Health Consequences of Exposure to Aircraft Contaminated Air and Fume Events

Overview

This document provides a protocol for investigating aircrew and passenger exposure to contaminated air and fume events on aircraft, highlighting health consequences and recommended medical evaluations.

Biological Sampling

• Blood Sampling

  • Target: Volatile Organic Compounds (VOCs)
  • Timing:
    • As soon as possible after exposure
    • Ideally, additional sampling at 6 hours, 12 hours, and 1 month post-exposure
  • Procedure:
    • Collect 5ml in normal EDTA; transfer 2ml to coated headspace tubes as soon as possible

• Urine Sampling

  • Target: Organophosphates (OPs)
  • Timing:
    • As soon as possible after exposure
    • Ideally, additional sampling at 6 hours, 12 hours, and 1 month post-exposure
  • Volume Required: 20ml

Key Contaminants

• Organophosphates (OPs)

  • Tricresyl Phosphate Isomers:
    • Meta, para, ortho isomers
    • Sources: Oil
  • Trixylyl Phosphates:
    • Source: Oil
  • Tributyl Phosphate:
    • Source: Hydraulic fluids
  • Triphenyl Phosphate:
    • Sources: Oil, Hydraulic fluids
  • Other Relevant OPs:
    • Dibutyl phenyl phosphate (DBPP)
    • Triisobutyl phosphate (TiBP)
    • 2,6-di-tert-butyl-p-cresol (BHT)
    • Isopropylated phenyl, phosphate (3:1) (TIPP/PIP (3:1))
    • Sources: Hydraulic fluids, Oil

• Volatile Organic Compounds (VOCs)

  • Types to monitor:
    • Aldehydes, aliphatics, aromatics, ketones, alcohols
    • Specific examples: n-heptane, n-hexane, benzene, toluene, formaldehyde, acetaldehyde, n-pentane, n-octane
    • Organic acids: Valeric acid/pentanoic acid, heptanoic acid, octanoic acid
  • Reference: ASHRAE-Guideline 2021Table 81

Known OP Metabolites

• Substances and Metabolites:
  • T_m_CP: Dicresyl phosphate (DmCP)
    • Reference: Schindler et al. 2013
  • T_p_CP:
    • Metabolites: Dicresyl phosphate (DpCP), p-hydroxybenzoic acid, di-p-cresyl phosphate (DCP), p-cresyl p-carboxyphenylphosphate (1coDCP)
    • References: Schindler et al. 2013, Kurebayashi et al. 1985
  • T_o_CPd:
    • Metabolites: Dicresyl phosphate (DoCP), o-Cresyl dihydrogen phosphate, Di-o-Cresyl hydrogen phosphate, salicylic acid, o-hydroxybenzyl alcohol, o-cresol
    • References: Schindler et al. 2013, Abou-donia et al. 1990, Somkuti et al. 1990
  • TBP/DBP: Reference: Schindler et al. 2013
  • TPP/DPP: Reference: Schindler et al. 2013

References

• Schindler et al. 2013
• Kurebayashi et al. 1985
• Abou-donia et al. 1990
• Somkuti et al. 1990

This protocol is crucial for understanding the health risks associated with exposure to contaminated air in aircraft and provides a structured approach for detecting and analyzing potential toxins.