Commercial Airliner Cabins Research Articles

Psychosocial work environment and medical symptoms among Swedish commercial airline cabin crew

Associations between stress measured by the demands-control model, iso-strain model, and stress-related symptoms among cabin crew were studied. A questionnaire about psychosocial work environment and symptoms was answered by 918 (82%) flight attendants, stewards, and pursers at one airline company in 2005. Adjustment was made for age, gender, smoking, job category, and flight length using multiple logistic regression. Weekly headaches, concentration difficulties, fatigue, and gastrointestinal symptoms were reported at rates of 18%, 10%, 56%, and 13%, respectively. Pursers scored higher on control than the others and they had lower associations between the strain measured by the demands-control model and symptoms than stewards and flight attendants. All symptoms were more common in the high strain situation than in the low strain (reference). An active situation was related to an excess of symptoms. Low social support in the iso-strain model increased risk of symptoms. Demands-control and iso-strain models are useful in studying stress-related symptoms in cabin crews. The dimension of social support adds explanatory value.

Comparison of different decontaminant delivery methods for sterilizing unoccupied commercial airliner cabins

Effective decontamination is crucial if an airliner cabin is contaminated by biological contaminants, such as infectious disease viruses or intentionally released biological agents. This study used computational fluid dynamics (CFD) method as a tool and vaporized hydrogen peroxide (VHP) as an exemplary decontaminant and Geobacillus stearothermophilus spores as a simulant contaminant to investigate three VHP delivery methods for sterilizing two different airliner cabins. The CFD first determined the airflow and the transient distributions of the contaminant and decontaminant in cabins. Auxiliary equations were implemented into the CFD model for evaluating efficacy of the sterilization process. The improved CFD model was validated by the measured airflow and simulated contaminant distributions obtained from a cabin mockup and the measured efficacy data from the literature. The three decontaminant delivery methods were (1) to supply the mixed VHP and air through the environmental control system of a cabin, (2) to send mixed VHP and air through a front door and to extract them from a back door of a cabin, and (3) to send directly VHP to a cabin and enhance the mixing with air in the cabin by fans. The two air cabins studied were a single-aisle and a twin-aisle airliner one. The results show that the second decontaminant delivery method (displacement method) was the best because the VHP distributions in the cabins were most uniform, the sterilization time was moderate, and the corrosion risk was low. The method displaced the existing air by the air/disinfectant solution, rather than dispersive mixing as the other two methods.

Hearing status among cabin crew in a Swedish commercial airline company

To study hearing loss in commercial airline cabin crew (CC). Totally 155 male and 781 female CC (n = 936) in a Swedish airline company underwent repeated audiometric tests during 1974-2005. The last test was used to study hearing loss. The mean test values at 3, 4, 6 kHz were used for the ear with worse hearing loss. Data were compared with a Swedish population (n = 603) who were not occupationally exposed to noise. Equivalent noise levels (Leq) were measured in different aircraft. Leq was 78-84 dB (A), maximum A-weighted exposure was 114 dB. Median values for all ages were close to the reference group. No association was found between years of employment and hearing loss, when adjusting for age and gender by multiple logistic regression analysis. Cabin crew are exposed to equivalent noise levels below the current Swedish occupational standard, and have normal age-matched hearing threshold levels.

Microbial burden and diversity of commercial airline cabin air during short and long durations of travel

Total microbial burden and diversity associated with commercial airliner cabin air was assessed by molecular methods in 125 air samples from the business-class sections of 16 domestic and international flights. Viable microbial burden within these cabin air parcels constituted only 1–10% of the total microbial population and ranged from below detection limits to 1.2 × 104 cells m–3 as determined with a validated ATP-based technology. Cultivable bacterial diversity was almost entirely limited to Gram-positive bacteria such as Staphylococcus and Bacillus. In contrast, cloning and sequencing 16S rRNA gene directly from the samples without cultivation indicated a significantly broader diversity, as sequences representing more than 100 species, and encompassing 12 classes of bacteria, were retrieved in varying abundance. Sequences of proteobacterial and Gram-positive lineage were retrieved most frequently (58% and 31% of all clone sequences, respectively), with Gram-positive and α-proteobacterial sequences dominating international flight samples and β- and γ-proteobacterial sequences comprising the largest portion of those retrieved from domestic flights. Significant differences in bacterial load and diversity were noted between samples obtained on domestic and international flights. The disparities observed in microbial abundance and diversity further underscore the immense value of state-of-the art molecular assays in augmenting traditional culture-based techniques.Supplementary informationThe online version of this article (doi:10.1038/ismej.2008.11) contains supplementary material, which is available to authorized users.

