Toxic Cabin Air/Aerotoxic Syndrome
Join Date: Oct 2020
Location: Germany
Posts: 14
Likes: 0
Received 0 Likes
on
0 Posts
Hi, here is a jumping pad for those who want to "DYOR" ("do your own research): a quick 15 min search via Google Scholar reveals some relevant papers:
(Link to list and origin doc: https://scholar.google.com/scholar?c...iodt=0,5&hl=en)
TLDR:
Michaelis (2021):
Summary on the research from Harrison (2016): "Some researchers have suggested chronic exposure to OP compounds (particularly TCP) in engine oil may be to blame (Winder and Balouet, 2002). To reflect this, in 2000 Winder and Balouet proposed the term ‘Aerotoxic Syndrome’ to describe the common symptoms reported by aircrew following exposure to toxic fumes in aircraft cabins, and encompasses both short and long-term effects such as ear/nose/throat irritation, skin conditions, nausea and vomiting, respiratory problems, headaches, dizziness, weakness and fatigue, sensory changes and nerve pain, tremors, chemical sensitivity and cognitive impairment (e.g. Abou-Donia, 2003; Cox & Michalis, 2002; Coxon, 2002; Mackenzie Ross, Harper & Burdon, 2006; Mackenzie Ross et al, 2011; Michaelis, 2010; Montgomery, Weir, Zieve & Anders, 1977). In addition, recent studies have reported evidence of neuropsychological impairment (Heuser, Aguilera, Heuser, & Gordon, 2005; Mackenzie Ross et al, 2006; Mackenzie Ross, 2008; Mackenzie Ross et al, 2011; Reneman et al, 2015) and neurological damage (Heuser et al, 2005); evidence of nervous system degeneration (Abou-Donia, Abou-Donia, El Masry, Monro & Mulder, 2013; Abou-Donia, van de Groot & Mulder, 2014); and altered white matter microstructure, cerebral perfusion and activation (Reneman et al, 2015) in aircrew and pilots. Although these studies have shown those working in the airline industry complain of an array of symptoms and/or show evidence of neurological damage, none of these studies have been able to determine cause. Indeed, without any objective measurement of exposure, it is very difficult to claim that contaminated air is to blame. The only studies published to date that have attempted to explicitly measure and link ill-health with exposure to cabin fumes have relied solely on self-report questionnaires"
(Link to list and origin doc: https://scholar.google.com/scholar?c...iodt=0,5&hl=en)
TLDR:
- A. We know that toxic particles exist in cabin air, originating from the bleed air system
- B. We know that pilots and cabin crew self-reported "aerotoxic syndrome" for many years now
- C. However, science was not yet able to conclusively link A and B in a causal relationship. So the blood test might exactly be what we need
- Abstract: The thesis argues that the precautionary principle, occupational health and safety guidelines and aviation regulations are being ignored by the aviation industry, who continue to claim that cabin air is safe. The systemic misuse of available data is widespread, secondary to commercial objectives, and places passenger and crew health and flight safety at serious risk. The thesis concludes that the use of bleed air on commercial aircraft with no form of contaminated air detection or filtration system present should be discontinued. The risk to health and flight safety is no longer acceptable.
- My take on the study: comprehensive in analysis, but suffering a bit from its method (survey-based data collection) due to lack of more available data - she comments this herself in the work.
- Metrics: PHD thesis from respectable uni
Michaelis (2021):
- Abstract: This study identified increases in UFP concentrations associated with engine and APU power changes and changes in air supply configuration. These results correlated with times when engine and APU oil seals are known to be less effective, enabling oil leakage to occur. The concentrations reached in the passenger cabins exceeded those taken in other ground-based environments. UFP exposures in aircraft cabins during normal flight indicates there will be health consequences for long serving aircrew and some passengers.
- My take on the study: has a great practical relevance and identifies air bleed supply changes as the main events during which particles are blown into the cabin air. Still, only 4 flights were studies, suggesting further data collection is needed.
- Study metrics: Paper was submitted in ENV health, with an H-index of >100 this seems to be a good journal in the field.
