Memorandum by Virgin Atlantic
Virgin Atlantic was pleased to respond to the
previous consultation process prior to the publication of Air
Travel and Health and we welcome this opportunity to respond
to the follow-up inquiry by the House of Lords Science and Technology
Select Committee.
Since the original report, much progress has
been made. The Department for Transport's Aviation Health Working
Group has been effective in raising and addressing issues of concern,
promoting research and making recommendations. The establishment
of the Aviation Health Unit is also a welcome innovation which
has been able to provide an expert, objective and impartial perspective
on aviation health. There are areas that are still "work
in progress", but the nature of scientific research means
that it would be unrealistic to expect all the questions to have
been resolved.
The effects on health of travelling by air have
at times resulted in disproportionate levels of concern within
the media. Every day, millions of people of varying ages and states
of health travel by air, sometimes for very long distances, without
any trouble at all. Of course no mode of travel is risk free and
every year a small minority of our passengers do experience some
form of ill health, but very few of these are caused by the aircraft
environment itself.
Last year Virgin Atlantic carried 4.94 million
passengers, out of which there were only 28 significant reported
medical emergencies, many of these in passengers with existing
(and undisclosed) medical problems. Virgin Atlantic takes its
responsibility towards the health of both its passengers and staff
very seriously and actively promotes good health via our website,
in-flight media, reading material as well as our dedicated Special
Assistance Team and ground to air medical advice. It is clearly
not in our interest to endanger the health and safety of our passengers.
A HIGHER PROFILE
FOR HEALTH
1.15 Paragraph 8.41
Virgin Atlantic notes the recommendation by
the Committee that the Department of Health should monitor the
use of the revised version of Health Information Overseas Travel.
As this document was published in 2001, we would welcome an updated
version, and recommend that it is reviewed more often than at
five year intervals.
DEEP VEIN
THROMBOSIS
1.16 Paragraph 6.25
A number of research studies have been published
in recent years, including those conducted under the auspices
of the WRIGHT study (See Annex A). Overall these support the view
that the risks of DVT and flying are similar to those associated
with other forms of long distance travel. Furthermore, it appears
that any increase in risk is principally in those passengers with
other risk factors. Research into the effectiveness of preventive
measures would be useful but should also include train, coach
and car passengers.
1.17 Paragraph 6.29
Virgin Atlantic already provide information
on DVT via our Special Assistance section on our website. If a
passenger indicates to our Special Assistance Team that he or
she has previously experienced a form of disorder relating to
circulation, written information is provided on the prevention
of blood clots. This information advises passengers to exercise
their legs regularly on the aircraft; to avoid falling into a
deep sleep; avoid sleeping pills and drink plenty of fluids but
to avoid excessive alcohol consumption. If they have specific
risk factors we suggest that they consider wearing professionally
fitted below knee compression stockings; and they are encouraged
to discuss with their GP whether other measures are needed to
avoid the risk of Thrombosis. Information to passengers regarding
their health, including DVT, is also available on our in-flight
entertainment system and in-flight publications, brochures provided
at check-in, inflight publications and onboard announcements by
the crew.
AIR QUALITY
1.26 Paragraph 5.50
Virgin Atlantic operates and maintains its aircraft
in accordance with the manufacturers' and regulator's requirements.
The Committee's recommendation for airlines to collect cabin environment
data would not be quite as straightforward as is suggested. Such
measurements needed to monitor the data are complicated as evidenced
by the long deliberations of the Aviation Health Working Group
into allegations of contaminated cabin air.
We support the efforts of the Department for
Transport Aviation Health Working Group and the Committee on Toxicity,
and we believe it would inappropriate to take this recommendation
any further until they have reported their findings.
1.29 Paragraph
4.47
Virgin Atlantic already has ozone converters
on all our aircraft and we have done so for many years.
TRANSMISSION OF
INFECTION
All Virgin Atlantic aircraft have first aid
and emergency medical kits including equipment such as intravenous
sets, catheters, airways and emergency drugs. Unlike many other
airlines, Virgin Atlantic supplies bottled oxygen free of charge
to passengers with medical conditions that require it.
1.31 Paragraph 7.33
Virgin Atlantic has 24-hour onboard specialist
medical advice via satellite, telephone or radio communications
to MedLink (MedAire), based in Phoenix, Arizona. Medaire have
many years experience in providing remote medical advice and are
regarded as a leader in the field. Medical professionals and crew
members working under their instructions are indemnified by the
airline (although one of the major UK medical indemnity providers
has no recorded case where a medical professional has been sued
by a passenger). Virgin Atlantic ground staff are fully trained
to recognise ill passengers. Guidance on this is also supplied
in Virgin Atlantic's Air Service Manual.
