Examination of Witnesses (Questions 1-19)
Dr Nigel Dowdall, Dr Mark Popplestone and Mr Roger
Wiltshire
26 JUNE 2007
Q1Chairman: Thank
you very much for coming to see us, and could I welcome members
of the public. There is an information note on this inquiry for
you if you wish to have it. It is easiest if we start by you introducing
yourselves, please.
Dr Dowdall: I am Dr Nigel Dowdall, I am Head
of Health Services for British Airways.
Mr Wiltshire: I am Roger Wiltshire, I am Secretary
General of the British Air Transport Association.
Dr Popplestone: I am Dr Mark Popplestone, I
am Head of Medical Services for Virgin Atlantic.
Q2 Chairman: Thank you for being
here. Would you like to make any opening statement or shall we
go straight into the questions?
Mr Wiltshire: My Lord Chairman, I would just
like to say a few words. Thank you for inviting us and we welcome
your inquiry. We here have been in the industry for many years
and were involved with the original inquiry in 2000 and ever since
then with groups such as the Aviation Health Working Group, so
we look forward to contributing and hope we can help you this
morning.
Q3 Chairman: Thank you. Let me ask
the first question then which is perhaps the main point that we
are trying to gather in this inquiry, and the question is what
progress have airlines made in improving flying conditions for
passengers and crew since 2000?
Mr Wiltshire: I am sure my colleagues will want
to add specific issues, but I believe that during the year 2000
the airlines made a considerable move on advising passengers on
health risks, in particular the need to do exercises, the risks
of DVT and a lot of the changes occurred during that year, so
that by the end of the year 2000 airlines in the UK flying long
haul services had plenty of information available for customers.
We have maintained that information and monitored it through the
period, including after reviewing the jointly funded study that
the industry funded together with the Department of Health, the
study into DVT perception in the public, and we have reviewed
our information following that work. We also now have a much more
modern fleet of aircraft in the UK fleet and as newer aircraft
come on stream in the future we see improvements in technology
which means more reliable systems and processes in the aircraft.
One issue I would like to raise is as regards passenger comfort,
which was an issue in the original inquiry. Since the year 2000
UK airlines have introduced product enhancements on long haul
services so that most airlines, charter and scheduled, now offer
a premium economy, or economy plus product, where passengers can
get additional legroom for a modest premium, but sadly that category
of product is defined as the high rate of air passenger duty and
since air passenger duty was doubled on 1 February it has had
an influence on that market; we find that very unfortunate for
passengers who wish to purchase at a modest premium some extra
legroom. We are talking to the Treasury and hope we can have that
product type categorised as a standard rate of air passenger duty.
Q4 Chairman: What are the consequences
of having it categorised as a premium product?
Mr Wiltshire: The long haul air passenger duty
was the lowest rate, £20, and the premium rate of air passenger
duty was £40 up until 1 February. Those rates have now doubled,
so for passengers purchasing this extra legroom they now have
to pay £80 each just in UK tax to take the privilege of that
product, and that is having an effect on the market, we believe,
and we feel it is appropriate for that product to be categorised
as a standard rate of air passenger duty rather than the rate
that applies to first and business class seating, which is an
entirely different product, often with beds or similar-size seating
areas.
Q5 Chairman: You say that the new
planes provide better facilities. Have there been significant
changes in, for example, the air supply systems in the newer planes?
Mr Wiltshire: The filtration systems now are
all up to the highest HEPA filter standards—again, my colleagues
can probably answer in more detail here. Some of the oldest planes
some years ago were still operating with lower quality filters,
but those oldest planes as I say have been phased out in the last
few years and so we are now operating a fairly consistent fleet
as far as air filtration is concerned.
Q6 Earl of Selborne: British Airways
in their evidence say that "the highest efficiency HEPA filters
are standard fit on all new commercial aircraft." Does that
mean that they are the most efficient filters and what would be
the filters that the older aircraft would have and how would they
compare?
