Disease outbreaks and other matters of airline medical interest

We start with cabin air research:

- In response to the question: “Is there evidence of exposure to chemical contaminants in cabin air that could have long-term health impacts, either from acute exposures or due to long-term low level exposures including mixtures, e.g., of volatile organic compounds (VOCs)?”, the UK Committee on the Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) issued earlier in April a Statement on Aircraft Cabin Air Quality. You can read it here: https://cot.food.gov.uk/sites/default/files/2024-04/Aircraft%20Cabin%20Air%20statement%202024%20Acc%20V%20SO_0.pdf

You will also find a non-technical summary here: https://cot.food.gov.uk/Statement%20on%20Aircraft%20Cabin%20Air%20Quality%20%E2%80%93%20Non-technical%20Summary

The Committee assessed the new evidence, since their previous 2007 Statement. “Overall, the COT concluded that the concentrations of the chemical contaminants (organophosphates, VOCs including as mixtures, carbon monoxide and CO2) reported in aircraft cabin air are unlikely to cause adverse health effects in aircrew following acute or long-term exposures. However, there is still limited information about the levels of chemicals in cabin air following smoke or fume events.”

- More specifically in relation to smoke or fume events, a team led by researchers from the Ruhr University Bochum Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, published their work – also known as the FUSE II study - on biomonitoring of VOCs and organophosphorus (OP) flame retardants in commercial aircrews after “fume and smell events“. They assessed exposure to VOCs and OPs in 375 aircrew members after self-reported “fume and smell events”, as well as in 88 persons of the general population. Twenty blood and urine parameters were analysed. They concluded that “comparative VOC and OP analyses in biological samples of a large number of aircrew members and controls suggest that exposures are similar in both groups and generally low”. You can read the article in full here: https://authors.elsevier.com/sd/article/S1438-4639(24)00062-2

- In the same field, here is a reminder of the ANSES (French Agency for Food, Environmental and Occupational Health & Safety) report published at the end of last year - an extensive review of the scientific literature, as well as of the grey literature and of health data from the French national occupational disease surveillance and prevention network. The ANSES reached the same conclusion as the US National Research Council (NRC) in 2002: “there is a low level of evidence for the existence of a syndrome specifically linked to exposure to various polluting substances or breakdown products from aircraft engine or hydraulic fluid leaks”. More research is ongoing.  Short summary in English here: https://www.anses.fr/en/content/health-flight-crew-members . If you would like to review the details, look up the Medical Contact Group email of 20-Dec-2023.

 

From Airfinity’s curated analysis of various health and media sources and from the ECDC (European Centre for Disease Prevention and Control) Weekly Communicable Disease Threats Report:

  • The respiratory infectious disease season has begun in the Southern hemisphere with influenza rising in countries like Brazil, Chile and New Zealand.  Meanwhile, in the Northern hemisphere, in countries like the US, the respiratory diseases burden continues to decline.
  • The H5N1 virus has been confirmed in 34 dairy cattle herds in nine US states since late March, as well as in one person in Texas. One dog in Canada and six cats in the US have tested positive for H5N1. There is currently no evidence of human-to-human transmission.Recent data suggests that the virus circulating among US cows likely originated from a single spill-over event from birds to cows in late December 2023.
  • Measles continues to be reported globally. 
  • Fiji has officially declared a dengue outbreak, while the Maldives are experiencing an outbreak of chikungunya.
  • A virulent monkeypox clade I strain that seems to spread through sexual contact has caused a cluster of infections in a conflict-ridden region of the Democratic Republic of the Congo. The DRC is also contending with the spread of other diseases, such as cholera. The combination of disease and humanitarian crisis means there could be  “substantial risk of outbreak escalation beyond the current area”.
  • Malaria and typhoid were after all the diseases behind the fatal outbreak of an ‘unknown pathogen’ in northern Nigeria earlier in April.

 

Events:

Chicago, USA

- IAMA International Airline Medical Association Scientific Meeting, May 4th – programme here: https://iama-assn.org/news/187-77th-annual-scientific-meeting

- AsMA Aerospace Medical Association Annual Scientific Meeting, May 6th-9th - https://www.asma.org/scientific-meetings/asma-annual-scientific-meeting/asma-94th-annual-scientific-meeting-chicago,-il

 

Lisbon, Portugal

- ICAM 2024 International Congress of Aerospace Medicine, October 3rd-5th – new and final abstract submission deadline is May 19th - www.icam2024.com

- Aviation Health Conference, October 7th-8th – programme here: https://quaynote.com/conference/aviation-health-conference-24/


Dr Rui Pombal

IATA Medical Advisor