Silent killer on airlines

By MARTIN JOHNSTON and ALAN PERROTT

Economy-class syndrome kills four air travellers landing in Auckland every year, doctors say.

Some die at Auckland Airport or in the air from blood clots in their lungs after long-haul flights.

But the condition - also called deep vein thrombosis (DVT) - creeps up on others, sometimes weeks later.

The syndrome, linked to extended immobility in cramped seats, kills up to 30,000 travellers a year worldwide, aviation-health researchers in Britain have calculated.

Ashford Hospital in London, the closest emergency department to the world's busiest airport, Heathrow, has recorded 30 deaths from DVT in three years. The victims were aged between 28 and their late 70s.

Mass legal action is now planned against many airlines.

Some carriers, including Air New Zealand, have decided to stamp warnings and advice on tickets.

Yesterday, an Australian MP claimed that an Australian airline had reached a "substantial" out-of-court settlement with a passenger who suffered DVT on a flight six years ago, but Qantas and Ansett Australia, which is owned by Air New Zealand, refused to comment.

MP Neil O'Keefe would not name the airline or the amount, but said the secret payment proved the airline knew about economy-class syndrome and failed to act.

Arriving international passengers the Herald interviewed at Auckland Airport yesterday were mostly well aware of the risks and had exercised during their long-haul flights and taken other precautions.

The first person the Herald spoke to, Neil Carlisle, said he had lost his father to the condition.

"He had just got off the plane in Heathrow on his way home to Ireland. He reported he was feeling ill and two minutes later he collapsed and died. It's pretty scary, and I think about it all the time when I'm flying. In fact, the whole family is very conscious of the danger."

To prevent any problems, Mr Carlisle walks around the cabin as often as he can, wears loose clothes with sandals and drinks plenty of water.

Auckland Mortuary pathologist Dr Jane Vuletic said yesterday that she and colleagues performed up to four autopsies a year on people who had died from pulmonary embolism - lung clots - after long flights.

The number of deaths from the condition - in which the clots form in the legs and later shift to the lungs - had been steadily increasing for 10 years.

Many victims are elderly but it can also strike the young, and doctors say pregnant women, smokers and the overweight are most at risk.

Dr Vuletic thought the increase might be due to rising numbers of people travelling, particularly older passengers.

A colleague, Dr Tim Koelmeyer, suspected that the condition might have been less common when most aircraft had to stop more often to refuel and passengers could get off for a walk.

Many of the cases he cited involved passengers dying on arrival at Auckland Airport or during their flights.

There were airport deaths in 1991 and 1999, with two in 1998. One passenger died in-flight in 1994, en route from Los Angeles, and another last year.

Dr Koelmeyer said others would have collapsed at the airport, have been resuscitated, and later died in Middlemore Hospital, the closest hospital to the airport.

The hospital's intensive care unit reports treating three travellers in the past two years for a pulmonary embolism after long flights. One died from complications of treatment, said intensive care specialist Dr Tony Williams.

Mr Carlisle, who with his partner, Kim Austin, had returned to live in New Zealand after several years in South Africa, expressed anger that airlines did not do more to warn passengers about DVT.

"I've just flown on South African Airways and Air New Zealand and nothing was said. It's not that I'm all that worried about myself. I worry more about the older people sitting around me."

Mr Carlisle's family are investigating legal action against British Airways.

"It's not the financial recognition, it's just making them recognise there is a problem," he said.

English traveller Wendy Morgan said she always took aspirin before flying - it thins the blood - and while in the air drank plenty of water or fruit juice and moved around a lot.

Morag, another traveller, said she went one step further and started taking aspirin four days before any flight.

Tony Borich, a chemist based at the airport, said sales of aspirin were "going through the roof," but mainly to foreign tourists. "Now I take them as well."