Proceedings of the BALPA Air Safety and Cabin Air Quality International Aero Industry Conference ...

320 Pages·2005·2.48 MB·English

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Reports in Safety and Environmental Science
School of Safety Science, The University of New South Wales
August 2005

www.AOPIS.ORG

Chris Winder, editor. Contaminated Air Protection: Proceedings of the Air
Safety and Cabin Air Quality International Aero Industry Conference, held at
Imperial College, London, 20-21 April 2005. Published by the British Airline
Pilots Association (BALPA) and the School of Safety Science, University of
New South Wales, Sydney NSW 2052, Australia, August 2005.
Cost: £25-00 or Aus$55-00 including tax.
Copyright © the British Airline Pilots Association (BALPA) and the School of
Safety Science, University of New South Wales, Sydney NSW 2052.
All rights reserved. This work is published subject to the conditions that it
shall not, by way of trade or otherwise, be lent, sold, hired out or otherwise
circulated without the prior written consent of the authors.
ISBN 0-7334-2282-9
Proceedings of the Contaminated Air Protection Conference Preamble

TABLE OF CONTENTS
Table of Contents _______________________________________________________ ii
Foreword ______________________________________________________________xi
Conference Program___________________________________________________ xvii
Introduction to the Conference ___________________________________________ 1
Jim McAuslan
Opening Speech ________________________________________________________ 3
Paul Tyler, CBE MP
Biographical Sketch_________________________________________________ 3
Conference Introduction_____________________________________________ 3
References_________________________________________________________ 7
Hazardous Chemicals on Jet Aircraft: Case Study – Jet Engine Oils _____________ 8
Chris Winder
Biographical Sketch_________________________________________________ 8
Abstract___________________________________________________________ 8
Introduction _______________________________________________________ 9
The Chemical Products used in Aviation ______________________________ 10
Case Study: The Toxic Ingredients of Jet Oils __________________________ 14
The Substituted Diphenylamine _________________________________ 15
N-Phenyl-alpha-naphthylamine _________________________________ 16
Tricresyl phosphate ___________________________________________ 17
Monitoring Studies_________________________________________________ 20
Numbers of Leaks _________________________________________________ 21
Effects of Hazardous Chemicals Leaks on Crew_________________________ 23
The Cockpit/Cabin Environment _____________________________________ 25
Combustion and Pyrolysis Processes__________________________________ 26
Aerotoxic Syndrome _______________________________________________ 27
Conclusions ______________________________________________________ 28
Acknowledgements ________________________________________________ 31
References________________________________________________________ 31
The Current State of Risk Assessment of Organophosphate Compounds in Jet
Lubrication Oils for the Unborn Child_____________________________________ 37
C Vyvyan Howard
Biographical Sketch________________________________________________ 37
Introduction ______________________________________________________ 37
Risk assessment ___________________________________________________ 37
Where in the Risk Assessment Paradigm does Jet Oil II Fit?_______________ 39
Hazard Identification__________________________________________ 39
Hazard Characterisation _______________________________________ 39
Exposure Assessment __________________________________________ 39
Risk Assessment ______________________________________________ 41
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Proceedings of the Contaminated Air Protection Conference Preamble
References ________________________________________________________42
Illness Related to Cabin Air: A Survey of Symptoms and Treatment Among
Commercial Pilots and Cabin Crew________________________________________43
Andrew Harper
Biographical Sketch ________________________________________________43
Introduction _______________________________________________________43
Methods __________________________________________________________43
Results____________________________________________________________44
Respondent Details ____________________________________________44
Aircraft Type__________________________________________________44
Exposure Events _______________________________________________44
Symptoms – Range, Onset, Diagnosis and Treatment________________46
Discussion ________________________________________________________48
References ________________________________________________________50
Lung Injury Following Hydrocarbon Inhalation in BAe 146 Aircrew____________53
Jonathan Burdon and Allan R Glanville
Biographical Sketch ________________________________________________53
Introduction _______________________________________________________53
Clinical Study______________________________________________________55
Discussion ________________________________________________________57
Organophosphate Ester Induced Chronic Neurotoxicity (OPICN)______________59
Mohamed B Abou-Donia
Biographical Sketch ________________________________________________59
Abstract___________________________________________________________59