Influence of cabin conditions on placement and response of contaminant detection sensors in a commercial aircraft

Potential causalities due to airborne disease transmission and risk of chem-bio terrorism in commercial airliner cabins can be reduced by fast responses. Fast responses are only possible by using sensors at appropriate locations in the cabins. Cost, size and weight factors restrict the number of sensors that could be installed inside a cabin. Since release locations and seating patterns of passengers can impact airborne contaminant transports, this study first addressed this impact by using a validated computational fluid dynamics (CFD) program in a four-row mockup of twin-aisle airliner cabin. It was observed that occupancy patterns and release locations have little influence on longitudinal contaminant transports though localized variations of contaminant concentrations may exist. The results show that response time of the sensors is considerably reduced with the increase in number of sensors. If only a single sensor is available across a cabin cross-section then it should be placed at the middle of the ceiling. A cabin model of a fully occupied twin-aisle airliner with 210 seats was also build to study the diverse contaminant distribution trends along cabin length. The results reveal that seating arrangements can make cross-sectional airflow pattern considerably asymmetrical. Similar airflow patterns make the longitudinal contaminant transport in the business and economy classes alike. The presence of galleys greatly affected the longitudinal transport of contaminants in a particular cabin section. The effects due to galleys were less significant if a multipoint sampling system was used. The multipoint sampling system can also reduce the number of sensors required in a cabin.

Molecular bacterial diversity and bioburden of commercial airliner cabin air

Culture-independent, biomarker-targeted bacterial enumeration and identification strategies were employed to estimate total bacterial burden and diversity within the cabin air of commercial airliners. Samples from each of 4 flights on 2 commercial carriers were collected via air-impingement. The total viable microbial population ranged from below detection limits to 4.1 x 10(6) cells/m(3) of air, as assessed by the ATP assay. A gradual accumulation of microbes was observed from the time of passenger boarding through mid-flight, followed by a sharp decline in bacterial abundance and viability from the initiation of descent through landing. Representatives of the alpha-, beta-, and gamma-Proteobacteria, as well as Gram-positive bacteria, were isolated in varying abundance. Neisseria meningitidis rRNA gene sequences were retrieved in great abundance from Airline A followed by Streptococcus oralis/mitis sequences. Pseudomonas synxantha sequences dominated Airline B clone libraries, followed by those of N. meningitidis and S. oralis/mitis. The cabin air samples examined herein housed low bacterial diversity and were often dominated by a particular subset of bacteria: opportunistic pathogenic inhabitants of the human respiratory tract and oral cavity.

Mortality among pilots and cabin crew in Greece, 1960-1997.

Specific health hazards, among them radiation of cosmic origin, have caused some concern among aircrew in civil aviation in recent years. Several cohort studies in Northern countries have investigated mortality and cancer incidence among aircrew. Our goal was to study the pattern of mortality among Greek commercial airline cockpit and cabin crew. We performed a retrospective cohort study including 843 Olympic Airways cockpit crew and 1835 cabin attendants. Standardized mortality ratios (SMR) were calculated based on death rates of the Greek population. Duration of employment as a proxy for occupational exposure was used to stratify the cohort. For cockpit crew, the overall SMR was 0.7 (n = 65, 95% CI: 0.5-0.9). The SMR for all cancers was also significantly decreased (n = 17; SMR = 0.6; 95% CI: 0.3-0.9). Most of this reduction was due to a large deficit in lung cancer deaths (SMR = 0.1; 95% CI: 0.0-0.5). Slight but non-significant increases were noted for brain and liver cancer. The SMR for cardiovascular death was close to unity. Among female cabin attendants the SMR for all causes was 0.8 (95% CI: 0.4-1.3). The SMR for all cancers was 0.8 (95% CI: 0.3-1.7). Mortality from breast cancer was not increased. Among male cabin crew, SMR for all causes was 0.5 (95% CI: 0.3-0.9). Analyses according to duration of employment showed no pattern. In this first-ever occupational cohort study in Greece, Greek aircrew had a low overall and cancer mortality. Due to the small number of events, the strength of our study is limited. The Greek data will be included in a pooled analysis of European studies.

