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  • Cabin Air Quality Incidents Project Report

    Occupational Health Research Consortium in Aviation University of Oregon, Eugene, OR 97403 University of British Columbia, Vancouver, BC Canada V6T 1Z4 University of California- San Francisco, San Francisco, CA 94143 Association of Flight Attendants-Communications Workers of America, Washington, DC 20001 Airliner Cabin Environment Research Harvard University, Boston, MA 02115 University of California- Berkeley, Berkeley, CA 94720 Authors: Steven Hecker, University of Oregon, University of Washington* Laurel Kincl, University of Oregon Eileen McNeeley, Harvard School of Public Health Christiaan van Netten, University of British Columbia Robert Harrison, University of California, San Francisco Judith Murawski, Association of Flight Attendants -Communications Workers of America Jose Vallarino, Harvard University John D. Spengler, Harvard University Donald Milton, University of Massachusetts- Lowell Ira Tager, University of California, Berkeley Sarah Gale, University of California, Berkeley Julie Bradley, Harvard University Other Contributors: Timothy Ma, University of British Columbia Brian LaBrecque, Harvard University John Cornelius, Association of Flight Attendants- Communications Workers of America Helen Moss, University of Oregon Judy Guerriero, University of California, San Francisco Chris Witkowski, Association of Flight Attendants- Communications Workers of America John Balmes, University of California, San Francisco July 2014 Final Report *Corresponding author: Steven Hecker shecker@uw.edu

    mailto:shecker@uw.edu

  • NOTICE

    This document is disseminated in the interest of information exchange. The United States Government

    assumes no liability for the contents thereof. ___________

    This is the final version of the report initially submitted to FAA in

    June 2009 in fulfillment of FAA Research Grant No. 200505-G-014, "Cabin Air Quality Incident Monitoring and

    Reporting," This revised version responds to comments from FAA's internal review of August 2009. The FAA elected to not publish this report as an official Office of Aerospace Medicine technical report because it was submitted after the agency’s

    apparent deadline. Because it accurately reflects the research conducted to fulfill the FAA Research Grant listed above, it is

    available via www.ohrca.org in the interest of sharing the findings with the aviation health community and other

    researchers.

    http://www.ohrca.org/

  • iii

    CONTENTS

    List of Tables………………………………………………………………………………. iv List of Figures……………………………………………………………………………… v Abbreviations……………………………………………………………………… …….... vi Executive summary………………………………………………………………………. viii

    I. Introduction and Background……………………………………………………… 1 II. Study Implementation and Limitations …………………………………………… 2

    A. Study Design Changes……………………………………………………………4

    III. Flight Attendant Health Research…………………………………………………. 5 A. Introduction and Background………………………………………………….. 5

    B. Medical Case review and Diagnostic and Treatment Protocol………………. 5 C. Flight attendant health survey…………………………………………………. 10 IV. Cabin Air Exposure Assessment………………………………………………….. 34 A. Air Sampler Development and Testing………………………………………... 34

    1. van Netten Sampler Component Refinement and Finalization…………. 34 2. Electromagnetic Testing…………………………………………………... 34 3. Incorporation of CO Sensor into VN Sampler……………………………. 36

    B. Method Development For Collection And Analysis Of Air Samples Using the VN Sampler…………………………………………………………. 36 1. Engine Oil and Hydraulic Fluid Sample Analysis……………………….. 37 2. GC/MS Analysis of Tricresyl Phosphates In Air…………………………. 41 3. Inter-laboratory analysis for QA/QC………………………………………42 4. Environmental Chamber Testing of the VN Sampler……………………. 45 5. Flow Rate Measurement of the VN Samplers…………………………….. 50

    C. Collection and Analysis of In-flight Samples and Controls…………………….53 V. Overall Recommendations………………………………………………………………65 APPENDICES Appendix A: Exposure to Aircraft Bleed Air Contaminants Among Airline Workers: a Guide for Health Care Providers Appendix B: Quick reference guide for health care providers: health impact of exposure to contaminate supply air on commercial aircraft Appendix C: Flight Attendant Health Survey