Dr Dowdall: As an example the highest efficiency
HEPA filters, High Efficiency Particulate Filters are described
as 99.99% efficient and those are the standard of filter that
you would find, for instance, used in a hospital operating theatre
air circulation system. As an example of an older type of filter
that has been installed in the past on the Boeing 737, that was
a different type of filter, that was equivalent to approximately
a 95% efficient filter. Again, to put that in context, that is
the sort of standard of filter that you would expect to find in
a hospital intensive care facility, so although the highest efficiency
ones clearly give you the best efficiency, even the less efficient
ones actually compare very well in terms of environmental protection.
If you buy a new Boeing or a new Airbus that has a recirculation
system then it will come fitted with a standard 99.99% highest
efficiency filter.
Q7 Lord Haskel: What is the 0.1 that
gets through the filters?
Dr Dowdall: 0.01. I am not an engineer or a
technologist, but it has to do with how they measure the efficiency
of these particular types of filter. I guess it is a reflection
of the fact that no filter could be absolutely 100% efficient,
otherwise you would not get adequate airflow through. 99.99% efficiency
is extremely high and from the studies that have been done of
cabin air quality, if you look at the microbial load in the air—viruses,
bacteria, fungi—then the levels that you will find in cabin
air are lower than you would find in a typical office or domestic
environment. It is very, very good and more than adequate for
the task.
Q8 Lord Colwyn: I had imagined that
they are the sort of thing you might change weekly or monthly,
but in fact we heard last week that it is annually or bi-annually.
How come an efficient filter like that can last quite so long?
I do not understand that.
Dr Dowdall: I am told—again, I am not
a filter expert—that actually the filters become slightly
more efficient as they come into use in that you actually reduce
the size of some of the gaps within the structure of the filter
so that it becomes slightly more efficient. Clearly, the manufacturers
of the filters design them, assess them and they recommend a period
of maintenance and when they should be changed, and the airline
practice would be to change those filters in accordance with the
manufacturer's recommended schedules. The main impact you will
see of deteriorating performance is actually the impact on the
airflow.
Q9 Chairman: May I ask you how effective,
in your experience, has the Aviation Health Working Group been;
how frequently do you take part in its meetings and does it embrace
a sufficiently wide spectrum of interests and opinions?
Dr Dowdall: I was involved from when the group
was first set up. Putting it in context, 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 and the Aviation Health Unit, it is seen in the
activity that is taking place in Europe and in the world. In terms
of the Aviation Health Working Group its functions evolved; initially,
every other meeting was what was described as exclusive so it
did not involve the non-government partners, but that has recently
changed so that we attend all of the meetings. It has a very broad
spread, including government departments, passenger groups, staff
representatives, the TUs and the industry. It works very effectively;
I guess like most people I was perhaps slightly sceptical of how
it would work when it was first set up but I have been very impressed
with the work that has happened and that is a tribute particularly
to the chairs of the group who have driven the direction.
Mr Wiltshire: I have nothing to add to that.
Q10 Chairman: From your point of
view it is available to you and you can get to speak to them whenever
you want.
Dr Dowdall: Yes, it has created a very good
working tool and, with its research sub-group, is really driving
things forward.
Q11 Chairman: Mr Wiltshire, you mentioned
the literature but can I ask formally what changes have airlines
made to the literature and information that they provide to passengers
since our previous report?
