Severe Pulmonary Embolism Associated with Air Travel
Frederic Lapostolle, M.D., Vanessa Surget, M.D., Stephen W. Borron, M.D., Michel Desmaizieres, M.D., Didier Sordelet, M.D., Claude Lapandry, M.D., Michel Cupa, M.D., and Frederic Adnet, M.D., Ph.D.
Background Air travel is believed to be a risk factor for pulmonaryembolism, but the relation between pulmonary embolism and distanceflown has not been documented. The aim of this study was toinvestigate whether the duration of air travel is related tothe risk of pulmonary embolism.
Methods From November 1993 to December 2000, we systematicallyreviewed all cases of pulmonary embolism requiring medical careon arrival at France's busiest international airport. Data onthe geographic origins of all flights and the numbers of passengerswere collected in order to evaluate the incidence of pulmonaryembolism per million passenger arrivals as a function of thedistance traveled.
Results A total of 135.29 million passengers from 145 countriesor other areas arrived at Charles de Gaulle Airport during theperiod of the study, of whom 56 had confirmed pulmonary embolism.The incidence of pulmonary embolism was much higher among passengerstraveling more than 5000 km (3100 mi) (1.5 cases per million,as compared with 0.01 case per million among those travelingless than 5000 km). The incidence of pulmonary embolism was4.8 cases per million for those traveling more than 10,000 km(6200 mi).
Conclusions A greater distance traveled is a significant contributingrisk factor for pulmonary embolism associated with air travel.
Source Information
From Service d'Aide Médicale Urgente (SAMU) 93, Hôpital Avicenne, Université Paris XIII, Bobigny, France (F.L., V.S., S.W.B., M.D., D.S., C.L., M.C., F.A.); and the Department of Emergency Medicine and the Division of Occupational and Environmental Health, George Washington University School of Medicine, Washington, D.C. (S.W.B.).
Address reprint requests to Dr. Lapostolle at SAMU 93, Hôpital Avicenne, 125 rue de Stalingrad, 93009 Bobigny, France, or at frederic.lapostolle{at}avc.ap-hop-paris.fr.
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