Aviation Health Working Group minutes: 11 February 2005

Aviation Health Working Group # 28

11 February 2005, DfT, Great Minster House

Present
Chair	Sandra Webber	DfT/ACCD 2
Secretary	Robert Baker	DfT/ACCD 2
	Peter Smith	DfT/ACCD 2
	Dr Annette Ruge	CAA/AHU
	Tom Hamilton	CAA/SRG
	Steve James	CAA/SRG
	Andy Freeman	HSE
	Dr Bill Maton-Howarth	DoH
	Roger Wiltshire	BATA
	Dr Mark Popplestone	BA/BATA
	Nikki Jones	BAASA/TGWU
	James Freemantle	AUC
	George Blundell - Pound	Thomas Cook
	Dr Tony Goodwin	BALPA
	Tristan Loraine	BALPA-AETG
Apologies
	Mike Carrivick	BAR-UK
	Kath Martin	HSE
	Alison Tingle	DoH
	Abimbola Alli	DfT/ACCD 2

Item 1: Minutes of the previous inclusive meeting (27 October 2004)

1. Following the last meeting, BALPA attended the AHWG Research Sub-Group meeting on 9 November 2004.
2. Tristan Loraine said that BALPA had reminded its members of the CAA confidential reporting scheme.

Item 2: Chair's introductory remarks

3. The Chair reported that in December Paul Tyler MP, John Smith MP and Lord Pearson asked questions in Parliament about air quality on long-haul flights, including organophosphates.
4. The Sunday Times on 9 January 2005 had reported on DVT research and made reference to the WRIGHT Project. The report was based on remarks made by Professor Rosendaal, Leiden University. However, there have been no other media enquiries about the project.

Item 3: Update of the work of the Aviation Health Unit

5. Dr Ruge said that the AHU would be collecting information about the current provision of medical kits and procedures of UK airlines. The Operations Director of the Central Joint Aviation Authorities (CJAA) is considering changing the regulations regarding defibrillators and make them mandatory, in the interest of JAA/FAA harmonisation. There was an issue over the cost of implementing this proposal. The JAA will discus the issue at the next Operations Sector Team (OST) meeting on 28 February. Roger Wiltshire said that one of the main issues facing the UK airlines would be the cost of training. The biggest impact would be on the smaller operators.
6. The Internal Cabin Environment (ICE) project will apply to the EC for funding in the Third Call (mid March to 15 July). The ICE program is being revised to take into account some of the advice from the Building Research Establishment (BRE).
7. Dr Ruge had recently given presentations on the AHU to the Air Transport Users' Council and will be attending conferences in France and Norway.

Action:

BATA to send to Dr Ruge information on the cost of introducing defibrillators on UK air carriers.

Tony Goodwin to send to Dr Ruge information from Virgin Airlines on the cost of medical equipment and training.

Item 4: Research

The use of Aspirin for DVT (DH)

8. Dr Maton-Howarth advised that ISIS had completed research into public perceptions of DVT and the use of Aspirin. It indicated that 20% of air passengers interviewed were self-prescribing Aspirin. The levels of dosage were variable. The figure was not as high as thought but was still significant. The study will be published towards the end of April. However, there was a better chance of publicity if linked to the publication of the WRIGHT Study.
9. Mark Popplestone said that there was no clear advice on the DoH website about Aspirin. Dr Maton-Howarth said that the public could not be advised not to take it, but could be made more aware of potential risks. George Blundell-Pound asked what advice could be provided to passengers about Aspirin. Dr Ruge said that there was a need for passengers to be informed before they boarded a flight, and that airlines were already doing this. Dr Maton-Howarth said that there was an opportunity to raise Aspirin as part of the next stage of the WRIGHT Project.

Update on WHO Wright Project

10. Peter Smith said that the work at the centres was finished and results were currently being written up. The papers will be submitted to scientific journals for publication in 2005. It is important that the research is peer reviewed. We are working with the WRIGHT Scientific Executive Committee to agree a press statement for issue later in the year to announce the outcome of the work. WHO will issue a single report on the whole project, but this will be issued even later. The documents will be published on the DfT website once WHO had published.
11. The initial findings showed that prolonged exposure to the reduced atmospheric pressure that was characteristic of aircraft cabins was not found to produce hypoxia. Initial results indicated that although air travel increases the risk of DVT, it was no worse than any other form of transport or activity, involving prolonged immobility.

Item 5: Future research issues

Cabin Air Quality: BRE proposal on organophosphates

12. Dr Maton-Howarth reported that in response to the presentation made by BALPA at the last AHWG Inclusive meeting, BRE, who have already carried out two research projects for DfT/DH, had been invited to advise the research sub-group on possible methods for a programme of work to measure low level presence of organophosphates during a 'fume event' in flight. BRE's advice in relation to the possible techniques, and instrumentation requirements, would be sought. When this has been received and reviewed, a case will be submitted to Ministers for the necessary funding.  Further work will be considered in the light of the results of this work. 

