BBC Panorama [Archive] - PPRuNe Forums

VTSP

11th Jun 2001, 03:47

I only saw the trailers for the prog... but from what I saw, BA had been advocating 'exercise' prior to the 'discovery' of 'economy class syndrom', except they did not mention DVT so as not to create panic. To my mind, I believe this was a good move.
a: Because it isn't a regular occurence
b: Why restrict it to air travel, when cases of DVT can occur in any situation where people can be 'imobile' for hours on end?

If I remember correctly, several other airlines had recommended various exercises for short haul as well as long haul flights.

Correct me if I'm wrong.

Wings

11th Jun 2001, 09:46

On our flights from South east Asia to Europe, we stop off in either Dubai or Abu Dhabi. On the P.A. during descent in the Middle east I always say " While we're in DXB / AUH, we will be asking you to disembark. This will give us the chance to refuel, re cater and clean the aircraft. It will give you the chance to stretch your legs,get some exercise do some duty free shopping ......."
The number of passengers, especially those who would be considered 'likely candidates' for DVT (old / overweight), sitting in EY who refuse to disembark and insist on sitting down for the 8 hours into DXB the 1 hour transit, then the 8 hours to LHR, is staggering.
Fear of getting lost in the Terminal and missing the onwards flight is usually the reason given.
I wonder if laziness is the real reason though.

HotDog

11th Jun 2001, 10:38

In my 33 year flying career, which was mainly long haul, I never heard of any incident of DVT amongst our pax or my colleagues.

Notso Fantastic

11th Jun 2001, 10:49

What about amongst ppruners? Actually the program was the usual documentary alarmism and rubbish that has been the way of Brit documentaries for a few years. I can't see how DVT can be worse on airlines than long distance coach travel, movies like Titanic, Pearl Harbour, hospital A & E units!..... Once again the BBC shows shallowness!

11th Jun 2001, 10:56

I didnt see the programme,,,but what about the chaps up front??

JPJ

11th Jun 2001, 11:21

One of my colleagues recently returned from China, (in Business) and suffered DVT in both legs, followed by a pulmonary embolism. Fortunately he is now OK. It's certainly made me more aware.

One case doesn't prove anything much, but aren't we in danger of dropping into the PPRuNe 'shoot-the-messenger' mode that appears whenever the Press carry any aviation story?

twistedenginestarter

11th Jun 2001, 11:43

I know it didn't deal with some obvious questions like what is the non-flying level of DVT but there were quite a few impressive looking experts all saying it's bad news. No airlines put up the slightest defence.

Thing is where else do you sit in the same place for over 8 hours?

I admit I went out and bought a bottle of 75mg aspirin first thing this morning...

Best Western

11th Jun 2001, 12:30

Last March, my now wife got DVT in a 5-hour car journey, but you don’t have the BBC interviewing Volkswagen do you? She was recovering from a broken leg, and we ended up driving rather than flying. She ended up in hospital for 6 days.

Also, they made everyone panic about DVT, but did they tell anyone how reduce the risks??? Of course not…. they just showed reconstructions of ambulances in a tunnel outside Heathrow.

My wife was told to take these precautions whilst flying.

· To drink 1½ litres of mineral water before the flight and take an aspirin.
· Drink water constantly – and don’t rely on the cabin crew for water.
This has two effects, firstly it thins the blood, and secondly it makes you go to the loo often… which means that you wander around the aircraft
· Go for a wander around the cabin every hour or so. It makes you move around. Take an aisle seat… easier to stretch your legs.
· Take her shoes off whilst sitting.

Hope this helps someone else... you really don't want to go through what she did...especially when you are later told that she had a 50% chance of not living through the situation (told after she was better!- Best to drink water, and ignore the view!)

