The Cabin Air Quality Issue

Editorial, by Jon L. Jordan, MD, JD

Issues related to air carrier cabin air quality were raised recently by an article that appeared in the June 6, 1993, issue of the New York Times. The article cited complaints received from flight attendants and passengers regarding air carrier cabin air quality and symptoms allegedly related to air travel. The complaints seemed to focus on the operation of newer generation aircraft and recirculation of cabin air.

In a subsequent New York Times article, it was revealed that the Centers for Disease Control and Prevention (CDC) is conducting an epidemiological study of two airline passengers and one flight attendant known to have tuberculosis. There is concern whether the disease might have been spread from the flight attendant to the passengers and other crewmembers.

Studies of air carrier cabin air quality have not demonstrated a unique or significant health hazard for either passengers or crew. When compared to known air quality in many homes, office buildings, or other enclosed spaces where people congregate, the air quality in air carrier operations appears to be equivalent or superior.

Spread of communicable diseases in U.S. air carrier operations has not been documented as a major problem. An incident some years ago involving an aircraft that was held on the tarmac in Homer, Alaska, for several hours without ventilation was reported revealing the spread of influenza from one passenger to others. This was, however, a unique circumstance. Although there is anecdotal information regarding persons who developed upper respiratory infections after flight, studies pinpointing suboptimal cabin ventilation as a factor in spreading disease do not exist. Other factors may play a role in the symptoms claimed by travelers— including stresses related to travel, time zone changes, fatigue, food and alcohol intake, etc. The finding in one study of low numbers of bacterial aerosols and fungi does not support contentions that air carrier cabin air quality provides the opportunity for dissemination of communicable disease. This study included the assessment of air quality in newer generation aircraft that recirculate air.

We are following the CDC study now underway concerning the transmission of tuberculosis and have requested FAA involvement in the study. Additionally, the FAA is sponsoring a study through the National Institute on Occupational Safety and Health that will include the measurement of some cabin air quality parameters.

While previous studies suggest minimal (if any) adverse health effects from cabin air exposure since the ban on smoking went into effect, we intend to continue to monitor the development of data on cabin air contamination to further ensure the health of the flying public.

JLJ