The Airliner Cabin Environment Air Quality and Safety (1986) / Chapter Skim
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6 Health Effects Associated with Exposure to Airliner Cabin Air
6 Health Effects Associated with Exposure to Airliner Cabin Air
Pages 190-213
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From page 190... ...
Although his review focused on occupational effects unrelated to cabin air quality, he did present original data on occupational illness that are relevant to our study. He used 1979 California statistics on occupational illness and injury to compare the reported numbers of illnesses and injuries in flight attendants with the numbers expected, which were based on combined overall percentage distributions for all occupations.
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From page 191... ...
Many illnesses classed as "symptoms, signs, and ilIdefined conditions" might have been related to the cabin environment, including hyperventilation, syncope and collapse, and ear problems; but it is not possible to attribute any of these illnesses or injuries directly to cabin air quality. HEALTH EFFECTS OF CONCERN IRRITATION AND INFLAMMATION Passengers and cabin crew in an airliner can be exposed to a number of substances that can cause eye, nose, and respiratory irritation, which also appear to be commonly reported by passengers and crew when complaining about the air quality in airplanes.
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From page 192... ...
In 1978, Reed et al., at the California State Department of Health, conducted a questionnaire study of flight attendants in three airlines: Pan American World Airways, which usually flew long distances at high altitudes; Pacific Southwest Airlines, which flew only short distances at lower altitudes; and Trans World Airlines, which flew both types of routes. 50 Of questionnaires mailed to 3,280 flight attendants, 1,330 completed questionnaires were received.
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From page 193... ...
Although it suggested that symptoms were due to ozone exposure, this study was limited by the lack of direct measurements of ozone exposure and by the very poor rate of response to the questionnaires, particularly in the comparison group. A third study was performed by the Occupational Health Clinic of San Francisco General Hospital in 1984 at the request of the Independent Union of Flight Attendants.30 The study was designed to see whether the prevalence of ozone-related symptoms reported by Reed et al*
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From page 194... ...
Phase II was hampered by very small numbers, self-selection, use of flow meters with questionable accuracy, self-administered data collection, an ambiguous protocol for data collection (which allowed different persons to contribute different numbers of observations) , a lack of ozone measurements in flight, and inappropriate data analysis.
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From page 195... ...
People wearing soft contact lenses have more eye symptoms that result from low humidity. Patients with chronic pulmonary disease might have more symptoms from inhaling ozone.
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From page 196... ...
Several studies have investigated pulmonary function in flight attendants or pilots. One report found that higher percentages of members of self-selected groups of Miami- and New York-based Pan American World Airways flight attendants, but not San Francisco-based flight attendants, had spirometric abnormalities than of an age- and sex-matched Michigan group.44 The finding is difficult to interpret, because of the self-selection process, questions of comparability of measurements in the flight attendants and the Michigan group, and
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From page 197... ...
Navy's "l,OCO-aviator cohort" revealed that decrements in pulmonary function were associated with cigarettesmoking, coronary arterial disease, and weight gain. No correlation was reported between a career in military aviation and the development of pulmonary disease; but a career in military aviation was a dichotomous variable, which was coded (present)
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From page 198... ...
with lubricating oil could lead to intoxication. As noted earlier, patients with underlying pulmonary disease are more susceptible to changes in cabin air that affect pulmonary function.
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From page 199... ...
The many papers on coronary arterial disease and resulting sudden death of pilots are not reviewed here, because they are concerned with screening and related health examinations, rather than with possible deleterious effects of cabin air. Some persons with symptomatic cardiovascular disease are under medical care, so decisions about the possibly increased hazards of reduced PO2 and exposure to cigarette smoke, carbon monoxide, and ozone could be made by their physicians.
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From page 200... ...
REPRODUCTIVE DISORDERS A few studies on reproductive disorders or pregnancy outcome in flight attendants have been reported. Menstrual disorders are thought to be related primarily to stress and interruption of circadian rhythm, but there is some speculation that they can be attributed to solar radiation,, 6 which might also predispose to unfavorable pregnancy outcome.
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From page 201... ...
Air Force women with age- and time-matched civilian patients Although the Air Force women had generally higher rates of perinatal death, low-birthweight babies, small-forgestational-age babies, and prematurity, the differences were not statistically significant; there were several significant differences in risk factors, including nulliparity, race, and marital status. In addition, the duties of the Air Force women in this study varied, so they were not good surrogates for flight attendants.
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From page 202... ...
Except for miscellaneous reports, there is no solid information on an association of neoplasia with cabin air quality. The English-language reports on pregnancy outcome in flight attendants are flawed, and the Committee has not fully evaluated foreign-language reports that purport to show increased rater of unfavorable pregnancy outcome.
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From page 203... ...
The extensive data available on the health of pilots are of little use in studying the health effects of cabin air. A primary limitation is that the special cockpit environment is not indicative of the general cabin environment.
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From page 204... ...
The Association of Flight Attendants receives reports submitted by flight attendants concerning poor cabin air quality. From January 1977 to April 1982, 297 reports were received, and descriptive statistics were tabulated for presentation to the Subcommittee on Aviation of the U.S.
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From page 205... ...
The system gives additional data elements, provides for English-like retrievals and reports, puts emphasis on ad hoc retrievals, provides easily utilized standard reports and provides user access through data terminals. The basic design of the AIDS system is to provide the user with current and accurate information about general aviation accidents and incidents coupled with the facility to produce "standard" reports and "ad hoc" reports based on specific requirements.
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From page 206... ...
Without good information on the data collection process, the Committee found it difficult to judge the quality of the data (for health monitoring purposes) and the desirability of using them for health monitoring.
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From page 207... ...
Patients with chronic pulmonary problems -- such as cystic fibrosis, emphysema, chronic asthma, or fibrotic pulmonary conditions -- should have supplemental oxygen whenever flight altitude is greater than 22,500 ft. · Eyed ear, nose, and throat -- recent eye surgery, acute sinusitis, or acute otitis media.
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From page 208... ...
· Miscellaneous -- Scuba divers should not fly for at least 12 h after diving -- 24 h after repeated deep diving -- before flying. The flight surgeon should be consulted if a patient requires intravenous fluids or special medical apparatus.
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From page 209... ...
Federal Aviation Administration, Civil Aeromedical Institute, 1984.
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From page 210... ...
Federal Aviation Administration, Civil Aeromedical Institute, 1984. Dermksian, G., and L
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From page 211... ...
Federal Aviation Administration, Civil Aeromedical Institute, 1982.
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From page 212... ...
Independent Union of Flight Attendants: Interim Report #1. HETA B2~083e Cincinnati9 Ohio: National Institute for Occupational Safety and Health, 1982.
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From page 213... ...
U.S. Federal Aviation Administration, Flight Standards National Field Office.
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