What is Aerotoxic Syndrome? - Aerotoxic Associ...

http://aerotoxic.org/about-aerotoxic-syndrome/

What is Aerotoxic Syndrome?

What is Aerotoxic Syndrome?
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Why does the cabin air get contaminated?

How often does a fume event occur?
How can I tell if the cabin air is contaminated?
How prevalent is normal contamination?
What are the symptoms?
Is Aerotoxic Syndrome treatable?
Can anyone be aected?
Are all aircraft prone to engine oil leaks?
How long has the problem been known about for?
Are there any solutions?
Is the aviation industry addressing the issue?

Aerotoxic Syndrome is the term given to the illness caused by exposure to contaminated air in jet
aircraft.
The term was introduced on 20 October 1999 by Dr Harry Homan, Professor Chris Winder and Jean
Christophe Balouet, Ph.D. in their report, Aerotoxic Syndrome: Adverse health eects following exposure to jet
oil mist during commercial ights.

Why does the cabin air get contaminated?

In order to have a comfortable environment and suicient air pressure to breathe at the altitudes at which jet
airliners y, a supply of warm compressed air is required.
This is nowadays (with the sole exception of the new Boeing 787) supplied direct from the jet engines and is
known as bleed air. It is mixed inside the aircraft with recirculated cabin air at a ratio of 50/50. Although
some of the air is subsequently recirculated, all of the air originates from the jet engines.
Bleed air comes from the compressor section of the jet engine, which has to be lubricated. Jet engines mostly
have wet seals to keep the oil and air apart, which cannot be 100% eective. Furthermore these seals, like
any mechanical component, slowly wear out and their eectiveness gradually declines. This wear can occur
more rapidly when the engine is working hard, such as climbing under full throttle. They may also fail suddenly
and will then let a signicant amount of oil into the very hot compressed bleed air, resulting in fumes and/or
smoke entering the cabin. This is known as a fume event.
There are no lters in the bleed air supply to stop this happening.
Note that the oil used to lubricate jet engines is not based on petroleum hydrocarbons, as are lubricants for
internal combustion engines used in motor cars, outboard motors, tractors etc. Jet engines operate at much
higher temperatures and, therefore, use special synthetic chemicals as oil. They also contain organophosphate
additives as antiwear agents and other aromatic hydrocarbons as antioxidants. Some of the oil gets partially
decomposed, i.e. chemically altered (pyrolysed) due to the high temperatures in the engine.
In summary, the contamination is composed of the oil, the additives, and the decomposition products. The
toxicity seems to be due to the last two of these three.

How often does a fume-event occur?

UK Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) accepts that
fume events occur on 1 ight in 100 in its 2007 report (see para 69).
However, on some aircraft types crews report that they experience fumes to some degree on every ight and as
the denition of fume event is not agreed upon, it makes it impossible to give a true gure.

How can I tell if cabin air is contaminated?

Slight leakage of oil into the cabin may be detected by smell (descriptions such as sweaty socks, wet dog,
vomit, sweet oily smell have been used). Background levels of contamination may not be detectable by smell.
If a fume event occurs bluish haze or smoke in the cabin may be visible. Only visible smoke is oicially
reported in the ight log, leading to under-reporting of the actual frequency.
There are no chemical sensors in modern jet aircraft. The noses of the aircrew are the only detectors at the
moment.

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What is Aerotoxic Syndrome? - Aerotoxic Associ...

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How prevalent is normal contamination?

By normal we mean slight (relative to a fume event) but signicant contamination. The degree of
contamination depends on jet engine type and how recently it was serviced, among other factors. There are few
reliable measurements but based on what has been done we estimate that about a quarter of ights suer
slight but signicant contamination. It is important to remember that this contamination might be continuous
throughout a ight; hence the total exposure might end up as much as after a brief fume event.
Swab-testing conrms that fume events also deposit substantial residues on all the interior surfaces of the
cabin, including the skin of those aboard.

What are the symptoms of aerotoxic syndrome?

Symptoms may be acute, i.e. for a short time or chronic, i.e. long-lasting.
Any combination of the following may be experienced:
Fatigue feeling exhausted, even after sleep
Blurred or tunnel vision
Shaking and tremors
Loss of balance and vertigo
Seizures
Loss of consciousness
Memory impairment
Headache
Tinnitus
Light-headedness, dizziness
Confusion / cognitive problems
Feeling intoxicated
Nausea
Diarrhoea
Vomiting
Coughs
Breathing diiculties (shortness of breath)
Tightness in chest
Respiratory failure requiring oxygen
Increased heart rate and palpitations
Irritation of eyes, nose and upper airways.
which is why the term syndrome is used. Many general medical practitioners are unaware of Aerotoxic
Syndrome and may diagnose suerers with illnesses such as psychological or psychosomatic disorders (i.e.,
theyll tell you its all in your mind), Chronic Fatigue Syndrome (CFS), mysterious viral infections, sleep
disorders, depression, stress or anxiety or simply jet lag, which is caused by crossing time zones.
Although some of these disorders may form part of Aerotoxic Syndrome, such part-diagnoses on their own miss
the root cause of the problem, which is exposure to toxic oil components in a conned space. Furthermore, any
misdiagnosis is likely to lead to inappropriate treatments, which may make the condition even worse.
Aviation medicine specialists are aware of the problem but Aerotoxic Syndrome does not seem to have gained
oicial acceptance among the majority of them. Hence, despite (or because of) their expert knowledge they are
likely to seek other explanations and there are plenty of neurological symptoms associated with aviation that
have nothing to do with inhaling oil.