Mr Wiltshire: The information is usually involved
in different channels, firstly on websites where passengers booking
that way can find out something about looking after yourself during
the flight, and the information contained in that sort of section
covers not just things like doing exercises and maintaining some
mobility in the aircraft, it is also to do with feeling well at
the end of the flight, so it is about not drinking too much, it
is about taking water and other general well-being issues. Almost
100% of airlines in their in-flight magazines that you see on
board the aircraft, there will be a piece about that including
diagrams on how to exercise. There is usually a reference in the
in-flight video if one is playing and on long haul flights there
are often different channels with in-flight entertainment and
there is usually a channel to do with health or well-being and
looking after yourself. That information is being reviewed, as
I mentioned earlier, following the inquiry into perception of
DVT and any references to the use of aspirin have been muted because
one of the conclusions of that research. The Department of Health
then went on and investigated further that perhaps people were
using aspirin far too often as some sort of way of ensuring they
did not have a problem when they took a long journey, and that
was not thought medically to be necessarily an appropriate response,
so we reviewed our inputs to ensure that we were not encouraging
people to take aspirin because there are of course side effects
for some members of the public.
Q12 Lord Howie of Troon: Smoking
has been banned on quite a number of flights. If alcohol is harmful
how would you think of banning it?
Mr Wiltshire: Excessive alcohol certainly is
an issue that the industry has to be aware of and it is known
that airlines will ban somebody travelling if it is obvious that
they are really worse for wear and they are going to cause a problem,
and obviously there have been some incidents in flights that have
been linked to excessive drinking. Whether those incidents have
actually been triggered originally by some frustration as that
person is a smoker and cannot smoke and decides to move to alcohol
as an alternative form of easing their journey is difficult to
say. The industry would be concerned if it was attempting to ban
too many activities by individuals. Many, many travellers enjoy
a modest alcohol intake at the beginning of a long journey—it
relaxes them it seems. They have been through quite a stressful
experience quite often at the airport on departure and it is a
way of relaxing, it is a way of feeling that they can now deal
with the journey in front of them and we would be quite loathe
to try and impose another ban on people.
Lord Howie of Troon: Can I express some
relief?
Q13 Chairman: Can we go back to aspirin
a minute? You said the information on aspirin was muted; does
that mean it is still there or has it been eliminated?
Mr Wiltshire: We leave it to people to get medical
advice from their doctor or medical adviser.
Dr Popplestone: The thing about aspirin is that
the evidence of benefit in prevention of DVT is extremely limited
and certainly what is significant about it, I would suggest, is
that the side effects outweigh any potential benefit.
Q14 Lord Colwyn: Having taken aspirin
for many, many years I was told at the meeting last week that
in fact it only affects arterial thrombosis, so for venous thrombosis
it has no value at all. I am medical and I did not know that,
and I imagine that that information probably does not get through
to the public.
Dr Dowdall: If I can make a comment, My Lord
Chairman, one of the great advances we have seen is the gathering
together of the international groups. One of the issues the Aviation
Health Working Group identified early on was the lack of consistency
of information to passengers, not just within the UK. There have
been huge strides made in trying to bring groups together to use
the same sort of information and to try and make sure that those
sources of information are accurate as far as they can be, where
the evidence is good. As an example, the World Health Organisation
has a publication on travel and health; the chapter on air travel
and health was revised in 2004 with direct involvement from IATA—its
medical adviser and members of the Medical Advisory Group. We
recognise that inconsistency of information is a problem and we
are doing our best to address that, eg by using common sources
of information whether it is at Department of Health level, the
individual airlines or at World Health Organisation level.
Q15 Lord Haskel: It is rightly believed
that the democratic profile and physical characteristics of the
flying public have changed. Passengers are getting older, they
are getting bigger, they are getting taller. Do the airlines monitor
or collect this data and, if so, how do they react to it?
Dr Popplestone: I do not think that the airlines
generally do collect data on that and they certainly do not collect
the ages or the dates of birth of travelling passengers to have
an awareness of what the specific age profile would be on a flight.
There is anecdotal evidence—and I stress it is anecdotal—that
would suggest that people with more complex medical problems,
for example, and more complex disabilities may be travelling,
and that may be the case but the overall numbers of medical clearances,
for example, that I see in Virgin and have seen previously at
British Airways I do not think have changed over time. In terms
of the general physiological gathering of the size and shape of
individuals, no, we do not really have a mechanism to be able
to collate that information.