Introduction _______________________________________________________59
Cholinergic Neurotoxicity ___________________________________________60
Symptoms of Cholinergic Toxicity Resulting from Organophosphate
Poisoning ____________________________________________________61
Severity of Symptoms __________________________________________62
Effect of Route of Exposure______________________________________63
Human Exposure ______________________________________________63
Organophosphorus Pesticide-Induced Delayed Neurotoxicity (OPIDN)_____64
Characteristics of OPIDN _______________________________________64
Factors Involved in the Development of OPIDN____________________65
Neurological Dysfunction of OPIDN in Humans ___________________70
Mechanisms of OPIDN_________________________________________71
Organophosphate-Induced Chronic Neurotoxicity (OPICN)_______________72
Characteristics of OPICN _______________________________________72
Neurological and neurobehavioral alterations______________________72
OPICN following large toxic exposures to organophosphorus
compounds___________________________________________________73
OPICN following Sub-clinical Exposures to Organophosphorus
Compounds __________________________________________________76
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Proceedings of the Contaminated Air Protection Conference Preamble
Conclusions ______________________________________________________ 83
References________________________________________________________ 83
In Flight Smoke and Fumes ______________________________________________ 92
Bhupinder Singh
Biographical Sketch________________________________________________ 92
Introduction ______________________________________________________ 92
The Extent of the Problem___________________________________________ 92
Source of Smoke and Fumes_________________________________________ 93
Effects of Toxic Substances__________________________________________ 94
Aircrew Protective Systems__________________________________________ 95
Management of Smoke/Fumes Incident in the Air_______________________ 97
Guidelines for the Medical Management of Aircrew Exposed to Smoke
and Fumes________________________________________________________ 98
Engine Bleed Air Contamination in Military Aircraft________________________ 101
Jeffery Kibby, George Denola, PeterJ Hanhela, Wally Mazurek
Biographical Sketch_______________________________________________ 101
Abstract_________________________________________________________ 101
Introduction _____________________________________________________ 101
Methods_________________________________________________________ 102
Cockpit Air Sampling_________________________________________ 102
Extraction of TCP and Amines from Sorbents and Filters____________ 103
Analyses of TCP Sorbent/Filter Extracts __________________________ 103
Analysis of amines ___________________________________________ 103
Chemical Reference Standards_________________________________ 104
Results and Discussion ____________________________________________ 104
TCP________________________________________________________ 104
PAN and DODPA____________________________________________ 105
conclusions______________________________________________________ 105
References_______________________________________________________ 106
Clinical Evaluation of Flight Attendants After Exposure to Fumes in Cabin Air__ 107
G Heuser, MD, O Aguilera, MD, S Heuser, MA, R Gordon, JD.
Biographical Sketch_______________________________________________ 107
Abstract_________________________________________________________ 107
Introduction _____________________________________________________ 107
Methods_________________________________________________________ 108
Experimental Subjects ________________________________________ 108
Positron Emission Tomography (PET)____________________________ 108
Neuropsychological Evaluation ________________________________ 109
Physical Examination_________________________________________ 109
Results__________________________________________________________ 109
Discussion_______________________________________________________ 110
Acknowledgements _______________________________________________ 112
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Proceedings of the Contaminated Air Protection Conference Preamble
References _______________________________________________________112
Biomarkers for Exposure and of Sensitivity to Organophosphorus (OP)
Compounds___________________________________________________________113
Furlong, CE, Cole, TB, Richter, RJ, Yee, NK, Costa, LG, MacCross, MJ
Biographical Sketch _______________________________________________113
Abstract__________________________________________________________113
Introduction ______________________________________________________114
Biomarkers of exposure________________________________________114
Biomarkers of Sensitivity_______________________________________115
Materials and Methods_____________________________________________119
In vitro Inhibition of Carboxylesterase by Tricresyl phosphate _______119
Protein Sample Preparation for Mass Spectrometry_________________120
Identification of Organophosphorous Modifications on
Carboxylesterase by µLC/µLC/MS/MS____________________________120
Results and Discussion_____________________________________________122
Conclusions ______________________________________________________126
