PDA

View Full Version : Save 5000 deaths or 3 maybe 4 a year; Which ?


Tartan Giant
3rd Dec 2000, 01:44
Air Travel and Health – House of Lord’s Select Committee Report - 15 Nov 2000

I mean no offence to any affected party whose loved one died from DVT however caused.

Westminster Scenario.

MP : “Do you think we should have a Select Committee to look into these 5,000 DEATHS /year we definitely know about due to infections picked up in our UK hospitals” ?

Science and Technology - Fifth Report (Air Transport and DVT) member : “No !….too scandalous”.

MP: “Do you think we should concentrate on the 3 maybe 4 DVT deaths this year that may have/allegedly been related to air travel ?

Science and Technology - Fifth Report (Air Travel and Health - and DVT) member : “Yes, we must think of the bigger picture.”

So did they ???

Of the many contradictions the Select Report trips up on, there are a few worth mentioning. For instance I do not understand this statement.
“1.12 In the case of pilots, we recommend that, if the authorised medical examiner (AME) finds evidence of significant ill-health not necessarily affecting a pilot's fitness certification, this should be recorded and reported both to the Civil Aviation Authority (CAA) and to the affected person's general practitioner. (Paragraph 3.48)

How the hell does a pilot with, “..significant ill-health.. escape passing a Class One medical, as it apparently does, “not necessarily affecting a pilot's fitness certification” ? One of the perplexing items that surfaces.

The Committee goes on…..
“Turning to what we consider to be the main medical concern, Chapter 6 discusses deep vein thrombosis (DVT) together with associated issues of seating, stress and the scope for harmful interaction between aspects of the cabin environment.”

Out of the waffle, and jobs for the boys foundation laying, there is this bit,
“6.10 Pulmonary embolism is a relatively rare complication of DVT, Professor Kakkar and Dr De Lorenzo (p 181) giving an incidence of about 1 in 100 post-surgical patients who have suffered a DVT”.

So from being a relatively rare thing, getting a life threatening thrombi through air travel becomes the main medical concern ! Wonderful logic.
Yes, I know not all passengers are post-operatives, but the other contributory factors which encourage DVT are present in a huge percentage of passengers. The ‘pill’ or hormone therapy treatments for ladies are but two pointers….and as half the flying population are women, then the odds are only too obvious.

How exactly are airlines/doctors going to pin the entire blame on an airline for DVT when the life threatening condition takes weeks sometimes to manifest itself ?
“….. between the development of the initial small thrombi and such an embolism may be anything from days to weeks.”
The airline thus becomes an easy scapegoat for the “weeks” of a pre-existing condition to develop through the patients own contributory pre or post-flight actions, which are unmonitored and covert.

With so many cases arising outwith flying, how is it flying is getting it in the neck ?
“6.11 To keep this in proportion, it has been concluded from post-mortem studies that up to one half of all people with DVT and/or pulmonary embolism will show no signs or symptoms at all (pp 181 & 246), and only one in three cases of suspected DVT is subsequently confirmed (p 181).”

Even post-mortems show half have had a DVT and they did not even know about it; so half the population still alive theoretically have DVT and don’t know they have it…….nor their doctors !
If they indulge in known activities that encourage overt symptoms, then is that any negligence or fault of an airline ?

If all this nonsense about “economy class syndrome” was so common as to be “..the main medical concern..” then why was it hidden for so long by Government/s ?
“….the first strong evidence that pulmonary embolism was causally linked with spatial confinement, immobility and constrained seating conditions was published 60 years ago by the late Professor Keith Simpson”.

Consider the Professor’s findings,
“He noted a sharp increase in deaths from pulmonary embolism among people who had spent long periods in air-raid shelters, and found that such deaths were six times higher among those who had sat in hard-edged deckchairs than among those who had not.”

So before you lie out in the sun on your DECK CHAIR (or similar contraption) watch out for the health warning the Government so kindly stuck on it by law - having taken careful note of the first STRONG evidence they warned us about so openly 60 years ago and every year since (ha !).

