Cabin Air Safety/Aerotoxic Syndrome

Rachael Maskell Excerpts

Thursday 17th March 2016 Westminster Hall

[Rachael Maskell (York Central) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Mrs Gillan. May I also congratulate my hon. Friend the Member for Stalybridge and Hyde (Jonathan Reynolds) on opening this debate so well? All the contributions have been incredibly positive in addressing this important issue. I, too, was at the meeting. It was humbling to hear from Mr Bass in January, when he presented us with a moving account of what happened to his son Matt, who died so tragically at the age of just 34. He deserves answers; he deserves action.

I, too, declare an interest as a member of Unite and a former national official of the union, but I also had a dual career. I was a clinician and worked in the interface between respiratory and neurological medicine, so I very much understand the clinical presentations that have been described by many cabin crew staff.

Matt had spent 10 years as a flight attendant. He was a young man. Following a shift, he had gone out to socialise with his friends, like so many others. He was fatigued, so he went to rest on the sofa. He never woke up. In fact, the organophosphates that he was exposed to during his career had caused him to feel unwell for some time. He was not to know why; he was not to know that they could kill him. The job he loved could have been slowly poisoning his system. We know this is true for the 61 cases that Unite is currently pursuing. As the hon. Member for Crawley (Henry Smith) said, this could well be a global issue; therefore, the number of cases is unknown.

[Margaret Ferrier]

Does the hon. Lady agree that, in addition to needing greater evidence-gathering, we should perhaps develop routine blood testing to measure the effects on cabin crew?

[Rachael Maskell]

It is important that proper screening is introduced—obviously the methods of screening need to be determined—thereby ensuring that cabin crew staff have proper occupational health support. The availability of those health services is vital.

We have also heard how long these symptoms have been recognised in the aviation industry. Indeed, my research showed that it was realised in 1954 that using air in this way with jet engines can result in gases escaping and coming into planes’ air systems, so we can establish that this has been recognised as a long-term issue, whatever date that was first known. We have also heard today about the report from the senior coroner, who has clearly established, as a matter of fact, that organophosphates are present in aircraft cabins and therefore can have a detrimental impact on the health of those who occupy that space.

It is important to understand who this issue could affect. We have talked about the cabin crew staff, but pilots and frequent fliers could also be exposed to the cumulative risk from such gases. Also, we are talking not just about the civilian airline industry, but about what is happening with military aircraft, where people are already putting their lives on the line. Could there be a risk for our service personnel as well? It would be interesting to know what work is being done to protect members of the RAF.

Before moving on, I want to thank the Unite the union health and safety reps, who are at the forefront of taking forward these issues, many in their own time, but all serving their fellow colleagues day in, day out, asking very difficult questions of their employers. It is to be regretted that they have been unable to find an industrial solution to this problem or get a direct response from the airline industry. That is why it is so important that they brought to the attention of parliamentarians the plight of people working in the industry. It is absolutely right that we support them in that. Indeed, the way in which this serious issue of concern was raised and presented to parliamentarians shows—if I may say so in this debate—a really responsible use of the political levy, which is what unions continually do. We should note that the current attack on the trade union political levy is totally inappropriate, because without it we might not be having these kinds of debate in this House.

I will now return to the matter under consideration. What is really shocking about this debate is that we are talking about a safety-critical industry—one that works to ensure the greater safety of those who work in and use it. In such a safety-critical industry, where lives could be put at risk, we therefore need to ensure that measures are taken as a matter of urgency. I know there has been a long, drawn-out debate, but this is a matter of urgency, because it may only take a pilot to be poisoned during a journey for there to be fatalities. We already understand that lives have been lost, but how many more need to be taken before action is taken? Therefore, I urge that we move forward in addressing this issue.

We know that there are poisonous gases that we experience in all sorts of places in our environment. The complete, holistic impact that that has on our lives is not yet understand, but what has been brought to the fore is the fact that these fume events are occurring frequently. I, too, had the statistic of one in 100 instances, which I share with my hon. Friend the Member for Heywood and Middleton (Liz McInnes), but the research suggested there could be even more. None of us know, because we do not have the detection systems to give us that information. What we do know is that the impact is very serious indeed.

