Aviation Health Working Group minutes: 27 July 2001

AHWG/27-07-01/Note

Aviation Health Working Group Meeting

Friday 27 July 2001, Great Minster House, London SW1

Present
Chair	Michael Smethers	DTLR/MLD
Secretary	Peter Smith	DTLR/MLD3
	Mike McGovern	DH
	Dr Bill Maton-Howarth	DH
	Dr Annette Ruge	CAA/AHU
	Tom Hamilton	CAA/SRG
	Dr Tony Evans	CAA/SRG
	Graeme Henderson	HSE
	Roger Wiltshire	BATA
	Roger Wiltshire	BATA
	Hazel Cullinane	Virgin Atlantic
	Simon Evans	AUC
	John Merne	AEA
	Catherine Concoran	AEA
Apologies
	Bruce D'Ancy	BALPA
	Peter North	BARUK

Item 1: Minutes of the last meeting (13 June 2001)

1.1 The Chair reported that no response had been received from the British Sub Aqua Club seeking information on the advice they offer to recreational divers on flying before or after diving. DH to look at the Government advice that is currently offered to divers and consider whether it would be appropriate for the British Sub Aqua Club to disseminate this further. Action DH

Item 2: Recent Developments

2.1 The Healthy Flying conference in June had passed off well, although Baroness Wilcox continues to be critical of Government progress in addressing the various issues. BA's input to the conference reported a range of modifications to the Boeing 777 to remedy various health-related problems. John Scurr's input was well received, noting that taking aspirin and wearing support stockings should only be after seeking medical advice.

Item 3: In-flight medical emergencies

3.1 BATA presented information on medical equipment carried by UK airlines. A paper from BARUK, presenting similar information in relation to three non-UK airlines, was noted.

3.2 In discussion the Chair asked what airlines could do to spread best practice as recommended by the House of Lords Select Committee Report. BATA offered to raise the matter in the airlines' Medical Liaison Group and if possible to promote wider membership of the Group. Action BATA.

3.3 The CAA confirmed that further regulation through the JAA was unlikely but that the Authority had powers to require airlines to carry more medical kit than the JAA minimum. The Chair asked CAA to check and report back if there is evidence of airlines not having adequate medical equipment on board. Action CAA.

3.4 BATA reported that all UK airlines operating long-haul flights were equipped with defibrillators and that there was a trend for them to be included on short-haul flights, mainly by those airlines operating both long and short haul flights. The Chair commented that there was no need for regulation in relation to long-haul flights and that more statistical information was needed before a recommendation could be made in relation to short-haul flights. Anecdotal evidence given to the meeting suggested very few lives were saved as a result of using defibrillators. BATA offered to assist with obtaining information to enable the costs and benefits to be compared, both on the use of defibrillators and the number of deaths during flight. The Group should aim to prepare a draft Regulatory Impact Assessment. Action BATA

Item 4: Health Advice to Passengers

4.1 DH reported that the booklet Health Information for Overseas Travel, issued to GPs, would be re-issued shortly and would contain advice on DVT. The pamphlet Health Advice to Travellers was updated regularly and will contain expanded advice on DVT.

4.2 The draft DTLR advice on DVT was circulated at the meeting. Both DH and BATA commented on aspects of the drafting and agreed to submit written comments to DTLR. Once complete, the advice will be offered to airlines and placed on the DTLR website. The Chair said that although many airlines had already published similar advice, this document would be important in containing authoritative advice from Government given the existing state of knowledge. Action DTLR to update advice in the light of comments from BATA & DH and consult with AHWG members before finalising.

4.3 Consultants from AEA, working for the FCO, presented details of the Know Before You Go campaign that aims to inform travellers on a wide range of issues, mainly by electronic means. They were content to include advice on DVT. Action DTLR to submit copy for publication.

Item 5: Noise

5.1 In the absence of BALPA and in view of pressure on other agenda items, the meeting merely noted the progress of the draft Physical Agents Directive given by HSE. Matter to be considered at the next inclusive meeting.

Item 6: Research

6.1 The BRE report on Stage 2 of the scoping study was well received. DH welcomed the report as a commendable effort given the constraints placed on the consultants but noted that a peer review was needed to validate the scientific method used. It was agreed to go ahead with the peer review but also to press ahead with the priority recommendation on DVT and consider action in relation to cabin air quality. Action DH to initiate peer review.

6.2 It was agreed that, if possible, the UK effort on DVT should be linked with the WHO/IATA global initiative but despite considerable effort, little progress had been made by DH or DTLR in establishing meaningful contact with WHO. DH to use the reply to the recent letter from WHO, referring to the BRE report. Action DH

Item 7: Any Other Business

7.1 DTLR reported on research being undertaken by Cranfield University into the sampling and analysis of air entering aircraft cabins via the APU or ground-based start up units. Although potentially harmful substances had been identified, more work was needed to establish their concentration.

7.2 The work of the Cosmic Radiation Advisory Group was noted, particularly in relation to the advice to be given to very frequent fliers. BATA agreed to investigate the best way to identify and inform those most at risk. Although the promise of simple advice was welcomed, concern was expressed about what further actions people affected might take. Matter deferred for consideration when the CRAG advice becomes available. Action BATA

Item 8: Dates of the next meetings

8.1 The next inclusive meeting will be held on Friday 19 October, and the next exclusive meeting on Friday 7 September.

MLD3

July 2001

ANNEX

Ad-hoc meeting of the permanent AHWG members

1. Publication of the BRE Report

It was agreed to publish the report on the DTLR website but with a note mentioning that it was subject to peer review. Action DH to supply DTLR with a suitable form of words.

DTLR to inform Ministers of the report together with a Press Note. Submission to include a plan of action in handling the recommendations. Action DTLR to circulate a draft PN for comment before submission.

The plan of action will include initiating work on DVT. The high priority recommendation on cabin air quality, along with other recommendations in the report, will be discussed at the meeting with BRE on 7 September.

2. Initiating DVT research

The Chair speculated that DTLR Ministers would be willing to find funding towards the cost of the research on DVT. DH has submitted a bid for funds to cover research requirements. HSE and CAA may not be in a position to provide support along the same lines as agreed for the scoping study.

In order to expedite progress, it was agreed to set up a small research steering group headed by Bill Maton-Howarth, including Graeme Henderson, Tom Hamilton and Peter Smith. The Steering Group will aim to meet in the last week of August, and in any event before 7 September. Action DH.

Although the WHO/IATA proposed global DVT study seemed a promising programme through which the UK might direct resources and obtain cost effective research, the evident difficulties and inertia of WHO were acknowledged. It remained a possibility that the UK might have to fund independent research. Action DH to pursue actively with WHO. DTLR to establish contacts with IATA.