Perils of flying cheaply

Press, 27 September 1988, Page 12

Perils of flying cheaply

DR JOHN CRUICKSHANK, who works for Dr Richard Gorlin of the Mount Sinai Medical Centre in New York and Dr Bryan Jennett of the Southern General Hospital in Glasgow are all distinguished scientists. So naturally they travel around the world a lot.

When they went to a conference last winter they happened to discuss a neglected complaint that each, independently, had discovered: economy-class syndrome (E.C.S.). The symptoms can appear several weeks after flights as short as three hours, and can— in extremis— lead to death. The three doctors decided to publicise E.C.S. (in the “Lancet”) because they knew of six long-distance passengers who ended up in hospital. Two of

them were Dr Jennett and Dr Cruickshank.

Nobody knows exactly what causes E.C.S., but leg-room has something to do with it. Cramped conditions mean that passengers’ legs cannot move around freely: in economy class the knee room (the distance between the edge of the seat to the one in front) is usually some 35cm compared with 80cm in first class. Econ-omy-class seats lean back some 12.5 cm; first-class armchairs recline by a leisurely 36cm.

Restricted movement can lead to an interruption of blood flow; “still” blood causes clots, which can cut off the supply of oxygen to various organs and kill them. In 1986 a three-year study carried out at Heathrow Airport found that 18 per cent of 61

sudden deaths over three years among long-distance passengers were due to blood clots in the lung. The most likely victims drink a lot on their flights: alcohol causes dehydration which also interferes with the blood circulation. But even healthy and sensible people, such as Dr Cruickshank, can succumb to the syndrome. He developed pneumonia caused by blood clots in the lungs after travelling to Asia on an economy-class ticket. The best medical advice for people who are worried about E.C.S. is clear: go first class. Unfortunately the doctors forgot to mention first-class syndrome, in which passengers risk a heart attack when they learn the price of a ticket.

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