Acknowledgements________________________________________________126
References _______________________________________________________126
Assessing over Thirty Flight Crew who have Presented as a Result of Being
Unwell after Exposure to Fumes on the BAe 146 Jets________________________131
Moira Somers
Biographical Sketch _______________________________________________131
Personal Background ______________________________________________131
First Contact with Air Cabin Quality Problems ____________________131
Experience to Date____________________________________________132
Process of Assessment______________________________________________132
Typical Approach_____________________________________________132
The Challenge _______________________________________________132
My Approach to Patient Assessment _____________________________133
Data ____________________________________________________________134
Number of Air Crew Seen______________________________________134
Reasons for Presentation_______________________________________134
Prior Education_______________________________________________134
Symptoms___________________________________________________135
Reports of Other Crew Involved ________________________________136
Aircraft______________________________________________________137
Timing of Symptoms __________________________________________137
Correlation Of Fume Incidents With Documented Technical Faults___137
Alternative Diagnoses _________________________________________137
Descriptions of Cognitive Impairment____________________________138
Case Studies______________________________________________________139
Case Study 1_________________________________________________139
Case Study 2_________________________________________________140
Case Study 3_________________________________________________141
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Proceedings of the Contaminated Air Protection Conference Preamble
Case Study 4 ________________________________________________ 142
Discussion_______________________________________________________ 143
Overview___________________________________________________ 143
Response by All Parties _______________________________________ 144
Future Needs________________________________________________ 144
Conclusion ______________________________________________________ 144
Reference _______________________________________________________ 145
The Effects of Neurotoxic Emissions on the Cognitive Functioning of Workers
in Medical, Industrial and Aviation Settings_______________________________ 147
Leonie Coxon
Biographical Sketch_______________________________________________ 147
Abstract_________________________________________________________ 147
Introduction _____________________________________________________ 148
Occupations at Risk__________________________________________ 148
Occupations at Risk__________________________________________ 148
Neurotoxic Substances________________________________________ 148
The Effects of These Neurotoxicants and Neurotoxins on Workers ___ 149
How is Neuropsychological Performance Affected? _______________ 150
What Methods of Neuropsychological Assessment are used to Verify
these Deficits?_______________________________________________ 151
Neurotoxicity Problems in Medical Settings___________________________ 151
Glutaraldehyde Exposure______________________________________ 151
Glutaraldehyde Research Project_______________________________ 152
Neurotoxicity Problems in Industrial Settings__________________________ 154
Neurotoxicity Problems in Aviation Settings __________________________ 154
Preliminary BAe-146 Study in Western Australia__________________ 157
Neurotoxicity Problems Among Aircraft Engineers _____________________ 159
Magnitude of the Problem_____________________________________ 160
Details of the Study __________________________________________ 160
Common Deficits Among All Three Groups______________________ 160
Conclusions _____________________________________________________ 160
References_______________________________________________________ 161
Multi-system and Multi-Organ Illnesses in the UK: Gulf War Syndrome ME-
CFS, Pesticide Poisoning, MCS and Fibromyalgia___________________________ 163
Malcolm Hooper
Biographical Sketch_______________________________________________ 163
Summary________________________________________________________ 163
Introduction _____________________________________________________ 164
Shared Symptoms of Chronic Illnesses _______________________________ 166
Somatisation and Illnesses involving Nonspecific Symptoms_____________ 168
Summary of Evidence in Support of Organic Damage in Chronic Illnesses_ 172
Discussion and Conclusions________________________________________ 173
References_______________________________________________________ 174
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Proceedings of the Contaminated Air Protection Conference Preamble
Clinical Diagnosis of Chronic Fatigue-Pain-Cognitive Illness: Lessons and
Approaches from Gulf War Illness Research _______________________________177
Robert W Haley
Biographical Sketch _______________________________________________177
Abstract__________________________________________________________177
Introduction ______________________________________________________178
The Lessons ______________________________________________________179
