The Real Danger of Air Travel Isn't a Crash
The real danger of air travel isn't the plane going down...
In fact, air passengers face a more common threat – one that kills more people, especially seniors, than plane crashes. And these days, it can start before you even make it to your gate...
I'm talking about a condition called venous thromboembolism ("VTE"). It's a deadly type of blood clotting.
Your odds of dying in a plane crash are 1 in 13.7 million. But your odds of developing a blood clot are roughly 1 in 1,000 each year. Worse, if you're more than 80 years old, those odds magnify to 1 in 100.
While your risk of getting in a plane crash automatically drops to zero as soon as your feet touch the ground, that sure isn't the same case with blood clots... You're not safe after landing...
Roughly 30% of patients who end up developing VTE die within a month. Or if they survive the first time around, a third of them get it again within 10 years. Plus, the damage to your body regularly leads to a debilitating long-term complication.
And get this... You might associate these travel-induced clots with hours of sitting in a cramped airplane seat.
But being stuck on your feet in a barely moving security line at the airport can trigger the same threat, too. So today, we'll go over VTEs and how to avoid them with a few simple tips...
When Blood Clots Go Wrong
Our bodies are designed to clot (and to not clot) at the right time and place.
Clotting keeps blood from leaking while our bodies repair damage. But when it happens in veins deep in your body, it can lead to VTE.
VTE comes in two forms: deep vein thrombosis ("DVT") and a pulmonary embolism ("PE").
DVT happens when a clot forms in your deep veins. With a PE, the clot (or a piece of it) breaks off and travels to your lungs. Blood to this major organ gets blocked. That cuts off your body's flow of oxygen. The American Lung Association estimates that 10% to 30% of PE patients die within a month of the diagnosis. Some die instantly.
PEs happen in 60% to 80% of DVT patients, and a pulmonary embolism is the No. 3 most common cause of death among all hospital inpatients. And even among those folks who were already in the hospital when they died of a PE, only 30% had been correctly diagnosed.
Here are common DVT symptoms to watch for...
- Swelling ("edema"), the most specific DVT symptom
- Soreness or sensitivity, which happens in 75% of cases
- Leg pain, which happens in half of the cases (but can be caused by other things, too)
- Redness or discoloration
- Limbs feel warm to the touch
Or you might not have any of these symptoms at all and instead have PE symptoms. These typically include...
- Sudden shortness of breath
- Sharp chest pain that worsens if you breathe deeply
- Coughing up blood
- Irregular heartbeat or heart palpitations
- Dizziness
- Anxiety
Once you develop DVT, your doctor will put you on blood thinners. It can take months to dissolve an existing clot and then to protect against a future one.
But wait, there's more... You also face a 20% to 50% risk of developing post-thrombotic syndrome ("PTS")... even more than two years after you thought you'd "beaten" DVT.
PTS symptoms typically worsen if you stand for a while and improve with elevating the affected limbs. Those symptoms include variations of DVT symptoms, like...
- Chronic swelling
- Brownish or reddish discoloration
- Skin thickening
- Pain, aches, or heaviness
- New varicose or spider veins
- Ulcers (in severe cases)
DVT can strike any part of your body. But your legs are the most common spot. And PEs from DVTs typically originate from those limbs. Blood in the lowest parts of your body – your legs – has a tougher journey to the heart than the blood in the other veins in your body since it has to fight against gravity.
When you move, the muscles surrounding the deep veins squeeze and help push the blood up. When you're not moving, your body loses this extra boost. And that's one reason why flying increases your danger of developing VTE...
Do What I Do to Stay Safe...
The top trigger is immobility.
Sitting for hours without moving means you're not using your leg muscles to squish the veins and get that blood moving upward. At the same time, you don't want to compress them too much. According to the American Society of Hematology, flights longer than eight hours pose the greatest risk. But one study of 8,755 adults aged 18 to 71 found that even four-hour flights can triple your risk of getting DVT.
So if you want to lower your risk, do what I do…
- Get up and walk every 45 to 60 minutes. This is crucial. You can set a recurring alarm reminder to go for a mini stroll (also giving yourself time for a 30-minute power nap between walks if you're very tired). If you have trouble getting in and out of your seat, don't be afraid to ask flight attendants for help. It's part of their training, and it's their job. I recommend letting them know of any mobility needs you have.
- Keep your legs uncrossed. This will keep the blood flowing in your veins.
- Wear graduated compression stockings. They should cover your feet and go up to your knees. Make sure to measure your calves and order according to the manufacturer's sizing chart.
- Keep yourself warm. Airplanes can go from hot to cold during your flight. Cold air can cause vasoconstriction (constricted veins), so dress in layers so you can keep yourself safe and comfortable as the air temperature changes. Don't be shy about asking for a blanket, either.
- Do seated leg exercises during the time you're not getting up to stretch. I do some mini exercises that the National Blood Clot Alliance also suggests, including ankle circles (twirling your feet lifted off the ground), foot pumps (raising your toes while keeping your heel on the floor and vice versa, for 30 seconds at a time), shoulder rolls (hunching your shoulders and moving them in a circle for 30 seconds in each direction), and arm curls (putting your elbows on your armrests and moving your hands to your chests and back). This video from a physical therapist shows the leg exercises.
- Stuck standing in a long security line? Do some calf raises, roll your ankles a bit, and try to walk around every now and then. Just keep an eye on your carry-on and don't lose your spot in the queue.
Immobility also raises your DVT risk when you're traveling by car, train, or bus. So adapt these tips to other travel lasting more than four hours as well.
Alongside immobility, there's two more major DVT triggers lurking on the plane, specific to flying. I covered them in a recent Retirement Millionaire issue. Grab a trial issue here.
What We're Reading...
- Something different: Spring is here... and so is sock burning.
Here's to our health, wealth, and a great retirement,
Dr. David Eifrig and the Health & Wealth Bulletin Research Team
March 31, 2026