Stress has been noted as an ingredient in premature death; I would suspect there were lots of cases of STRESS in those air-raid shelters, and above ground before getting into those shelters - the same analogy as those boarding an aircraft for perhaps a stressful 12 hours (not to mention the hard chairs in the departure lounge, or on the train, bus, car ! ).

The report thankfully acknowledges DVT is triggered from other travel experiences,
“Many of the subsequent reports cite this important paper in their linking of DVT with enforced immobility and unsuitable seating in cars, coaches, trains and, in particular, aircraft.”

They slag off aircraft again with their, “….and, in particular, aircraft”.
There have been so many fatalities littering Arrival lounges ( nearly as many thousand as those from hospital infections) of every airport in the UK that it must of be of course linked to aircraft “particularly”. What UTTER TRIPE these folk have given signature to.

FIVE THOUSAND die in the UK each year from infections picked up in hospitals, and where is the IMMEDIATE health warnings on that one ? Not even an Enquiry ? Dear…Dear….let’s slag airlines first and worry about these allegedly related few DVT deaths and forget 5000 deaths they know for sure are caused by a quick hospital visit.

From POSITIVELY identifying travel by aircraft as, “the main medical concern” we now have them on the back foot retracting the notion that DVT “may”, note the word, “may” be linked to flying - they are not even sure if they are on the right track !! Cause a fortune to be spent researching microscopic possibilities.

“RISK FACTORS
6.13 From studies on surgical patients, various factors have been recognised as contributing to a raised risk of DVT - see Box 2. As discussed in paragraph 6.17, there are also factors in the aircraft cabin environment which may be risk factors for DVT in themselves, or which may augment the risk from the predisposing factors.”

My whole point in all my ‘posts’ against the notion of “economy class syndrome” are those elements of PREDISPOSING FACTORS - and my utter disbelief and total despair that Government ignores reacting strongly and immediately, to eradicate these 5000 deaths/year to fit and well persons visiting hospitals.

If 100% of passengers are free from the following PREDISPOSING FACTORS then I want to know how they do it, where they live, what they eat, what job they hold down, and what seats they sit in to “down under” !

Predisposing factors for DVT
Generally agreed by witnesses
• Increasing age above 40 years
• Pregnancy
• Former or current malignant disease
• Blood disorders leading to increased clotting tendency
• Inherited or acquired impairment of blood clotting mechanisms
• Some types of cardiovascular disease or insufficiency
• Personal or family history of DVT
• Recent major surgery or injury, especially to lower limbs or abdomen
• Oestrogen hormone therapy, including oral contraception
• Immobilisation for a day or more
• Depletion of body fluids causing increased blood viscosity
Witnesses' views variable
• Varicose veins
• Obesity
• Current tobacco smoking
Sources: Dr Giangrande (p 234), Professor Kakkar & Dr De Lorenzo (p 181), Dr Kesteven (p 246), Professor Meade (p 174), Professor Mohler (p 251), Royal College of Physicians of Edinburgh (p 280), Mr Scurr (p 283)

I cannot believe a normal healthy person (or the BILLIONS that have flown) and those who will fly, can contract DVT through flying if they use their airborne time intelligently. Taxpayers money is wasted in this DVT flying investigation nonsense; money that could be spent “cleaning” hospitals of deadly infections.

The Select Committee say it themselves,
“…..only 11% of cases of post-surgical DVT had no risk factors identifiable by non-laboratory tests, and that 40% of new acute DVT cases were associated with inheritable clot-enhancing conditions.”

What a waste of public funds and of the time of experts, whilst THOUSANDS upon THOUSANDS die prematurely miles away from an aircraft.

Trust this Government to get their priorities right……..all the best if you go anywhere near a hospital, “fasten your seat-belts…it’s going to be a bumpy night” !!!

The committee say,
“1.4 Although we have found no significant impact of air travel on health for the vast majority of travellers, there are substantial points that need to be addressed for a minority”.

