Providing a detailed examination of the issues that affect the long term health of aircrew, cabin crew and passengers, Air Travel and Health offers guidance to engineers designing aircraft in the difficult field of legislation and product liability.

About the Authors xv Preface xvii Series Preface xix Acknowledgements xxi Acronyms and Abbreviations xxiii 1 Introduction 1 1.1 Factors Affecting Health 2 1.2 The System of Interest 2 1.2.1 The Operating Environment 2 1.2.2 The Atmosphere 3 1.2.3 The Aircraft Inhabitants 4 1.2.4 Sources of Environmental Stimuli 5 1.3 The Aircraft 6 1.3.1 Military Aircraft 6 1.3.2 Commercial Aircraft 8 1.4 Design Considerations 10 1.5 Summary 14 References 16 Further Reading 16 Useful Web Sites 16 2 Some ‘Minor’ Ailments 17 2.1 Introduction 17 2.1.1 Health Information 17 2.1.2 Considering the Whole Trip 18 2.1.3 Some Symptoms Reported by Travellers 18 2.1.4 Health Risks 19 2.2 Some Common Conditions of Air Travel 20 2.2.1 General Discomfort 20 2.2.2 Jet Lag (Circadian Dysrhythmia) 21 2.2.3 Fear of Flying (Aerophobia) 23 2.2.4 Discomfort of the Ears 23 References 25 Further Reading 25 Useful Web Sites 26 3 Air Quality 27 3.1 The Environment 28 3.1.1 The Atmosphere 28 3.1.2 Air Quality 28 3.1.3 Cabin Air Supply 29 3.1.4 Sources of Contamination 29 3.2 Aircraft Environments 31 3.2.1 Commercial Aircraft 31 3.2.2 Military Aircraft 33 3.3 Environmental Control Systems 36 3.3.1 Air Cooling 36 3.3.2 Air Distribution 36 3.4 Health Issues 40 3.4.1 Effects of Contamination 41 3.4.2 Aerotoxic Syndrome 41 3.4.3 At Risk on the Ground? 47 3.4.4 Spreading Illness 47 3.5 System Implications 48 3.5.1 Contaminants 48 3.5.2 Future Systems 51 3.6 Request for Further Information 55 References 56 Further Reading 57 Useful Web Sites 58 4 Deep Vein Thrombosis 59 4.1 Introduction 59 4.1.1 How Common Is It? 61 4.1.2 How Long Is a Long Flight? 62 4.2 The Environment 62 4.3 Aircraft Environments 63 4.3.1 Commercial Aircraft 63 4.3.2 Large Military Aircraft 64 4.3.3 Fast-Jet Military Aircraft 67 4.4 The System 67 4.4.1 Commercial Aircraft 67 4.4.2 Military Aircraft 68 4.5 Health Issues 69 4.5.1 Cabin Altitude and Pressure 70 4.5.2 SoWho Is at Risk? 71 4.5.3 Summary of Risks 72 4.6 System Implications 73 4.6.1 Litigation 73 4.6.2 Preventative Measures 74 4.6.3 Advice to Passengers 74 4.6.4 Continuing Work 76 References 77 Further Reading 78 Useful Web Sites 78 5 Noise and Vibration 79 5.1 The Environment 81 5.2 Aircraft Environment 82 5.2.1 Commercial Aircraft 82 5.2.2 Military Aircraft 83 5.3 Health Issues 85 5.3.1 Hearing 85 5.3.2 Vibration 85 5.4 System Implications 86 5.4.1 Limiting Flying Hours 86 5.4.2 Active Noise Cancellation 87 5.4.3 Microphone Disabling 87 5.4.4 Personal Noise Management 87 5.4.5 Risk Assessment 88 References 88 Further Reading 88 Useful Web Sites 88 6 Exposure to Radiation 89 6.1 The Environment 89 6.1.1 Cosmic Radiation 90 6.1.2 Radiation in Space 92 6.1.3 Non-ionising Radiation 92 6.2 The Aircraft Environment 93 6.2.1 Ionising Radiation from Space 93 6.2.2 Non-ionising RF Radiation 94 6.2.3 Understanding the Risk in Commercial Aircraft 97 6.2.4 Understanding the Risk in Military Aircraft 99 6.3 Aircraft Systems 100 6.4 Health Issues 101 6.4.1 Risk of Cancer 101 6.4.2 Risks to Female Crew Members 103 6.4.3 Risks to Passengers 103 6.4.4 Eye Damage 104 6.4.5 Damage to Life Support Equipment 104 6.5 System Implications 104 6.5.1 Legislation 104 6.5.2 Mitigating Action 108 6.6 Future Developments 109 References 110 Further Reading 112 Useful Web Sites 112 7 Back and Neck Pain 113 7.1 Back Pain 113 7.1.1 Lower Back Pain 113 7.1.2 Posture 