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AIRCRAFT INFRASOUND THE ESSENTIAL CAUSE OF DVT? AIRCRAFT INFRASOUND CAUSE DVT? THE ESSENTIAL Analysis of published scientific and medical research suggests that infrasound from engine vibrations may be responsible for traveller's deep vein thrombosis. xposure to infrasound generated by jet engines is proposed as the essential cause of deep vein thrombosis (DVT) syndrome in airline passengers, temporal lobe atrophy in airline flight attendants, and air rage. According to the website http://www.aviation-health.org, of the 54 million passengers carried by European airlines on long-haul trips for an average of 9.4 hours, one million passengers, or around 5%, suffer from air-related DVT. On short-haul trips of 3-4 hours, it is 1-2 per cent. The UK House of Lords inquiry into this syndrome was not impressed with the evidence given by the owner of this website (which has nothing on infrasound), but the fact remains that these particular figures are consistent with those from other sources. The UK lobby group Victims of Air-Related DVT Association (VARDA) is linked to this website. The Airhealth website, http://www.airhealth.org, has collated 21 medical reports lead- ing to a conservative estimate of one million airline passengers diagnosed and treated in the USA each year, with 100,000 fatalities. Combining the European and American fig- ures, we are likely to have greatly in excess of 100,000 fatalities per annum. Simple addition is not valid because many flights are between USA and Europe, hence shared by the two groups quoted. There are, of course, other parts of the world covered by air- lines which would also add to these figures, so an overall world figure of 200,000 DVT fatalities per annum is possible. These are significant numbers which justify the atten- tion now being given to this issue, and which fly in the face (sic) of those who suggest that the DVT risk is small. A present "failure to screen, assess, diagnose and/or prevent with pharmacological intervention the growing number of patients who are at risk for venous thromboembolism (VTE)" is admitted in Poponick and Bosker (2002). VTE includes DVT and pulmonary embolism (PE). In a recent trial of 116 people, Scurr et al. (2001) showed that around 10% of long- haul (median 24 hours) passengers older than 50, but selected to exclude other known risk factors, developed "symptomless" DVT (small blood clots) after one return flight, returning to the UK within six weeks. This appears to be a significant finding (the gen- eral population is probably more at risk, compared with this specially selected sample), but it has not yet had an impact on the mind of the travelling public. These smaller blood clots are also capable of moving to the lungs, sometimes with fatal results. In this trial, all positive c were treated with heparin and referred to their GPs. There are two class-actions in progress: one involving Collins Solicitors, working with VARDA in the UK on a A$55 million case against several airlines, alleging that the airlines did not warn passengers of the risks of developing DVT; the other involving Slater & Gordon in Austr: suing QANTAS, BA, KLM and the Australian air safety body CASA on the same basis, as at July 2001. The website http://www.flyana.com inter alia provides professional insight into how airline passenger health has been compromised by commercial or economic considera- tions in recent years. by David Collier, BSc, DCH © 2002 GPO Box 1755 Canberra, ACT 2600 Australia Email: dc888@tpg.com.au by David Collier, BSc, DCH © 2002 GPO Box 1755 Canberra, ACT 2600 Australia Email: dc888@tpg.com.au STUDIES IN PROGRESS The BEST (Business class vs Economy Syndrome as a cause of Thrombosis) study was undertaken between 9 April and 9 May 2002, and involving Dr Alberto Smith of King's College, London, the University of Witwatersrand in South Africa and South NEXUS = 33 SIZE OF THE PROBLEM DECEMBER 2002 — JANUARY 2003 www.nexusmagazine.com