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Self-rated health and respiratory symptoms among civil aviation pilots: Occupational and non-occupational risk factors
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine. (Dan Norbäck)
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

There is concern about the indoor environment in aircraft but few stud-ies exist on self-rated health (SRH) and respiratory symptoms among pilots. Occupational and non-occupational risk factors for SRH, respira-tory symptoms and other symptoms among commercial pilots were investigated in this thesis. One cohort study and one prevalence study were performed among pilots in one Scandinavian airline company. Fungal DNA, furry pet allergens and volatile organic compounds of microbial origin (MVOC) were measured on board. Cat (fel d1), dog (Can f1) and horse (Ecu cx) allergens were found in all dust samples and allergen levels were 27-75 times higher in aircraft with textile seats as compared to leather surfaces. The sum of MVOCs in the cabin air was 3.7 times higher than in homes in Uppsala and 2-methyl-1-butanol and 3-methyl-1-butanol concentrations were 15-17 times higher. Asper-gillus/Penicillium DNA and Aspergillus versicolor DNA were more common in aircraft with textile seats. One fifth reported SRH as poor or fair, 62% had fatigue, 46% overweight/obesity and 71% insomnia. Poor or fair SRH was associated with overweight/obesity, lack of exercise, insomnia, low sense of coherence (SOC) and high work demand. Re-covery from work was worse among those with insomnia and low social support at work. Fatigue was more common among young or female pilots and related to insomnia and high work demand. Pilots flying MD80 or Saab 2000 aircraft had less fatigue. Pilots exposed to environmental tobacco (ETS) on board had more eye symptoms and fatigue which were reduced after the ban of smoking (in 1997). Pilots with increased work demand developed more rhinitis, dermal symptoms and fartigue and those with decreased work control developed more eye symptoms. The incidence of doctors’ diagnosed asthma and atopy were 2.4 and 16.6 per 1000 person years, respectively. Pilots changing type of flight got more airway infections. Those reporting decreased work control had a higher incidence of atopy. Risk factors in the home environment included ETS, dampness or mould, window pane condensation in winter and living in houses built after 1975. In conclusion, SRH and respiratory health among pilots are associated with specific occupational and non-occupational risk factors.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2017. , 79 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1323
Keyword [en]
Civil Aviation, Aircraft pilot, Indoor environment, Self-rated health (SRH), Respiratory health, Asthma, Rhinitis, Headache, Fatigue, Insom-nia, Body mass index (BMI), Sense of Coherence (SOC), Psychosocial work environment, Quantitative PCR, Fungal DNA, Volatile organic compounds of microbial origin (MVOC), Cat allergen, Dog allergen, Horse allergen
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-318806ISBN: 978-91-554-9880-1 (print)OAI: oai:DiVA.org:uu-318806DiVA: diva2:1085346
Public defence
2017-05-22, Frödingsalen, Ulleråkersvägen 40, Uppsala, 09:00 (English)
Opponent
Supervisors
Available from: 2017-04-28 Created: 2017-03-28 Last updated: 2017-05-05
List of papers
1. Self-rated health (SRH) and fatigue among commercial pilots in relation to work conditions, psychosocial work environment, life style factors, insomnia, and sense of coherence (SOC)
Open this publication in new window or tab >>Self-rated health (SRH) and fatigue among commercial pilots in relation to work conditions, psychosocial work environment, life style factors, insomnia, and sense of coherence (SOC)
(English)Manuscript (preprint) (Other academic)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-318816 (URN)
Available from: 2017-03-28 Created: 2017-03-28 Last updated: 2017-03-28
2. Furry pet allergens, fungal DNA and microbial volatile organic compounds (MVOCs) in the commercial aircraft cabin environment
Open this publication in new window or tab >>Furry pet allergens, fungal DNA and microbial volatile organic compounds (MVOCs) in the commercial aircraft cabin environment
Show others...
2013 (English)In: Environmental Science: Processes & Impacts, ISSN 2050-7887, Vol. 15, no 6, 1228-1234 p.Article in journal (Refereed) Published
Abstract [en]

There has been concern about the cabin environment in commercial aircraft. We measured cat, dog and horse allergens and fungal DNA in cabin dust and microbial volatile organic compounds (MVOCs) in cabin air. Samples were collected from two European airline companies, one with cabins having textile seats (TSC) and the other with cabins having leather seats (LSC), 9 airplanes from each company. Dust was vacuumed from seats and floors in the flight deck and different parts of the cabin. Cat (Fel d1), dog (Can f1) and horse allergens (Equ cx) were analyzed by ELISA. Five sequences of fungal DNA were analyzed by quantitative PCR. MVOCs were sampled on charcoal tubes in 42 TSC flights, and 17 compounds were analyzed by gas chromatography mass spectrometry (GC-MS) with selective ion monitoring (SIM). MVOC levels were compared with levels in homes from Nordic countries. The weight of dust was 1.8 times larger in TSC cabins as compared to LSC cabins (p < 0.001). In cabins with textile seats, the geometric mean (GM) concentrations of Fel d1, Can f1 and Equ cx were 5359 ng g(-1), 6067 ng g(-1), and 13 703 ng g(-1) (GM) respectively. Levels of Fel d1, Can f1 and Equ cx were 50 times, 27 times and 75 times higher respectively, in TSC cabins as compared to LSC cabins (p < 0.001). GM levels of Aspergillus/Penicillium DNA, Aspergillus versicolor DNA, Stachybotrys chartarum DNA and Streptomyces DNA were all higher in TSC as compared to LSC (p < 0.05). The sum of MVOCs in cabin air (excluding butanols) was 3192 ng m(-3) (GM), 3.7 times higher than in homes (p < 0.001) and 2-methyl-1-butanol and 3-methyl-1-butanol concentrations were 15-17 times higher as compared to homes (p < 0.001). Concentrations of isobutanol, 1-butanol, dimethyldisulfide, 2-hexanone, 2-heptanone, 3-octanone, isobutyl acetate and ethyl-2-methylbutyrate were lower in cabin air as compared to homes (p < 0.05). In conclusion, textile seats are much more contaminated by pet allergens and fungal DNA than leather seats. The use of seats with smooth surfaces should be encouraged. The MVOC levels differed between cabin air and homes.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-203691 (URN)10.1039/c3em30928b (DOI)000319668900013 ()
Available from: 2013-07-17 Created: 2013-07-17 Last updated: 2017-03-28Bibliographically approved
3. Respiratory Illness and Allergy Related to Work and Home Environment among Commercial Pilots
Open this publication in new window or tab >>Respiratory Illness and Allergy Related to Work and Home Environment among Commercial Pilots
Show others...
2016 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 10, e0164954Article in journal (Refereed) Published
Abstract [en]

