“Led by the GCAQE Head of Research Susan Michaelis, we are delighted that after 6+ years of hard work by an international team, the medical protocol and its very important supplement have been published in a high calibre peer reviewed journal.”
Published paper - ‘Health consequences of exposure
to aircraft contaminated air and fume events: a narrative review and medical protocol for the investigation of exposed aircrew
and passengers’
Available at:
https://ehjournal.biomedcentral.com/articles/10.1186/s12940-023-00987-8
Extensive supplement supporting the published paper available at:
https://static-content.springer.com/esm/art%3A10.1186%2Fs12940-023-00987-8/MediaObjects/12940_2023_987_MOESM1_ESM.pdf
Authors - Jonathan Burdon1, Lygia Therese Budnik2^, Xaver Baur3,4, Gerard Hageman5, C. Vyvyan Howard6, Jordi Roig7, Leonie Coxon8, Clement E. Furlong9, David Gee10, Tristan Loraine11, Alvin V. Terry Jr.12, John Midavaine13, Hannes Petersen14, Denis Bron15, Colin L. Soskolne16 and Susan Michaelis17*
Author details
1Respiratory Physician, St Vincent’s Private Hospital, East Melbourne, Australia. 2Institute for Occupational and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 3European Society for Environmental and Occupational Medicine, Berlin, Germany. 4University of Hamburg, Hamburg, Germany. 5Department of Neurology, Medisch Spectrum Twente, Hospital Enschede, Enschede, The Netherlands. 6Centre for Molecular Biosciences, University of Ulster, Coleraine, Northern Ireland, UK. 7Department of Pulmonary Medicine, Clínica Creu Blanca, Barcelona, Spain. 8Clinical and Forensic Psychologist, Mount Pleasant Psychology, Perth, Australia. 9Departments of Medicine (Div. Medical Genetics) and Genome Sciences, University of Washington, Seattle, USA. 10Centre for Pollution Research and Policy, Visiting Fellow, Brunel University, London, UK. 11Technical Consultant, Spokesperson for the Global Cabin Air Quality Executive, London, UK. 12Department of Pharmacology and Toxicology, Medical College of Georgia, Augusta University, Augusta, USA. 13Lifemedic Bilthoven, Bilthoven, The Netherlands. 14Faculty of Medicine, University of Iceland, Akureyri Hospital, Akureyri, Iceland. 15Federal Department of Defence, Civil Protection and Sport (DDPS), Aeromedical Institute (FAI)/AeMC, Air Force, Dübendorf, Switzerland. 16School of Public Health, University of Alberta, Edmonton, AB, Canada. 17Occupational and Environmental Health Research Group, Honorary Senior Research Fellow, University of Stirling, Scotland / Michaelis Aviation Consulting, West Sussex, England.
‘Abstract
Thermally degraded engine oil and hydraulic fluid fumes contaminating aircraft cabin air conditioning systems have been well documented since the 1950s. Whilst organophosphates have been the main subject of interest, oil and hydraulic fumes in the air supply also contain ultrafine particles, numerous volatile organic hydrocarbons and thermally degraded products. We review the literature on the effects of fume events on aircrew health. Inhalation of these potentially toxic fumes is increasingly recognised to cause acute and long-term neurological, respiratory, cardiological and other symptoms. Cumulative exposure to regular small doses of toxic fumes is potentially damaging to health and may be exacerbated by a single higher-level exposure. Assessment is complex because of the limitations of considering the toxicity of individual substances in complex heated mixtures.
There is a need for a systematic and consistent approach to diagnosis and treatment of persons who have been exposed to toxic fumes in aircraft cabins. The medical protocol presented in this paper has been written by internationally recognised experts and presents a consensus approach to the recognition, investigation and management of persons suffering from the toxic effects of inhaling thermally degraded engine oil and other fluids contaminating the air conditioning systems in aircraft, and includes actions and investigations for in-flight, immediately post-flight and late subsequent follow up.
Keywords Aerotoxic syndrome, Fume events, Oil fumes, Cabin air, Bleed air, Aircrew, Organophosphates’
Many thanks to Susan Michaelis and all of the authors for their hard work.