1.32 Paragraph 7.22
It is Virgin Atlantic's practice to keep air
conditioning in operation on the ground whilst passengers are
onboard wherever possible. It should be noted that to do so requires
the auxiliary power unit to be running or to have a supply of
ground power.
1.33 Paragraph 7.40
Virgin Atlantic already holds extensive passenger
information via the APIS and PNR data systems. APIS data contain
passengers' passport information (some countries, such as the
US, require more detailed APIS data that include a passenger's
first night of stay) and PNR data contain information of the passengers
booking. Any notification by a passenger of a pre-existing health
condition would also be included within the PNR data. Virgin Atlantic
holds both APIS and PNR passenger data for at least five years.
In our view there is no need to add an extra system of data collection
when there is already a more than adequate system in place.
AIR FILTRATION
1.36 Paragraph 7.26
Virgin Atlantic aims to ensure that passengers
onboard its aircraft receive the highest quality of air practicable.
All of our aircraft ventilation systems meet the Civil Aviation
Authority's requirements and all our aircraft have High Efficiency
Particulate Air filters (HEPA) as standard. Re-circulated air
is passed through a HEPA filter to remove 99.9% of all pathogenic
bacteria and viruses. The filter manufacturer states that HEPA
filters will remove viruses (including the influenza virus) and
bacteria (including SARS and TB). The design of modern aircraft
air conditioning systems mean that airborne circulation of infectious
diseases through the cabin is extremely unlikely and there is
no evidence to support the suggestion that such filters cause
cross-infection. Of course direct person to person spread to adjacent
passengers is still possible in common with any other public place.
IN -FLIGHT
MEDICAL EMERGENCIES
1.41 Paragraph 7.77
We see no need for further regulation to make
it compulsory to carry Automatic External Defibrillators (AEDs).
Virgin Atlantic has chosen to exceed all required standards for
medical kits for passengers and for training of staff. Virgin
Atlantic was one of the first airlines to place defibrillators
on all its aircraft in 1992. We do not believe that the provision
of AEDs should become mandatory and the decision should remain
with the airline.
Virgin Atlantic provides an excellent standard
of training in first aid, emergency life support, occupational
health issues and aviation physiology. All new cabin crew complete
a five-day training course and receive recurrent training throughout
their career. In our view, crew training and expert ground-to-air
medical advice are probably the most important and beneficial
aspects of in-flight medical care.
RESEARCH
1.43 Paragraph 9.3
Research that has already been undertaken on
DVT has been helpful and has assisted in putting the risk of DVT,
associated with flying, into perspective.
1.44 (b) Paragraph 9.5
The option to pre-book seats with additional
legroom is not always appropriate. Priority for such seats is
given to people travelling with infants and people with significant
disabilities. The allocation of exit row seats is only given to
people who are physically able to assist in an emergency.
On a separate point, there is anecdotal evidence
of passengers being offended by questions asked about their physical
health. For example, legislation in the United States prevents
our staff from asking direct question of this kind. In order to
avoid such problems, it is far better to make information freely
available to passengers, not just by airlines, but airports, governments
and other such relevant bodies.
1.46 Paragraph 9.8
Virgin Atlantic actively promotes good health
to our passengers. Onboard all Virgin Atlantic flights an announcement
is made by cabin crew encouraging passengers to move their legs
and stretch frequently. Passengers are informed that they can
find tips on seated exercises and jetlag in our in-flight publication.
We also encourage our passengers to walk around the cabin once
the fasten seat belt signs have been switched off and remind them
in doing so to be careful of any unexpected turbulence.
CONCLUSION
In Virgin Atlantic's view, our responsibility
is to inform our passengers and our staff on matters of health
without sensationalising the issue. As the statistics regarding
medical emergencies show, the overwhelming majority of passengers
travel by air safely without cause for medical concern. Therefore
it is our conclusion that airlines' efforts are best served by
targeting the passengers who have greater susceptibility to medical
problems rather than applying a crude blanket approach. At the
same time, Virgin Atlantic will continue to encourage all our
passengers and staff to take care of their health whilst onboard
our aircraft.
18 June 2007
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