The aim was to study associations between work and home environment and prevalence and incidence of respiratory health and a history of atopy in a 3-y cohort of commercial pilots. A questionnaire was mailed in 1997 to all pilots in a Scandinavian airline company (N = 622); 577 (93%) participated. The same questionnaire was sent to the participants 3 years later, 436 participated (76%). There were questions on asthma, respiratory symptoms and infections, allergies, the cabin environment, psychosocial environment and the home environment. Associations were analyzed by multiple logistic regression, calculating odds ratios (OR) with 95% confidence intervals (95% CI). The incidence of doctors' diagnosed asthma and atopy were 2.4 and 16.6 per 1000 person years, respectively. Pilots changing type of flight during follow-up got more airway infections (OR = 11.27; 95% CI 2.39-53.14). Those reporting decreased work control (OR = 1.85; 95% CI 1.03-3.31 for 1 unit change) and those with environmental tobacco smoke (ETS) at home (OR = 3.73; 95% CI 1.09-12.83) had a higher incidence of atopy during follow up. Dampness or mould at home was associated with a higher prevalence of asthma symptoms (OR = 3.55; 95% CI 1.43-8.82) and airway infections (OR = 3.12 95% CI 1.27-7.68). Window pane condensation in winter at home, reported at baseline, was associated with increased incidence of asthma symptoms (OR = 4.14; 95% CI 1.32-12.97) and pilots living in newer buildings at baseline had a higher incidence of airway infections (OR = 5.23; 95% CI 1.43-19.10). In conclusion, lack of work control and ETS at home can be a risk factors for development of allergic symptoms in pilots. Window pane condensation at home can be a risk factor for incidence of asthma symptoms. Dampness and mould at home can be a risk factor for prevalence of asthma symptoms and airway infections and living in newer buildings can be a risk factor for incidence of airway infections.

National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:uu:diva-307536 (URN)10.1371/journal.pone.0164954 (DOI)000385507000084 ()27741314 (PubMedID)
Available from: 2016-11-17 Created: 2016-11-17 Last updated: 2017-03-30Bibliographically approved
4. Medical Symptoms Among Pilots Associated with Work and Home Environments: A 3-Year Cohort Study
Open this publication in new window or tab >>Medical Symptoms Among Pilots Associated with Work and Home Environments: A 3-Year Cohort Study
2015 (English)In: AEROSPACE MEDICINE AND HUMAN PERFORMANCE, ISSN 2375-6314, Vol. 86, no 5, 458-465 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To study associations between the cockpit environment, psychosocial work environment, home environment, and medical symptoms in a cohort of commercial pilots followed over 3 yr. METHODS: A standardized questionnaire was mailed in February-March 1997 to all Stockholm-based pilots on duty in a Scandinavian flight company (N = 622); 577 (93%) participated. During this time smoking was allowed on long haul flights, but not on shorter flights. Smoking was prohibited on all flights after September 1997. The same questionnaire was sent to the cohort of 577 pilots in February-March 2000; 436 participated (76%). The questionnaire contained questions on symptoms, the psychosocial work environment, and the home environment. Associations were investigated using multiple logistic and ordinal regression. RESULTS: Symptoms were common, especially eye symptoms (38.5%), nose symptoms (39.9%), and tiredness (29.9%). Pilots exposed to environmental tobacco smoke (ETS) on long haul flights had more eye symptoms (odds ratio = 1.91) and tiredness (odds ratio = 2.73). These symptoms were reduced when no longer exposed to ETS. Those who started working on long haul flights developed more nose symptoms. Pilots reporting increased work demands developed more nose and dermal symptoms and tiredness and those with decreased work control developed more eye symptoms. Pilots living in new houses, multifamily houses, and in recently painted homes reported more symptoms. CONCLUSION: Eliminating ETS exposure on board reduced medical symptoms. Further work to reduce ETS exposure globally is needed. Psychosocial aspects of the work environment for commercial pilots should be considered, as well as the home environment.

Keyword
aircraft environment, commercial pilots, environmental tobacco smoke, psychosocial work environment
National Category
Environmental Health and Occupational Health
Identifiers
urn:nbn:se:uu:diva-259128 (URN)10.3357/AMHP.4216.2015 (DOI)000357377800006 ()25945663 (PubMedID)
Available from: 2015-07-28 Created: 2015-07-27 Last updated: 2017-03-28Bibliographically approved

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