What has been code named “Coach or Economy Class Syndrome” is actually only one group at risk for venous thrombosis. 

The truth is any type of travel with long hours of immobility (e.g. bus, train or car trips) carries similar risks as air travel.

It should also be pointed out that people in sitting occupations or performing leisure tasks involving hours of sitting in the same position are also subject to the dangers of developing deep vein thrombosis.  (For example, it was reported from Korea that a high intensity computer gamer died suddenly from a blood clot after a marathon gaming session).

For many of us air travel has become part of our way of life.  Embarking on extended travel via long distance flights can put you at an increased risk for the formation of blood clots.  This condition, also known as deep vein thrombosis (DVT), tends to occur in the legs when spending a long time sitting inactive in an upright position.  If a blood clot inside a vein breaks loose it can travel to your heart, lung or brain, where it can lodge and cause serious damage or even a life threatening blockage.

 
Wearing graduated compression support hosiery during long flights, bus trips or car rides can reduce your risk of “Economy Class Syndrome”.

Graduated compression garments can help improve blood flow from the legs to the heart and prevent swelling of the feet and lower legs due to accumulation of retained fluid.  It is important to wear only graduated compression hosiery where the pressure is greatest at the ankle area and gradually decreases going up the leg.

Regular support hose which apply equal pressure all over should not be worn for long distance travel and may actually worsen the problem.  Compression hosiery should not be worn if you have circulation problems in your legs.  It is always best to discuss the use of compression garments with your physician prior to your travels.

When traveling for many hours at a time, the combined effects of insufficient hydration, immobility, and the pressure of the seat at the knee level make it harder for your leg veins to provide optimal blood flow to the heart.  Lack of movement can make your muscles tense or cramp up, cause back and leg muscle aches, and creates a general feeling of fatigue. 

Some medications and medical conditions may also increase the risk of deep vein thrombosis in combination with prolonged sedentary positions.  Suppressed flow of blood and fluids against gravity force (e.g. during long flights) can also manifest itself in the swelling of the lower legs and feet, also known as edema.

 
Symptoms of Blood Clots (DVT)

One out of two people with deep vein thrombosis (DVT) have no symptoms whatsoever.  The following are the most common symptoms occurring in the affected area of the body:

• Pain
• Tenderness
• Swelling
• Skin redness

If you have any of these symptoms, seek medical help as soon as possible.

You may be at an increased risk for blood clots (deep vein thrombosis) during long distance travel if you have experienced one or more of the following:

• Previous or family history of DVT (deep vein thrombosis) or embolism.
• Congestive heart failure
• Recent surgery (under anesthesia)
• Pregnancy or recent childbirth
• Recent chemotherapy treatment for cancer
• Blood disorders (e.g. factor V Leiden)
• Varicose veins
• Recent period of immobility
• If you are overweight (20% or greater above your ideal body weight)
• If you are taking birth control or hormone replacements
• If you are a smoker

In summary, it can be said that individuals exhibiting none of the above risk factors have a low likelihood of developing blood clots during prolonged travel.

This is especially true if you are employing standard precautions such as regular leg exercises, proper hydration and preventive wearing of compression socks or stockings.

However, if you have one or more of the above risk factors, a visit with your physician is highly recommended prior to extended travel.  Your doctor can offer professional advice on how to best protect yourself against the potential dangers of “Economy Class Syndrome”.

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