BALPA proposal on organophosphates

13. Captain Tristan Loraine presented a proposal into research into contaminated air on commercial jet aircraft. The proposal is supported by TGWU, BASSA, the International Transport Workers Federation (ITWA) and Occupational Health Research Consortium in Aviation (OHRCA). It is linked to research work funded by the FAA which will shortly begin in USA and will last two years. BALPA has been invited onto the oversight committee for this work.
14. Tristan Loraine said that the FAA research would involve American airlines and would be focused on monitoring the cabin environment during an incident. Samplers would be taken onboard by selected crew members in the aircraft cabin and flight deck and switched on when an incident occurs. The BALPA proposal would use the same samplers as the FAA but would primarily focus on incidents on the flight deck as the US work is mostly cabin based and flight deck air is 100% bleed air compared to the 50/50 mix found in the cabin. In addition the BALPA proposal would co-ordinate the drafting of incident reporting forms using existing forms as a template. The BALPA proposal seeks funding from the appropriate UK government agency. The BALPA proposal seeks to develop a medical protocol for dealing with crews and passengers after a contaminated air event and get a better idea of the medical effects being currently seen short and long term in crews exposed to contaminated air events. Additionally the BALPA proposal aims to take a 'snap shot' of the number of events crews have had in the past and also report all current events. Dr Tony Goodwin said he had contacted various experts on this issue and it was clear that there was a need for further research.
15. Dr Maton-Howarth said that the AHWG Research Sub-Group would consider the proposal. However, its objective was to identify where there is a need for research and then go out to tender; it was not within the remit of the group to agree to the funding of externally planned research. He was unclear how it would be different from the FAA research.
16. Steve James said that the issue should be raised with EASA as it was an issue requiring international co-ordination. There was a risk of a lack of co-ordination with other research and hence 'buy-in' from all parties to the findings.
17. The Chair asked Tristan Lorraine whether or not it was possible to include the BALPA proposal with the FAA research. He said that he had not contacted the FAA. The Chair said that the research Sub-Group should consider the research proposal at its next meeting.

Action:

BALPA proposal to be discussed at the next AHWG Sub-Group

Research on respiratory disease following flights

18. Dr Ruge said that Dr. Zuckermann (Royal Free Hospital) was very close to securing initial funding for the project which will have a slightly wider approach than just respiratory diseases and include other infectious diseases. Dr Zuckermann was not looking for funding but did hope for recognition from the AHWG.

Next phase of WRIGHT project

19. Peter Smith said that the Scientific Executive Committee of the WRIGHT Project wishes to complete the research originally envisaged by the WRIGHT Protocol: mainly intervention studies, including wearing compression stockings, drinking water and taking exercise. The aim would be to consider how beneficial they actually were. There is an unwillingness to consider Aspirin or other drugs for ethical reasons. The SEC will shortly be lobbying for sponsorship.

Item 6: AOB

Leg room on aircraft

20. The Chair thanked Roger Wiltshire BATA for his briefing on airline seating practice. The issue was primarily to do with comfort of passengers. James Freemantle said that the AUC received approximately 3% of complaints on leg room. Steve James said that seat dimensions in aircraft were the responsibility of EASA.

House of Lords decision on DVT litigation

21. The Chair said that the provisional date for the hearing is 19 and 20 October 2005 and that judgement would be announced in January 2006.

Contaminated Air Protection Conference

22. Tristan Loraine said that BALPA is organising a conference entitled "Contaminated Air Protection Conference" on 21 - 22 April 2005 at Imperial College, London. It will focus on the issue of organophosphates and their alleged effect on the long-term health of air crew and, presumably, passengers.

Purpose built gym on Virgin's A380

23. Dr Ruge said that she had contacted Virgin about its proposals for fitness facilities on their Airbus A380s. There was no definitive proposal in place but Virgin was aware of the need to provide users with proper health advice.

AOB

24. There is an International Civil Aviation Organization (ICAO) state letter listing a series of actions members need to meet. Dr Ruge will prepare for the next AHWG Exclusive meeting a review of the compliance of UK regulations.
25. Dr Ruge said that she had been contacted by a cargo pilot concerned that toilets had been removed from aircraft. Nikki Jones said that TGWU had received advice on a similar case and would contact Dr Ruge. Tom Hamilton said that it was not seen by the CAA as a safety problem.
26. The Chair asked for feedback on the AHWG, in particular if there was a need to make any changes.

Action:

Nikki Jones to send Dr Ruge information on the provision of toilet facilities.

All to provide feedback to the Chair on the value of the AHWG

Dates of next meetings:

Exclusive - 7 April 2005
Inclusive - 28 April 2005
Exclusive - 20 June 2005
Inclusive - 4 August 2005
Exclusive - 2 September 2005
Inclusive - 17 November 2005
Exclusive - 2 December 2005

ACCD2

14 March 2005