Dr Dowdall: If I can come in there we do have
some indirect information in that we do obviously collect a lot
of information from passengers on their view of the travel experience,
and clearly an important factor in that and something that airlines
compete quite strongly on is comfort—was your seat comfortable
and is our seat more comfortable than our competitors. There is
therefore some indirect information drawn from that. Clearly,
the same issue affects all industries involved in transport, whether
you are talking about trains, buses or whatever, all have standard-sized
seats and demographic change is something that we need to be aware
of. At the moment there is not any indication that it is causing
us a major problem, and certainly in terms of customer satisfaction
the seats are still positively rated.[1]
Q16Lord Haskel: What about the space between
the seats if people are getting a bit taller; are people able
to adopt the brace position, for instance, which we were told
about last week?
Dr Dowdall: Most people can. Clearly there are
extremes in terms of the size of the population and you may get
some people who actually find that difficult; it is extremes at
both ends, as very short people may have issues as well. That
is one of the benefits of the so-called "premium economy"
that gives you a bit more legroom if actually that is what you
require. Another issue is to remember that pure seat pitch does
not actually give you an awful lot of information about how much
space the individual passenger has got. Seat design comes into
that as well and if we were purely to use seat pitch as a measure
of how much space the passenger has got, then I think that could
be quite misleading.
Q17 Lord Howie of Troon: Do the manufacturers
of seats have this information, the demographic information? If
the airlines do not gather it do the people who design and manufacture
seats gather this information?
Mr Wiltshire: We would have difficulty answering
that, you would have to ask seat manufacturers or perhaps we could
ask the seat manufacturers for you and pass the answer back. I
would imagine they understand general body shape and size and
have an understanding about whether they actually have information
suggesting a trend or a change in body dimensions. I do not know.
Q18 Lord Howie of Troon: Do you buy
a seat which an industrial designer has designed; that is really
what I am saying?
Dr Dowdall: Also, the passenger buys a seat
and if the passenger is not satisfied with the seat on the airline
they are unlikely to fly with that airline again and will go and
find somebody who they are more comfortable with. An interesting
example of that is a couple of years ago American Airlines thought
that with the change in demographics it may well be worthwhile
reducing the number of seats and they took a couple of rows of
seats out of their aircraft. They advertised it quite heavily
but, in fact, economically it did not stack up and they were forced
to reverse the decision and put the seats back in again, so price
was a bigger driver in that market than actually how much legroom
you had and the extra inch or couple of inches did not make much
difference to the travelling public who, after all, we are trying
to serve.
Q19 Lord Haskel: Irrespective of
price do the airlines feel that they have a duty of care, that
they should at least provide enough space for people to adopt
the brace position or that they should not be physically uncomfortable
during the flight. What about the low cost airlines, do they feel
that they have a duty of care to at least provide some sort of
minimum conditions?
Mr Wiltshire: Yes, I think they do, as all airlines
would feel they have a duty of care and they do operate within
the regulations. There is in this country a seat pitch regulation
and it does not apply in other states—no other state in
the world so far as we know has a regulation that specifies what
the minimum seat pitch should be, and all airlines as far as I
know operating in the UK operate above that minimum seat distance,
whether it be on short haul or long haul.
1 From customer surveys, British Airways collects
basic demographic data including age, gender, nationality and
country of residence. We do not collect data on physical characteristics,
such as height and weight. We track satisfaction with seat comfort
and this data is fed into any seat improvement work. A few customers
reference their height/size as a factor in discomfort, but not
enough to quantify effectively. We have very few complaints about
seat comfort-it tends to be a driver of satisfaction/dissatisfaction,
not complaints. Seating complaints tend to be about not getting
pre-allocated seating requests, etc. We use specialist ergonomic
agencies to assist us with seat trials, to ensure we understand
the comfort, safety, etc, implications of different seat widths
and pitches. The agencies recruit people of all shapes and sizes
to ensure that their findings are representative of the passenger
population. Back
| 
