Aviation Health Working Group minutes: 4 May 2001

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AHWG/04-05-01/Note B

Aviation Health Working Group Meeting

Friday 4 May 2001, Great Minster House, London SW1

Present

     

Chairman

Michael Smethers

DETR/MLD

  

Secretary

Tim Hemmings

DETR/MLD3

  
 

Mike McGovern

DH

  
 

Tom Hamilton

CAA/SRG

  
 

Capt. Tim Sindall

CAA/SRG

  
 

Graeme Henderson

HSE

  
     

from agenda item 5 onwards

 

Roger Wiltshire

BATA}

  
 

Hazel Cullinane

BATA}
 

Peter North

BAR-UK}
 

Simon Evans

AUC}

Item 1: Introductory Remarks

1.1 The Chair welcomed the permanent members of the Aviation Health Working Group to the second meeting of the group, explaining that airline and consumer representatives would join the meeting for agenda item 5 onwards. He stressed again the importance of the Group meeting on a regular basis and of continuing active participation by all permanent members.

Item 2: Minutes of the last meeting

2.1 The minutes of the last meeting were approved.

2.2 On the action points contained in the minutes which would not arise under separate agenda items, HSE had passed the Secretary information on responsibility for health warnings to professional scuba divers. The Chair agreed that this should be circulated (copy attached) and suggested that DETR contact leisure divers' representatives to ensure that they are aware of the health risks associated with flying after diving. (Action: occupational diving - HSE; recreational diving - DETR)

2.3 DH reported that the leaflet "Are You Fit To Fly?", which is sent to GPs offering advice to be given to patients travelling abroad, is currently being updated and could include enhanced advice on DVT. The information included in this leaflet could also be posted on the NHS Direct web-site. (Action DH)

2.4 DETR were drafting a paper on aviation health issues, summarising UK experience, to be presented as an information paper to the forthcoming ICAO Assembly.

Item 3: Working Arrangements for the Group

3.1 The Chair suggested that meetings of the Group alternate between meetings of the permanent members and more inclusive meetings involving airline and consumer representatives, and possibly other experts. DH agreed to consider whether health experts might be invited to a future meeting. (Action DH)

3.2 Subject to any comments addressed to the Secretary within seven days, the attached draft mission statement for the Aviation Health Working Group was agreed (note: one comment was received from CAA).

Item 4: Information on Deep Vein Thrombosis

4.1 DH said that work was continuing with health experts on producing detailed Government advice on reducing risk of deep vein thrombosis while travelling by air. This should be ready soon, and will be circulated for comments in advance of the next meeting. DETR had received examples of the advice being offered by a number of airlines - as an example, an excellent leaflet produced by Britannia was circulated. It was agreed that it was important for the Government to issue advice as soon as possible which was as authoritative as it could be within the current state of knowledge. This was unlikely to be significantly different to Box 4 in the House of Lords' Report, and in the meantime the best available advice to airlines and others was to base information to passengers on Box 4.

At this point, airline and consumer representatives joined the meeting. Welcoming invitees to the meeting, the Chair stressed the importance to the permanent members of the group of maintaining close contact with airlines, consumer representatives and other interested parties. It was agreed that inclusive meetings should take place around every three months.

Item 5: Recent Developments

5.1 The Chair listed a number of recent developments relating to aviation health, for information.

  • -in general terms aviation health issues continued to receive some publicity, but less than the high point of earlier this year;
  • -Bob Ainsworth, Minister for Aviation, had appeared in a piece by ZDF (German State Television) on DVT, which had also featured John Scurr and Farrol Kahn. The programme had taken the line that the UK Government and airlines had been more active in relation to DVT than was the case in Germany. A Panorama programme devoted to aviation health issues was also possible in the coming weeks.
  • -Emirates had announced that it would offer anti-DVT exercise cushions on its flights. An example of such a cushion (though made by a different company) had been sent to DETR and information was available to the Group, if requested;
  • -A conference on Healthy Flying was to be held by the Royal Society for the Promotion of Health on 22 June. Baroness Wilcox is scheduled to speak;
  • -John Smith MP had tabled a Private Members Bill entitled "Air Travellers (Provision of Information)", to force airlines to provide information on the risk of DVT. This was scheduled for debate on 11 May, though depending on the possible dissolution of Parliament, might not be taken.
  • -The Air Accident Investigation Board was investigating two incidents involving fumes leaking on-board BAE 146 aircraft. CAA had produced amended guidance to apply if a crew-member became ill, and the Group will be informed of the outcome of the AAIB investigation.

5.2 BATA added that a conference covering aviation health issues was being organised by Lawtel on 4 July.

Item 6: Research

6.1 DETR reported on Stage II of the Government study which is being carried out by BRE Ltd to review the research that has been done to date on aviation health matters. The aim of this work is to identify gaps in current knowledge and provide advice on possible future Government-backed research (Stage III). Stage II is likely to be completed in early June, and will be presented to the group.

6.2 BATA reported on a meeting organised by the World Health Organisation (WHO) to develop research protocols looking into the link between air travel and deep vein thrombosis. It had been agreed that WHO and IATA would co-operate on this issue, but work was still at a very early stage, and funding had not yet been discussed in any detail. IATA was organising a conference from 17-18 May on cabin health issues in general, which would include discussion of DVT.