- Abstract: We present strong evidence for the presence of aerosols of Nano-particles (also termed Ultrafine Particles (UFPs) in aerosol science) in the breathing air of pressurized aircraft using engine bleed air architecture. The physical and chemical nature of engine oils and the high temperatures attained in aircraft jet engines (up to 1,700°C in the oil circulation and up to 30,000°C in the bearings) explain why UFPs are to be expected. A discussion of oil seals used in gas turbine engines concludes that they will permit UFPs to cross them and enter the breathing air supply, in conjunction with a complex mixture of chemicals such triaryl phosphates which are neurotoxic. A consideration of the toxicology of Nano-particles concludes that their continual presence over a typical working lifetime of up to 20,000 hours in aircrew will predispose them to chronic respiratory problems and will exacerbate the translocation of neurotoxic substances across the blood brain barrier.
- My take on the study: This seems to be a literature review on the topic rather than original research. Howard references to her previous work (which is widely cited): https://www.sciencedirect.com/scienc...69409X11002328
- Study metrics: The journal in which this paper was published does not seem to be relevant, however, the main researcher is a widely cited scholar in the field. I think I wouldn' use this paper in research but the papers referenced by this one.
- Abstract: "Toxicology is a new science, the complexities of which have been highlighted in the papers contained within this special section. Our understanding of the mechanisms through which various chemicals interfere with nervous system function is constantly evolving and research is unable to keep up with the speed with which new chemicals are produced and put onto the market. Thus there are often controversies surrounding the health-effects of commercially available compounds and disagreement around what constitutes safe exposure limits. This article will introduce readers to an emerging concern in this field, the potential risk to health of toxic fumes in airplane cabins. We explore the challenges and methodological issues encountered by researchers who have tried to investigate this issue and highlight the need for further research on this topic. We hope this article will promote discussion amongst academics and clinicians, and lead to the identification of creative solutions to the methodological issues encountered to date."
- My take: seems to be a balanced perspective and highlights method and data gaps
- Study metrics: not journal-published
Summary on the research from Harrison (2016): "Some researchers have suggested chronic exposure to OP compounds (particularly TCP) in engine oil may be to blame (Winder and Balouet, 2002). To reflect this, in 2000 Winder and Balouet proposed the term ‘Aerotoxic Syndrome’ to describe the common symptoms reported by aircrew following exposure to toxic fumes in aircraft cabins, and encompasses both short and long-term effects such as ear/nose/throat irritation, skin conditions, nausea and vomiting, respiratory problems, headaches, dizziness, weakness and fatigue, sensory changes and nerve pain, tremors, chemical sensitivity and cognitive impairment (e.g. Abou-Donia, 2003; Cox & Michalis, 2002; Coxon, 2002; Mackenzie Ross, Harper & Burdon, 2006; Mackenzie Ross et al, 2011; Michaelis, 2010; Montgomery, Weir, Zieve & Anders, 1977). In addition, recent studies have reported evidence of neuropsychological impairment (Heuser, Aguilera, Heuser, & Gordon, 2005; Mackenzie Ross et al, 2006; Mackenzie Ross, 2008; Mackenzie Ross et al, 2011; Reneman et al, 2015) and neurological damage (Heuser et al, 2005); evidence of nervous system degeneration (Abou-Donia, Abou-Donia, El Masry, Monro & Mulder, 2013; Abou-Donia, van de Groot & Mulder, 2014); and altered white matter microstructure, cerebral perfusion and activation (Reneman et al, 2015) in aircrew and pilots. Although these studies have shown those working in the airline industry complain of an array of symptoms and/or show evidence of neurological damage, none of these studies have been able to determine cause. Indeed, without any objective measurement of exposure, it is very difficult to claim that contaminated air is to blame. The only studies published to date that have attempted to explicitly measure and link ill-health with exposure to cabin fumes have relied solely on self-report questionnaires"
Join Date: Oct 2020
Location: Germany
Posts: 14
Likes: 0
Received 0 Likes
on
0 Posts
Also link to the other discussion here: New blood test for contaminated air events
Salute!
A blood test every flight or two? No good.
There are personal monitoring systems that are not that expensive and can provide warning ahead of time, versus telling the Doc that you and SLF were exposed to bad things on that flight last night when something smelled bad. I am not talking about being wired up ;like for an EKG that most of us here have done dozens of times.
