Aerotoxic Syndrome: a New Occupational Disease?

Background: Concerns related to adverse health effects experienced by aircrew exposed to aircraft contaminated air have been ongoing for over 6 decades. Unfiltered breathing air is supplied to the cabin via the engine compressor. The likelihood that oil leaking over the engine oil seals may enter the cabin air supply has prompted continuing debate about the hazards associated with exposure to neurotoxic substances and to the thermally degraded or pyrolysed mixture. In this study, we undertook an in-depth investigation of aircrew involved in suspected aircraft contaminated air events. Methods: Two studies were conducted to review the circumstances and symptoms of a cohort of aircrew working in the pressurized air environment of aircraft. A table of effects was then used for categorizing symptoms and reviewing other sources of data related to aircraft fluids and selected other conditions. Results: Both acute and chronic exposures to neurotoxic and a wide range of thermally degraded substances were confirmed, along with a clear pattern of acute and chronic adverse effects. The latter were supported by medical findings and diagnoses, notably involving the neurological, neurobehavioural and respiratory systems. Conclusion: A clear cause and effect relationship has been identified linking the symptoms, diagnoses and findings to the occupational environment. Recognition of this new occupational disorder and a clear medical investigation protocol are urgently needed.