very aware that the cabin crew are often irritated by my standing up at the back doing my exercises. I always explain exactly why I am doing them and they reluctantly tolerate me after that. Cabin crew could certainly not cope if all 360+ passengers wanted to walk up and down taking exercise. Why can't small cycle-like leg exercisers be installed instead of foot rests so that we can keep our calf muscles active? The airlines have a responsibility for the safety of their passengers and your programme has shown just how negligent they have been about this. If a smoker can be awarded a large sum of money in compensation by a tobacco company, surely passengers deserve to be compensated by airlines if they have suffered DVTs as a result of a lack of adequate warning about the health risk.
Sue Wall
Broadstairs

I fly on a long-haul flight between Europe and Japan every two weeks. I am tall, overweight and so should probably be at a high risk of DVT. But I make a policy of going for a walk around the plane every hour and always ask for an aisle seat. I'm sure I'm an air-hostess's nightmare. But what surprises me is that so many people get up just once to go the loo on an 11-hour flight. Isn't it just laziness? If every passenger did as I do we'd surely even have the side benefit of airlines having to provide more space to facilitate it.
Andi-Tsuyoshi Williams
Sapporo, Japan

The airlines could include support stockings in the bag with the sockettes and eyemask. In the quantities they'd be buying it couldn't add that much to the flight cost for the passenger. Also, all airlines should copy the example of one I flew with, who gave every passenger a bottle of water - more use than the tiny cups most airlines offer and one less thing to have to cary in your hand baggage.
Jeanette Bloor
Ireland

My wife was suspected of having a DVT after a short flight from Spain last year, and now she is worried about flying. But should the airlines not under general health and safety regulations be liable to inform passengers of the possibity of DVT as the company's obligation's to public safety? That no one should put themselves or the public at risk by anything they do in the course of their business or work.
Mr M.S. Ridings
Blackpool, Lancs

I watched your programme on DVT last night with great interest. I travel frequently to the West Coast USA in economy class. Like a lot of people I cannot afford the 3x price of business class. Being over 6 ft tall, I find the journey very uncomfortable and it is quite common for me to suffer lower leg cramps. After watching your programme, I am now concerned about future travel. Surely it would make sense to take a couple of rows out of economy class. On a 747 that would give everyone about 2.5 inches extra leg room and would increase the air fare by about 6%. Any sensible airline would be able to market this benefit.
Keith Huxley
Chester

I don't want to seem cold or cruel but growing up in Sydney of UK parentage I knew from a very early age that you must exercise while on long haul flights. It seems commonsense to me to get up and walk about the plane when it is safe to do so. Also another point is why not take advantage of the stop over on long haul flights and walk briskly about the airport you're in? It's always worked for me. We don't sit for 24 hours normally so why should you on a plane?
CS
London

I found the programme very revealing. I need to know if I can develop DVT without knowing it and if by sitting on my desk at work for long hours can cause DVT. And also just how long, is 'too long' and long enough to cause a blood clot in the leg? Also I want to comment on a certain airline spokesman that made a very silly statement on the programme yesterday, (don't remember his name!) along the lines of, "...passengers need to inform themselves on the dangers of DVT and are supposed to know, if they are at greater risks!!" I think he made absolutely no sense. What exactly are the airlines doing about this 'economy class syndrome'
Valerie
Stockton-on-Tees, Cleveland

After watching the programme last night I thought does this only happen to people after flying? I mean there are many people who travel on long coach journeys for example who are sat in seats smaller that those on aircraft. Being a frequent traveller myself, during long-haul flights I get up exercise and move around the cabin several times throughout the flight.
Mark Bearman
Windsor