The Approach ____________________________________________________180
Defining Epidemiologic Studies_________________________________180
Nested Clinical Case-Control Studies of Biomarkers________________181
Laboratory Studies in Experimental Animal Models ________________182
Studies of Genetic Susceptibility ________________________________183
Replication of Findings ________________________________________183
Conclusion_______________________________________________________184
References _______________________________________________________184
Cognitive Deficits Associated with Long Term, Low Level Exposure to
Organophosphate Pesticides: A Small Group Study _________________________186
Sarah Mackenzie Ross
Biographical Sketch _______________________________________________186
Introduction ______________________________________________________186
Present Study _____________________________________________________187
Methodological and Clinical Issues Raised ____________________________187
Differentiating Acute versus Low Level Exposure __________________187
Quantifying and Characterising Exposure_________________________187
Comparisons between studies __________________________________188
Vulnerable Sub-Groups________________________________________188
Sensitivity of Measures used in Assessment _______________________188
Impact of mood disorder_______________________________________188
Clinical Issues________________________________________________188
References _______________________________________________________189
Development of a Standard for Aircraft Air Quality_________________________191
Dr Byron Jones
Biographical Sketch _______________________________________________191
Introduction ______________________________________________________191
Due Process in Standards Setting ____________________________________192
Standard 161 Air Quality in Commercial Aircraft_______________________193
Revision of Standard 161 ___________________________________________196
References _______________________________________________________196
The Politics of Aircraft Health and Safety – Senate Inquiry, Australian
Parliament – October 2000 _____________________________________________197
The Reverend John Woodley
Biographical Sketch _______________________________________________197
Introduction ______________________________________________________197
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Proceedings of the Contaminated Air Protection Conference Preamble
The Australian Senate Inquiry into Air Safety and Cabin Air Quality in
BAe 146 Aircraft__________________________________________________ 199
The Evidence Submitted to the Inquiry _______________________________ 199
Listening to the Evidence __________________________________________ 200
Two Reports _____________________________________________________ 204
Conclusion ______________________________________________________ 205
The United States Jury System: A Much Maligned but Effective Regulator of
Corporate Misconduct – The Dangerous Cockpit, a Case in Point ____________ 207
Stuart Calwell
Biographical Sketch_______________________________________________ 207
Introduction _____________________________________________________ 207
Has Anyone Ever Proven that the Toxic Molecules in Cockpit Air Actually
Injures Humans?__________________________________________________ 209
But have Lawsuits ever brought about Regulatory Changes where
Organophosphates are Concerned?__________________________________ 210
A Few Words About Power ________________________________________ 210
The Jury System: What is it and How Does it Work?____________________ 212
But isn’t the American Jury System a Rip-Off? _________________________ 213
So What Could This American Jury System do About the Unsafe Cockpit?_ 215
A Modest Proposal for Action_______________________________________ 216
Pattern of Autonomic Lesions and Neurophysiological Features of Long-Term
Exposure to the Organophosphates in Sheep-dip___________________________ 219
Peter OO Julu, Stig Hansen, Goran A Jamal
Biographical Sketch_______________________________________________ 219
Abstract_________________________________________________________ 219
Introduction _____________________________________________________ 220
Subjects, Materials and Methods ____________________________________ 221
Results__________________________________________________________ 227
Evidence of Peripheral Neuropathy in Groups –one and –two Farmers227
Evidence of autonomic neuropathy in group-three farmers _________ 229
Discussion_______________________________________________________ 232
Specific and Unique Pattern of Autonomic Dysfunction____________ 232
Important Negative Results from Examination of Autonomic Functions233
What could cause Paradoxical Heart Rates in Group-three Farmers? _ 234
Distal Somatosensory Neuropathy in Farmers who Regularly Use OP in
Sheep Dip __________________________________________________ 234
Possible Diagnostic Markers of OP Neurotoxicity _________________ 235
Potential diagnostic values of these neurological markers in aircrews _____ 236
Conclusion ______________________________________________________ 236
References_______________________________________________________ 237
Cabin Air Filtration – Present and Future _________________________________ 241
Karen Bull
Biographical Sketch_______________________________________________ 241
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