Flying in coach may save money, but it could also come with serious health risks, including the potentially fatal condition known as “economy class syndrome.” This term refers to deep vein thrombosis (DVT), a condition where blood clots form in the deep veins, usually in the legs or pelvis, due to prolonged inactivity, like sitting in cramped spaces on long flights.
What is DVT?
DVT occurs when a blood clot forms in a deep vein, impeding blood flow. Symptoms include pain, swelling, warmth, and changes in skin color near the affected area. However, not everyone with DVT experiences symptoms, making it a stealthy threat. If untreated, DVT can lead to a pulmonary embolism—a blood clot that travels to the lungs—causing life-threatening complications. Dr. Robert Lookstein, a radiology professor at Mount Sinai Health System, warns that “ten to thirty percent of pulmonary embolisms will not survive,” highlighting the serious nature of this condition.
Risks on Long Flights
While DVT can develop at any time, long-haul flights pose a higher risk due to prolonged sedentariness, confined seating, and dehydration. Dr. Pinakin V. Parekh, a cardiologist at Singapore’s Harley Street Heart and Vascular Centre, explains that the risk is not confined to economy class; it is linked to a lack of movement. “People in better classes of air travel—business class, first class—have more space to move about, stretch their legs. So it’s all about real estate in the plane,” Parekh says.
Dr. Lookstein adds that the stereotype of a traveler at risk is someone who drinks a double latte, boards a coach seat, falls asleep after a scotch, and wakes up hours later without having moved, “profoundly dehydrated and with a blood clot.” Although DVT is often associated with flights lasting eight hours or more, recent data suggests that even trips as short as four hours can pose significant risks.
Broader Implications
DVT isn’t limited to flying. Extended periods of inactivity, such as sitting for hours playing video games, can also lead to this condition. One case in England involved a young gamer who died from DVT after prolonged gameplay during the COVID-19 lockdown.
Risk factors for DVT include obesity, smoking, pregnancy, heart disease, certain medications, and hormone treatments like birth control. Prolonged inactivity, especially in cramped conditions like economy-class seating, exacerbates these risks.
Prevention Tips
To mitigate the risk of DVT, experts recommend staying mobile during long trips. Dr. Lookstein advises travelers to move every two hours, whether on a flight or in a car. The Mayo Clinic suggests simple in-seat exercises like circling your ankles, drinking plenty of water, and wearing support stockings.
For those unable to afford the luxury of first-class, Dr. Parekh recommends choosing an aisle seat, which makes it easier to get up and move around. “When you’re all the way inside the row, you’re always worried you’re disturbing the guy [next to you],” he notes.
While upgrading your seat can provide more comfort and space, the key to avoiding “economy class syndrome” lies in maintaining circulation through regular movement and hydration, regardless of your seat assignment.