A Retrospective Cohort Mortality Study of Italian Commercial Airline Cockpit Crew and Cabin Attendants, 1965–96

A Retrospective Cohort Mortality Study of Italian Commercial Airline Cockpit Crew and Cabin Attendants, 1965–96

A retrospective cohort mortality study of Italian commercial airline cockpit crew and cabin attendants, 1965-96.

A retrospective cohort mortality study was conducted among Italian commercial flight personnel for the period 1965-1996. The cohort was composed of 3,022 male cockpit crew members and 3,418 male and 3,428 female cabin attendants. Cause-specific standardized mortality ratios (SMRs) and exact 95% confidence intervals (CIs) were calculated as estimates of the relative risk. Mortality from all cancers was less than expected for all categories (SMRs of 0.58 for male cockpit crew, 0.67 for male cabin attendants, and 0.90 for female cabin attendants). Among male flight personnel, the SMR for leukemia was somewhat elevated (SMR 1.73; 95% CI: 0.75-3.41) based on eight deaths, with a positive trend by length of employment (p = 0.046). Additionally, an excess of death by suicide was seen among female cabin attendants (SMR 3.38; 95% CI: 1.24-7.35). Other Italian studies of flight personnel are under way, including a detailed assessment of cosmic radiation exposure and investigations of non-radiation occupational risk factors and prevalence of nonfatal outcomes.

Incidence of cancer among Finnish airline cabin attendants, 1967-92

To assess whether occupational exposure among commercial airline cabin attendants are associated with risk of cancer. Record linkage study. Finland. SUBJECTS-1577 female and 187 male cabin attendants who had worked for the Finnish airline companies. Standardised incidence ratio; expected number of cases based on national cancer incidences. A significant excess of breast cancer (standardised incidence ratio 1.87 (95% confidence interval 1.15 to 2.23)) and bone cancer (15.10 (1.82 to 54.40)) was found among female workers. The risk of breast cancer was most prominent 15 years after recruitment. Risks of leukaemia (3.57 (0.43 to 12.9)) and skin melanoma (2.11 (0.43 to 6.15) were not significantly raised. Among men, one lymphoma and one Kaposi's sarcoma were found (expected number of cases 1.6). Although the lifestyle of cabin attendants is different from that of the reference population--for example, in terms of social status and parity--concentration of the excess risks to primary sites sensitive to radiation suggests that ionising radiation during flights may add to the cancer risk of all flight personnel. Otherwise the lifestyle of cabin attendants did not seem to affect their risks of cancer. Estimates of the effect of reproductive risk factors only partly explained the increased risk of breast cancer. If present estimates of health hazards due to radiation are also valid for cosmic radiation, then the radiation doses of cabin attendants seem too small to account entirely for the observed excess risk.

Airline advisory nursing

The commercial airliner cabin is a specialized environment, usually pressurized to an equivalent of 2,438-meter pressure altitude. Such an altitude can adversely affect people prone to hypoxia. Preflight attention to this and other problems by an advisory nurse (AN) can minimize or prevent in-flight emergencies. The AN can also facilitate travel for passengers with medical needs by being familiar with airline policies and federal regulations. By educating the patient/passenger, health care providers and airline personnel, the safety, comfort and dignity of all concerned can be maximized.