I wear a ring at altitudes above 5,000 feet due to my lung problem and mild anemia. It vibrates like crazy at a certain oxygen saturation and/or pulse rates. Costs less than $200. Then we should consider basic aircraft detection systems besides the simple cabin altitude stuff we already have. Oh well.
Remember, besides histoxic anemia we can have hypemic hypoxia. Carbon monoxide detection is cheap, and if we are using bypass for the cabin pressure, it is a player.
Glad to see more interest in our breathing systems nowadays.
Gums sends...
A blood test every flight or two? No good.
There are personal monitoring systems that are not that expensive and can provide warning ahead of time, versus telling the Doc that you and SLF were exposed to bad things on that flight last night when something smelled bad. I am not talking about being wired up ;like for an EKG that most of us here have done dozens of times.
I wear a ring at altitudes above 5,000 feet due to my lung problem and mild anemia. It vibrates like crazy at a certain oxygen saturation and/or pulse rates. Costs less than $200. Then we should consider basic aircraft detection systems besides the simple cabin altitude stuff we already have. Oh well.
Remember, besides histoxic anemia we can have hypemic hypoxia. Carbon monoxide detection is cheap, and if we are using bypass for the cabin pressure, it is a player.
Glad to see more interest in our breathing systems nowadays.
Gums sends...
Join Date: Apr 2005
Location: U.K.
Age: 68
Posts: 380
Likes: 0
Received 0 Likes
on
0 Posts
Respected aviation journalist David Learmount has just commented on the recent Cabin Air conference: https://davidlearmount.com/2023/07/1...g-the-verdict/
Join Date: Apr 2005
Location: U.K.
Age: 68
Posts: 380
Likes: 0
Received 0 Likes
on
0 Posts
Respected aviation journalist David Learmount has just commented on the recent Cabin Air conference: https://davidlearmount.com/2023/07/1...g-the-verdict/
I flew 757s for 20 years and regularly experienced the “sweaty socks”smell, usually at top of descent. I now suffer many of the commonly reported symptoms and know of others whose deaths probably resulted from such exposure.
I have been asked to provide an update on the TCP blood test. The blood test was presented at the 2023 Aircraft Cabin Air Conference by the research team at the University of Washington in Seattle. Their results clearly show that the blood test can confirm an exposure to the organophosphate tricresyl phosphate (TCP). TCP is used in a number of different applications but a specific formulation of TCP is widely used in jet engine oils, it has a low ortho isomer content especially blended to reduce expousre to the ortho isomers - this was done on the basis the other isomers were less problematic. This will soon be shown to be an error. Swab samples of aircraft cabins confirm exposure to these specific low ortho blends.
The TCP blood test works by seeing the additional molecular weight (part of the TCP molecule) attached to a specific protein. The research has been funded entiterly by the Royal Australian Air Force and pilot / cabin crew unions including AIPA, ALAEA and AFAP in Australia; APA, AFA (the primary investor), TWU in the US; Aeropers, SNPL, VC, IPA, Unite the Union and others in Europe to name a small few.
The research is now being prepared to be published in a peer reviewed journal and adapted so any certified laborartory anywhere in the world will be able to run the tests. This requires additional funding and unions are being asked to help with this final step.
I was on a flight in 2006 where there was a serious contaminated air exposure, the ailrine told me it was only de-icing fluid and it was perhaps something I had eaten that caused my and the co-pilot's symptoms. My blood was taken and sent to the USA and frozen for 17 years until last month, when it was tested and shared with my doctor. The results - significant exposure to TCP.
The blood test will be a very useful tool for aircrew who encounteer any form of impairment or where flight safety was compromised in any way from contaminated air or unknown sources. Many passengers and crews are actively asking for the test and ultimately I believe it will expedite the introduction of bleed air cleaning technologies currently being evaluated by the big 3 aircraft manufacturers and new less hazardous synthetic engine oils in advanced phases of development.
For more information please email the Global Cabin Air Quality Executive at [email protected]
The TCP blood test works by seeing the additional molecular weight (part of the TCP molecule) attached to a specific protein. The research has been funded entiterly by the Royal Australian Air Force and pilot / cabin crew unions including AIPA, ALAEA and AFAP in Australia; APA, AFA (the primary investor), TWU in the US; Aeropers, SNPL, VC, IPA, Unite the Union and others in Europe to name a small few.
