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
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...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-05-01
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| Series: | Environmental Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12940-023-00987-8 |
| _version_ | 1797647199012651008 |
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| author | Jonathan Burdon Lygia Therese Budnik Xaver Baur Gerard Hageman C. Vyvyan Howard Jordi Roig Leonie Coxon Clement E. Furlong David Gee Tristan Loraine Alvin V. Terry John Midavaine Hannes Petersen Denis Bron Colin L. Soskolne Susan Michaelis |
| author_facet | Jonathan Burdon Lygia Therese Budnik Xaver Baur Gerard Hageman C. Vyvyan Howard Jordi Roig Leonie Coxon Clement E. Furlong David Gee Tristan Loraine Alvin V. Terry John Midavaine Hannes Petersen Denis Bron Colin L. Soskolne Susan Michaelis |
| author_sort | Jonathan Burdon |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-11T15:12:49Z |
| format | Article |
| id | doaj.art-7b95a6089a6d4ae1adcba211e8ec42d6 |
| institution | Directory Open Access Journal |
| issn | 1476-069X |
| language | English |
| last_indexed | 2024-03-11T15:12:49Z |
| publishDate | 2023-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Environmental Health |
| spelling | doaj.art-7b95a6089a6d4ae1adcba211e8ec42d62023-10-29T12:35:33ZengBMCEnvironmental Health1476-069X2023-05-0122112910.1186/s12940-023-00987-8Health consequences of exposure to aircraft contaminated air and fume events: a narrative review and medical protocol for the investigation of exposed aircrew and passengersJonathan Burdon0Lygia Therese Budnik1Xaver Baur2Gerard Hageman3C. Vyvyan Howard4Jordi Roig5Leonie Coxon6Clement E. Furlong7David Gee8Tristan Loraine9Alvin V. Terry10John Midavaine11Hannes Petersen12Denis Bron13Colin L. Soskolne14Susan Michaelis15Respiratory Physician, St Vincent’s Private HospitalInstitute for Occupational and Maritime Medicine, University Medical Center Hamburg-EppendorfEuropean Society for Environmental and Occupational MedicineDepartment of Neurology, Medisch Spectrum Twente, Hospital EnschedeCentre for Molecular Biosciences, University of UlsterDepartment of Pulmonary MedicineClinical and Forensic Psychologist, Mount Pleasant PsychologyDepartments of Medicine (Div. Medical Genetics) and Genome Sciences, University of WashingtonCentre for Pollution Research and Policy, Visiting Fellow, Brunel UniversityTechnical Consultant, Spokesperson for the Global Cabin Air Quality ExecutiveDepartment of Pharmacology and Toxicology, Medical College of Georgia, Augusta UniversityLifemedic BilthovenFaculty of Medicine, University of Iceland, Akureyri HospitalFederal Department of Defence, Civil Protection and Sport (DDPS), Aeromedical Institute (FAI)/AeMCSchool of Public Health, University of AlbertaOccupational and Environmental Health Research Group, Honorary Senior Research Fellow, University of Stirling, Scotland / Michaelis Aviation ConsultingAbstract 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.https://doi.org/10.1186/s12940-023-00987-8Aerotoxic syndromeFume eventsOil fumesCabin airBleed airAircrew |
| spellingShingle | Jonathan Burdon Lygia Therese Budnik Xaver Baur Gerard Hageman C. Vyvyan Howard Jordi Roig Leonie Coxon Clement E. Furlong David Gee Tristan Loraine Alvin V. Terry John Midavaine Hannes Petersen Denis Bron Colin L. Soskolne Susan Michaelis 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 Environmental Health Aerotoxic syndrome Fume events Oil fumes Cabin air Bleed air Aircrew |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | Aerotoxic syndrome Fume events Oil fumes Cabin air Bleed air Aircrew |
| url | https://doi.org/10.1186/s12940-023-00987-8 |
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