The use of low-dose aspirin to prevent flight-related deep vein thrombosis (DVT) is recommended by a new House of Lords report.
The report on air travel and health by the Select Committee on Science and Technology recommends that a case-control research programme examining links between DVT and air travel should be commissioned by the Government as soon as possible. It says that currently there are no authoritative data to show a clear difference in the incidence of DVT between those who have recently travelled and those who have not. In the meantime, the report postulates risk factors for DVT associated with long-distance travel and gives interim precautionary and preventive advice concerning air travel and DVT.
For people with no known risk factors, the report recommends moving around, exercising the calf muscles, avoiding excessive consumption of alcohol and caffeine-containing drinks and drinking water or non-caffeinated soft drinks when thirsty.
It recommends additional precautions for people with different levels of risk. People at minor risk should avoid taking sleeping tablets and should consider wearing support stockings. People at moderate risk, including those who take the contraceptive pill or hormone replacement therapy, should seek professional medical advice about the risks involved with air travel. They should take a pre-flight low dose of aspirin, unless contraindicated, and possibly wear compression stockings, it adds. For people at substantial risk of DVT, including those with a known clotting tendency or on current chemotherapy, the flight should be avoided or postponed. If this is not possible, low molecular weight heparin should be prescribed rather than aspirin.
General risk factors given for DVT include age above 40, pregnancy, use of oral contraceptives, depletion of body fluids leading to increased blood viscosity, immobilisation and history of clotting impairment. The report also lists risks of travel that it says might be factors in their own right or might augment the risk from predisposing factors. These include increased duration and frequency of travel, seating constraints, reduced oxygen and/or pressure leading to blood clotting tendency, low humidity affecting body fluid content and excessive consumption of alcohol and caffeine.
The report says that the term "economy class syndrome "is seriously misleading and that "flight-related DVT "or "traveller's thrombosis "are more appropriate.
The report can be accessed at www.publications.parliament.uk.