Is Aerotoxic Syndrome treatable?

For short exposures, the eects are usually reversible and will resolve themselves. But serious or repeated low
dose exposures can lead to severe symptoms. Permanent neurological damage may be caused, which cannot be
recovered from.
There are many prematurely medically retired aircrew with mysterious neurological symptoms, most have
been grossly misdiagnosed.
There is no magic cure, but there are specialists who may be able to help and strategies to aid recovery.
The rst step is to recognise the problem, and avoid or limit further exposures.

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Can anyone be aected?

Yes. The toxins attack the central nervous system (including the brain). Its not easy to predict how dierent
exposures may aect dierent people, due to the genetic variability of individuals. Hence, one persons body
may have less success than anothers at detoxifying contaminants and so be aected after just one ight, whilst
others may be unaected after years of exposure. Depending on detoxifying eiciency, the adverse health
eects may be cumulative. Therefore, anyone frequently ying (which means once or more a week) is
repeatedly exposed and is therefore especially at risk.
Even after a serious fume event, it is possible that no symptoms show initially, but a few days later ill health
associated with Aerotoxic Syndrome may kick in.
Anyone in the aircraft can potentially be aected, whether pilots, cabin crew/ight attendants, passengers, rst
class, economy, minors etc.
Airlines provide no protection to passengers against fume events. Drop-down masks are not eective for
removing contaminants. This is because the oxygen supplied by these masks is ONLY allowed to be used in the
event of cabin decompression and supplies a maximum of 20 minutes of oxygen, which is mixed with
contaminated cabin air.
Activated carbon face masks can oer some protection from toxic oil fumes, but can never provide 100%
protection.

Are all aircraft prone to engine oil leaks?

All jet aircraft including turboprops are susceptible to fume events.
Some aircraft have a worse history with the worst oenders being the BAe 146, Boeing 757.

How long has the problem been known about?

The rst well-documented case was of a C-130 Hercules navigator becoming incapacitated after breathing
contaminated cabin air in 1977. The neurotoxic properties of organophosphates have been known about since
before the Second World War. The toxicity of heated jet oil was known from 1954.

Are there any solutions?

In todays existing modern bleed air aircraft, the quality of cabin air could be improved, and the risk of
contamination by engine oil reduced, with these known solutions:
The new Boeing 787 Dreamliner is the obvious answer as it eliminates the possibility of cabin air
contamination. Instead of bleed air, cabin air is supplied by electrically-driven compressors taking their air
directly from the atmosphere.
As bleed air is not presently ltered, installation of bleed air ltration systems would eliminate the
problem, although a technically eicient system does not yet seem to have been developed.
A less toxic oil formulation could lead to signicant improvement. The French oil company NYCO is
continuously developing such oils.
Chemical sensors to detect contaminated air in the bleed air supplies instead of human noses would
alert pilots to problems, allowing prompt preventive action.

Is the aviation industry addressing the issue?

Numerous independent scientic studies have produced clear evidence of contaminated cabin air being the
cause of chronic health problems. On the other hand, various governments and regulatory authorities have
commissioned research, which, while admitting an association between contaminated cabin air and chronic
health problems, have stopped short of admitting causation. The aviation industry has tended to use the latter
set of research (despite its often dubious scientic quality) to deny the existence of the problem, while ignoring
the evidence of the independent studies or victims testimonies.
One feature of the complex international situation of aviation is that the regulating authorities, while nominally
government agencies, are actually nanced and controlled by the aviation industry and therefore follow the
industrys desires.

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What is Aerotoxic Syndrome? - Aerotoxic Associ...

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Doubtless mindful of the expense of addressing the issue, industry maintain there is no evidence whilst tacitly
acknowledging there is a problem; as shown by the introduction of the new Boeing 787.
Until now this has been a sustainable strategy because few doctors, aircrew or passengers are aware of
aerotoxicity and Aerotoxic Syndrome.

As of 21st September 2012 there are 31 pilots currently on the UK Civil Aviation Authority (CAA) Medical
Departments database who have suggested an association between illnesses and the cabin environment.

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