Estimates of how many airline passengers die from deep-vein thrombosis run the gamut from disturbing to frightening. The jury is still out on what the precise extent of the problem is vis-à-vis air travel, but several facts are already known: DVT can occur in any situation of extended immobility, be it air, rail or car travel or simply a long time in bed, and this is not a new phenomenon. As Dr Ion Morrison, Qantas' general manager for aviation health services, has pointed out, "DVT has been known for centuries".
Some medical experts confide they do not believe that the DVT lawsuits which are planned against airlines can succeed because conclusive evidence linking air travel to the condition does not yet exist. The airlines, however, must not be lulled into complacency by believing that the introduction of "quick fix" solutions will make the problem go away - and call a halt to planned legal action against them - as rapidly as it has surfaced in tabloid headlines. After bringing online the videos, additional soft drinks, air-to-ground medical services, and the health warning information to accompany the tickets, the airlines are now duty-bound to continue those offerings to demonstrate their long-term commitment to passenger well-being. In fact, the DVT misnomer, "economy-class syndrome", may well have grabbed the public and the press imagination in great part because of a nagging perception that airlines are not concerned for those in the cheap seats, and skimpy seat space in the middle of a five-abreast row on a Boeing 777 - so bad for one's state of mind on a long-haul flight - also endangers one's physical health.
An even greater concern than DVT's airborne threat by itself, however, is a wider implication: the much vaunted "friendly skies" and the "metal tubes" we fly in form an unholy alliance which imperils passengers and aircrew alike with multiple health hazards. Research already links cosmic radiation with cancer and pregnancy problems; the European Union, under its Fifth Framework aeronautics research and development programme, is funding a three-year research project involving 15 organisations from seven European countries which will address issues related to cabin air quality in commercial aircraft. As London consultant vascular surgeon John Scurr says, aviation is still so new a field that unknowns still remain about the effects on humans of altitude, materials used to build, fuel and air-condition the aircraft, frequency of air travel and other variables.
The World Health Organisation is among the groups the world over planning round tables to put DVT under the microscope - in and of itself a healthy move in airing the issues and, hopefully, mapping out a strategic plan for combatting and preventing the problem.
The danger, however, is in focusing on DVT - or cosmic radiation, or cabin air quality - in isolation. What is needed is an integrated, holistic approach to aviation health that crosses national and organisational boundaries. And the implementation of environmental and health-protective measures must be obviously free from the taint of suspicion that information is being withheld or slanted in such a way to benefit the industry - to the detriment of the human cattle: the aircrews and air passengers themselves.
The new super-jumbo aircraft being built - the Airbus A380 and Boeing's 747X - promise new opportunities for innovation and exploitation as models of environment and health-friendly technology. Furthermore, consortiums such as Cabinair - the multinational, multiorganisation group which is tackling the cabin air quality study - are strongly positioned to optimise individual members' specialties and authorities for a common, possibly even global, good.
The trick will be to organise and integrate all of the well-intended efforts in a long-term linkage of medical and industrial interests. Industry, including the airlines, must meet commercial goals, but achieving those aims depends heavily on assuring the trust, good will and well-being of the air travelling public.
Source: Flight International
