Air cares

Awareness-raisers about flying and blood clots raise public anxiety sky-high.

Deep-vein thrombosis (DVT) is no longer a scare. It has become just one more example of a twenty-first century social pathology in the West: a pathology that exaggerates personal hazards into a generalised neurosis about risk.

There is no new convincing evidence that travel causes blood-clots – but still, the idea that to fly is to put your body at risk has become part of common sense. And it is now claimed that DVT can also affect long-haul computer users on the ground (1).

In the UK, the Aviation Health Institute (AHI) has been one of the most assiduous publicisers of DVT. Since its establishment as a registered charity in 1996, the Oxford-based institute has, it says, been ‘promoting the health and well-being of airline passengers worldwide’.

But has it really done that? Here are some of the top ‘Latest News’ headlines on the home page of its website in February 2003:

Latest DVT Incident – 74th DEATH: A very fit, 52-year-old male died of DVT after what was to be a four-month holiday of a lifetime with his wife;

One in 30 long-haul passengers ‘gets DVT’: Several million people in the UK are deemed at high risk of DVT, with previous incidences of thrombosis, blood-clotting problems, circulatory problems in the legs or a significant weight problem;

DVT tragedy of the wife who flew first class: A woman who booked first-class airline seats to avoid ‘economy class syndrome’ died from a condition linked to deep vein thrombosis, an inquest heard yesterday;

Why airlines have a licence to kill: Every year many thousands of air travellers suffer from deep-vein thrombosis – blood clots that can kill;

Judge halts DVT hearing by admitting he had BA shares: A judge has wasted more than £100,000 in legal fees and taxpayers’ money by admitting he had shares in a company facing court action before him;

Airlines ‘are hiding behind charter’ in thrombosis cases (2).

Notably, the AHI puts a two-year-old story from the UK Daily Mail in a prominent position. The headline is ‘Socks that could save your life’, above a feature about ways to improve your blood circulation while flying.

‘Want to prevent inflight disease?’, the AHI asks innocently. One of its solutions, costing a mere £24, is what looks like a gas mask: ‘Bugs Stopper LM (Low Maintenance) meets the requirements of the HSE Approved Standard EN 140 and is a stylish flying respirator mask is ideal for the frequent and/or long-haul flyer.

‘It is a robust, low-maintenance facepiece with a soft comfortable surround for wearing over long periods. The straps are adjustable, and it can be slipped away from the face for eating or talking. It is packed individually in a plastic bag for travel and storage and comes with a free pair of filters, which filter out at least 99.95 percent of airborne particles down to 0.6 micron. The screw-on filters are designed to protect the wearer from the risk of exposure to potential infections such as tuberculosis and only occasionally need replacing.’

Not content with alarmism about DVT and air quality, the AHI also talks up the danger of exposure to ionising radiation at high altitudes. The AHI website features an article by its founder that was published by the Financial Times back in April 1999, which says:

‘The average person in the UK receives an annual background dose of 2.6 millisieverts (mSv) of ionising radiation a year. Air crew and some frequent fliers, including couriers, are at the top of the occupational exposure league with 4.6 mSv a year, compared with nuclear workers who receive 3.6 mSv. The annual limit for nuclear power plant workers in Europe is 20 mSv, whereas 6 mSv is the limit for air crew.

‘A frequent flier on conventional transatlantic routes between London and the east coast of the US, spending 700 hours in the air, could receive an annual dose of 5.7 mSv, including the average dose from background radiation.

‘Wallace Friedberg of the Federal Aviation Administration’s Civil Aeromedical Institute, says this represents 170 chest X-rays a year (based on 4.1 hours at 37,000 ft equalling one chest X-ray).’

But how many people really spend 700 hours a year over the Atlantic? And aren’t they the kind of people who could use a little video-conferencing from time to time?