The toxicity of organophosphates inhibits enzymes. That inhibits the neurotransmitters in our nervous system and at the neuromuscular junctions from operating fully, and that is the reason for some of the symptoms we see, such as drowsiness, along with some of the neurological impact and the impact on the autonomic nervous system. Our red blood cells, too, are affected, so exposure, as we would expect, will affect people in different ways, whether because of their genetic make-up, or even their body mass index or other factors. The important thing to do is to carry out research so that we have a good understanding of why people experience the different symptoms.

The symptoms can range from nausea and other gastroenterological conditions, through respiratory problems to the fatigue-type syndromes—the sickness syndromes—that are typically experienced. Often, people would not relate that to their work environment, and might think that they just feel under the weather, but continual exposure to such risk can build up toxicity over a period of time, thereby causing neurological injury.

We know—we have heard about this in quite a lot of detail—how those gases come into aircraft cabins, but what stood out for me was that it is often because of the failure of the seals on aircraft. Therefore, it is important that we ensure that the maintenance programmes of these aircraft are brought into check, because we have also heard how developments in the 787 Dreamliner aircraft have shown that that does not have to be the case with new designs.

I want to conclude by listing some of the things that I believe could be done to improve the aircraft environment for staff and public. First, as we have heard, there is monitoring. Monitoring devices would not be an expensive way of getting information and also ensuring that staff are kept safe as they go about their daily duties of keeping us safe in aircraft. I make a plea that we should put proper monitoring devices on aircraft, but also ensure that there are proper alerts when fume events happen, so that cabin crew can take the appropriate action to safeguard themselves and, obviously, the people they are there to serve.

We have also heard about reporting, which is so important. We know that it is absolutely at the centre of health and safety legislation, so that we can understand the prevalence of an issue. I would therefore ask that reporting be put at the forefront. We have also heard about the independent inquiry—which is so important as well—and the need for research into the impact of toxicity on individuals. I would also like to ask about the opportunities for greater engineering development. We know that filtration systems can be developed to filter out such air, so I would urge the Minister to make resources available for research into this area, to develop filtration systems that can provide the protections we need on existing aircraft, but also to look at the design of future aircraft.

I have already mentioned the need for good health checks and making sure that occupational health support is made available for staff, but we also need to ensure that the public are aware of the risks as they take their flights, so that they are conscious, if they detect any symptoms themselves, of what support they need, should such an occurrence arise. Finally, we know that the oxygen supply in cabins comes mixed with cabin air, which could well be toxic. Is it possible to look into how to get cleaner air into that oxygen supply, so that, should there be a serious escape of fumes, we know that we have a safe source of air to inhale during the flight?

Matt Bass was one of so many people in the airline industry who put our lives ahead of their own, day to day, serving us. Tragically, he lost his life. I do not want there to be another like Matt Bass, so I urge positive action today.

--- Later in debate ---

[Mr Goodwill]

Research is ongoing, not least through the European Aviation Safety Agency, but the levels of OP concentration in situations where no fume event has occurred—which have been measured widely—have been found to be no greater than they are in this Chamber or any domestic location. They are very small background levels, as one would expect. Particularly given the sensitivity of some of the testing that can now be carried out, it is not difficult to find OPs almost anywhere.

As a toxic mechanism for the reported illnesses was found to be unlikely, a nocebo effect was considered a plausible alternative explanation for the symptoms. A nocebo effect can be defined as a detrimental effect on health produced by psychological or psychosomatic factors—for example where a subject develops symptoms as a reaction to a situation that he or she perceives as dangerous or hazardous. However, neither option could be proved beyond doubt given the available data; but we know that the nocebo effect happens in other circumstances. I hesitate to give this example from my own experience, but when I was a child my mother would serve us a cooked breakfast and after we had finished she would say, “I hope those sausages were all right. They were well past their sell-by date,” and one felt a feeling in one’s stomach. It is not the same thing, but it shows how psychological effects can pass into physical effects. That is one of the theories put forward by the scientists looking at the matter. The nocebo is an established psychological and medical situation.

