Irritant-induced Asthma Caused by Aerotoxic Syndrome

Roig, Jorge Luis González; Domingo, Christian; Burdon, Jonathan; Michaelis, Susan

doi:10.1007/s00408-021-00431-z

Cited by 9 publications

(12 citation statements)

References 32 publications

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“…The pattern of symptoms reported included a diffuse range of acute and chronic effects include the following areas: neurological, neurobehavioural, respiratory, cardiovascular, gastrointestinal, general (fatigue, rheumatological, chemical sensitivity, performance decrement, soft tissue) irritant and skin [ 6 ]. Similar patterns have been increasingly reported elsewhere [ 4 , 5 , 9 , 57 – 68 ]. The FAA reported a range of similar adverse effects as well as delayed effects could be expected following exposure to the complex mixtures associated with pyrolysed jet oils [ 53 ].…”

Section: Discussionsupporting

confidence: 90%

“…Adverse effects being reported by aircrew in relation to exposures to aircraft supply air contamination include a range of both acute and chronic effects that is being labelled primarily as a discrete occupational health condition increasingly termed ‘Aerotoxic Syndrome’ [ 4 – 9 ]. The diffuse pattern of acute and chronic effects include the following areas: neurological, neurobehavioural, respiratory, cardiovascular, gastrointestinal, general (fatigue, rheumatological, chemical sensitivity, performance decrement, soft tissue), irritant and skin [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Ultrafine particle levels measured on board short-haul commercial passenger jet aircraft

Michaelis

Loraine²,

Howard

2021

Environ Health

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Background Airline crew members report adverse health effects during and after inhalation exposure to engine oil fumes sourced to the air supply system onboard commercial and military aircraft. Most investigations into the causal factors of their reported symptoms focus on specific chemical contaminants in the fumes. The adverse health effects reported in aircrew exposed to the aircraft air supply, bled unfiltered off the engine or Auxiliary Power Unit (APU) may be related to particulate exposures, which are widely known to effect health. While oil contaminates the aircraft air supply, some suggest that this will only occur when there is a bearing seal failure, others document that there is low level oil contamination of the air supply during normal engine operation. This brief pilot study explores whether particulate exposure may be associated with the normal engine/APU and air supply operation and to therefore increase the understanding that UFP exposures may have on crew and passengers. Methods An ultrafine particle counter was utilised by an experienced airline captain in the passenger cabin of four short-haul commercial passenger aircraft. All flights were under 90 min on aircraft from two different carriers ranging from 7 months to 14 years old. Results UFP concentrations showed maximum concentrations ranging from 31,300 to 97,800 particles/cm3 when APU was selected on as a source of air on the ground and with engine bleed air and the air conditioning packs selected on during the climb. In 2 of the 4 flights the peaks were associated with an engine oil smell. Increases in UFP particle concentrations occurred with changes in engine/APU power and air supply configuration changes. Conclusions 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.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Ultrafine particle levels measured on board short-haul commercial passenger jet aircraft

Michaelis

Loraine²,

Howard

2021

Environ Health

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“…A variety of diagnoses have been applied to fume event affected individuals including chronic bronchitis, nasal pathology and sinusitis, vocal cord polyps, irritant induced asthma, interstitial lung disease, cognitive dysfunction, and toxic encephalopathy [ 26 ]. Multiple chemical sensitivity is sometimes diagnosed [ 20 , 23 , 25 , 26 , 29 - 32 ]. People suffering from the effects of aircraft fume events are commonly misdiagnosed as being anxious, stressed or experiencing other clinical complaints [ 20 , 23 - 26 , 36 , 37 , 124 , 125 ].…”

Section: Resultsmentioning

confidence: 99%

“…Respiratory complaints consistent with lung injury among aircrew are common [ 2 , 14 , 17 , 19 - 27 , 29 - 34 , 48 , 106 - 108 , 112 , 114 - 116 , 118 , 122 , 124 ]. Granulomata consistent with sarcoidosis has been occasionally reported in pilots and military veterans [ 116 , 127 ].…”

Section: Resultsmentioning

confidence: 99%

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

et al. 2023

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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.

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“…Obstructive airways disease was again well represented in the journal. An eclectic collection of published articles examined various aspects of chronic obstructive pulmonary disease and asthma [ 2 , 11 , 15 , 31 , 55 , 64 , 69 – 73 ].…”

mentioning

confidence: 99%

LUNG Year in Review: 2021

Dicpinigaitis

2022

Lung

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Irritant-induced Asthma Caused by Aerotoxic Syndrome

Cited by 9 publications

References 32 publications

Ultrafine particle levels measured on board short-haul commercial passenger jet aircraft

Ultrafine particle levels measured on board short-haul commercial passenger jet aircraft

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

LUNG Year in Review: 2021

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