Here is a splendid opportunity for an “start-up” airline who wish to cater for the “minority” who feel present airline arrangements are not good enough for them !

To cater for the very tall, the very fat, and the ill at large (no offence intended) who insist on travelling 12 – 18 hours (and longer) in one go, for the cheapest deal they can find, and then feel aggrieved thereafter for innumerable reasons, pressing complaints into the hands of no win/no fee lawyers seeking extortionate compensation.
You may have seen the t/v advert where a young bloke talks of the bucket of hot tar he splashed over his legs (self induced accident) and then boasts he got £20,000 off his company.
It is this sort of climate of compensation mania that grips this once resilient and proud nation which is being drip fed by an ever increasingly nanny pandering government.

Now the DVT debate, fuelled by rag bag press statements, leading to a Lord’s Select Committee on airline travel and related health. Pathetic.

Many lame and weak comment was advanced by this Select Committee’s report such as,
1.16 It is imperative that the current paucity of data on deep vein thrombosis (DVT) be remedied
The reason for this “paucity” of data is the microscopic incidences allegedly associated with long-haul flying, otherwise airport doctors would be inundated, likewise GP’s, with cases clearly connected with flying.
If this committee wanted data on the subject, they did very little looking, as there has been sporadic reports spanning decades where the subject crops up as medically academic interest.
Mind you, they have the FACT that BILLIONS have flown and not dropped down dead via DVT.

1.17 As an interim measure pending the development of more authoritative guidance, we recommend airlines, their agents and others with consumer interests to repackage the summary indicative and precautionary advice on DVT
If all these people took half as much interest in passengers as airlines do, then such “precautionary advice” would be available filling their letter boxes.
You would think this committee were lining up passengers for a bungee jump down over the Amazon, when they say, “This will enable those who have no access to other advice to make preliminary decisions about their travel and the risk of DVT”. No access to other advice – what utter nonsense !

1.18 “…..we recommend the Government to consider tackling DVT on a wider travel-related front or, indeed, as a general public health matter”.
VERY interesting that ‘they’ only ask the Government to “consider tackling” this DVT problem as a general public health matter, yet they ask all in sundry to come up with “precautionary advice” for just airline passengers; a bit of the cart before the horse mentality.

1.20 In relation to air travel alone, however, and applying the precautionary principle used in other fields where health risks are considered possible…
The “precautionary principle” – what a laugh……like the notices on car steering wheels that say, “Obey the Highway Code and you will not be involved in an accident which KILLS or injures over 250,000 people a year in the UK”.
There is a health risk getting out of bed that has not been properly looked at, “with consumer interests to repackage the summary indicative and precautionary advice”.
Health risks are considered possible if you go into hospital for an appendix operation, but do you get a document telling you of all the risks ?

SEATING
1.21 We were pleased to hear about new CAA research into people's size and the reduction in mobility after long flights…
Sharp cookies noticing people are getting fatter and drinking themselves under the seat when they go on holiday !

1.22 To facilitate passengers' choice of seating….
The same considerations that the train companies use and of course car manufacturers, not to mention cinema operators……who all used the,
“The key issues are: the minimum size of seat taking account of health considerations”.
How do you regulate a seat for “health considerations”. Backside size I can understand, but if Mrs. Thingy has a bent spine or is on the ‘pill’ what do you do to the seat ?
This committee wants blood from a stone; “….material in seat-back pockets and fold-down tables…”
What are the options ? Nothing in the pockets and no table ?

What about the colour of the carpets, just in case they are not soft enough, or the wrong colour, for the minority who are mentally affected by pattern hysteresis due to prolonged exposure to humans waiting to fly ?
And the lighting in cabins….is it not too bright or the wrong spectrum colour ? Of course there is the noise ! That can be very annoying and disturbing; can the Select Committee not “recommend” airlines do more to suppress this intrusive noise violation on minority ear drums ?

