Blood clots and long distance flights: information for travelers.

Traveling for long distances in cramped seating is not only uncomfortable; it could affect your health. People who travel on long plane rides may be at increased risk for the development of blood clots due to long periods of limited mobility. When you stay in one position for a long time, blood can stagnate in your veins leading to the possibility of a clot formation. Because we don’t currently track the number of blood clots related to travel it is difficult to determine the actual risk that travel contributes. What we do know is that the incidence of travel related blood clots is low. One estimate is that a blood clot forms in one of every 6,000 flights greater than 4 hours in length. Another study estimated that the risk of developing a symptomatic blood clot after traveling for greater than 8 hours was 0.3%. Deep vein thrombosis (DVT) is a condition when a blood clot forms in the deep veins, most often in the lower extremities. A part of the clot could break off and travel to the lungs, causing a pulmonary embolism (PE). PE is a very serious and possibly life threatening condition.

Some risk factors related to blood clots are

• Older age (risk starts to increase after age 40)

• Obesity

• Estrogen use (birth control or hormone replacement therapy)

• Pregnancy and the period shortly after birth

• Blood clotting disorders

• Previous blood clot

• Active cancer

• Serious medical conditions (congestive heart failure, inflammatory bowel disease)

• Recent surgery or trauma

• Limited mobility

There are things you can do to decrease your risk of developing a blood clot. Frequent walking is best. If you are able to get up from your seat and walk around the plane do it. A simple walk to the restroom can do wonders. When you are unable to get out of your seat, calf muscle exercises can get the blood flowing. Simply squeeze your leg muscles for 10 or 20 repetitions. Flex your toes….then point your toes. Repeat this exercise several times. Try to get an aisle seat if you are able to. The extra legroom an aisle seat offers can allow you to move your legs and prevent blood from pooling. Stay well hydrated by drinking plenty of non-alcoholic fluid. Being well hydrated will not only help prevent clots, but also leads to walks to the bathroom, keeping the blood circulating in your legs. Graduated compression stockings are not generally recommended, but should be used if you have any of the risk factors listed above. The stocking should be below the knee and properly fitted with a pressure of 15-30 mm Hg at the ankle level.

Symptoms of a DVT can be non-specific, but generally include pain or tenderness in the affected extremity with increased warmth and swelling. There may be redness of the skin over the blood clot. Symptoms of a PE include unexplained shortness of breath, chest pain, and a cough, which may or may not produce bloody sputum. Another possible symptom is dizziness. If you experience these symptoms seek immediate medical attention.

At Arcadia Physician’s Travel Clinic we are committed to helping people prevent complications before they occur. By knowing a few simple strategies to prevent the serious complication of a DVT or PE you can travel and explore the world safely. So go…see…taste…explore! Just be sure to stretch your legs along the way. Bon Voyage!

References:

Centers for Disease Control and Prevention (2017) Deep Vein Thrombosis and Pulmonary Embolism retrieved from https://wwwnc.cdc.gov/travel/yellowbook/2018/the-pre-travel-consultation/deep-vein-thrombosis-pulmonary-embolism

Aryal KR, Al-Khaffaf H. Venous thromboembolic complications following air travel: what’s the quantitative risk? A literature review. Eur J Vasc Endovasc Surg. 2006 Feb;31(2):187–99