6.3 DH said that Stage II of the Government backed study was likely to lead to a recommendation for further research into the link between air travel and DVT. The possibility of becoming involved in the WHO-backed work on the same subject should be considered. The Chair agreed, but felt that more information on the latter was required. BATA said that none of the health experts involved in the WHO work had yet produced completed research protocols. It was agreed that DH would contact the WHO to explore what research proposals were in the pipeline. The Chair invited airline representatives to take any suitable opportunities to let it be known that the UK Government might be interested in associating itself with WHO/industry research. The possibility of European Commission involvement was also mentioned. (Action DH)

Item 7: In-Flight Medical Emergencies

7.1 The Chair said that the Government response to the House of Lords' report undertakes to disseminate good practice in the treatment of in-flight medical emergencies. The issue had taken on a higher profile in recent weeks, with some press coverage and one parliamentary question on the recent US Government initiative to require all US carriers to carry external defibrillators. If airline representatives could provide information on current practice, the Group could consider how information might best be disseminated.

7.2 CAA explained the regulatory background on the carriage of medical equipment, set out in a Joint Aviation Requirement, and agreed to provide the Group with a short paper describing the minimum requirements. (Action CAA)

7.3 BATA explained that all UK carriers exceed JAA minimum requirements and that all long-haul flights carry external defibrillators, while most have access to a ground-to-air medical service. BATA members had also taken steps to ensure that crew were trained in the treatment of medical emergencies, whilst some were looking at the Tempus 2000 programme which allowed patient data to be transmitted via satellite to a ground-based medical team. In order for a group to have an overview of current practice, BATA agreed to provide information on the equipment carried by its main members. BAR-UK agreed to provide information on the medical kit carried by some major non-UK airlines. (Action BATA/BAR-UK)

7.4 AUC pointed out that Holiday Which occasionally published tables detailing the equipment carried by various carriers, and undertook to circulate copies of the most recent table to the Group. (Action AUC)

Item 8: Health Briefing

8.1 BATA said that some UK airlines (British Airways, Britannia) had already shown information material to DETR and provided examples of video and booklet briefings offered by other airlines (JMC, Air 2000). While it was a matter for individual airlines to decide how the information was presented, the content was broadly consistent. However, airlines were looking to the Government to provide advice on issues such as whether passengers should be advised to wear stockings to reduce risk of DVT, and for a definitive list of pre-disposing factors in the risk of DVT.

8.2 DH reported that they were in the process of consulting health experts and hoped to produce definitive advice (based on Box 4 contained in the House of Lords' 'Air Travel and Health' Report) which could be circulated for comments within the next month. (Action DH)

8.3 BATA had also been made aware of the "Know Before You Go" scheme, initiated by the Foreign and Commonwealth Office to promote health awareness in people travelling abroad. DETR would seek more information on this initiative. (Action DETR)

8.4 The Chair summarised by asking airline representatives to pass on to airlines the congratulations of the Group for the work done to date, in particular in relation to long haul travel. On a suggestion by the HSE he reminded them not to ignore the possibility of problems arising on shorter flights.

Item 9: Noise

9.1 The Chair explained that the task of the Working Group was to gather information on action taken to date, before considering if further research is necessary.

9.2 BAR-UK pointed out that it is necessary to distinguish between cockpit and cabin noise levels, and that aircraft manufacturers were often best placed to provide such information. The Chair agreed but was still interested in the work that airlines had done to date on noise levels. BATA was aware that research had been done, including some by Airbus which indicated that aircraft noise levels did not exceed legal workplace noise requirements - which, HSE pointed out, do not currently apply to aircraft. There is, however, a possibility that a forthcoming EU Directive on Physical Agents, including noise might apply to aircraft. HSE undertook to clarify and report back to the next meeting. (Action HSE)

9.3 BATA agreed to compile information stating Members' current practice in relation to aircraft noise, any research done to date on noise issues and any procedures which are applied. This would then be presented to the Group at the next inclusive meeting. (Action BATA)

Item 10: Any Other Business

10.1 BATA drew the meeting's attention advertisement produced by Scholl for stockings which were claimed to reduce the risk of DVT. The advertisement contained an endorsement from the Aviation Health Institute, the Director of which, Farrol Kahn, had been criticised by the House of Lords Report for "a lack of substance and erroneous statements". The Chair agreed that the credence given to the Aviation Health Institute by some parties was troubling, and said that the DETR Press Office took what appropriate opportunities it could to reinforce the Committee's findings. The AUC had also conveyed a similar message on several occasions.

Item 11: Date of Next Meeting

11.1 The next meeting of permanent members will take place on Wednesday 13 June 2001. The next inclusive meeting will be held on Friday 27 July.

MLD3

May 2001

Draft Mission Statement for the Aviation Health Working Group

The Aviation Health Working Group will meet on a regular basis and will work in partnership with other interested parties to give effect to the Government response to the House of Lords Inquiry into Air Travel and Health. Particular responsibilities identified in the response are to:

-Provide a forum for interested Government departments and agencies to consider issues relevant to aviation health;

-Provide an interface with the air transport industry, health experts and other interested parties on aviation health issues of mutual interest;

-Evaluate the need for research into issues related to air travel and health, and consider the role of Government in supporting such research;

-Ensure Ministers are kept informed and receive comprehensive advice on aviation health matters;

-Monitor developments that impinge on the health of those travelling by air.