Have you ever heard such a load of TRIPE as this epic little statement….
“In addition, we see a general need to improve practices to minimise any risks for the remainder”. What an rear-posture covering statement that is.

minimise any risks Now there is a challenge that will keep money flowing for the “do gooders” !

It is not good enough that European jet airlines fatality rates have a safety record of roughly 0.5 / MILLION flights. Airlines here do their very best (as do their crews) to get passengers safely from A-B. Not a scratch for all those MILLIONS, nay BILLIONS, yet we have a bleating Select Committee wanting a pound of flesh. Spoon feed the passengers next with more BS.

They do admit to one thing which is encouraging, “Like all other human activities, air travel can never be risk free”.

I find it difficult to see how ‘they’ say, “Our concern is not that health is secondary to safety but that it has been woefully neglected” when BILLIONS fly and then walk away from the aircraft without a scratch. The ‘duty of care’ has been unmistakably proven by flying safely from A to B and back, and now we have some academics saying the airline industry has been “woefully” negligent in providing such care. Good God…..we have been so bloody bad !
Are Boeing and Airbus pushing out aircraft equipped with seats or conditioning systems that are killing us all ? I don’t think so. Are we building cleaner hospitals….are we cleaning out killer hospitals….I don’t think so.

This STUPID government allows car manufacturers to roll out cars that are capable of exceeding 70 mph by a factor of two, when a simple regulator could be fitted to limit top speed to the lawful limit - but that would reduce their income from speeding fines ! Consumer choice and the voters; don’t upset them by saving the carnage on the roads.
SPEED KILLS but do they clamp down in this area….NO…..it is the soft targets that are easy meat.

Thank you Select Committee for pointing out the horrendous failings this airline industry has heaped upon the nation for decades. They shall jump to finding solutions to the innumerable potential catastrophes they have overlooked for so many years and billions of safe passenger miles.

I’m going to walk the dog, but before I do, may I have a Select Committee appointed to access the risks please, so I can make an informed decision prior this minority exercise ?

I have a "human right" to an answer or is that being silly or being realistic; as the Committee says,
"...there are substantial points that need to be addressed for a minority" ?

Dog walkers are a minority, so we have "rights" too.......I want a Select Committee to investigate....NOW !

Dr. Red
3rd Dec 2000, 13:26
You made a similar point in a previous thread. I don't dispute that there are serious problems in health systems around the world, with issues that need to be looked at.

But my question is, why do you think that DVT and other health issues are mutually exclusive?

I agree that govt. reports can be filled with waffle, etc, etc, but there is no reason why we can't look at both DVT and airborne infections, and household accidents, or whatever, at the same time.

Otherwise I agree with you, but check your premises!

Bird Strike
3rd Dec 2000, 18:48
TG,

That was quite an essay ...

All I can say is "Yuck, darn government..."
The trouble is, to reduce hospital infections, it costs NHS (therefore the government). To do a bit of research and require airlines to stick warnings on airline tickets, it doesn't cost the government much money. (Certainly far less than how much it would cost to fix NHS problems!)
Therefore they can be seen to be doing 'the right thing' without spending much at all. Basically, I feel that aviation has been made a scapegoat. It was just a convenient topic that arose when they probably already knew about the state of affairs at NHS hospitals that would be coming out into public later on.

Why can't they do BOTH? Because if the raise tax, they'll be unpopular. They cannot resolve the NHS problem without raising a lot of tax. The whole system needs a shake-up and they don't really want the voters to be remided of that.

I'd say ... "Self-serving government tossp*ts!"

Having said that, I am still glad that the DVT and flying topic has been highlighted, as some research (even though not all)suggests that there are link between flying and DVT.
You said
<font face="Verdana, Arial, Helvetica" size="2">
I cannot believe a normal healthy person (or the BILLIONS that have flown) and those who will fly, can contract DVT through flying if they use their airborne time intelligently
</font>
Without being rude, what percentage of general population in UK would use their airborne time intelligently? Do they get out of their seat to stretch their legs? Have most of then even heard of DVT? Probably not. If there is some evidence that flying (whether flying inherently or inactivity) is linked to the increased risk of DVT, it is better to educate the general public about the benefit of not being inactive and not over-drinking (over-drinking has been linked to increased risk of DVT), isn't it? So I do not knock the government for the recommendation itself, whatever their true agenda and even though their reports may not have been particularly accurate.

