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Changes in the ocular and nasal signs and symptoms of aircrews in relation to the ban on smoking on intercontinental flights
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
2000 (English)In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, Vol. 26, no 6, 514-522 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: This study determined the influence of exposure to environmental tobacco smoke (ETS) in aircraft on measured and perceived cabin air quality (CAQ), symptoms, tear-film stability, nasal patency, and biomarkers in nasal lavage fluid.

METHODS: Commercial aircrews underwent a standardized examination, including acoustic rhinometry, nasal lavage, and measurement of tear-film break-up time. Eosinophilic cationic protein, myeloperoxidase, lysozyme, and albumin were analyzed in the nasal lavage fluid. Inflight investigations [participation rate 98% (N=39)] were performed on board 4 flights, 2 in each direction between Scandinavia and Japan. Scandinavian crew on 6 flights from Scandinavia to Japan participated in postflight measurements after landing [participation rate 85% (N=41)]. Half the flights permitted smoking on board, and the other half, 0.5 months later, did not. Hygienic measurements showed low relative air humidity on board (2-10%) and a carbon dioxide concentration of <1000 ppm during 99.6% of the cruising time.

RESULTS: The smoking ban caused a drastic reduction of respirable particles, from a mean of 66 (SD 56) microg/m3 to 3 (SD 0.8) microg/m3. The perceived CAQ was improved, and there were fewer symptoms, particularly ocular symptoms, headache and tiredness. Tear-film stability increased, and nasal patency was altered.

CONCLUSIONS: Despite a high air exchange rate and spatial separation between smokers and nonsmokers, smoking in commercial aircraft may cause significant air pollution, as indicated by a large increase in respirable particles. This ETS exposure is associated with an increase in ocular and general symptoms, decreased tear-film stability, and alterations of nasal patency.

Place, publisher, year, edition, pages
2000. Vol. 26, no 6, 514-522 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-90535PubMedID: 11201399OAI: oai:DiVA.org:uu-90535DiVA: diva2:162919
Available from: 2003-05-09 Created: 2003-05-09 Last updated: 2010-11-22Bibliographically approved
In thesis
1. Cabin Air Quality in Commercial Aircraft: Exposure, Symptoms and Signs
Open this publication in new window or tab >>Cabin Air Quality in Commercial Aircraft: Exposure, Symptoms and Signs
2003 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The objective of the dissertation was to study the cabin environment, and identify personal and environmental risk factors, associated with symptoms, and perception of cabin air quality. Another objective was to study if ban of smoking, and increased relative air humidity on intercontinental flights, could have a beneficial health effect. The studies were performed among Scandinavian cabin crew in one Airline Company. Office workers from the same company served as controls. Exposure differed between cruise and non-cruise conditions. Air humidity was very low during intercontinental flights (3-8%). Concentration of moulds, bacteria, formaldehyde, and ozone was low. Tobacco smoking increased respirable particles in the cabin air, from 3 to 49 mg/m3, and increased cotinine in urine. The ETS-exposure was highest in the aft part of the cabin. Symptoms and environmental complaints were more common among flight crew than office workers. We could identify personal factors of importance, and certain conditions that could be improved, to achieve a better cabin environment. There was an association between symptoms and environmental perceptions and work stress, lack of influence on working condition, and a history of atopy. After ban on smoking in aircraft, there was a decrease of ocular and general symptoms, and increased tear-film stability in aircrew. Air humidification reduced headache and ocular, nasal, and dermal dryness symptoms, increased tear-film stability, and increased nasal patency. Our result indicates that ETS and low air humidity are important environmental factors in aircraft, and that atopy, and work stress could be significant risk factors for symptoms and environmental perceptions.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2003. 71 p.
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 0282-7476 ; 1262
Medicine, airline crew, aviation medicine, micro-organism, cabin air quality, air humidity, atopy, occupational exposure, environmental tobacco smoke (ETS), psychosocial work environment, Medicin
National Category
Dermatology and Venereal Diseases
Research subject
Occupational and Environmental Medicine
urn:nbn:se:uu:diva-3462 (URN)91-554-5631-6 (ISBN)
Public defence
2003-06-03, MIC AULA (vid restaurang Rullan), Hus 6, Polacksbacken, Uppsala, 13:15
Available from: 2003-05-09 Created: 2003-05-09Bibliographically approved

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