Golden Monkey

11th Jun 2001, 12:41

I saw the programme last night and while I agree it was clearly somewhat sensationalist in it's presentation, the facts were quite compelling. They interviewed one of the doctors at Ashford (sorry, correct me if I'm wrong but I think that's the hospital where Heathrow casualities get shipped off to) who said they get one fatal DVT a month coming off long haul airlines at Heathrow. And that's purely those who suffer IMMEDIATELY after disembarking at Heathrow, the frequency of such incedents days after arrival may be many times higher. DVT is unlikely to occur in any other aspect of life with such frequency purely because - as someone's just pointed out - nowhere in modern life would you be sitting for as long as you would on a Sydney to Heathrow flight, for example.

Basically the upshot is that advising people to move their legs during a flight is not exactly a major issue these days. Most people are aware of DVT now, hence basic tips from cabin crew are unlikely to induce any "panic" or whatever about the problem. Basically people need to fly, hearing someone tell them about elementary safety information isn't going to put them off.

Indiana Jones

11th Jun 2001, 13:05

It would have been useful as well to compare the frequency of DVT between long haul scheduled carriers and long haul charter carriers, with the number of seats being so much more on the latter, for an A330, for example, up to a 100 more seats.......

Golden Monkey

11th Jun 2001, 13:12

I'm not sure that the difference would be that great between "highly compressed" seating and normal airline formats. The programme highlighted that although the condition is known purely as an "economy class" syndrome it does occur across all seating classes. The sheer numbers of passengers flying economy skews the results heavily, although presumably having their legs in an "upright" position as opposed to business class types in heavily reclined seats presumably doesn't help any.

INKJET

11th Jun 2001, 14:04

JPJ, a sensible comment i think. Before everyone starts slaging off the beeb, consider the facts and the options open to paxs and airlines alike. Yes you can develope DVT in circumstances other than flying, however a combination of immobility,alcohol,cabin altitude & fatigue must be hard to beat!!. so what can be done, well in part programs such as Panorama do help in educating all of us to the risk and as such are likely to do more than a few obscure non alarmist words in an inflight mag. On its own this is not enough, and airlines can and should do more. If a pax is aware of the risks and wants to do something about it then it helps if you can move your legs!. I flew to the Gambia with Britannia twice, on the first flight(about 6-8 years ago) the leg room was fine(not an exit seat) on my next visit(4 years ago) the room was a complete joke, on arrival at Banjul i could hardly walk, and suffered pain in my lower leg for a couple of days(was this DVT?) i`am youngish,fit and i did not drink alcohol prior to or during the flight. On my flight home i spoke to the crew about the lack of room, and my problems post flight inbound. I was told that Britannia had put additional seats in that year(both flights on B757). Now i don`t want to start a Boieng-v-Airbus, but there does seem to be more leg room on Airbus 320s than either the 737 or 757, why would that be, or is it just different airlines?,and if so how do you find out before you fly, is there a website that gives this info? In our airline we had a twenty something f/o who after not moving from his seat during a four sector 6 hour duty had to be stretchered off the a/c with DVT. One last point for airline execs to ponder,Philip Morris and other ciggy companies have always protested that the link between smoking and cancer was unproved. Last week they were fined $2bn for just one death, it strikes me that DVT may well be the airlines "cancer"

newswatcher

11th Jun 2001, 14:17

It is difficult to form an complete opinion during a programme like this, since when a point is raised and no "right of reply" is immediately given, this does tend to give the one-sided view that many people have mentioned.

I was particularly concerned about the possibility that leading airlines had been approached to assist with a scientific analysis, but all had refused, or failed to reply.

Quote - "Five scientists studying DVT had their separate requests for information from airlines refused or ignored, they told the programme.

Professor Sam Shuster, of Newcastle University, said that he asked British Airways for access to passengers in 1996.

I'm sure that airlines do know about it, and it's vital that more research is carried out into the risks

In a letter of reply, BA refused, writing: "Most passengers do not wish to get involved and are simply keen to get on with their journey.

"There is the added difficulty that we have to tread carefully because as a commercial organisation we have no wish to imply that flying might be bad for one's health."