Tartan Giant
3rd Dec 2000, 22:17
Dr Red,

You are correct, I did make a similar point in another ‘thread’ - however this new one highlights the disgrace of 5000 avoidable deaths a year being basically ignored with no time or quarter given for a “Select Committee”.

Here’s a question for YOU.
Would you rather be actively involved in saving 5000 lives a year, or fumble in the gloom of debatable research on 3 or 4 deaths a year ?

Tartan Giant
4th Dec 2000, 00:31
Bird Strike,
I don't doubt any government can juggle lots of balls in the air, and I do not dispute the notion,
"Why can't they do BOTH ? Because if the raise tax, they'll be unpopular".

The UK press highlights a basic lack of hygiene in hospitals as the cause of these 5000 deaths……cross infection and deaths go hand-in-hand. I do not think fixing this hygiene problem would/should be the catalyst for taxes to go up.

We all know the whole NHS system needs a shake up, but that is not the fundamental cause of 5000 deaths. Bad hygiene procedures and poor standards of cleanliness are the identified reasons.

I’m all for reducing ANY premature death figures and although sensationalist press stories keep the gullible public eye on DVT and flying, I really want this unwarranted fixation to be slapped down to concentrate on these more VITAL issues.

Sure, let some money be spent on DVT and flying research, but not at expense of greater needs. This mealy-mouthed government wants to wake up to a real crisis which surrounds them.

You ask that the general public be “educated” - OK…then let the government spend money in proportion to the risk, not lumber airlines with money-sapping over reactive propaganda.

Dr. Red
5th Dec 2000, 13:37
Actually, I'd rather be saving 5004 lives a year.

My original question remains - why do you see it as an either/or situation?

Both DVT and hospital deaths are important issues today. Both need further scientific research. But this is an aviation forum, DVT is an aviation issue, and hospital deaths are not.

Tartan Giant
6th Dec 2000, 00:03
Dr Red,

You should consider being a politician with an answer like that !

Point me to the sentence where I say it is “either/or ”.

I think most readers will recognise I am totally hacked off with academics probing around nebulous areas looking at reasons why 3 or 4 travellers die, precipitating parliamentary big-guns to issue Select Committee Reports whilst there’s an epidemic being ignored (no Select Committee to tell us what to do about it) whilst hospitals kill 5000 of us.

You seem to have been attracted by the suction too by stating, “DVT is an aviation issue” - it is not JUST an aviation issue Dr. it is a “travellers” disease.
In fact it kills people who did not fly……remember the reference to the Air Raid Shelters ? How many of those who died from DVT took a long-haul flight ? Bugger all I would suggest !
Even that Select Committee wants DVT looked at, “…on a wider travel-related front or, indeed, as a general public health matter”. So don’t spread this nonsense about DVT being “an aviation issue” please.

Whilst I recognise this is an “aviation Forum” it does not preclude evidence or experiences from other quarters being deposited here as a basis of argument. Parallels must be used as a medium for focusing in on problems.
There’s murder and there’s stealing apples off a tree. To win a war, you select a target that is VITAL.

I think to stop the killing of 5000/year has a higher priority than finding why/if 3 or 4 were killed by DVT due to travel.
It is not either/or but let’s concentrate on what’s VITAL.

Perhaps it is time to bury this debate as I hate going round in circles.

Good luck with your studies Dr. Red.

Dr. Red
6th Dec 2000, 10:51
Yeah, I totally agree with the main thrust of your argument. Just providing a little extra debate! :)

And please don't say I sound like a politician or I'll go insane (again)