Six years ago my husband and I flew from Glasgow to Toronto then on to Los Angeles after a two hour wait and onward to Auckland after a four hour wait. On arrival in New Zealand for 3 or 4 days I felt tired and exhausted and spent most of the time sleeping and assuming that this was jet lag. But now I wonder. On the advice of the doctor on the Jimmy Young programme on BBC Radio 2 we had taken half an aspirin for the 3 days prior to our flights and for 3 days after. He had also advised drinking carrot juice. Also on the doctor's advice we took regular walks up and down the plane and drank plenty of water which was constantly on offer. Your Panorama programme was a real eye opener and I do hope that something will be done by the airlines now.
Rosalind McLennan
Glasgow

I wonder if the airlines offer somewhat more proactive guidance and information to their flight crews, who presumably also have to sit still for long periods.
Roderic Cameron
Maidstone

We are now supplying the SKY WALKER - this device imitates walking from a seated position. This easy, effortless motion causes the calf muscles to contract, assisting venous blood back to the heart. SKY WALKER is compact, 250 grm, only costs £9.95p available from Parkside Healthcare 0161 795 2792 and soon from the local Chemist.
Sam Keanan
Salford, Manchester

I suffered a DVT in November 1999 while travelling Business Class from Heathrow to Chicago.
Robert McWilliam
London

Last Xmas I travelled to Boston and then onto Florida and back to the UK with a well known American airline. I travelled with my husband, my sister and brother-in-law. We are all in our 50's and the seat allocation we were given was terrible. It was in Economy, but we measured the access at the end of the row and it was 6 inches less than the row in front, in which the airline had placed children, all, I would say, under 12 years of age. We sat for the entire Transatlantic flight with our knees digging into the seats in front when they were reclined. We had an unavoidable delay of 2 and half hours in the aircraft because of snow in Boston, but were not offered on drink in that time. Another factor in the development of DVT is thought to be dehydration/lack of oxygen, so this was a pretty poor show. I did not let the matter of the seat allocation and this lack of care at Boston go and wrote to the airline concerned. The letter I received in reply was just a PR exercise about removing seats in First and Business Class in the near future - and this to a complainant who travelled economy! I pointed out that, at the very least, staff could be trained to allocate seating according to height, age, and other factors and that, even if I had to pay more, I would prefer to travel with an airline who did not squash so many seats into Economy. To date I have not had any response to these further suggestions and will not be travelling with that airline again. In their PR response they avoided mention of DVT altogether, even though I had pointed out the risks in my original complaint. I read with interest the lawyer's comments about a test case under the Human Rights Act and I say - the sooner the better!!
Angie Stone
High Wycombe, Bucks

Great programme and entertaining TV but serious investigation I don't think so. There was no attempt made to show a link between DVT and flying - for example what is the incidence of DVT in the non long haul flying population at large. If it really is a 'space' related issue then I'm sure the airlines would be happy to provide more space but would the public be able to afford them?
Ian Milne
Reading

My daughter Sara aged 23 died 12 April 2001. She was admitted to hospital 19 days after a long haul flight from Australia with a suspected embolism. Only an X-ray was taken and she was discharged with antibiotics for a chest infection. Had she been given a scan I believe my daughter would be here today. The medical profession have to sit up and take notice of the risks of flying as do the Airlines.
Pat
Swansea

I watched your programme last night with interest. Six weeks ago I returned from Florida and four weeks after my return I started to get a pain in my foot, which then went to the back of my leg. I went to the doctors and was rushed to A & E, where I was informed that I had DVT. I was aware of DVT before I flew, and made sure that I got exercise on the flight and drank plenty of water, but somehow I still ended up with DVT. I was told by the hospital that if I hadn't of acted as quickly as I did, that I would possibly not be here now. It has really frightened me, as I have 3 young children and only being 34! I feel that the airlines should take out a few rows of seats in order to make a bit more room. They should also make passengers more aware. I only knew about DVT from watching a BBC Holiday programme.
Alison Proctor
Stotfold