BA issues exercise advice but medical officer David Flower told Panorama the airline's inflight "well-being" pamphlet did not mention DVT because of fears that international passengers would not understand the condition."

Whilst past shortcomings might be unfortunate, it is what research is currently being done, that interests me. It was recently reported that a team lead by a consultant from the Middlesex and University Hospitals, London, had used extremely sensitive ultrasonographic assessment which enabled them to pick up more cases.

A number of cases occur, without the drastic effect of the blood clot moving to the heart, and in these cases, the clot breaks down naturally. Unless this is monitored at the time of occurrence, it will not form part of the statistics.

This team studied over 200 passengers who had travelled on flights of eight hours or more.

Half were given special support stockings and showed no symptoms - 10% of the others did show clots in their calves.

In response to "Best Western", although I am not a medical expert, I believe that DVT is a known side effect of a broken leg, and sensible precautions are advised in these circumstances.

Golden Monkey

11th Jun 2001, 14:30

Inkjet - certain similarities to the cigarette issue also crossed my mind during the programme last night (large industry knows about potentially damaging side effects of it's product but keeps said information to itself for many years for fear of scaring off consumers).

However, it was made quite clear when discussing legal issues that airlines cannot be held liable (in the UK at least - America tends to be on a different planet when it comes to litigation) for injury as a result of conveyance unless (and I found this terminology slightly odd) it is a result of an accident. Apparently DVT is not technically an accident and a passengers' medical health is not the responsibility of the airline?

flypastpastfast

11th Jun 2001, 14:44

'L' is for litigation.

I found this programme very interesting. Having worked at Ashford, Middlesex, I am aware of the way in which Belstead is highly respected in A&E circles.

As regards the incidence in the general population compared to flying, the real point is this; several factors can influence the likelihood of developing DVT, it just so happens that sitting still for a long time in a dry environment, at altitude does seem to make things worse. Yes it could happen on a bus, or even in first class, but the extremely cramped conditions in economy (American Airlines excepted)on a long flight mean it is more likely. Taking oral contraceptives or some types of HRT will also increase the risk (it increases the risk marginally even when not flying, but flying increases the risk).

Without hysteria, as someone has already pointed out, the reason for airlines reluctance to admit the problem is fear of litigation.

As regards the comments someone made regarding moving in flight, this can be very difficult when in very compressed seating, with people on either side of you asleep, and knees pinned to the seat in front. I believe this was the case for the girl cited in Panorama, people asleep on either side and she couldn't move.

As regards the nonsense about passengers being too lazy to get up when a plane has a stop en route, all you need to say is that if you do not move you may develop fatal blood clots - I'm sure it would work!

The reality is that most passengers do not know much at all about this.

No doubt we'll see the usual people with 'vested interests' trying to deny the problem even exists.

as I said at the beginning 'L' is for litigation.

tony draper

11th Jun 2001, 14:52

I have always enjoyed documentries,
good, science based , like Horizon ect.
I have notices recently that these tend to show a bias nowadays,not simply showing the evidence, in a fair and honest way of a subject that has a number of different proponents of one theory or another,they now seem to tilt the evidence.
It probably won't be science that decides about DVT it will be the media,the scientists will then look for evidence to support that view.
This is a great pity, throughout my life I have always regarded science as one of the few honest pastimes we humans have.
Remember cold fussion, the media pre judged that, and science backed them,looks like they were wrong.

bobtoldmetodoit

11th Jun 2001, 14:54

Actually, Golden Monkey, the lead case on the definition of accident (and the Warsaw Convention demands an accident or there is no liability) is an American Supreme Court Judgment - Air France v Saks (1985) - which holds that a passengers reaction to the normal operation of an aircraft does not constitute an accident - this case has been followed by UK and Australian courts, and bodes ill for anyone making a claim for DVT - if anyone would like a copy of this judgment send me an e-mail and I will forward it to you.