The research is now being prepared to be published in a peer reviewed journal and adapted so any certified laborartory anywhere in the world will be able to run the tests. This requires additional funding and unions are being asked to help with this final step.
I was on a flight in 2006 where there was a serious contaminated air exposure, the ailrine told me it was only de-icing fluid and it was perhaps something I had eaten that caused my and the co-pilot's symptoms. My blood was taken and sent to the USA and frozen for 17 years until last month, when it was tested and shared with my doctor. The results - significant exposure to TCP.
The blood test will be a very useful tool for aircrew who encounteer any form of impairment or where flight safety was compromised in any way from contaminated air or unknown sources. Many passengers and crews are actively asking for the test and ultimately I believe it will expedite the introduction of bleed air cleaning technologies currently being evaluated by the big 3 aircraft manufacturers and new less hazardous synthetic engine oils in advanced phases of development.
For more information please email the Global Cabin Air Quality Executive at [email protected]
Thank you Tristan
Keep at it.
In the face of your organisation's (and others') constant and increased pressure, I'd like to think airlines and manufacturers are slowly realising that things have to change wrt Cabin Air Quality. I do know of some airlines who have already swapped out the engine oils they use, who have added better air filters and modified their maintenance/ engine inspection regimes to reduce the likelihood of fume events. There are also some airlines who have fitted detector/warning systems that are allied to better post-fume-event crew checklists, procedures and after-flight medical responses. Whilst they have done this very quietly so as not to embarrass the industry (maybe), it still is a start. Even the ever-increasing presence of the B787 on the world register is 'bio-marker' in itself - and those who fly this ac are immensely impressed by the air quality on board (even if Boeing SAY the concept was (re)introduced for other reasons).
Nonetheless, there is still a long, long way to go and all of the above does nothing for those who were harmed in the past, the recent past, or even those being harmed presently in aircraft/airlines who are slow on the uptake. Furthermore, it beggars belief that the most of the world's regulators are, in the main, still silent (Wake up CAA/FAA/EASA!).
The concerted Bradford Hills approach bears a close resemblance to the events of the 1960s and cigarette-smoking in Europe and America - which sadly took 20+ years to get governments to introduce bans on that 'bad habit' in public - but because of the slow response, many millions died or got sick despite the world getting there eventually. Let's hope that global aviation learns from that and introduces more-quickly the means to prevent airlines from poisoning their own staff and their fare-paying passengers in the pursuit of 'profits over safety' - also airlines would do well to consider compensating those personnel already affected. This might be expensive but probably a lot less so than fighting a deluge of class actions in the courts once the medical evidence exceeds critical mass for frequent-flyers - which is not far off even now.....
Contrary to what David Learmount says, I understand that 'Aerotoxic Syndrome' IS now an accepted medical term in many fields but that it needs to have its profile raised amongst the new generation of healthcare professionals - so when suffers present with symptoms, they can refer them more expeditiously to the appropriate specialists.
Well done and Good luck,
Flip
Keep at it.
In the face of your organisation's (and others') constant and increased pressure, I'd like to think airlines and manufacturers are slowly realising that things have to change wrt Cabin Air Quality. I do know of some airlines who have already swapped out the engine oils they use, who have added better air filters and modified their maintenance/ engine inspection regimes to reduce the likelihood of fume events. There are also some airlines who have fitted detector/warning systems that are allied to better post-fume-event crew checklists, procedures and after-flight medical responses. Whilst they have done this very quietly so as not to embarrass the industry (maybe), it still is a start. Even the ever-increasing presence of the B787 on the world register is 'bio-marker' in itself - and those who fly this ac are immensely impressed by the air quality on board (even if Boeing SAY the concept was (re)introduced for other reasons).
Nonetheless, there is still a long, long way to go and all of the above does nothing for those who were harmed in the past, the recent past, or even those being harmed presently in aircraft/airlines who are slow on the uptake. Furthermore, it beggars belief that the most of the world's regulators are, in the main, still silent (Wake up CAA/FAA/EASA!).
