Select Committee on Science and Technology First Report


Air Travel and Health: an Update

CHAPTER 1: Introduction

Impact of the original report—overview

1.1.  At the end of the 1990s public concern about the health effects of air travel became increasingly acute. At the same time the evidence for such health effects was still largely anecdotal and heavily influenced by a number of widely reported cases of deep vein thrombosis (DVT)[1]. The state of scientific knowledge of aviation health issues was inconsistent and there was no strategy underpinning research. In response to this state of affairs we set up an inquiry in November 1999 to look into all aspects of air travel and health. We heard evidence from a wide range of organisations and individuals representing manufacturers, airlines, cabin crew, passengers and Government departments. Our report was published in November 2000[2].

1.2.  The report was well received and, in the words of the British Medical Association (BMA), "is generally agreed to be the most authoritative and detailed study of aviation health issues yet written"[3]. The impact of our report was not limited to the United Kingdom. Dr Nigel Dowdall, Head of Health Services at British Airways, told us "the original House of Lords report has stimulated a much greater interest in passenger and crew health, and that is seen not just in the Aviation Health Working Group (AHWG) and the Aviation Health Unit (AHU), it is seen in the activity that is taking place in Europe and in the world" (Q 9).

1.3.  The Government response to the original report was positive and congratulated the Committee for "bringing together the full range of health issues … an exercise which to the Government's knowledge has not been previously attempted elsewhere." They also pledged to "work closely with passenger organisations, medical experts and the industry to ensure that the range of issues the Committee has identified receive the attention they merit"[4].

1.4.  The response set out ambitious plans for the future, including bringing together professionals and Government departments to oversee aviation health in the form of the AHWG. The Government also endeavoured to stimulate and encourage research in this area which until then had been neglected. Their first step was to commission a study to identify areas of concern and gaps in knowledge with a view to targeting future research.

1.5.  More recently, the Government changed the law in 2006 to give the Secretary of State the "general duty of organising, carrying out and encouraging measures for safeguarding the health of persons on board aircraft"[5], thus addressing a regulatory void in aviation health. The Civil Aviation Act 2006 also amended the functions of the Civil Aviation Authority (CAA) to include responsibility for the health of all persons aboard aircraft, not just crew.

1.6.  The impact of our report on commercial airlines was also significant. Most airlines updated the information they gave to passengers on fitness to fly and the risks associated with air travel for those with existing medical conditions. Some airlines also included advice on the prevention of DVT on their inflight magazines and as part of their safety briefing prior to or shortly after take-off. High efficiency particulate air (HEPA) filters, although not yet mandatory, are now fitted as standard on most aircraft and the majority of long-haul airlines carry automated external defibrillators.

Reasons for the present inquiry

1.7.  The previous section shows that much has changed, largely for the better, since 2000. Yet public concerns over the health effects of air travel remain high. To this day the Committee regularly receives correspondence on aviation health from individuals, pressure groups and charities. For instance, at the end of 2006 we received a letter from the Work-related Death Advice Service, a charity funded by the Joseph Rowntree Charitable Trust, which provides advice to families bereaved by work-related deaths. The letter claimed that a number of key findings in the Committee's original report—in particular, that there was no regulatory body willing to take responsibility for protecting passenger health—had still not been addressed.

1.8.  There have also been a number of reports in the press of alleged contaminated air events affecting the health of pilots and passengers. Two major health threats, the outbreak of severe acute respiratory syndrome (SARS) in 2002-03 and the increasing threat of an influenza pandemic since 2004, have focused attention on the role of air travel in the spread of disease.

1.9.  At the same time the number of people travelling internationally is increasing every year. According to statistics issued by the World Tourism Organization, international tourist arrivals exceeded 800 million in 2005, of which 45 percent had travelled by air[6]. The advent of ultra long-haul services on wide-body aircraft will enable airlines to carry larger numbers of passengers in flight for longer periods. With the expansion of low-cost airlines domestic air travel within the United Kingdom has also increased dramatically in the last few years. There has also been an upsurge in air travel amongst older people.

1.10.  The Committee therefore decided that the time was right to revisit the subject and examine what progress had been made since 2000 in the form of a short follow up inquiry.

1.11.  In Chapter 2 of this report we enumerate the changes in regulatory arrangements since 2000. Chapter 3 describes the different research projects that have taken place since the original inquiry and in Chapter 4 we tackle the issues that are still pending and new areas of concern.

1.12.  Our 2000 report was very comprehensive, and in the course of this shorter follow-up we have not been able to cover all issues raised at that time. Where an issue referred to in 2000 is not brought up in this report it is because we have not received any new evidence in that area, not because we do not regard it as important.

1.13.  We issued a call for evidence which is reprinted in Appendix 3. We received substantial amounts of written evidence from airlines, manufacturers, unions and pressure groups. Written evidence was supplemented with oral evidence heard at three public meetings held in July. We also received many personal accounts from pilots and others who believe they have suffered ill health following contaminated air events. Such contributions, although we have not treated them formally as evidence, are summarised in Appendix 5 and can be viewed by appointment in the Parliamentary Archives.

Acknowledgements

1.14.  The membership of the Committee is set out in Appendix 1. We are grateful to those who submitted written and oral evidence, who are listed in Appendix 2. We launched the follow up inquiry with an informal seminar held on 21 June 2007, a note of the seminar is given in Appendix 4. We are very grateful to all participants in this event

1.15.  Our Specialist Adviser for this inquiry was Dr Michael Glanfield, Aviation Medicine Specialist and Engineer. We are grateful to him for his expertise and guidance throughout our inquiry. However, the conclusions of this follow-up inquiry are ours alone.


1   We use the term DVT in this report as it is the initial deep vein thrombosis that may be related to the aircraft cabin environment. Venous thromboembolism (VTE) is a complication which occasionally arises from DVT and this term is used in some of the evidence. Back

2   Science and Technology Committee, 5th Report (1999-2000): Air Travel and Health (HL 121-I). (Hereafter referred to as Science and Technology Committee Air Travel and Health 2000).  Back

3   See http://www.bma.org.uk/ap.nsf/AttachmentsByTitle/PDFFlying/$FILE/Impactofflying.pdf Back

4   See http://www.dft.gov.uk/transportforyou/airtravel/safety/airtravelandhealthgovernment6189 Back

5   Section 8, Civil Aviation Act 2006 Back

6   See http://www.unwto.org/media/news/en/press_det.php?id=621 Back


 
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