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Epidemic of e-thrombosis?

Epidemic of e-thrombosis?

Until recently, physiologists and medics thought that deep vein thrombosis (DVT) mainly struck passengers on long haul plane flights – but not anymore. In this short piece I want to look at the ways you can avoid an often unrecognised office danger. It has been called a hidden, silent epidemic.

While most of us are know about risks of trips and falls at work, of sore eyes or a stiff neck, it now seems that lack of movement could make millions of workers vulnerable to a health risk that’s being called – ‘e-thrombosis’. This condition may be most common among call centre workers and in the information technology sector. Some people work for up to 14 hours a day maybe going 3-4 hours at a time without getting up and moving.

Sitting at a desk for hours working at a computer may earn you brownie points with your boss, but evidence that it could damage your health is mounting.

It’s immobility – that is a key factor in causing e-thrombosis. Reactive oxygen species (ROS) – normally have an important role in homeostasis of the lining of blood vessels; changes associated with immobility and altered levels of ROS causing oxidative stress could be part of the feed-forward cascade that leads to higher risk of thrombosis (see figure).

Blood clots form when people are sitting for long periods in one place, especially where the legs may be cramped or circulation restricted, for example if you cross your legs or have them pinned firmly together and tucked up under your seat. It’s not uncommon for someone to spend hours sitting at work and then go home and sit and watch television or play computer games.

Virchow’s triad describes the way blood clots can form in the veins of the veins of the leg; they can be dislodged and form emboli which travel through the chambers of the heart to become lodged in the lungs – or the brain.

What is e-thrombosis?

  • A deep vein thrombosis is a blood clot that develops in a deep vein, usually in the lower leg.
  • In most cases of DVT, the clots are small and do not cause any symptoms. The body’s own clot-busting mechanisms are able to gradually break them down so there are no long-term effects.
  • In less common cases the clot can lodge in the lung with potentially fatal effects.
  • Previously DVT was generally only recognised as a risk for air travelers and hospital patients who are confined to bed after surgery – particularly those confined to bed following operations such as hip or knee surgery.

What can I do to avoid it?

  • Always take a tea break away from the computer. Walking around just five to 10 minutes each hour could substantially reduce your risk
  • Get a phone with a wireless headset that allows you to pace during phone conversations.
  • Avoid lunching at your desk. Instead walk around and stretch your legs.
  • If your workplace permits it, have music on in the background so you can tap your feet along to it, keeping the skeletal muscle pump in your lower legs working which helps prevent blood pooling in your lower limbs.
  • Cardiovascular exercise lowers your blood pressure and reduces the risk of clots building up in the first place, so make sure you exercise at least three or four times a week before or after work.

What are the symptoms?

  • If a DVT damages the valves in the vein, the blood pools in the lower leg rather than flowing upwards towards the heart. This can result in swelling and ulcers on the leg, causing pain which becomes worse when standing or walking.
  • Less common, but more serious is chest pain and shortness of breath due to a pulmonary embolism. This can occur if a clot partially or totally blocks the blood flow in the lungs and requires emergency treatment.

What is the treatment?

  • Anticoagulant medications are the most common drugs to stop clots forming so easily. Anticoagulants include Heparin and Warfarin.

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