[Rachael Maskell]

The Minister is being generous with his time this afternoon. What I want to know is what is behind the research. What about the cumulative impact of constant exposure to instances of gases being released into the cabin?

[Mr Goodwill]

I am going to come on to the frequency of fume events. I think none of the toxicologists or other scientists involved in the projects consider that there is a risk in the normal background level of chemicals in an aircraft cabin. As I have said, those are similar to the levels found in any other setting in the UK. The fume events are what we need to look at, and I will be discussing a little more evidence that I have been given about the frequency of those events.

As a toxic mechanism could not be categorically ruled out as the cause of the symptoms, the Committee concluded that more research would be beneficial. It stated, however, that it would be necessary to balance the likelihood that the further research will usefully inform further management of the problem against the costs of undertaking the research. There are various aspects of the issue to take into consideration, including the results of the research that has been undertaken and the unpredictability and rarity of the fume events. I said I would have some information on that. The Civil Aviation Authority operates a mandatory occurrence-reporting scheme and, contrary to what we may have heard during the debate, the CAA is determined that every type of occurrence should be reported. Indeed, if airlines do not report instances, questions are asked about whether their culture is a good one.

When I was a member of the Select Committee on Transport we visited the CAA and were given a list of the sorts of reports that came forward, which included things that people might not see as relevant, such as both pilots eating the same sandwich. That would be an issue if there were a food poisoning incident. Even what might seem trivial and unimportant incidents must be reported, and there is a culture of reporting in the airline industry, not least in the case of fume events, which people are well aware of.

[Mr Goodwill]

I am advised that if a fume event occurs it is apparent to everyone on the aircraft. The smell of the oil is absolutely apparent to people. As I mentioned, there is a culture of reporting in the CAA and the aviation industry—which, incidentally, we would like to spread to the health service, where near misses and potential accidents are often not reported. Its reporting culture ensures that the aviation industry is one of the safest in the world.

[Rachael Maskell]

That is the crux of the debate. The reality is that it may be possible to detect a serious fuel event; but what about a minor one, where there is slight leakage into the cabin?

[Dawn Butler]

rose—

--- Later in debate ---

[Mr Goodwill]

A lot of air quality monitoring has been carried out on aircraft. The problem is that fume events are relatively rare and therefore there has not been the ability to pick one up during one of those monitoring situations.

Under the CAA’s mandatory reporting scheme, the trigger for a report is an event that is considered by the crew to be a

“safety-related event which endangers or which, if not corrected or addressed, could endanger an aircraft, its occupants or any other person.”

None of the flights where fumes and smells were reported in post-flight questionnaires met those criteria; they are the ones that we actually tested. However, I have some data from the CAA on the number of those reports where smells have been reported in the cabin. We heard from the hon. Member for Stalybridge and Hyde that he had been given the figure of about one in 2,000 flights. We heard from the hon. Member for Heywood and Middleton (Liz McInnes) that it is about one in 100. The evidence that I have is that in the last decade we have seen annually between 282 and 471 reports of smells or fumes in the cabin. The last year that we have report numbers for is 2014, when there were 426.

However, it must be emphasised that up to now, reports of fumes have included all causes of smoke, odour or fumes, both internal and external, and not just incidents of bleed-air contamination. The CAA estimates that a maximum of 10% of those incidents reported are regarding bleed-air contamination—in other words, less than one a week—and therefore it has not been possible as yet to have testing equipment on an aircraft when one has happened. I hope that that puts into context the frequency with which these situations occur.

[Rachael Maskell]

I would like to press the Minister a little further on this issue, because it is very important. The fact that detection equipment is not available or not placed on aircraft means that we are moving to subjective measures of whether an incident has occurred. Is it not vital that we first do the correct monitoring in order to understand how big, small or frequent these incidents are, and then go on to take action? I do not think that the reports to which the Minister is referring are satisfying us that that empirical evidence is available.

[Mr Goodwill]

I could not agree with the hon. Lady more. I am laying out what research has been done and what information we have to date. That is why it is very important that EASA makes further progress. Indeed, we are keen to find out what research is happening around the world. Because of the international nature of the aviation industry, it is the Government’s view that an international approach to any future research investigations would be appropriate.