It is important to get medical claims in perspective. Behind every claim, one is bound to wonder, there is likely to be a research scientist trying to get more grants and public prominence. That does not make the claim invalid, any more than the AHI’s desire to sell socks made by Scholl at £11.99 renders claims of DVT invalid. But here is what the AHI lets slip:

‘According to a study by Dudley Goodhead, who runs one of the world’s leading radiation and genome stability units, ions can cause genetic mutations in human egg cells and sperm cells, and can damage a developing foetus. Professor Goodhead, who is based at the UK’s Medical Research Council, has found that ionising radiation can produce a wide spectrum of damage to DNA, breaking single and double strands of its double-helix structure.

‘“This is exciting as we know that cancer grows from a single cell that experiences multiple changes”, says Professor Goodhead. “Cosmic radiation increases the chance of changes or aberrations in the cell.”’

‘For most people, this should not raise any health issues. But, as Robert Souhami, dean of the Medical School at University College, London, observes: “The radiation risk is dosage related.” So the more you fly the greater the risk.’

Well, yes. It is also true that the more you live, the greater the risk. And it is true, too, that scientists who declare that cosmically induced DNA aberrations are ‘exciting’ risk letting their enthusiasms run away with them – to the detriment of the mental wellbeing of passengers.

Another campaign group, Victims of Air-Related DVT Association (VARDA), was set up in 2001 by families of air travellers who had died from the condition. VARDA works closely with the AHI, and its chairman, Mrs Ruth Christoffersen, is on the AHI board of trustees.

What impact are these campaigners having? In December 2002, London’s High Court blocked an effort by more than 50 victims of DVT to sue more than 20 airlines. But in the same month American Airlines, one of the world’s largest carriers, reached an out-of-court settlement in a blood-clot case; and the Supreme Court of Victoria in Melbourne decided that blood clots could be classified as ‘accidents’ under the Warsaw Convention, opening the way for 500 Australian litigants to pursue writs in local courts.

The alleged dangers of flying now extend to tuberculosis and pneumonia. Singapore Airlines sends out instructions on aerobics before you fly; Delta Airlines gives you a 32-page book on what to eat. Indeed, Delta has hired LGE Performance Systems to make passenger food subject to the dietary concerns that now afflict modern living. This is what Jack Groppel, a co-founder of LGE, has to say:

‘Business travellers often have to hit the ground running [sic] and we recommend salads, pasta and fruit to help them rest on board and be alert for meetings. For those who will work on board and rest at their destination, steak, seafood, poultry and veal will enhance the development of vitamins to the brain to keep them alert.’ (3)

Like airline travel itself, airline food has become an overwhelmingly medical affair.

These airline safety measures do more harm than good. To promote ‘Socks that could save your life’ adds to passenger anxiety, confusion and cynicism. Such moralising injunctions appear trivial compared to the real loss of life, when it occurs. From terminal parking through to take-off and landing, air travel has always been stressful. But in airline health matters, we need to speak out now against a vicious spiral of claim and even more exaggerated claim.

It cannot be long before the Federal Aviation Administration (FAA) in America and the Brussels Commission in Europe start to legislate further on passenger health and comfort. Already James Currie, the Brussels Commission’s director-general for environment, nuclear safety and civil protection, has suggested that cosmic rays should make manufacturers design aircraft that have greater fuel efficiency at lower altitudes.

It is likely that this increasing regulation of passenger health and comfort will dovetail with environmentalist hostility to airports and to lightly taxed, low-cost flying. But are these things conducive to passenger calm? Will they help an industry that is already almost on its knees? Or will they boost Europe and America’s railways…until they too fall victim to similar fears about safety in transit?

The long-term logic of today’s risk consciousness, whether medical, environmental or directed against terrorism, is to rule out much of the air travel we see around us today. This sounds incredible, but it is no more exaggerated a thesis than that propounded by advocates of a compensation culture in the skies.

Footnotes and references

(1) See Health threat from computer use, BBCi, 28 January 2003

(2) See the Aviation Health Institute website

(3) Quoted in ‘Reasons to be cheerful in the coming year’, Steve Keenan, The Times (London), 26 October 2002