114 7.1.3 Back Pain and Military Aircraft 114 7.1.4 Helicopter Pilots 115 7.1.5 Posture and Pain 117 7.2 Neck Strain 120 7.3 Commercial Aircraft Issues 122 7.3.1 Flight Attendants 122 7.3.2 Passengers 123 7.4 Lumbar Support 123 7.5 Advice for Passengers 125 References 126 Further Reading 127 8 Military Issues 129 8.1 The Cockpit Environment 130 8.2 Effects of Acceleration 133 8.3 Pressure Oxygen Breathing and Hypoxia 136 8.3.1 Hypoxia 136 8.3.2 Decompression Sickness 137 References 137 Further Reading 138 Useful Web Sites 138 9 Workstation Use 139 9.1 The Environment 140 9.2 Aircraft Environments 141 9.2.1 Commercial Aircraft 141 9.2.2 Military Aircraft 142 9.3 The System 143 9.4 Health Issues 146 9.4.1 Sight 146 9.4.2 Posture 147 9.4.3 Back and Neck Pain 147 9.4.4 Vibration 148 9.5 System Implications 148 Reference 150 Further Reading 150 Useful Web Sites 150 10 Regulation and Control of Risks to Health 151 10.1 General 151 10.2 Legislative Framework 152 10.2.1 Health and Safety 153 10.2.2 EU Legislation 154 10.2.3 Environmental Legislation 156 10.2.4 Air Navigation Order 157 10.2.5 Duty of Care 157 10.3 Summary of Legal Threats 157 10.3.1 Criminal Prosecution 157 10.3.2 Civil Lawsuits 158 10.3.3 Customer/Public Relations 158 10.4 Issues Arising 158 11 The Design Process 161 11.1 Control of Risk 161 11.1.1 Governance 161 11.1.2 Company Policy 162 11.1.3 Company Procedures 162 11.2 Design 162 11.2.1 Standards 162 11.2.2 Good Practice 163 11.2.3 Design and Qualification Process 163 11.3 Application 174 11.3.1 Incorporation 175 11.3.2 Operations 175 11.4 Feedback 175 11.4.1 Public Comment 176 11.4.2 Complaints 176 11.4.3 Litigation 176 Reference 177 12 Summary and Conclusions 179 12.1 Integration Effects 180 12.2 Predisposition 182 12.2.1 The Travel Experience 183 12.2.2 Genetic Factors 183 12.2.3 Public Health 183 12.3 Domestic Circumstances 183 12.3.1 Carrying and Lifting 184 12.3.2 Do-It-Yourself (DIY) 184 12.3.3 Noisy Pursuits 184 12.3.4 Lifestyle Factors 184 12.3.5 Water Sports 185 12.3.6 Obesity 185 12.4 Comparison with General Public Health Conditions 185 12.4.1 Sick Building Syndrome 185 12.4.2 Myalgic Encephalomyletis (ME) or Chronic Fatigue Syndrome (CFS) 186 12.4.3 WiFi Sensitivity 187 12.4.4 Electrical Power Line Sensitivity 188 12.4.5 New Car Syndrome 189 12.4.6 Household and Industrial Cleaning Products 190 12.4.7 Discussion 191 12.5 Serious Conditions 191 12.6 Advice to Industry 191 12.6.1 Processes and Procedures 192 12.6.2 Independent Medical Advice 193 12.6.3 Research 193 12.6.4 Seeing the ‘Big Picture’ 193 12.7 Advice to Operators 195 12.7.1 Promote Awareness 195 12.7.2 Independent Medical Advice 195 12.7.3 Research 195 12.8 Advice to Travellers 195 12.8.1 Obtain Medical Advice 196 12.8.2 Improve Awareness 196 12.9 What Can Be Done? 199 12.10 Finally 204 References 204 Further Reading 205 Useful Web Sites 205 Bibliography 207 Index 217

Providing a detailed examination of the issues that affect the long term health of aircrew, cabin crew and passengers, Air Travel and Health offers guidance to engineers designing aircraft in the difficult field of legislation and product liability. Examining the facts, anecdotes and myths associated with health and travel, Seabridge and Morgan draw balanced conclusions on which the aircraft operations and design communities can act to provide cost-effective solutions. The authors present a useful reference for aircrew, regulatory authorities, engineers and managers within the aerospace industry, and medical and human factor specialists, as well as an informative resource for undergraduate and graduate students.