Magnus Picus

11th Jun 2001, 15:07

There is one group of individuals who, under the reasons given by Panorama, should be struck down with DVT on a regular basis.

Pilots

I have a couple of points to make to the producers of this particular programme.
[list=1] Why did your background music match the current advertising choice of British Airways? This was unfair to subliminaly suggest that the problem was entirely a problem for BA. Would it have been fair to mention whether the 21 year old girl, who died after returning on a Quantas flight to LHR, was on the pill (Increases likelyhood of DVT) or was a smoker?[/list=a]

Panorama can usually be proud of it's level minded comment on burning issues but the producers missed some opportunity to educate the viewers on the prevention of DVT and instead chose to inflate the ego of irrelevant anecdotal Consultants at Ashford hospital.

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Magnus

Golden Monkey

11th Jun 2001, 15:15

To be fair the programme did mention (near the end) that the girl in question was on the pill. The point was made that as she was in a higher risk group some warning prior to departure would have been especially relevant in her case.

bobtoldmetodoit

11th Jun 2001, 15:21

Golden Monkey - why should the onus be on the airlines to warn that taking the pill etc when flying is dangerous - why weren't the BBC persuing the contraceptive manufacturers, after all the issue here is imobility which is hardly unique to flying - surely the drug companies are in a much better position to warn the people they are supplying drugs to ?

[This message has been edited by bobtoldmetodoit (edited 11 June 2001).]

Golden Monkey

11th Jun 2001, 15:26

Don't get me wrong I'm not arguing airline resonsibility per se, I was just reiterating what was presented in the programme in response to a previous post.

However, I don't think that in today's climate two or three sentences by cabin staff encouraging passengers to stretch their legs every now and again would provide any problems. Just as doctors could mention it when prescribing the pill. Sensible awareness can come from many angles without being deemed as "scare tactics".

airforcenone

11th Jun 2001, 15:37

Well spotted Magnus, I was going to point out the background music myself.

Cynical is the word that springs to mind.

PS: My grandmother is currently suffering from DVT brought about by travelling a long distance on a coach. I guess they forgot to interview her then .......

There's nothing like a balanced argument ... and that was nothing like a balanced argument.

HKPAX

11th Jun 2001, 15:56

Flypastpastfast (a few postings up) may have hit upon a significant factor behing DVT, namely the lower than ground level air pressure, which as a non-aviator I can only assume is to reduce the pressure differential load on the airframe at altitude / reduce airframe weight.

Even though I am fit (but smoke a bit) and irrespective of whether I drink Chardonnay or lots of water, I get swollen feet and ankles and end up feeling totally parched and generally unfit for a couple of days. Also prone to sinus trouble after a long flight. All this and I definitely would want a proper break before doing it all over again.

Any thoughts?

[This message has been edited by HKPAX (edited 11 June 2001).]

You splitter

11th Jun 2001, 16:45

Travelled SR a few weeks ago. They had an article in their in-flight magazine regarding DVT. So they aren't hiding anything. Are they?
Although, being rather childish that day, I couldn't take the article that seriously as the cheif medical officer was Dr. Muff.

Seriously, the SR article was not scaremongering, it just acknowledged a problem and gave advice on minimising risks. Maybe some of the other airlines should follow their lead, although preferably with a Dr Smith or something!

Capt PPRuNe

11th Jun 2001, 18:03

A couple of years ago there were a few threads about DVT affecting pilots. A couple of pilots posted their experiences and the effects of the problem and the subsequent treatment they had to undergo as well as the period of suspension of their medical certificates.

This was discussed here on PPRuNe nearly two years ago, long before the press latched on to the subject and created the misnomer 'economy class syndrome'. Unfortunately, the threads were deleted during some of the spring cleaning that took place here before the update to the previous server. :rolleyes: Aplogies to the original posters but if they are still reading these threads could they please repost their experiences and the follow up treatment which involved close monitoring of a blood thinning drug which is also used in rat poison.