I suffered my first DVT in my left calf following a flight from Rio De Janeiro to London in an economy seat. Two years later and after six months on anti-coagulant medication I suffered another DVT, this time in my right calf following a two hour flight in business class to Norway. As a result of which I have now been advised to take anti-coagulants for the rest of my life. It is about time the airline industry owned up to this problem. The comment made in last night's programme by one airline representative that individuals should be responsible for their own in flight health was ridiculous. I am six foot tall, have played rugby for ten years, and attend a gym two to three times a week. As a result I am relatively fit. I do not fall in to any of the at risk groups and had never even heard of DVT until I got it.
Max English
Weybridge

First let me state that your programme on DVT was very good and people must be advised if there are any pitfalls of travelling by aircraft. I am confined to a wheelchair and in 1988 I travelled twice around the world on aircraft, 46,000 miles for charity. I did not move about the aircraft, in fact 5 and a half days I was invariably in the seat of the aircraft. Obviously I am not susceptible; but perhaps it would be advantageous to find a true percentage of people who are, to put it in some context.
George Goodger
Ashford, Middlesex

I think that it is misleading to call DVT 'Economy Class Syndrome'. It should be called 'Flying Syndrome' - I am in my late 60s and 6 feet tall. So as to avoid DVT and to be able to stretch out in comfort, I paid a considerable sum to upgrade to Business Class. In March my wife and I returned from Bangkok and travelled Business Class and I was seated on the front row in a bulkhead seat. At the start of the 12 hour flight, I complained to the cabin staff about the lack of even adequate legroom. I was told that the flight was full and so they couldn't change my seat. The staff could see that I was seriously uncomfortable and cramped. During the flight one attendant told me that the only way that I could stretch out in comfort was if a hole was made in the bulk head wall in front of me. I suffered agonising and painful leg cramps during the flight. For the next 2 nights at home I was awakened from my sleep suffering from painful cramps in my leg. I wish that on my return I had gone to the hospital for tests to find out if I had developed blood clots.
Michael Walton
Congleton

I was surprised to see you calling for comments on "Economy Class Syndrome" even though your programme acknowledged that the term is misleading: people are no more likely to contract DVT in Economy than in First or Business Class. Having worked in the aviation industry for many years, I can state with confidence that there has never been any attempt to cover up information about DVT. Airlines have known about DVT, but because its symptoms are usually manifested some days after travel and because there were so few reported cases, it was never considered to be a serious problem. While the spate of recent - and largely misleading - publicity has made the risk of suffering from DVT appear to be far greater than is actually the case, it has served to remind people who may be frail, under certain medication, or who may have circulatory or respiratory problems of the importance of establishing their fitness to fly before they book their tickets.
Charles Miller
London

I was both gratified and horrified with your programme on DVT yesterday. It is evident that many airlines have known about this for some years, but saw fit to pretend it did not exist. It reminds me of the tobacco companies in the light of lung cancer researches. I have had only one near-DVT experience myself. I have made four or five trips to Hong Kong from the UK, but most have been on business using Business Class. When my wife and I had a silver wedding trip some ten years ago, we travelled economy. In the last hour before arriving I was aware of discomfort around my shins, and in fact there was no sensation when I pressed my finger against my leg. After walking about, there was little change. On arrival in HK my hotel directed me to a local doctor who examined it and said there was nothing to worry about. However this lack of sensation persisted for two days and was certainly most alarming. I was fortunate to have no other symptoms then or since, and of course it may have not been DVT. However there is no doubt that it was caused by cramped conditions. I hope that your programme will bring this matter more into the public consciousness. It is clear that more publicity is needed so that the airlines will have to raise their heads from the sand
Geoff Jacobs
London

I watched your excellent programme last night and was staggered by the arrogance of the various airline medical officers who basically tried to pretend that the problem didn't exist, or if it did (Lufthansa) then it was up to the passenger to find out for him/herself before flying. Having flown long haul frequently in the past I am extremely grateful that I regularly walked around during the flight. The only airline that came out with any credibility was BA who have at least been advising passengers to exercise on their flights - something that none of the others (as far as I am aware) ever did.
Jos Coad
London