The concerted Bradford Hills approach bears a close resemblance to the events of the 1960s and cigarette-smoking in Europe and America - which sadly took 20+ years to get governments to introduce bans on that 'bad habit' in public - but because of the slow response, many millions died or got sick despite the world getting there eventually. Let's hope that global aviation learns from that and introduces more-quickly the means to prevent airlines from poisoning their own staff and their fare-paying passengers in the pursuit of 'profits over safety' - also airlines would do well to consider compensating those personnel already affected. This might be expensive but probably a lot less so than fighting a deluge of class actions in the courts once the medical evidence exceeds critical mass for frequent-flyers - which is not far off even now.....
Contrary to what David Learmount says, I understand that 'Aerotoxic Syndrome' IS now an accepted medical term in many fields but that it needs to have its profile raised amongst the new generation of healthcare professionals - so when suffers present with symptoms, they can refer them more expeditiously to the appropriate specialists.
Well done and Good luck,
Flip
On a very recent VA flight LHR to DEL and back, the cabin crew passed through the cabin with canisters of what may have been insecticide. The haze lasted for quite a while and left most coughing and wheezing.
Cabin air quality eh?
Cabin air quality eh?
We have been able to measure TCP for some time. de Ree et al produced a good paper which found the levels were below those that could cause the symptoms. (https://boerenlandvogels.nl/sites/de...20response.pdf). In the absence of any other publications on this point it seems a blood test may not be the panaces
We have been able to measure TCP for some time. de Ree et al produced a good paper which found the levels were below those that could cause the symptoms. (https://boerenlandvogels.nl/sites/de...20response.pdf). In the absence of any other publications on this point it seems a blood test may not be the panaces
We have been able to measure TCP for some time. de Ree et al produced a good paper which found the levels were below those that could cause the symptoms. (https://boerenlandvogels.nl/sites/de...20response.pdf). In the absence of any other publications on this point it seems a blood test may not be the panaces
Join Date: Jul 2021
Location: Planet Earth
Posts: 36
Likes: 0
Received 0 Likes
on
0 Posts
Another Contaminated Air Event
Another contaminated air event…
When will the authorities take action?
Aerotime
“A Qantas cabin crew was hospitalized in Melbourne after feeling unwell due to an ‘unusual’ smell reported as coming from the aircraft flight deck just prior to landing.
The incident occurred in the evening of October 26, 2023 just after 20:00 local time after flight QF1527 landed at Melbourne Airport (MEL) from Canberra Airport (CBR).
Emergency medical crew had been on standby and quickly took the cabin crew to a local hospital for a medical check-up.”
https://www.aerotime.aero/articles/q...k-to-melbourne
When will the authorities take action?
Aerotime
“A Qantas cabin crew was hospitalized in Melbourne after feeling unwell due to an ‘unusual’ smell reported as coming from the aircraft flight deck just prior to landing.
The incident occurred in the evening of October 26, 2023 just after 20:00 local time after flight QF1527 landed at Melbourne Airport (MEL) from Canberra Airport (CBR).
Emergency medical crew had been on standby and quickly took the cabin crew to a local hospital for a medical check-up.”
https://www.aerotime.aero/articles/q...k-to-melbourne
Another contaminated air event…
When will the authorities take action?
Aerotime
“A Qantas cabin crew was hospitalized in Melbourne after feeling unwell due to an ‘unusual’ smell reported as coming from the aircraft flight deck just prior to landing.
The incident occurred in the evening of October 26, 2023 just after 20:00 local time after flight QF1527 landed at Melbourne Airport (MEL) from Canberra Airport (CBR).
Emergency medical crew had been on standby and quickly took the cabin crew to a local hospital for a medical check-up.”
https://www.aerotime.aero/articles/qantas-cabin-crew-hospitalized-after-unusual-smell-on-flight-deck-to-melbourne
When will the authorities take action?
Aerotime
“A Qantas cabin crew was hospitalized in Melbourne after feeling unwell due to an ‘unusual’ smell reported as coming from the aircraft flight deck just prior to landing.
The incident occurred in the evening of October 26, 2023 just after 20:00 local time after flight QF1527 landed at Melbourne Airport (MEL) from Canberra Airport (CBR).
Emergency medical crew had been on standby and quickly took the cabin crew to a local hospital for a medical check-up.”
https://www.aerotime.aero/articles/qantas-cabin-crew-hospitalized-after-unusual-smell-on-flight-deck-to-melbourne
So out of all the crew and passengers onboard, only one person was affected. They may have some sort of disposition to certain ‘fumes’. A bit like peanut allergies!