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Capt PPRuNe
aka Danny Fyne
The Professional Pilots RUmour NEtwork

BOAC

11th Jun 2001, 18:48

Found these references to DVT in general (and some pilot problems) on the medical forum

http://www.pprune.org/ubb/NonCGI/Forum52/HTML/000307.html
http://www.pprune.org/ubb/NonCGI/Forum52/HTML/000274.html
http://www.pprune.org/ubb/NonCGI/Forum52/HTML/000244.html
http://www.pprune.org/ubb/NonCGI/Forum52/HTML/000249.html
http://www.pprune.org/ubb/NonCGI/Forum52/HTML/000351.html
http://www.pprune.org/ubb/NonCGI/Forum52/HTML/000525.html

Whirlybird

11th Jun 2001, 19:15

I don't quite understand all the fuss about airlines squeezing in extra seats. Yes, it does make it more uncomfortable, but if you have a window seat on any airline you still have to get people to move if you want to get out. I always ask people to move, whether they're asleep or not, so I can go to the loo and get a bit of a break at frequent intervals - and that's before I heard of DVT. And I always get a window set if possible so I can look at the view when I'm not wandering about.

So perhaps all the publicity will persuade other passengers to be as selfish and inconsiderate as I am :)

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Whirly

To fly is human, to hover, divine.

BahrainLad

11th Jun 2001, 20:52

I find it laughable that the same people who have been demanding cheaper and cheaper fares, forcing airlines into ever more tight profit margins, are now demanding that airlines remove rows of seats for their own comfort.

I've been flying longhaul for 18 years, have never suffered from DVT. Why? Because I get off my backside from infront of the personal television, walk to the galley and get a glass of water every hour. It takes 5 minutes, and could save your life.

alosaurus

12th Jun 2001, 00:38

Capt.PPRUNE An F/O in my company doesn't do walk arounds and,on our four sector European days,may regularly stay bolted to his seat for eight hours.Recently it was advised that F/Os complete at least one walkaround per day.There is no doubt that this is a real issue and that some of our number can be affected.The effects of dry air and 8,000' cabin alt do make our mode of transport more prone to this kind of problem.

mainfrog2

12th Jun 2001, 01:55

newswatcher

With regard to scientists approaching airlines for information. I don't think the airlines would be allowed to give out any information because of the data protection act.

[This message has been edited by mainfrog2 (edited 11 June 2001).]

Capt PPRuNe

12th Jun 2001, 02:23

Alosaurus, not sure where you may have misinterpreted my comments, I was merely pointing out that the problems of DVT were discussed here on PPRuNe long before the press found it 'fashionable' to highlight.

I fly a mix of short, medium and long haul and some of our longest sectors are over 11 hours, yes 11 hours long and we only operate with 2 flight deck pilots! Shortest sectors from my base are just over 2 hours long. Personally, I make a point of getting out of my seat at least once an hour and stretching my legs as well as getting out of the flight deck for a few minutes, if not to visit the bathroom then at least to have a chat with the cabin crew. If I am not visiting the bathroom once an hour then I am not drinking enough water.

If you or your F/O are operating four busy sectors over an 8 hour period and the F/O doesn't even get out of his or her seat for the duration then that person is probably doing themselves some kind of damage and probably biding time for an occurance of DVT to develop into a full blown embolism. I don't think there can be any excuse for someone not to get out of their seat at least once on any sector that is over an hour in length even if it is only to strech ones legs.

Whilst I have every sympathy for the families and friends of victims of DVT that may have been exacerbated by long periods on a flight and especially now that the dangers have been highlighted there is no excuse for anyone, especially flight crew, to put themselves in a situation where they do not even get out of their seat at least once an hour to stretch and possibly alleviate the danger of suffering from a DVT.

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Capt PPRuNe
aka Danny Fyne
The Professional Pilots RUmour NEtwork