Your programme on deep vein thrombosis was very interesting highlighting the sad death of the young girl from Wales. She was on the pill and she did engage in an unusual amount of parachute activity which requires very tight harness particularly in the groins restricting venous return from the lower limbs. This was not mentioned in favour of the easier criticism of the airlines. There are many risk factors which may have equal if not greater bearing on this syndrome and I would be interested in your A&E consultant's view on this particularly as he highlighted a more common cause of deep vein thrombosis namely orthopaedic operations around the hip.
Dr G Hartley
Stockport

I was recently advised by my doctor to take precautions when flying but did not fully understand why until last night. I cannot believe that airlines have turned a blind eye for so long and that they refuse to help in research. Their hostesses should be giving us advice along with the rest of the information that we receive about the flight before take off. I hope that this documentary will highlight the need for research into this terrible problem - people should be made aware, especially if they fall into 2 or more of the categories mentioned. People are dying when they need not - why should ignorance be a price for life?
Rhiannon Garrett
Newbury

I suffered from a DVT ten years ago following a flight from Florida. I nearly died, spent 6 weeks off work and then 3 months on Prozac trying to recover from a brush with death at the age of 23. It completely changed my life. Every time I want to try and get life insurance I am immediately penalised because of this illness, even though I am no more likely to have a second DVT than someone else is to have their first. I wish I had known then what I know now - maybe if I had it would not have happened to me.
Abby Ewen
London

Having recently returned from a business trip to Sydney, I watched with great interest and some anxiety the programme about DVT. I agree with some of the comments already posted that the severe lack of space in Economy class makes a mockery of the well being videos and exercises. I am 6'2" and am lucky if I can raise my toes. As a minimum I always try to ask for an aisle seat - I guess stretching one leg is little better than none! Also when the plane is plunged into perpetual 'sleep mode' it does make it easier to get up and walk about. If more people are going to travel longer distances for work and pleasure, then surely it is in everyone's interest to make sure the passengers and airlines know and do everything possible to minimise DVT occurring. It would be a bad business model that permits the killing off of its customers!!
Rob Beckwith
Cambridge

The programme on DVT was very interesting and informative. I as a lawyer was disturbed that airlines may not be held responsible as the liability is strict. However, having acted for some crash victims in Africa and having read a lot on the regular conventions held by the airline industry, it would be worth exploring the liability issues in detail particularly from the imputation of knowledge. Also under the new human rights act one could formulate a case. On another related issue, airlines deliberately keep food trays on your seat for too long in order to ensure least movement in the aisles. They are also reluctant to let you have more water and the crew are really poor at public relations these days. The gangway to the toilets are too small and the toilets too few. All this is really to ensure minimum movement by passengers in economy class.
Mumtaz Kassam
London

The Royal Society for the Promotion of Health has organised a Conference on 'Healthy Flying' on the 22nd of June at the IOD Pall Mall. Speakers include John Scurr, interviewed by Panorama, and Baroness Wilcox. Delegates already include BA, Virgin and many other representatives from the aviation industry. For further information regarding the conference and attendance please contact Vishal Patel at the Royal Society for the Promotion of Health, on 0207 630 0121.
Vishal Patel
London

I would like to see the airline industry, or the government, make an appeal for people affected by this condition to come forward. Then perhaps we will know the true extent of the suffering. I had a DVT after a trip to Australia at the age of 25. I would like to think that I am included in the statistics.
James Stark
Southampton

It is difficult to see how the airlines can say this is recent: the first article on this appeared in BMJ 8/12/79 page 1478. My invention, PUSH CUSH, was patented in UK in 1981 and is currently on sale through Boots catalogue.
Joan Stuckey
Sydney, Australia

I have flown long haul many times in economy class and get extremely frustrated with the lack of space, especially if it is a full flight. Airlines will argue that DVT is not an 'economy class syndrome' as it has affected those travelling in business class as well. However, due to the incredible lack of space in 'steerage class' it is sometimes hard to perform basic exercises, especially if you are in the middle of a row. I don't expect acres of legroom with a cheap flight but it can be torture on some airlines.
Dan Rees
Esher

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