  • iv

    LIST OF TABLES Table 1. Case Series – Acute health effects following exposure to contaminated bleed air. Table 2. Acute and chronic symptoms following exposure to contaminated bleed air. Table 3. Demographics of Union Health and Safety Representatives participating (3 focus groups:

    1 in Chicago and 2 in Los Angeles), n=18. Table 4. Descriptive Statistics of the Flight Attendants (FAs) surveyed. Table 5. Prevalence of health conditions reported by at least 15% of flight attendants. Table 6. Prevalence of Health Conditions in NHANES Survey (2005-2008) and Flight

    Attendants’ Health Survey (2007) with Standardized Prevalence Ratio. Table 7. The Relationship Between Job Tenure and the Prevalence of Health Conditions in Flight

    Attendants Adjusted for Age, Smoking, Education, Overweight. Table 8. Electromagnetic Test Results Summary. Table 9. Percent of TCP isomers per unit weight in oils and fluids as well as relative percent of

    each isomer to the total. Table 10. GC/MS Conditions: Agilent Technologies GC/MS 5973. Table 11. Retention times using Single Ion Monitoring (SIM). Table 12. Mean (ng/filter) and percent relative error (%) of the sample results for interlaboratory

    comparison of spiked filters. Table 13. Results from round 1 of chamber experiments. Table 14. VN and SKC sampler results from round 2 of chamber experiments. Table 15. Battery configurations with average flow rates and sampling durations and standard

    deviations (sd). Table 16. Results of the in-flight duplicate sampling in ng per filter. Table 17. Estimation of concentration of in-flight duplicate sample results in µg/m3 (corresponds

    to Table 16). Table 18. Select self-reported in-flight condition results from the duplicate samples.

  • v

    LIST OF FIGURES Figure 1. Flow chart for sample selection and distribution of the survey. Figure 2. Percentages for varying levels of service by airline. Figure 3. Hours Worked in Past Month By Airline (n=3,999). Figure 4. Percentage of FA Working Aircraft Types in Previous 12 months. Figure 5. Percentage of flight attendants according to number of injuries (N=3,667). Figure 6. Distribution of the types of work-related injuries/illnesses reported in last year. Figure 7. GC/MS Single Ion Chromatograms of TCP (m/z 368) in Jet Oil and Hydrualic Fluids. Figure 8. Chromatograms of TCP isomer standards and constituents in Mobil II jet engine oil Figure 9. Fluka Chemika TCP standard solution – diluted with ethyl acetate and run for retention

    time checks Figure 10. Arrangement of VN and SKC sampling systems for round 1 testing Figure 11. Mobil II released and the TCP concentration detected with the VN sampler Figure 12. VN sampler flow rates for various configurations

  • vi

    ABBREVIATIONS

    As used in this report, the following abbreviations/acronyms have the meanings indicated

    ABBREVIATION MEANING ASHSD ----------------- Air Safety Health and Security Department ACER ------------------- Airliner Cabin Environment Research ATA --------------------- Airline and Air Transport Association AQ ----------------------- Air Quality ABS---------------------- Acrylonitrile butadiene styrene AOEC ------------------ Association of Occupational and Environmental Clinics AFA --------------------- Association of Flight Attendants AFA-CWA ------------- Association of Flight Attendants-Communications Workers of America APU --------------------- Auxiliary power unit BMI --------------------- Body mass index BLS ---------------------- Bureau of Labor and Statistics CO ----------------------- Carbon monoxide CDC --------------------- Centers for Disease Control and Prevention COPD ------------------- Chronic Obstructive Pulmonary Disorder CAMI ------------------- Civil Aeronautical Medical Institute CVD --------------------- Cardiovascular Disease ESD --------------------- Electrostatic Discharge ER ----------------------- Emergency Room FAA --------------------- Federal Aviation Administration FA ----------------------- Flight Attendant GC/MS ----------------- Gas chromatography/ mass spectrometry GED -------------------- General Education Diploma GCAQE ---------------- Global Cabin Air Quality Executive GC ----------------------- Gas chromatography HSPH ------------------ Harvard School of Public Health HCP ------

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