Air Travel Related Venous Thromboembolism ("Coach Class Thrombosis") –

A Hawaiian Syndrome with a Hawaiian Solution?

By: Bo Eklof, MD, PhD
Chief, Vascular Center, Straub Clinic & Hospital
Medical Director, Straub Foundation
Clinical Professor, John A. Burns School of Medicine,
University of Hawaii

Death and morbidity from blood clots formed in the legs during long haul flights has become a hot international subject. Straub Foundation has been involved in research, publications and presentations since 1993, and has achieved an international position on this controversial issue.

1993

Based on our first retrospective study of 44 patients with significant blood clots after flying admitted to Straub, I contacted 56 airlines associated with Honolulu International Airport. I gave a brief information on our findings of the major risk factors and suggested further research collaboration. Only one airline responded.

1994

• Presented our study at the American Venous Forum annual meeting and published the first paper in the Straub Foundation Proceedings.
• Informed Senator Dan Inouye about the activities here in Hawaii. Senator Inouye who successfully chaired a senate subcommittee on hazards with flying in 1983 (resulting in the ban on smoking in the airplanes!) responded positively to support research here in Hawaii.

1996

The retrospective study was published in Dermatological Surgery.

1999

• A prospective study on risk factors in 25 patients admitted to Straub for blood clots after flying was published in Vascular Surgery.
• Straub Foundation organized the first international panel on this problem at the Third Pacific Vascular Symposium on Venous Disease at the Mauna Lani Bay Hotel with leading authorities from London, Vienna, Chicago and Sydney.

2000

Emma Christofferson, a 28 year old fit British lady died from blood clots going to her lungs at Heathrow Airport in London after flying from Sydney in October. This started a media blitz with hundreds of law suits against the airlines pending.

2001

• In January, I was invited to a meeting in Frankfurt, Germany to meet with representatives for a few of the major airlines (BA, LH, Quantas) to discuss research.
• In March, I was invited to a consultation with the World Health Organization (WHO) in Geneva, Switzerland as one of ten experts to present the Hawaiian views for representatives for 15 of the major airlines, none from the USA.
• In May, I was interviewed by BBC for a TV news program on this subject.
• In July, the TV crew for CBS news program "48 Hours" came to Honolulu for interviews.
• In July, Hawaii is selected by WHO as one of four centers for a major, international, multicenter study on prevention of air travel related venous thromboembolism. The other centers are Chicago, London and Vienna.
• Research collaboration is discussed with Hawaiian Airlines and the University of Hawaii.
• Plan to establish a research laboratory at the Clinical Research Center (CRC) at Kapiolani Medical Center. CRC is a NIH supported facility.
• The research protocol approved by WHO will necessitate a research grant for Hawaii of about $1.4 million for a 18 month study.
  
  
  

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